Theory, Research and Evidence-Based Practice

Glossary Know the Key Terms at beginning of chapter

Sources of Knowledge Traditional — passed down from generation to generation Authoritative — comes from an expert Scientific — arrived at through the scientific method

Types of Knowledge Science — knowledge in and of nursing Philosophy — the study of wisdom Process — conceptual frameworks and theories Historical influences — Florence Nightingale, societal changes Societal influences — schools of nursing

Framework of Nursing Theory Theory — group of concepts that describe a pattern of reality Can be tested, changed, or used to guide research Concepts — abstract impressions organized into symbols of reality Conceptual framework or model

Types of Reasoning Deductive reasoning — examines general ideas and considers specific actions or ideas Inductive reasoning — builds from specific ideas or action to conclusions about general ideas

Interdisciplinary Base for Nursing Theories General systems theory — theory for universal application Adaptation theory — adjustment of living matter to other living things and environment Developmental theory — orderly and predictable growth and development

Benefits of Nursing Theory Directs nurses toward common goal Leads to improved patient care Provides rational and knowledgeable reasons for nursing actions

Benefits of Nursing Theory Gives nurses knowledge base necessary for appropriate actions Helps resolve current nursing issues Prepares nurses to question assumptions and values Serves research, education, and practice

Goal of Theoretical Frameworks Holistic patient care Individualized care to meet needs of patients Promotion of health Prevention or treatment of illness

Common Concepts in Nursing Theories Person (patient) Environment Health Nursing

Goals of Research Develop explanations (in theories) Find solutions to problems

Methods of Nursing Research Quantitative Involves concepts of basic and applied research Qualitative Conducted to gain insight by discovering meanings Based on belief that reality is based on various and differing perceptions

Protecting Rights of Research Subjects Informed consent Federal regulations Review boards

Legal Implications Ch 7

Glossary Know the Key Terms at beginning of chapter

Definition of Law Standard or rule of conduct established and enforced by government Designed to protect the rights of the public

Types of Laws Public law — government is directly involved Regulates relationships between individuals and government Private law — civil law Regulates relationships among people Criminal law — concerns state and federal criminal statutes Defines criminal actions, e.g., murder, theft

Four Sources of Law Constitutions — serve as guides to legislative bodies Statutes — enacted by a legislative body Administrative law — empowered by executive officers Common law — judiciary systems reconciles controversies, creates body of common law

Law Terminology Litigation — process of bringing and trying a lawsuit Plaintiff — person bring suit Defendant — person being accused of a crime

Professional and Legal Regulation of Nursing Practice Nurse practice acts Standards Credentialing Accreditation Licensure Certification

Reasons for Suspending or Revoking a License Drug or alcohol abuse Fraud, deceptive practice Criminal acts, previous disciplinary actions Gross or ordinary negligence Physical or mental impairments

Due Cause for Revoking a License Notice of investigation Fair and impartial hearing Proper decision based on substantial evidence

Nurse’s Best Defense of License Investigation Early legal counseling Character and expert witnesses Thorough preparation for all proceedings

Criminal Law Crime — wrong against a person or his or her property as well as the public Misdemeanor — punishable by fines or less than one year imprisonment Felony — punishable by imprisonment for more than one year

Criminal Law Tort — a wrong committed by a person against another person or his or her property Intentional Unintentional - negligence

Intentional Torts Assault and battery Defamation of character Invasion of privacy False imprisonment Fraud

Four Elements of Liability Duty Breach of duty Causation Damages

Three Outcomes of Malpractice Litigation All parties work toward fair settlement. Case is presented to malpractice arbitration panel. Case is brought to trial court.

Roles of Nurses in Legal Proceedings Nurse as defendant Nurse as fact witness Nurse as expert witness

Recommendations for Nurse Defendant Do not discuss the case with those involved in it. Do not alter patient records. Cooperate fully with your attorney. Be courteous on witness stand. Do not volunteer any information.

Legal Safeguards for Nurses Informed consent Contracts Collective bargaining Competent practice Patient education Documentation

Legal Safeguards for Nurses (continued) Adequate staffing Professional liability insurance Risk management programs Incident reports, JCAHO sentinel events Patient bill of rights Good Samaritan Laws

Safeguards to Competent Practice Respecting legal boundaries of practice Following institutional procedures and policies Owning personal strengths and weaknesses

Safeguards to Competent Practice Evaluating proposed assignments Keeping current Respecting patient rights and developing rapport with patients Keeping careful documentation Working within agency for management policies

Types of Risk Management Programs Safety program Products safety program Quality assurance programs

Information Contained in Incident Reports Complete name of person and names of witnesses Factual account of incident Date, time and place of incident

Information Contained in Incident Reports Pertinent characteristics of person involved Any equipment or resources being used Any other important variables Documentation by physician of medical examination of person involved

OSHA Legal Regulations Use of electrical equipment Use of isolation techniques Use of radiation Use of chemicals

Glossary Know Key Terms at beginning of Chapters 8, 9 & 10