1. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Chapter 3 Issues in Nursing Practice

2. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Health-Care Delivery  Health-illness Continuum  Health-care Delivery Systems

3. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Integrated Care Delivery Network

4. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Factors Influencing Health- Care Change  Changing Characteristics of American Population  Increasing Population  Increasing Number of Older Adults  Increasing Number of Uninsured/Underinsured  Increasing Cultural Diversity

5. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Factors Influencing Health- Care Change (cont’d)  Evidence-based Practice  Health Information Technology  Robotics  Resistant Infectious Organisms  Nursing Informatics

6. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Safe Practice  Joint Commission’s National Patient Safety Goals  Sentinel Events  National Quality Forum  Adverse Events (“Never events”)

7. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Safe Practice (cont’d)  Hospital-acquired Conditions  Medication Errors  Distractions

8. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Economic Issues  Medicare and Diagnosis-related Groups  Hospital-acquired Conditions and Present on Admission Indicator Reporting  Medicaid  Managed Health Care

9. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Health-Care Team  Certified Nursing Assistants  Licensed Practical Nurses (LPNs)  Licensed Vocational Nurses (LVNs)  Registered Nurses  Certified Registered Nurse Anesthetists  Certified Registered Nurse Practitioners

10. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Health-Care Team (cont’d)  Clinical Nurse Specialists  Certified Nurse Midwives  Physicians  Physician Assistants  Pharmacists  Social Workers

11. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Health-Care Team (cont’d)  Dietitians  Physical Therapists  Physical Therapy Assistants  Respiratory Therapists  Respiratory Therapy Technicians  Occupational Therapists

12. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Health-Care Team (cont’d)  Speech and Language Pathologists  Health Unit Secretaries  Student Nurses

13. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition LPN/LVN Role Provides direct patient care under direct supervision of physician, dentist, or registered nurse

14. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Leadership in Nursing  Decision Making  Communicating  Motivating  Guiding Others

15. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Communication of Patient Status

16. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Leadership Styles  Autocratic  Democratic  Laissez-faire  Coaching

17. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Management Functions  Planning  Organizing  Directing  Coordinating  Controlling

18. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Leadership and Delegation for LPNs/LVNs  Leader/Manager for Care of Assigned Patients  Does Your State Allow LPNs/LVNs to Delegate?

19. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition The Delegation Process  Know Your State Practice Act Rules  Identify Skills of Person Delegated to  Use Five Rights of Delegation

20. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Five Rights of Delegation  Right Task  Right Circumstances  Right Person  Right Communication  Right Supervision

21. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition LPN/LVN Career Options  Long-term or Acute Care  Home Health Care  Physician Offices  Clinics  Schools  Child Day-care Centers

22. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition LPN/LVN Educational Options  Advanced Education  Associate’s Degree  Bachelor’s Degree  Master’s Degree  Doctorate

23. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ethics  Ethics: Study of Traditions, Values, Beliefs Related to People/Relationships  Bioethics: Ethical Principles and Values Applied to Human Life  Ethical Questions: What Should/Ought We Do?

24. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Morals  Personal Values  Standards Set by One’s Conscience  Personal Choices of Good and Bad, Right and Wrong

25. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Values  Standards/Ideals/Concepts Giving Meaning to Individual’s Life  Derived from Societal Norms, Religion, Family Traditions  Guide Decisions and Actions

26. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Ethical Obligations  Responsibility to Practice Ethically

27. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition LPN/LVN Code of Ethics  National Association for Practical Nurse Education and Service (NAPNES)  Professional Guide for Ethical Practice  Public Statement of Ethical Principles for LPNs/LVNs

28. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Virtues  One's Values, Morality, or C onscience  Defines Who We Are

29. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Examples of Virtues  Fidelity  Veracity  Integrity  Compassion  Discernment  Trustworthiness  Respectfulness

30. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Rights  Bioethical Issues Framed Within Rights Context  Examples  Basic Human Rights  Patient Rights

31. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Privacy Is a Patient Right

32. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ethical Principles  Autonomy  Beneficence  Nonmaleficence  Justice

33. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ethical Theories  Utilitarianism  Deontology

34. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Theological Perspectives  Religious Traditions

35. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ethical Decision-Making Steps 1. Identify Ethical Dilemma 2. Identify Stakeholders and Their Values 3. Gather and Verify Information 4. Examine Possible Actions and Consequences

36. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ethical Decision-Making Steps (cont’d) 5. Determine Ethical Foundation for Actions 6. Determine the Best Action with the Strongest Ethical Support 7. Implement the Action 8. Evaluate the Outcome

37. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts  Regulation of Practice of Nursing  Administrative Laws  Health Insurance Portability and Accountability Act of 1996 (HIPAA)

38. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts (cont’d)  Nursing Liability and the Law  Liability: Level of Responsibility That Society Places on Individuals for Their Actions

39. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts (cont’d)  Criminal Law  Regulates Behaviors for Citizens  Civil Law  Rules by which Individuals Seek to Protect Personal and Property Rights

40. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts (cont’d)  Civil Liability Suit  Complaint  Summons  Torts  Lawsuits for Civil Wrongs

41. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts (cont’d)  Malpractice  Breach of Duty  Negligence  Injury Resulting from Failure of Wrongdoer to Exercise Care

42. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Legal Concepts (cont’d)  Ensuring Patient Rights  Documenting Procedures  Following Institutional Policies  Personal Malpractice/Liability Insurance  Pursuing Continuing Education  Practicing per Current Nursing Standards