Cchp rn apr 2010 final slides 041210
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  • D
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  • 45-50% of Test
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Cchp rn apr 2010 final slides 041210 Cchp rn apr 2010 final slides 041210 Presentation Transcript

  • CCHP-RN Certification Review Course www.slideshare.net/CCHPRN [email_address]
  • CCHP-RN Speakers Bureau
    • Margaret Collatt, BSN, RN, CCHP-RN/A
    • Catherine Knox, MN, RN, CCHP-RN
    • Susan Laffan, RN, CCHP-RN/A
    • Mary Muse, MSN, RN, CCHP-RN/A
    • Becky Pinney, MSN, RN, CCHP-RN
    • Lorry Schoenly, PhD, RN, CCHP-RN
  • CCHP-RN Certification
    • Current CCHP Certification
    • Active RN licensure
    • 2 years full-time practice as an RN
    • 2000 hours practice in corrections in last 3 years
    • 54 hours nursing continuing education (18 specific for correctional healthcare) in last 3 years
  • CCHP-RN Content Outline
    • Clinical Management of Inmate-Patients (45-50%)
    • Promotion of Safe and Secure Health Care Environment (5-10%)
    • Health Promotion and Maintenance (8-12%)
    • Professional Role and Responsibilities (30-35%)
  • Preparing for a Certification Exam
  • Certification Exams
    • Based upon a universal knowledge foundation
    • Items selected from generally recognized resources available to the examinee
    • Specific to the type of specialty area
  • Certification Exams Different from Clinical Practice
    • Only one best answer
    • Ideal, not real, situation
    • Conformity rather than brilliance
    • Dealing with a high level of certainty
  • Exam Performance
    • Knowledge Base 60%-70%
    • Test Taking Skills 25% - 30%
    • Personal Issues 10% - 15%
  • Developing Knowledge
    • Locate the Exam Blueprint/Study Guide
    • Evaluate your degree of understanding for each section
    • Determine best study time periods
    • Create a study space with your materials and supplies
    • Create a study plan based on the time until exam date
    • Work the plan
  • Developing Knowledge – Fact Memory
    • Flashcard
    • Crib Sheet
    • Recall during repetitive tasks
    • Audiotape
  • Developing Knowledge – Fact Memory
    • Concentrate on quality not quantity – most important facts
    • Use memory aides
      • Acronyms
      • Acrostics
      • ABCs
      • Imaging
      • Rhymes/music/links
  • Developing Knowledge
    • Focus on weak areas
    • Learn principles and patterns for application
    • Study to decide, not to tell
  • Developing Knowledge - Application
    • Apply facts and principles to cases
    • Study Groups - Group Discussion
    • Practice Tests
  • Developing Knowledge – Study Tactics
    • Spaced repetition is key to learning
    • Sleep is important
    • Best time of day to study for you
    • Take breaks
    • Practice on recall
    • Focus on application
  • Test Taking Skills
    • Become an expert at multiple choice questions
    • Read the direction to the questions carefully
    • Recognize the purpose of the test question
    • Identify the key word(s) in the test question
    • Recognize the components of the test question
  • Test Taking Skills Anatomy of a Question
    • Stem
    • Key Response
    • Distracters
  • An inmate has just been diagnosed with active tuberculosis. Which action should the nurse take as a safety measure?
    • Tell everyone that the inmate has tuberculosis
    • Isolate the inmate in a negative pressure room
    • Keep the inmate in population since antibiotics have been started
    • Advise only the medical staff of this inmate’s condition
  • Test Taking Skills – Educated Guesses
    • Three Tries to Get an Answer
    • Recall Pass: Recollection
    • Selection Pass: Recognition
    • Exclusion Pass: Remainder
  • An inmate has just been diagnosed with active tuberculosis. Which action should the nurse take as a safety measure?
