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CHAPTER I Virginia Henderson define nursing as the unique function of

the nurse is to assisst the individual, sick or well in the
HISTORICAL AND CONTEMPORARY OF performance of those activities contributing to health of its
recovery (or to peaceful death) that he would perform
NURSING PRACTICE unaidedif he had the necessary strenght, will or knowledge,
Kaiserswerth School in Germany where Florence Nightingale and to do this in such a way as to help him gain independent
recieved her training in Nursing as rapidly as possible

Harriet Tubman known as the “Moses of her people”for her 1973 American Nurses Association define nursing as direct,
work with the Underground Railroad. During the american goal oriented, and adaptable to the needs of individual, the
civil war (1861-1865), took care of the sick. family abd community during health and illness

Soujerner Ttruth, abolitionist, Underground railroad agent, 1980 ANA change the definition into “Nursing is the
preacher, and womens rights advocate and took care of the diagnosis and treatment of human responses to actual or
sick during the civil war with Harriet Tubman potential health problems

Dorothea Dix was the Union Superintendent of Female 1995 most recent definition of nursing by ANA is Nursing is
Nurses during the Civil War the protection, promotion and optimization of health and
abilitie, prevention of illness and injury, alleviation of
Elizabeth Kenney one of Australian nurse who fight for suffering through the diagnosis and treament of human
poliomyelitis during the World War II response and advocacy in the care of individuals, families,
communities and populations
Florence Nightingale founder of modern nusing
Consumers is an individual, group of people or a community
Clara Barton organized the American Red Cross that uses a service or commodity. Recipient of nursing is
sometimes called consumers, sometimes, patient, sometimes
Linda Richards was the first American trianed nurse, known
client.
for introducting nurse’s note and doctor’s order. Pioneer of
psychiatric nursing and industrial nursing Patient comes from a Latinword patient means to suffer or to
bear. Patient is a person who is waiting for or undergoing
Mary Mahoney was the first African American trianed nurse
medical treatment and care
Lilian Wald founder of Public Health Nursing
Client who engages the advice of services of another who is
Lavinia Dock a feminist, active in protest for womens right qualified to provide this service. Client is more preffered
and a friend of Wald term.

Margaret Higgins Sanger founder of Planned Parenthood, SCOPE OF NURSING

was imprisoned for opening the first birth control information
- Promoting health and Wellness
clinic in Baltimore
- Preventing Illness
Mary Brechinridge established the Frontier nursing Service - Restoring Health
- Caring for the Dying
DEFINITION OF NURSING
ROLES AND FUNCTIONS OF THE NURSE
Florence nightingale define nursing as the act of utilizing the
environment of the patient to assisst him in his recovery”. 1. Caregiver giving direct care for the client
Nightingale considered a clean, well ventilated and quite
2. Communicator to identify client problems, communication
environment essential for recovery. She considered as the
is the integral part to all nursing roles
first nursing theorist.
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3. Teacher, the nurse help client ot learn about their health 1. Nurse Practitioner employed in health care agencies
and health care procedures they need to perform, nurse also or community based setting
assesses client learning needs and readiness to learn 2. Clinical Nurse Specialist consider to be an expert in a
specialized area of practice
4. Client Advocate protect the client, represent the client 3. Nurse Anesthetist assist the anesthesiologist
needs and assissting in the client rights 4. Nurse Midwife assisst in prenatal, postnaltal care
and manages deliveries of normal deliveries
5. Counselor helping the client to cope up with stressful
5. Nurse Researcher investigate nursing problem to
psychologic or social problems to develop improved
improve nursing care and to refine expand nursing
interpersonal relationships, and to promote personal growth.
knowledge
6. Change Agent assissting client to make modifications of his 6. Nurse administrator manages client care, including
behavior the delivery of nursing service
7. Nurse Educator employed in nursing program at
7. Leader influence to other to achieve a specific goal educational institutions, and in hospital staff
education
8. Manager delegates activities to ancillary workers and other
8. Nurse Entrepreneur manages health related
nurses and supervices and evaluate their performance
business
9. Case Manager works with the multidisciplinary health care
BENNERS STAGES OF NURSING EXPERTISE
team to measure the effectiveness of the casemanagement
plan and to monitor outcomes Stage I NOVICE – No experienced, infelxible (nursing student)
perfomance is limited, governed by context-free rules and
10. Research Consumer to improve client care
regulations rather than experience
CRITERIA OF A PROFESSION
Satege II ADVANCE BEGGINER – Demonstrate marginally
Profession has been deifned as an occupation that require acceptable performance, recognize the meaningful “aspects”
extensive education or a calling that requires special of a real situation. Has experienced enough real situation to
knowledge, skills\ and preparation. make judgments about them

