Transcription
Licensed to: iChapters User
Licensed to: iChapters UserFundamentalsof NursingStandards & PracticeFourth EditionCopyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserFundamentalsof NursingStandards & PracticeFourth EditionSue C. DeLaune, MN, RNAssistant ProfessorRN-BSN CoordinatorWilliam Carey UniversitySchool of NursingNew Orleans, LouisianaPresident and Education DirectorSDeLaune ConsultingMandeville, LouisianaPatricia K. Ladner, RN, MS, MNFormer Consultant for Nursing PracticeLouisiana State Board of NursingNew Orleans, LouisianaAustralia Brazil Japan Korea Mexico Singapore Spain United Kingdom United StatesCopyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserThis is an electronic version of the print textbook. Due to electronic rightsrestrictions, some third party content may be suppressed. Editorialreview has deemed that any suppressed content does not materiallyaffect the overall learning experience. The publisher reserves theright to remove content from this title at any time if subsequentrights restrictions require it. For valuable information on pricing, previouseditions, changes to current editions, and alternate formats, please visitwww.cengage.com/highered to search by ISBN#, author, title, or keywordfor materials in your areas of interest.Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserFundamentals of Nursing: Standards and PracticeFourth EditionBy Sue C. DeLaune and Patricia K. LadnerVice President, Career and ProfessionalEditorial: Dave GarzaDirector of Learning Solutions: Matthew KaneExecutive Editor: Stephen Helbaª 2011, 2006, 2002, 1998, Delmar, Cengage LearningALL RIGHTS RESERVED. No part of this work covered by the copyright hereinmay be reproduced, transmitted, stored, or used in any form or by any meansgraphic, electronic, or mechanical, including but not limited to photocopying,recording, scanning, digitizing, taping, Web distribution, information networks, orinformation storage and retrieval systems, except as permitted under Section 107or 108 of the 1976 United States Copyright Act, without the prior writtenpermission of the publisher.Managing Editor: Marah BellegardeSenior Product Manager: Patricia GaworeckiEditorial Assistant: Meghan OrvisVice President, Career and Professional Marketing:Jennifer McAveyMarketing Director: Wendy E. MapstoneFor product information and technology assistance, contact us atCengage Learning Customer & Sales Support, 1-800-354-9706For permission to use material from this text or product, submit all requestsonline at cengage.com/permissions.Further permissions questions can be e-mailed topermissionrequest@cengage.com.Senior Marketing Manager: Michele McTigheMarketing Coordinator: Scott ChryslerProduction Director: Carolyn MillerProduction Manager: Andrew CrouthSenior Content Project Manager: Kenneth McGrathSenior Art Director: Jack PendletonLibrary of Congress Control Number: 2009937406ISBN-13: 978-1-4354-8067-4ISBN-10: 1-4354-8067-8Delmar5 Maxwell DriveClifton Park, NY 12065-2919USACengage Learning is a leading provider of customized learning solutions withoffice locations around the globe, including Singapore, the United Kingdom,Australia, Mexico, Brazil, and Japan. Locate your local office at:international.cengage.com/regionCengage Learning products are represented in Canada by Nelson Education, Ltd.For your lifelong learning solutions, visit delmar.cengage.comVisit our corporate website at cengage.com.Purchase any of our products at your local college store or at our preferred onlinestore www.CengageBrain.com.Notice to the ReaderPublisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of theproduct information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information otherthan that provided to it by the manufacturer. The reader is expressly warned to consider and adopt all safety precautions that might be indicated bythe activities described herein and to avoid all potential hazards. By following the instructions contained herein, the reader willingly assumes allrisks in connection with such instructions. The publisher makes no representations or warranties of any kind, including but not limited to, thewarranties of fitness for particular purpose or merchantability, nor are any such representations implied with respect to the material set forth herein,and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, orexemplary damages resulting, in whole or part, from the readers’ use of, or reliance upon, this material.Printed in the United States of America1 2 3 4 5 6 7 12 11 10Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserTo Jennifer and Ryan Cardinal, Katie and Jacob Segrave, and Sarabeth and Jay Accardo.I especially want to thank my husband and best friend, Jay, for his continued support andbelief in me. I want to acknowledge my father, Glynn Edward Carter, for unendingsupport and encouragement, especially for my academic endeavors.