    • Tell everyone that the inmate has tuberculosis
    • Isolate the inmate in a negative pressure room
    • Keep the inmate in population since antibiotics have been started
    • Advise only the medical staff of this inmate’s condition
  • Test Outline Self-Evaluation
    • Strengths and weaknesses
    • Create priority content list
    • Map out a training plan for the length of time remaining
    • Consider this marathon training
  • Clinical Management of Inmate-Patients
  • Screening/Triage/Sick Call
  • Screening
    • Principles
    • Outcome
    • Issues and Problem Areas
  • Types of screening
    • Intake
    • Work assignment
    • Mental Health
    • Segregated Housing
    • Other
  • Intake screening
    • Nurse’s role
    • Disposition and Documentation
  • Work or Other Assignments
    • Kitchen assignment
    • Forest/Fire crew
    • Boot camp
    • A & D treatment
  • Nurse’s Role
    • Training
    • Focused assessment
    • Timeframe
    • Disposition and documentation
  • Other types of screening
    • Mental health
    • Segregated housing
    • Use of force
  • Nurse’s Role
    • Training
    • Focused assessment
    • Timeframe
    • Disposition and documentation
  • Sick call
    • Components
    • Principles
    • Clinical and non-clinical requests
    • Issues and Problem Areas
  • Triage Request for Health Care Attention Received Nurse review Non-clinical Clinical Review Health Record Review the Health Record 1. Refer Face to Face Assessment 2. Appoint 1.Emergent: act now 3. Respond 2.Urgent: address/refer 4. Give direction 3.Routine: address/appoint
  • Triage
    • Time frames
    • Essentials
    • Steps in the encounter
    • Protocols
    • Referral
  • Issues and Problems w/Sick Call Triage
    • Timeframes
    • Practical nurses
    • Clinical or administrative
    • Diagnosis
    • Initiate treatment
  • Sick Call / Triage
    • Summary
    • Use of nursing judgment
    • Assertiveness as a patient advocate
    • Protocols can not force diagnosis
    • Always have clinical backup
    • Duty to ensure timely referral takes place
  • Referrals, Transfers Continuity of Care
  • Coordinate Off-Site Specialty Care
    • Schedule appointments
    • Patient preparation
    • Coordinate with the facility’s transportation
    • Ensure paperwork accompanies the patient
    • Verify that appointments occur
  • Provide Follow-Up Care after Off-Site Appointments
    • Importance of follow-up
    • Defined process
    • ID patients that require priority follow-up
    • Provide patient education
    • Facility and Security’s Involvement
    • Document / communicate all actions taken
  • Coordinate Onsite Chronic Care
    • Identify chronically ill patients
    • Be constantly aware of the chronically ill
    • Make appropriate referrals
    • Interface with the chronic care program
    • Participate in care, treatment and testing
    • Documents chronic care encounters
  • Receive and Make Referrals for Special Assistive Services
    • Provided by Other Community Agencies
    • Knowledge of the community services
    • Know the proper channels to access services
    • Positive relationships are a must!
    • Keep communication lines open
    • Note needs not met
    • Be an advocate
  • Provide for Continuity of Care
    • Critical aspect of care
    • Communication and coordination a must
    • Understand your environment
    • Note critical times in the process
  • Situation #1
    • Inmate Kim falls down stairs at the facility and
    • complains of arm and shoulder pain. X-rays
    • negative. Rest, passive ROM exercises and
    • analgesics ordered. Told to submit a sick call slip
    • if no improvement in 30 days.
  • Situation #1 Kim’s fall
    • Chronic care appt. 60 days later, no improvement.
    • MRI ordered. Sick call visit for asthma 30 day later. On 90 day Chronic Care visit, no MRI in chart. Stat MRI ordered. Inoperable rotator cuff tear noted on MRI reading.
    • What went wrong?
  • Referrals, Transfers Continuity of Care
    • Summary
    • Timeliness of referrals
    • Overcoming system barriers to care
    • Communication among staff, with custody, with outside entities
  • Management of Care
  • Application of the Nursing Process
    • Assessment
    • Diagnosis
    • Planning
    • Implementation
    • Evaluation
  • What defines our patient population and setting?
    • HIV
    • Tuberculosis
    • Hepatitis
    • Other Infections
    • STDs
    • Heart Disease
    • Diabetes
    • Mental Illness
    What defines our patient population and setting?
  • What defines our patient population and setting?