Professionalism refers to professional character, spirit, or Stage III COMPETENT – has 2-3 years of experience,
methods, a set of attributes a way of life that implies demonstrate organizational and planning abilities,
responsibility and committment. Influence by Florence diffirentiate important factors from lessaspects of care.
Nightingale Coordinates multiple complex care demands

Professionalization is the process of becoming professional, Stage IV PROFICIENT – has 3 to 5 years of experience,
that is, of acquiring characteristics considered to be percieves situation as wholes rather than in terms of parts, as
professional in stage II. Uses maxims as guides, has holistic understanding
of teh client which improves decision making. Focuses on
1. Specialized Education leng-term goal
2. Body of Knowledge
3. Service Orietntation Stage V EXPERT – performance is fluid, flexible, and highly
4. Ongoing research proficient; no longer requires rules, guidelines, maxims,
5. Code of Ethics demonstrate highly skilled intuitive and analytic ability in new
6. Autonomy situations, is inclined to take a certain action because “it felt
7. Professional Organization right”

EXPANDED CAREER ROLES FOR NURSES CHAPTER II

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NURSING EDUCATION, RESEARCH and collect information, often under conditions of

considerable control, that is analyzed using statistical
EVIDENCE-BASED PRACTICE
procedures. This is often viewed as “hard” science
Types of Educational Programs in Nursing and uses deductive reasoning and the measurable
attributes of human experience.
1. Licensed Practical (Vocational) Nursing Programs – 2. Qualitative Research – is often associated with
usually last for 9 or 12 months and provide both naturalistic inquiry, which explores the subjective
classroom and clinical experiences. LPNs (LVNs) and complex experiences of human beings.
provide basic direct technical care to clients Naturalistic investigation emphasizes the
2. Registered Nursing Programs understanding of human experience as it is lived,
3 major educational route usually through careful collection and analysis of
a. Diploma Programs – Nightingale qualitative materials that are narative and
established the Nightingale Training subjective.
School for Nurses at St. Thomas’s
Hospital in England in 1860. Protecting the Rights of Human Subjects
b. Community College/Associate Degree
1. Right not to be harmed – physically, emotionally,
Programs
socially, legal and financial, confidentiality and
c. Baccalaureate Degree Programs - first
privacy
school of nursing in a university setting
2. Right to Full Disclosure – act of making clear the
was established at the University of
client’s role in a research situation, is a basic right.
Minnesota
Patient consent is part of this
3. Graduate Nursing Education
3. Right of Sell-Determination – means that
a. Master’s Programs – generally take
participants should feel free from constraints,
from 1.5 to 2 years, MA, MS, MN MSN
coercion, or any undue influence to participate in a
b. Doctoral Programs – degrees of doctor
study
of Philosophy (PhD), doctor of nursing
4. Right of privacy and Confidentiality – privacy
science (DNS or DNSc), nursing
enables a client to participate without worrying
doctorate (ND)
about later embarassment. Confidentiality means
4. Continuing Education – refers to formalized
that any information a participants relates will not
experiences designed to enlarge the knowledge or
bemade public or available to others without the
skills of practitioners, this is more specific and
participant’s consent.
shorter
5. In-Service education – administered by an Quantitative Research Process
employer; it is designed to upgrade the knowledge
or skills of employees Polit and Beck (2005) define research as systematic inquiry
that uses disciplined methods to answer questions or solve
NURSING RESEARCH AND EVIDENCE-BASED PRACTICE problems