-SCDTo Wayne, Kelly, Wayne Jr., Gretchen, and Michael.-PKLWe dedicate this book to our grandchildren: Camille Anna Cardinal, Caroline AlexaCardinal, Leah Marie Ladner, Charles Thomas Lee, Michael and Joshua Ladner, andCooper and Paige Ladner.You are our future. ‘‘G’’ and ‘‘Mimi’’Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserBrief ContentsUNIT 1: Nursing’s Perspective: Past, Present, and FutureChapter 1Evolution of Nursing and Nursing EducationChapter 2Nursing TheoryChapter 3Research and Evidence-Based PracticeChapter 4Health Care Delivery, Quality, and the Continuum of CareUNIT 2: Nursing Process: The Standard of CareChapter 5Critical Thinking, Decision Making, and the Nursing ProcessChapter 6AssessmentChapter 7Nursing DiagnosisChapter 8Planning and Outcome IdentificationChapter 9ImplementationChapter 10 EvaluationUNIT 3: Professional AccountabilityChapter 11 Leadership, Delegation, and PowerChapter 12 Legal and Ethical ResponsibilitiesChapter 13 Documentation and InformaticsUNIT 4: Promoting Client HealthChapter 14 Nursing, Healing, and CaringChapter 15 CommunicationChapter 16 Health and Wellness PromotionChapter 17 Family and Community HealthChapter 18 The Life CycleChapter 19 The Older ClientChapter 20 Cultural DiversityChapter 21 Client EducationUNIT 5: Responding to Basic Psychosocial NeedsChapter 22 Self-ConceptChapter 23 Stress, Anxiety, Adaptation, and ChangeChapter 24 SpiritualityChapter 25 Loss and GriefUNIT 6: Responding to Basic Physiological NeedsChapter 26 Vital SignsChapter 27 Physical AssessmentChapter 28 Diagnostic TestingChapter 29 Safety, Infection Control, and HygieneChapter 30 Medication AdministrationChapter 31 Complementary and Alternative ModalitiesChapter 32 OxygenationChapter 33 Fluids and ElectrolytesChapter 34 NutritionChapter 35 Comfort and SleepChapter 36 MobilityChapter 37 Skin Integrity and Wound HealingChapter 38 Sensation, Perception, and CognitionChapter 39 EliminationChapter 40 Nursing Care of the Perioperative 3439463475Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserTABLE OFCONTENTSList of Procedures / xixContributors / xxiiiReviewers / xxvPreface / xxixHow to Use This Text / xxxiiiAcknowledgments / xxxviAbout the Authors / xxxviiUNIT 1Nursing’s Perspective: Past,Present, and Future / 1CHAPTER 1EVOLUTION OF NURSING AND NURSINGEDUCATION / 3Evolution of Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . 4Origins of Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Religious Influences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Demands of War . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Florence Nightingale (1820–1910) . . . . . . . . . . . . . . . . . . 8Nursing Pioneers and Leaders . . . . . . . . . . . . . . . . . . . . . 9Nursing in the Twentieth Century . . . . . . . . . . . . . . . . . . 11Social Forces Affecting Nursing . . . . . . . . . . . . . . . . . . . 14Nursing Education Overview . . . . . . . . . . . . . . . . . . 15Diploma Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Associate Degree Programs . . . . . . . . . . . . . . . . . . . . . . 17Baccalaureate Programs. . . . . . . . . . . . . . . . . . . . . . . . . 17Master’s Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Doctoral Programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Staff Development and Continuing Education . . . . . . . 18Preparing Nurses for Tomorrow’sChallenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Differentiated Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Accelerated Degree Programs . . . . . . . . . . . . . . . . . . . . 19Technology Changes in Nursing Education . . . . . . . . . 19Service Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20CHAPTER 2NURSING THEORY / 23Components of the Theoretical Foundation . . . . . 24What Is a Concept? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24What Is a Proposition? . . . . . . . . . . . . . . . . . . . . . . . . . . 24What Is a Theory? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Use of Theories from Other Disciplines. . . . . . . . . 25Importance of Nursing Theories . . . . . . . . . . . . . . . 25Scope of Theories . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Grand Theories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Middle-Range Theories . . . . . . . . . . . . . . . . . . . . . . . . . . 26Micro-Range Theories. . . . . . . . . . . . . . . . . . . . . . . . . . . 26Evolution of Nursing Theory. . . . . . . . . . . . . . . . . . . 26Knowledge Development in Nursing . . . . . . . . . . . 28Metaparadigm of Nursing . . . . . . . . . . . . . . . . . . . . . . . . 28Paradigms in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Selected Nursing Theories. . . . . . . . . . . . . . . . . . . . 30Florence Nightingale . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Early Nursing Theories . . . . . . . . . . . . . . . . . . . . . . . . . . 30Contemporary Nursing Theories . . . . . . . . . . . . . . . . . . 33Theories for the New Worldview of Nursing . . . . . . . . . 37Continuing Evolution of Nursing Theory . . . . . . . . 38viiCopyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserviiiTABLE OF CONTENTSCHAPTER 3RESEARCH AND EVIDENCE-BASEDPRACTICE / 41Research: Substantiating the Science ofNursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42Historical Development . . . . . . . . . . . . . . . . . . . . . . . . . . 42Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43Research Utilization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Nursing Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Evidenced-Based Practice. . . . . . . . . . . . . . . . . . . . 48Evidence Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Trends in Research and Evidence-Based Practice. . . . 50CHAPTER 4HEALTH CARE DELIVERY, QUALITY,AND THE CONTINUUM OF CARE / 53Health Care Delivery: OrganizationalFrameworks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Public Sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Private Sector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Health Care Team . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Nurse: Roles and Functions . . . . . . . . . . . . . . . . . . . . . . 55Advanced Practice Nurse: Roles and Functions. . . . . . 55Reimbursement Methods. . . . . . . . . . . . . . . . . . . . . 57Private Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Managed Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Government Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Factors Influencing the Delivery ofHealth Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60Quality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60Nursing Supply and Demand . . . . . . . . . . . . . . . . . . . . . 60Responses to Health Care Changes . . . . . . . . . . . 60Nursing Agenda for Health Care Reform . . . . . . . . . . . . 60Public versus Private Programs . . . . . . . . . . . . . . . . . . . 61Vulnerable Populations . . . . . . . . . . . . . . . . . . . . . . . . . . 61Community Nursing Organizations . . . . . . . . . . . . . . . . 61Continuum of Care . . . . . . . . . . . . . . . . . . . . . . . . . . 62Levels of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Health Care Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Fragmentation of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . 63Quality Management in Health Care. . . . . . . . . . . . 65Defining Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65Factors Influencing Quality in Health Care . . . . . . . . . . 66Quality and Health Care Economics . . . . . . . . . . . . . . . 67Principles of Quality Improvement . . . . . . . . . . . . . . . . . 67Customer Satisfaction. . . . . . . . . . . . . . . . . . . . . . . . . . . 67Organizational Structure for QualityManagement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Organizational Culture. . . . . . . . . . . . . . . . . . . . . . . . . . . 68Process Improvement . . . . . . . . . . . . . . . . . . . . . . . . . . . 70Nursing’s Role in Quality Management . . . . . . . . . 70Trends in Health Care Delivery . . . . . . . . . . . . . . . . 71UNIT 2Nursing Process: The Standardof Care / 73CHAPTER 5CRITICAL THINKING, DECISIONMAKING, AND THE NURSINGPROCESS / 75Critical Thinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76Components of Critical Thinking . . . . . . . . . . . . . . . . . . 76Development of Critical Thinking Skills . . . . . . . . . . . . . 77Critical Thinking and Creativity . . . . . . . . . . . . . . . . . . . . 78Critical Thinking and Problem Solving . . . . . . . . . . . . . . 78Critical Thinking and Decision Making . . . . . . . . . . . . . . 78The Nursing Process. . . . . . . . . . . . . . . . . . . . . . . . . 79Historical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Overview of the Nursing Process . . . . . . . . . . . . . . . . . . 79Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Outcome Identification and Planning . . . . . . . . . . . . . . . 83Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Evaluation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Critical Thinking Applied in Nursing . . . . . . . . . . . . 85CHAPTER 6ASSESSMENT / 89Purpose of Assessment . . . . . . . . . . . . . . . . . . . . . . 90Types of Assessment . . . . . . . . . . . . . . . . . . . . . . . . 90Comprehensive Assessment . . . . . . . . . . . . . . . . . . . . . 90Focused Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . 90Ongoing Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . 91Data Collection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91Types of Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91Sources of Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91Methods of Data Collection . . . . . . . . . . . . . . . . . . . . . . 