    • Addictions
    • Secondary Gains
    • Personality Disorders
    • PTSD/Trauma
    • Incarceration
    • Time
    What defines our patient population and setting?
  • Application of the Nursing Process
    • Assessment
  • Perform Assessments
    • Consistent with establish protocols and national clinical guidelines
    • Comprehensive, including consideration of patient’s safety
  • Using the Interview to Collect Information
    • Working with the tough patient
    • Set the stage for the interview
    • Set the agenda for the interview
    • Focus on the important
    • Build a clinical picture
  • Juveniles
    • Unique needs
    • Address immunization history and status
    • Screen for infectious infections
    • Parental consent
    • Confidentiality
  • Suicidal Behavior
      • Observation
      • Interview
      • Safety
      • Referral
      • Follow-up
  • Application of the Nursing Process
    • Assessment
    • Diagnosis
  • Perform and Evaluate Diagnostic Testing
    • Be proficient in performing diagnostic tests
    • Specimen collection
    • Documents diagnostic tests performed
    • Evaluation and reporting
    • Know how / when to communicate test results
    • Equipment testing and monitoring
  • Perform and Evaluate Diagnostic Testing
    • Peak Flow
    • Capillary Blood Glucose
    • O 2 Saturation
    • Vital Signs
    • EKG
    • Monofilament
    • Sputum
    • Nasopharyngeal Swab
  • Application of the Nursing Process
    • Assessment
    • Diagnosis
    • Planning
    • Has goals unrelated to their actual or potential health problems?
    • Is in treatment for addiction?
    • Has a terminal condition or advanced directive?
    • Is coping with life change?
    • Is non-English speaking?
    How Do You Provide Care When The Patient
  • Alteration in Nutritional Intake
      • Plan
      • Adjust diet,
      • Change delivery to include:
          • method,
          • time
          • food preferences
  • Application of the Nursing Process
    • Assessment
    • Diagnosis
    • Planning
    • Implementation
  • Implementation of Care
    • Respond to emergent health care needs
    • Manage health conditions, including pain
    • Hospice and palliative care
    • Medication delivery and other prescribed treatment
    • Referral and support
    • Documentation
    • Different settings
    • Ensure correct use of equipment in performing procedures and treatments
  • Application of the Nursing Process
    • Assessment
    • Diagnosis
    • Planning
    • Implementation
    • Evaluation
  • Evaluate the patient to determine the effect of care implemented.
  • Monitor Psychological and Physiological Response to Incarceration
    • Recognize the impact of incarceration
    • Patient Advocate
    • Know processes to report and monitor patient needs
    • Establish or revise care plan based on the patient needs
  • Evaluate Behavioral Changes
    • Assess the patient with behavioral changes
    • Make a clinical decision based findings
    • Take appropriate actions
    • Document all findings
    • Follow through to resolution
  • Management of Care Summary
    • What is unique about providing nursing
    • care in the correctional setting?
      • Population
      • Setting
      • Variety
      • Time
  • Practice Questions #1
  • On Saturday the registered nurse reviews written request dated Friday: “Attention Dr. P. chronic pain. Medication has not arrived yet and the pain is unbearable. Getting more. Need to see you as soon as possible.” Which of the following is the best triage action?
      • Schedule for routine nurse sick call on Monday
      • Schedule appointment with the doctor on Monday
      • Conduct face to face assessment on Saturday
      • Forward request to pharmacy to fill prescription
  • On Saturday the registered nurse reviews written request dated Friday: “Attention Dr. P. chronic pain. Medication has not arrived yet and the pain is unbearable. Getting more. Need to see you as soon as possible.” Which of the following is the best triage action?
      • Schedule for routine nurse sick call on Monday
      • Schedule appointment with the doctor on Monday
      • Conduct face to face assessment on Saturday
      • Forward request to pharmacy to fill prescription
  • What is the nurse’s role when called by a health-trained correctional officer conducting a receiving screening?
    • Further assess any person identified as having a medical, mental health or dental condition
    • Direct the correctional officers on the treatment that should be provided
    • Carry out the physician orders received by the correctional officer
    • Schedule the inmate-patient to be seen during the next nursing sick call
  • What is the nurse’s role when called by a health-trained correctional officer conducting a receiving screening?