Evidence-based practice(EBP) – the use of some form of 1. State a Research Question or Problem
substantiation in making clinical decisions. This substantiation Four Criteria in formulating a research
or evidence, can arise from tradition, authority, experience, problem
trial and error, logic or reason, or research. a. Significance – if it has the potential to
contribute to nursing science by
Approaches of Nursing Research
enhancing client care, testing or
1. Quantitative Research – progresses through generating a theory, or resolving a day-
systematic, logical steps acoording to specific plan to
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to-day clinical problem, the question is randomization or control that characterizes

“so what” true experiments
b. Researchability – means that the c. Nonexperimental Design – the investigator
problem can be subjected to scientific does no manipulation of the independents
investigation varaible
c. Feasisibility – pertains to the 6. Select the Population, Sample and Setting –
availabilityof time as well as the POPULATION includes all possible members of the
material and human resources needed group who meet the criteria for the study. SAMPLE is
to investigate a research problem or the segment of the population from whom the data
question will actually collected.
d. Interest of the researcher 7. Conduct a Pilot Study – is a “DRESSED REHEARSAL”
8. Collect the Data – reserach process relies on
Note: Dependent variableis the behavior, empirical data or an informationcollected from the
characteristics, or outcome that the researcher observable world. VALIDITY is the degree to which
wishes to explain or predict. Independent Variable an instrument measures what it is supposed to
is the presumed cause of or influence on the measure. RELIABILITY is the degree of consistency
dependent variable. Descriptive research has no with which an instrument measures a concept or
dependent variables variable.
9. Analyze the Data – in this srep, the collected data
2. Define the Study’s Purpose or rationale –
are orgnized, coded and analyzed for the purpose of
researcher intends to do with the researcher
answering the research question or testing the
problem identified, it includes what will the
hypothesis.
researcher do, who will be the participants, and
Central Tendency
where tha data will be collected
Mean – computed by summing all scores
3. Review the Related Literature – provides the
and dividing by the number of subjects
foundation on which to build new knowledge
Median – representing the exact middle
4. Formulate Hypothesis and Define Variables –
score or value in a distribution of scores
HYPOTHESIS is a prediction of the relationship
Mode – value that occurs more frequently
among two or more variables. OPERATIONAL
Variablity
DEFINITIONS definitions that specify the instruments
Range – difference between the highest
or procedures by which concepts will be measured.
and lowest
5. Select a Research Design to Test the Hypothesis – a
Variance – or dispersion, equal to the
research design is the overall plan for conducting the
square of standard deviation
study to answerthe research questions or test the
Standard Deviation – average to which
research hypotheses. It includes study setting, the
score deviate from the mean
sample, and the type of data to be collected as well
10. Communicate Conclusions and implications –
as strategies to control extraneous variables and
through journals or books
reduces bias.
a. Experimental Design – the investigator Qualitative Research Process
manipulates the independent variable by
administering an experimental treatment to The intent of qualitative research is to thoroughly
some participants while withholding it from describe and explain a phenomenon. The researcher collect
others. narrative data through interviews or observation.
b. Quasi-experimental Design – the
investigator manipulates the independent Ethnography – provides a framework to focus on the culture
variable but wihtout either the of a group of people
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Phenomenology – investigates people’s life experiencesand 3. Health – a degree of wellness or well-being that the
how they interpret those experiences and how they interpret client experiences
those experiences 4. Nursing – the attributes, characteristics, and actions
of teh nurse providing care on behalf of, or in
Grounded theory – focuses on generation of categories or conjunction with, the client
hypotheses that explain patterns of behavior of the people in
hte study Philosophy – is a belief system,often an early effort to define
nursing phenomena, and serve as the basisfor later
theoretical formulations

Florence Nightingale – ENVIRONMENTAL THEORY the act of

utilizing the environment of the patient to assisst him in his
recovery. Five environmental factors: Pure or fressh air, pure
water, efficient drainage, cleanliness, and light(direct
sunlight)

Peplau’s Interpersonal Relations Model – Hildegard Peplau is

a psychiatris nurse, use of therapeurtic relationship between
the nurse and the client.