92Data Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96Data Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Assessment Models . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Data Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . 98Data Documentation . . . . . . . . . . . . . . . . . . . . . . . . . 98Types of Assessment Formats . . . . . . . . . . . . . . . . . . . . 98CHAPTER 7NURSING DIAGNOSIS / 109What Is a Nursing Diagnosis? . . . . . . . . . . . . . . . . 110Comparison of Nursing and MedicalDiagnoses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110Historical Perspective. . . . . . . . . . . . . . . . . . . . . . . 111Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Purposes of Nursing Diagnoses . . . . . . . . . . . . . . 111Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserTABLE OF CONTENTSCommunication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Holistic, Individualized Care . . . . . . . . . . . . . . . . . . . . . 112Nursing Diagnoses and Nursing Informatics . . . . . . . . 112Components of a Nursing Diagnosis . . . . . . . . . . 114The Two-Part Statement . . . . . . . . . . . . . . . . . . . . . . . . 115The Three-Part Statement. . . . . . . . . . . . . . . . . . . . . . . 115Categories of Nursing Diagnoses . . . . . . . . . . . . . 115Taxonomy of Nursing Diagnoses . . . . . . . . . . . . . 116Clinical Judgment in Nursing: DevelopingNursing Diagnoses . . . . . . . . . . . . . . . . . . . . . . . . . 116Generating Cues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117Validating Cues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117Interpreting Cues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117Clustering Cues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118Using NANDA-Approved Nursing Diagnoses . . . . . . . 118Writing the Nursing Diagnosis Statement . . . . . . . . . . 118Avoiding Errors in Development and Useof Nursing Diagnoses . . . . . . . . . . . . . . . . . . . . . . . 118Assessment Errors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118Diagnostic Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119Limitations of Nursing Diagnosis . . . . . . . . . . . . . 120Overcoming Barriers and Limitationsto Nursing Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . 120CHAPTER 8PLANNING AND OUTCOMEIDENTIFICATION / 125Purposes of Planning and OutcomeIdentification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Process of Planning and OutcomeIdentification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Critical Thinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Establishing Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . 127Establishing Goals and Expected Outcomes . . . . . . . 128Components of Goals and Expected Outcomes . . . . 129Problems Frequently Encountered in Planning . . . . . . 130Planning Nursing Interventions. . . . . . . . . . . . . . . . . . . 132Evaluating Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134Nursing Outcomes Classification (NOC) . . . . . . . 134Plan of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135Types of Care Plans. . . . . . . . . . . . . . . . . . . . . . . . . . . . 135Strategies for Effective Care Planning. . . . . . . . . 136CHAPTER 9IMPLEMENTATION / 139Purposes of Implementation . . . . . . . . . . . . . . . . . 140Requirements for Effective Implementation . . . . 140Cognitive Skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140Psychomotor Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140Interpersonal Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140Implementation Activities. . . . . . . . . . . . . . . . . . . . 140Ongoing Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . 140Establishment of Priorities . . . . . . . . . . . . . . . . . . . . . . 141Allocation of Resources . . . . . . . . . . . . . . . . . . . . . . . . 142ixNursing Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . 144Evaluating Interventions . . . . . . . . . . . . . . . . . . . . . . . . 149Documentation of Interventions . . . . . . . . . . . . . . . . . . 149CHAPTER 10EVALUATION / 153Evaluation of Client Care . . . . . . . . . . . . . . . . . . . . 154Components of Evaluation. . . . . . . . . . . . . . . . . . . 154Techniques. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154Sources of Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155Goals and Expected Outcomes . . . . . . . . . . . . . . . . . . 155Methods of Evaluation . . . . . . . . . . . . . . . . . . . . . . 155Establishing Standards . . . . . . . . . . . . . . . . . . . . . . . . . 155Collecting Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155Determining Goal Achievement . . . . . . . . . . . . . . . . . . 