    • Further assess any person identified as having a medical, mental health or dental condition
    • Direct the correctional officers on the treatment that should be provided
    • Carry out the physician orders received by the correctional officer
    • Schedule the inmate-patient to be seen during the next nursing sick call
  • On Friday the registered nurse reviews written request dated Thursday: “I need my renewal for multi-vitamins, Thank you!” Which of the following is the best triage action?
    • Schedule for routine nurse sick call on Monday
    • Schedule appointment with the doctor on Monday
    • Conduct face to face assessment on Friday
    • Forward request to pharmacy to fill prescription
  • On Friday the registered nurse reviews written request dated Thursday: “I need my renewal for multi-vitamins, Thank you!” Which of the following is the best triage action?
    • Schedule for routine nurse sick call on Monday
    • Schedule appointment with the doctor on Monday
    • Conduct face to face assessment on Friday
    • Forward request to pharmacy to fill prescription
  • Preparations are being made for an off-site eye surgery consultation. Which of the following nursing actions should be taken?
    • Communicate the reason for the appointment to the security transportation division
    • Post the patient name and appointment date on the medical unit transportation bulletin board
    • Instruct the patient on the date and location of the appointment
    • Prepare a sealed package of necessary medical records
  • Preparations are being made for an off-site eye surgery consultation. Which of the following nursing actions should be taken?
    • Communicate the reason for the appointment to the security transportation division
    • Post the patient name and appointment date on the medical unit transportation bulletin board
    • Instruct the patient on the date and location of the appointment
    • Prepare a sealed package of necessary medical records
  • On Tuesday the registered nurse reviews written request dated Monday: “Refill my Lactulose. Please! Urgent! Thanks!” The nurse notes in reviewing the health record that this is the patient’s sixth request for a refill of Lactulose in the last five weeks. Which of the following is the best triage action?
    • Schedule for routine nurse sick call on Thursday
    • Schedule appointment with the doctor on Thursday
    • Conduct face to face assessment on Tuesday
    • Forward request to pharmacy to fill prescription.
  • On Tuesday the registered nurse reviews written request dated Monday: “Refill my Lactulose. Please! Urgent! Thanks!” The nurse notes in reviewing the health record that this is the patient’s sixth request for a refill of Lactulose in the last five weeks. Which of the following is the best triage action?
    • Schedule for routine nurse sick call on Thursday
    • Schedule appointment with the doctor on Thursday
    • Conduct face to face assessment on Tuesday
    • Forward request to pharmacy to fill prescription.
  • For what reason would the nurse asks about the detainee’s last drink of alcohol during receiving or intake screening?
    • To determine how much sedative to give to prevent delirium tremens
    • To see if the information matches objective data about the detainee’s mental status and behavior
    • To help the police identify where the person was and what they were doing before the arrest
    • To assess the likelihood and potential severity of withdrawal
  • For what reason would the nurse asks about the detainee’s last drink of alcohol during receiving or intake screening?
    • To determine how much sedative to give to prevent delirium tremens
    • To see if the information matches objective data about the detainee’s mental status and behavior
    • To help the police identify where the person was and what they were doing before the arrest
    • To assess the likelihood and potential severity of withdrawal
  • Therapeutic Communication and Behavioral Management
  • Corrections Nursing: Scope and Standards of Practice
    • Nurses are patient advocates
    • Maintains a therapeutic and professional patient-nurse relationship with appropriate professional role boundaries
  • Therapeutic Communication Definition
      • Therapeutic Communication is the face to
      • face process of interacting that focuses on
      • advancing the physical and emotional
      • well-being of a patient
  • Therapeutic Communication
    • Use therapeutic communication techniques to
    • provide support to inmate-patient
  • Therapeutic Communication Techniques
    • Using silence
    • Acceptance
    • Giving recognition
    • Offering self
    • Using open-ended statements
    • Offering general leads
    • Placing events in time sequence
  • Situation #1
    • The nurse is performing an intake assessment
    • screening. The young man does not make eye
    • contact and looks nervous. As the nurse arranges
    • materials to implant a TST, he says, “Do you think
    • it will be OK if I keep to myself and don’t get
    • involved with anyone here? I just want to do my
    • time and get out. I’ve never been in jail before.”