Phases

a. Orientation – client seek help and the nurse assisst

CHAPTER 3 the client to understand the problem
b. Identification - cleint assumes a posture of
NURSING THEORIES and CONCEPTUAL dependence, interdependence, or independence
FRAMEWORKS and the nurse’s focus is to assure the person that the
nurse know the interpersonal meaning of the client’s
Theory has been identified as a supposition or system of situation.
ideas that is proposed to explain a given phenomenon. Also c. Exploitation – client derives full value from what the
used to describe, predict, and control a phenomena. nurse offers through the relationship, Power shifts
from the nurse to the client.
Concepts often called the building blocks of theories
d. Resolution – old needs and goals are put aside and
Conceptual Framework is a group of related ideas statements new one’s adopted. Once older needs are resolved,
or concepts newer and more mature ones emerge.

Paradigm refers to a pattern of shared understandings and Virginia Henderson – 14 Basic human needs
assumptions about reality and the world.
Martha Rogers – The science of Unitary Human Beings,
FOUR METAPARADIGM FOR NURSING Roger views the person as an irreducible whole, the whole
being greater than the sum of its parts.
Metaparadigm originates from the Greek word meta means
“with” and paradigm means “pattern”. Dorothea Orem – Self Care Theory: self care (activities an
individual performed independently throughtout life to
1. Person or client – the recipient of nursing care promote and maintain personal well bieng), self care agency
2. Environment – the internal and external (individual’s ability to perform self-care activities), self care
surroundings that affect the client requisites (self care needs) and therapeutic self care demand
(refers to actions to maintain well-being.
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Imogene King – Goal Attianment Theory LEGAL ASPECT OF NURSING

Betty Neuman – System Model, She is a community health LAW – the sum total of rules and regulations by which a
nurse and clinical psychologist, developed a model based on society is governed. As such, law is created by people and
the individual’s relationship to stress, the reaction to it, and exists to regulate all persons
reconstitution factors that are dynamic in nature.
SOURCES OF LAW
Callista Roy - Adaptation Model, she defines adaptation as
the “Process and outcome whereby the thingking and feeling 1. Constitutional Law – supreme law of the country
person uses conscious awareness and choice to create human (ex. Due process, equal protection)
and environmental integration” 2. Legislation (Statutory Law) - law enacted by
legislative body (ex. Nurse practice act)
Madeleine Leininger – Cultural Care diversity and 3. Administrative Law – when a sate legislature
Universality Theory, she states that care is the essence of passess a statue, an administrative agency is given
nursing and the dominant, distinctive and unifying feature of the authority to create rules and regulations to
nursing and care varies in culture. enforce the statutory law.
4. Common Law – laws evolvong from court decisions
Jean Watson – Human Caring Model
TYPES OF LAW
Parse – Human Becoming theory, emphasizes how individual
choose and bear responsibility for patterns of presonal health a. Public Law – body of law that deals with
relationships between individuals and the
governmental agencies. Inportant segment of this
law is criminal law, which deals with actions against
the safety and welfare of the public (e.g., homicide,
manslaguhter, and theft)
b. Private law or Civil Law – deals with relationships
among private individuals
o Contract Law – involves the enforcement of
agreeements among private individuals or
the payment of compensation for failure to
fulfill the agreements (ex. Nurse and client,
nurse and employer, nurse and agensy and
nurse and insurance)
o Tort Law – defines and enforces duties and
rights among private individuals that are
nor based on contractual agreements. (ex.
Negligence, malpractice, invasion of
privacy, assault and battery)