155Relating Nursing Actions to Client Status . . . . . . . . . . 155Judging the Value of Nursing Interventions . . . . . . . . . 155Reassessing the Client’s Status . . . . . . . . . . . . . . . . . . 155Modifying the Plan of Care . . . . . . . . . . . . . . . . . . . . . . 155Critical Thinking and Evaluation . . . . . . . . . . . . . . . . . . 156Evaluation and Quality of Care . . . . . . . . . . . . . . . 156Elements in Evaluating the Quality of Care . . . . . . . . . 156Nursing Audit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158Peer Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159Evaluation and Accountability . . . . . . . . . . . . . . . . 159Multidisciplinary Collaboration inEvaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159UNIT 3Professional Accountability / 163CHAPTER 11LEADERSHIP, DELEGATION, ANDPOWER / 165Professional Nursing Practice. . . . . . . . . . . . . . . . 166Criteria of a Profession . . . . . . . . . . . . . . . . . . . . . . . . . 166Professional Accountability . . . . . . . . . . . . . . . . . . 168Elements of Professional Accountability . . . . . . . . . . . 168Legislative Accountability . . . . . . . . . . . . . . . . . . . . . . . 170Individual Accountability . . . . . . . . . . . . . . . . . . . . . . . . 171Student Accountability . . . . . . . . . . . . . . . . . . . . . . . . . 172Advanced Practice Nursing . . . . . . . . . . . . . . . . . . 172Leadership in Nursing . . . . . . . . . . . . . . . . . . . . . . . 175Managerial Functions . . . . . . . . . . . . . . . . . . . . . . . . . . 175Leadership Styles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175Leadership Characteristics . . . . . . . . . . . . . . . . . . . . . . 175Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180Mentoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Networking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Empowerment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182Politics of Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . 182Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Licensed to: iChapters UserxTABLE OF CONTENTSCHAPTER 12LEGAL AND ETHICALRESPONSIBILITIES / 187Legal Foundations of Nursing . . . . . . . . . . . . . . . . 188Sources of Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188The Judicial Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 190Legal Liability in Nursing . . . . . . . . . . . . . . . . . . . . . . . . 190Legal Responsibilities and Roles . . . . . . . . . . . . . . . . . 195Legal Responsibilities of Students . . . . . . . . . . . . . . . . 195Legal Safeguards for Nursing Practice . . . . . . . . . . . . 196Legislation Affecting Nursing Practice . . . . . . . . . . . . . 197Legal Issues Related to Death and Dying . . . . . . . . . . 199Ethical Foundations of Nursing . . . . . . . . . . . . . . . 200Concept of Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200Ethical Theories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201Ethical Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202Values and Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204Ethical Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204Clients’ Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205Ethical Dilemmas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205Ethical Roles and Responsibilities of ProfessionalNurses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Ethical Decision Making . . . . . . . . . . . . . . . . . . . . . . . . 208CHAPTER 13DOCUMENTATION ANDINFORMATICS / 213Informatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214Clinical Information Systems . . . . . . . . . . . . . . . . . . . . 214Electronic Health Record . . . . . . . . . . . . . . . . . . . . . . . 215Nursing Information Systems . . . . . . . . . . . . . . . . . . . . 215Documentation as Communication . . . . . . . . . . . 216Documentation Defined . . . . . . . . . . . . . . . . . . . . . . . . 216Purposes of Health Care Documentation . . . . . . . . . . 217Principles of Effective Documentation . . . . . . . . 223Elements of Effective Documentation . . . . . . . . . . . . . 224Methods of Documentation . . . . . . . . . . . . . . . . . . 226Narrative Charting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226Source-Oriented Charting. . . . . . . . . . . . . . . . . . . . . . . 226Problem-Oriented Charting. . . . . . . . . . . . . . . . . . . . . . 226PIE Charting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227Focus Charting. . . . . . . . . . . . . . . . . . . . . . . . . . .
Chapter 2 Nursing Theory 23 Chapter 3 Research and Evidence-Based Practice 41 Chapter 4 Health Care Delivery, Quality, and the Continuum of Care 53 UNIT 2: Nursing Process: The Standard of Care Chapter 5 Critical Thinking, Decision Making, and the Nursing Process 75 Chapter 6 Assessment 89 Chapter 7 Nursing Diagnosis 109