  • Therapeutic Communication Techniques
    • Making observations
    • Encouraging description of perceptions
    • Encourage comparison
    • Restating
    • Reflecting
    • Focusing
    • Exploring
  • Situation #2
    • An inmate arrives at sick call asking for his blood
    • test results from last week. The results won’t be
    • available until next week. The inmate is angry and
    • belligerent, shouting that he has waiting long
    • enough and needs to know his HIV status.
  • Therapeutic Communication Techniques
    • Giving information
    • Seeking clarification
    • Presenting reality
    • Voicing doubt
    • Seeking consensual validation
    • Encouraging evaluation
    • Attempting to translate feelings
    • Suggesting collaboration
    • www.scribd.com
  • Situation #3
    • During lockdown med rounds an inmate loudly
    • argues with the nurse that the doctor ordered
    • tramadol for him and this ibuprophen doesn’t do
    • squat.
  • Interpretation of Communication
    • Must be clear, concise, and consistent in providing information
    • Be aware of gestures that may be misinterpreted
    • Must have good listening skills
  • Behavior Management
    • Incorporate behavioral management techniques
    • Establish and maintain effective working relationships with inmate/patient/family
    • Provide a therapeutic environment for inmate/patient with emotional/behavioral issues
  • Behavior Management
    • Provide medication as ordered
    • Assess and provide proper environment
    • Techniques:
      • Positive reinforcement
      • Setting limits/boundaries
      • Being honest
      • Answering questions
  • Caring vs. Custodial Roles
    • Caring: providing assessment, treatment and interventions toward a therapeutic goal
    • Custodial: performing tasks without therapeutic relationship
  • Therapeutic Communication Behavioral Management
    • Summary
    • Maintain professional role boundaries in patient communication
    • Communicate to support the patient and advance the therapeutic goals
    • Select from a variety of techniques based on the individual need and situation
    • Be firm, fair and consistent in managing behaviors
    • Maintain a caring rather than a custodial role
  • Safe and Secure Health Care Environment
  • Infection Control Measures
    • Provide information on infection control measures
      • Medical staff
      • Correctional staff
      • Inmates/patients
  • Infection Control
    • Apply principles of infection control:
      • Hand hygiene
      • Isolation
      • Aseptic/sterile techniques
      • Standard precautions
  • Infection Control
    • Follow procedures related to environmental safety and public health data collection, tracking and reporting:
      • Bio-hazard waste
      • Infectious diseases
        • Tuberculosis, HIV/AIDS, MRSA, VRE, Swine Flu, Hepatitis
      • Health and Safety Inspections
  • Security Issues
    • Maintain secure storage and inventories of items subject to abuse:
      • Syringes/needles
      • Scissors
      • Dental/medical tools
      • Dental/medical equipment
  • Security Issues
    • Follow facility security procedures
      • Assure proper orientation to the correctional facility
      • Assure staff understand what items are considered contraband
      • Report all breaches of security procedures
  • Security Issues
    • Maintain safety of self and others within the correctional environment
      • Be aware of surroundings at all times
      • Report any unsafe areas or events
  • Safety Issues
    • Apply principles of professionalism and managing boundaries in maintaining relationship with all staff and inmates/patients.
      • Confidentiality issues
      • Professionalism
      • Work ethics
  • Safety Issues
    • Implement emergency response plans:
      • Internal/external disaster
      • Fire
      • Riot/hostage situation
      • Infectious disease breakout
    • Medical participation in cell extractions/searches
  • Safe and Secure Health Care Environment Summary
    • Environmental Health
      • Information and education
      • Reporting
      • Monitoring
    • Safety
      • Sharps/Contraband
      • Security Procedures
      • Disaster and Emergency Preparedness
  • Health Promotion and Education
  • Health Promotion and Education
    • “ The corrections nurse employs strategies to
    • promote health and a safe environment.”