Plaintiff – who claims that his legal right have been infringed
on by one or more other persons or entries reffered to as
defendants

Verdict – means decision

Burden of Proof – duty of proving an assertion of wrongdoing

CHAPTER 4
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Credentialing – process of determining and maintaining Delegation – transfer of responsibility for the performance of
competence in nursing practice an activity from one person to another while retaining
accountability for the outcome.
License – a legal permit that a government agency grants to
individuals to engage in the practice of a profession and to Euthanasia – act of painlessly putting to death persons
use a particular title. suffering from incurable or distressing disease

Standards of Care – skills and learning commonly possessed Crime – an act committed in violation of publiclaw and
by members of a profession punishable by a fine or imprisonment

Liability – is the quality or state of being legally responsible a. Felony – a crime of a serious nature such as murder,
for one’s obligations and actions to make financial restitution punishable by a term in prison. Second degree
for wrongful acts murder is called manslaughter
b. Misdemeanor – an offense less serious nature and is
Contractual Obligations – refer to the nurses duty of care, usually punishable by a fine or short-term jail
that is, dut yot render care, established by the presence of sentence or both.
an expressed or implied contract
Tort – a civil wrong committed against a person or a person’s
Respondeat Superior – “let the master answer” means the property
master assumes responsibility for the conduct of the servant
and can also be held responsible for malpractice by the 1. Unintentional Tort
employee. a. Negligence – misconduct or practice that is
below the standard expected of an
Right – is a priviledge or fundamental power to which an ordinary, reasonable and prudent person.
individual is entitled unless it is revoked by law or given up b. Gross Negligence – involves extreme lack of
voluntarily knowledge, skills, or decision making that
the person clearly should have known
Responsibility –obligation associated with a right
would put others at risk for harm
Collective Bargaining – formalized decision making c. Malpractice – is “professional negligence”
processbetween representatives of management (employer) that is, negligence that occcured wgile the
and representatives of labor (employee) to negotiate wages preson was performing as a professional.
and conditions of employment, including work hours, working Six elements to prove a malpractice: DUTY
environment, and fringe benefits of employment. nurse must have relationship with the client
that involves providing care and following
InformedConsent – an agreement by a client to accept a an accceptable standard of care, BREACH
course of treament or a procedure after being provided OF DUTY there must be a standard of care
complete information, including the benefits, and risks of that is expected in the expected in the
treatment, alternatives to the treatment, and prognasis if not specific situation but that the nurse did not
treated by a health care provider. observe, FORESEEABILITY a link must exist
between teh nurse’s act and the injury
a. Express Consent – either an oral or written
suffered, CAUSATION it must be proven
agreeement, usually invasive procedure
that the harm occured as a direct result of
b. Implied Consent – exist when the
the nurse could have known that failure to
individual’s nonverbal behavior indicates
follow the standard of care could result in
agreement.
such harm, HARM OR INJURY plaintiff must
demonstrate some type of harm or injury
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(physical, financial or emotional),

DAMAGES

Res ipsa Loquitur – the thing speaks for itself

2. Intentional Tort - the defendant executed tha act

on purpose or with intent
a. Assault – threat to touch abother person
unjustifiably
b. Battery – willful touching of a person (or
person’s clothes or even something the
person is carrying) that may or may not
cause harm
c. False Imprisonment – unjustifiable CHAPTER 6
detention of person without legal warrant
to confine the person HEALTH CARE DELIVERY SYSTEM
d. Invasion of Privacy
Health Care System – is the totality of services offered by all
e. Defamation – is a communication that is
health disciplines
false, or made with a careless disregrard for
teh truth, and results in injury to the TYPES OF HEALTH CARE SERVICES
reputation of a person. LIBEL defamation by
means of print, writing or pictures. 1. Primary Prevention: Health Promotion and Illness
SLANDER defamation by spoken words, Prevention adequate and proper nutrition, weight
stating unpriviledge or false words by which control and excercise, and stress education. Illness
reputation is damage. prevention involves immunizations, identifying risk
factors for illnesses, and helping peolpe take
measures to prevent this illnesses from occurring, it
also includes environmental programs.
2. Secondary Prevention: Diagnosis and Treatment –
early detection of disease
3. Tertiary Prevention: Rehabilitation, Health
Restoration and Pallative Care – the goal is to help
peolpe move to their previous level of health (i.e, to
their previous capabilities) or to the highest level
they are capable of given their current health status.
Pallative care is providing comfort and treatment for
symptoms

TYPES OF HEALTH CARE AGENCIES AND SERVICES

1. Public Health – government (official) agencies, their

funds are from taxes.
2. Physician’s Offices
3. Ambulatory Care Centers – they may or may not be
associated with an acute care hospital also termed
as CLINIC
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4. Occupational Health Clinics – industrial clinic setting 7. Paramedical Technologist – laboratory

for employee health care technologists, radiological technologists and nuclear
5. Hospitals medicine technologists are just three kinds of
6. Subacute Care Facilities – generally more intensive pramedical technologists. Paramedical means
than long-term care and less than acute care having same connection with medicine.
7. Extended Care (Long-Term Care) Facilities – 8. Phramacists – prepares and dispenses
formerly called as nursing homes, care for elderly, pharmaceuticals in hospital and community setting.
client who require rehabilitation and custodial care They monitor and evaluate the actions and effects of
8. Retirement and Assissted Living Centers – consist of medications
separate houses, condominiums, or apartments for 9. Physical Therapists – assisst client with
residents, clients are unable to remain at home but musculoskeletal problems, treat movement
do notrequire hospital or nusing home care dysfunctions by means of heat, water, excercise,
9. Rehabilitation Centers – usually are independent massage and electric current, assess client mobility
community centers or special unit, (e.g., drug and and strenght, providing therapeutic measures and
alcohol rehabilitation). This type of nursing requires teaching new skills (e.g., how towalk with an artificial
specialized skills and knowledge leg)
10. Home Health Care Agencies 10. Physician – responsible for medical diagnosis and for
11. Day Care Centers – care for infants and children determining the therapy required by a person who
while their parents are at work has a disease or injury
12. Rural Care 11. Physician Assisstant – takes under the direction of a
13. Hospice Services – originally hospice was a place for physician
travelers to rest now it is imporiving or maintaining 12. Podiatrist – diagnose and treat foot conditions and
the quality of life until death perform surgery and prescribed medications
14. Crisis Centers – provide emergency services to 13. Respiratory Therapist – care of clients with
clients experiencing life crises repiratory problems, knowledgeable about oxygen
15. Mutual Support and Self-Help Group therapy devices, intemittent positive pressure
breathing respirators, artificial mechanical
PROVIDERS OF HEALTH CARE ventilators, and accessory devices used in inhalation
therapy
1. Nurses – licensed practical nurse under RN,
14. Social Worker – counsels clients and their support
advanced practice nurses, nurse midwives, RN
persons regarding problems such as finances, marital
anesthetists, clinical nurse specialists
difficulties, and adoption of children.
2. Alternative (Complementary) Care Provider –
15. Spiritual Support Personnel – Chaplains, pastors
chiropractors, hebalist, acupuncturists, massage
rabbis, priests, and other religious or spiritual
therapists, reflexologists, holistic health healers
advisors attend the spiritual needs of clients.
3. Case manager – role is to ensure that clients
16. Unlicensed Assisstive Personnel – are health care
recieved fiscally sound, appropriate care in the best
staff who assume delegated aspects of basic client
setting (e.g., nurse, social worker, occupational
care. These task include bathing, assissting with
therapist, physical therapist
feeding, and collecting specimens.
4. Dentist – diagnose an treat dental problems
5. Dietitian or Nutritionist – has special knowledge FACTORS AFFECTING HEALTH CARE DELIVERY
about the diets required to maintain health and to
treat disease, supervise the preparation of meals to a. Increasing number of Elderly
ensure that clients receive the proper diet b. Advances in Technology
6. Occupational Therapist – assisst client with impaired c. Economics
function to gain the skills to perform activities of d. Women’s Health
daily living e. Uneven Distribution of Services
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f. Access to Health Incurance 8. Team Nursing – delivery of individualized nursing

g. Homeless and The Poor care to clients by a team led by a professional nurse
h. Health Insurance Portability and Accountability Act 9. Primary Nursing – system in which one nurse is
(HIPAA) responsible for overseeing the total care of clients
i. Demographic Changes 24 hours a dat, 7 days a week, provide
comprehensive, individualized, and consistent care.
Assess and prioritize client needs, this is the first-line
manager of the client’s care with all its inherent
FRAMEWORKS FOR CARE
accountabilities and responsibilities.
1. Managed Care – describes a health care system
RESPONSIBILITIES of CASE MANAGER/DISCHARGE
whose goals are to provide cost-effective, quality
PLANNERS
care that focuses on decreased costsand improved
outcomes for group of clients - Assessing clients and their homes and communities
2. Case Management – describes a range of models for - Coordinating and planning care
integrating health care services for individuals or - Collaborating with other health professionals
groups. Also involves multidisciplinary teams that - Monitoring client’s progress
assumes collaborative responsibility for planning, - Evaluating client outcomes
assessing etc.. Both case management and manage
care systems aften use critical pathways (also called
crtitical path, interdisciplinary plans, anticipated
recovery plans, interdisciplinary action plan and
actions plans) tool that specifies interdisciplinary
assessment, interventions, treatment and outcomes.
3. Patient-Focused Care – is delivery model that brings
all services and care providers to the client.
4. Differentiated Practice – is a system in which the
best possible use of nursing personnel is based on
CHAPTER 7
their educational preparation and resultant skills
sets. This model further requires the delineation of COMMUNITY NURSING and CARE CONTINUITY
roles
5. Shared Governance – model inwhich nursing staff
are cooperative with administrative personnel in
making, implementing, and evaluating client care
policies, focuses to encourage participation of nurses
in decision making at all levels of the organization
6. Case Method – referred to as total care, is one the
earliest nuring models developed. One nurse is
assisgned to and is responsible for the
comprehensive care of a group of clients within 8-12
hour shift, this is considered the precursor of
primary nursing
7. Functional Method – focuses on the job to be
completed, economical and efficient, also permits
centralized direction and control. Disadvantage is
not meeting the client’s emotional needs.
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HOME HEALTH CARE SYSTEM

1. Referral Process – client maybe referred to a home

health care providers by a physician, nurse, social
worker, therapists, discharge planner, or family
member. The initial visit, often referred to as
“opening the case”
2. Home Health Agencies
a. Official or public agencies operated by
state or local governments, funded by tax
b. Voluntary or private not-for-profit
agencies are supported by donations,
charity
c. Private, proprietary agencies are for-profit
organizations and are governed by
individual owners or national coporations
d. Institution-based agency under a parent
organization such as hospital
3. Private Duty Agencies referred to as a registry which
contracts with individual practitioners (e.g., nurse or
home health aides) to care for the client in the
home. The client may require care coverage from
the agency for 4 to 24 hours a day.
4. Durable Medical Equipment Companies provides
health care equipment for the client at home
5. Reimbursement

ROLES OF HOME HEALTH NURSE

CHAPTER 8
1. Advocate
HOME CARE 2. Caregiver
3. Educator
Home Care – involves a wide range of health care 4. Case Manager or Coordinator
professionals providing services in the home setting to people
recovering from an acute illness or injury, or who are
disabled, or who have a chronic condition.

Home Health Care Nursing or Visiting Nursing – includes

thenursing services and products provided to clients in theri
homes that are needed to maintain restore or promote their
physical, psychologic and social well-being. The focus of home
health care is individuals and their families unlike
community health nursing focuses on individual, families
and aggregate groups CHAPTER 10

Hospice Nursing – support and care of the dying person and CRITICAL THINGKING AND NURSING PROCESS
family, is often considered a subspeciality of home health
Critical Thinking
care nursing
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- In nursing practice is a discipline specific, reflective technique one can use to look beneath the
reasoning process that guides a nurse in generating, surface, recognize and examine
implementing, and evaluating apporaches for assumptions, search for inconsistencies,
dealing with client care and professional concerns. examine multiple points of view,
- Essential to safe, competent, skillful nursing practice differentiate what one knows from what
one merely believes
Nurses uses critical-thinking skills in a variety of ways: b. Incentive reasoning – from specific
examples (premises) to a generalized
- Nurses use knowledge from other subjects and fields
conclusions
- Nurses deals with change in stressful environments
c. Deductive reasoning – from general
- Nurses make inportant decisions
premise to the specific conclusions
TOP 10 REASONS TO IMPROVE THINKING
DIFFERENTIATING TYPES OF STATEMENTS
10. Things aren’t what they used to be or waht they will be STATEMENT DESCRIPTION EXAMPLE
Facts Can be verified by Blood pressure is
9. Patients are seeker with multiple problems investigation affected by blood
volume
8. More consumer involvement (patients and families) Inferences Conclusions drawn If blood volume is
from facts, going decreased (e.g.,
7. Nurses must be able to move from one setting to another beyond facts to make hemorrhagic shock)
a statement about the blood pressure
6. Rapid change and information explosion requires us to something not will drop
develop new learning and workplace skills currently known
Judgments Evaluation of facts or It is harmful to the
5. Consumers and payers demand to see evidence of information that client’s health if
benefits, efficiency and results reflects values or other blood pressure
criteria; a type of drops too low
4. Today progress often create new problems that can’t be opinion
solved by old ways of thinking Opinions Beliefs formed over Nursing
time and include intervention can
3. Redisigning care delivery and nursing curricula is useless if judgements that may assisst in
fit facts or be in error maintaining the
students and nurses don’t have the thinking skills require to
client’s blood
deal with today’s world pressure within
normal limits
2. It canbe done – it doesn’t have to be that difficult

1. Your ability to focus your thinking to get the result you

ATTITUDES THAT FOSTER CRITICAL THINKING
need can make the difference between whether you
succeed or fail in this fast paced-world 1. Independence individuals think for themselves
2. Fair-indedness assessing all viewpoints with the
INCENTIVE SPIROMETRY a treatment device that promotes
same standards and not basing their judgments on
alveolar expansion
personal or group bias or prejudice
SKILLS in CRITICAL THINKING 3. Insight into Egocentricity critical thinkers are open
to the possibility that their personal biases or social
a. Critical Analysis – application of a set of pressures and customs could unduly affect their
questions to a particular situation or idea to thinking
determine essential information or ideas 4. Intellectual Humility means having an awareness of
and discard superfluous information and the limits of one’s own knowledge. Critical thinkers
ideas. Socaratic Questioning bis a are willing to admit what they do not know; they are
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willing to seek new information and to rethink their

conclusions in light of new knowledge
5. Intellectual Courage to Challenge the Status Quo
and Rituals one is willing to consider the examine
fairly one’s own ideas or views, especially those to
which one may have strongly negative reaction
6. Integrity requires that individuals apply the same
rigorous standards of proof to their own knowledge
and beliefs as they apply to the knowledge and
beliefs of others
7. Perseverance finding effective solutions to client
and nursing problems
8. Confidence believe that well-reasoned thinking will
lead to trustworthy conclusions
9. Curiosity critical thinkers are filled with a lot of
questions

NURSING PROCESS – is a systematic, rational method of

planning and improving individualized nursing care

Problem Solving – the nurse obtains information that clarifies

the nature of the problem and suggest possible solutions