    • Standard 5 B. Corrections Nursing, Scope and
    • Standards of Practice American Nurses
    • Association, 2007
  • Health Promotion and Education
    • “ Provides health teaching to patients, family,
    • colleagues and security personnel that addresses
    • such topics as healthy lifestyles, risk reducing
    • behaviors, developmental needs, activities of
    • daily living, and preventive self care.”
  • Health Promotion and Education
    • “ Uses health promotion and health teaching
    • methods appropriate to the situation and the
    • patient’s developmental level, learning needs,
    • readiness, ability to learn, language preference,
    • and culture.”
  • Individuals/Families
    • Risk Assessment
    • Education
    • Counseling
    • Issues or Challenges
  • Risk Assessment
    • Information on Family History and Health Behaviors
    • Alcohol and Other Drug Use
    • Screening
    • Plan for Routine Interval Care
    • The Patient’s Role in Well Person Care
  • Education
    • Principles
    • Topics
    • Evaluating effectiveness
  • Counseling
    • Principles and essentials
    • Issues or challenges
  • Facility or Community
    • Health and Safety Inspection
    • Education and Health Promotion
  • Health and Safety Inspection
    • Why
    • Who does it
    • Analysis of data to determine action
    • How it relates to health promotion and education
        • Living conditions
        • Diet
        • Exercise
        • Access
  • Education and Health Promotion
    • How it differs from 1:1
    • Topics
  • Health Promotion and Education Summary
    • ANA Standard for Corrections Nurses
    • Individuals and families
    • Populations and Communities
    • Assessment and Routine Interval Care
    • Information/Education/Counseling
    • Environmental Health
    • Evaluation of Effectiveness
  • Professional Role and Responsibilities Ethical and Legal
  • Professional Duty to the Patient
    • To act in a manner consistent with the
    • actions of any ordinary, reasonable and
    • prudent nurse
  • Breach of Duty (Negligence)
    • Doing
      • Something a reasonably prudent nurse
      • would not do
    • Not Doing
      • Something a reasonably prudent nurse
      • would do
  • Professional Duty to the Patient
    • The duty you have based on
    • Your licensure status
      • Scope of practice
      • Professional standards
    • Your employment status
      • On duty
      • Job Description
    • Your relationship with the patient
      • Professional providing healthcare
  • Situation #1
    • Inmate Smith has been to the medical unit 3 times in the last week with back pain requesting stronger pain medication. Now he is complaining of chest pain. The officer on his pod thinks Smith is attention-seeking.
  • Legal Implications of Practice
    • Practice framework
    • State Practice Act(s)
    • Licensure and Delegation
    • Facility Policies and Procedures
  • Code of Ethics
    • American Nurses Association
      • Respect for human dignity
      • Primacy of the patient’s interests
      • Privacy and Confidentiality
      • Nurse accountability and responsibility
  • Code of Ethics
    • American Correctional Health Services Association
      • Provide healthcare regardless of custody status
      • Honor but not participate in custody functions
  • Inmate-Patient Rights
    • Refusal of treatment
    • Confidentiality/privacy
    • Informed consent
    • Response to healthcare concerns
    • Addressing barriers to access to care
    • Investigating patient grievances
  • Inmate-Patient Advocacy
    • Access to care
    • Patient autonomy, dignity, rights
    • Promotes self-advocacy skills
  • Situation #2
    • The inmate is on his bed in the cell facing the wall
    • with a blanket covering his head. The officer calls
    • out that morning medication round has started.
    • The inmate does not move or respond. The officer
    • tells the nurse the inmate is refusing his
    • medication this morning and moves on to the next
    • cell.
  • Professional Role and Responsibilities Ethical and Legal
    • Summary
    • Nurses have a professional duty to a person with whom they have a therapeutic relationship
    • Ethical and legal duty to a patient is considered with all requests and actions
    • Nurses are patient advocates
  • Professional Role and Responsibilities Standards and Regulatory Guidelines
  • Implications for Correctional Nurses
    • Nursing
    • Policy Development
    • Legislation and Regulations
    • Implications for Practice
    • Patient Safety and Practice
  • Regulatory Guidelines
    • Federal
    • State
    • Legal
    • Mental Health
    • Application of Standards (NCCHC)
    • Neglect, Abuse, and Rape
  • State and National Compliance Standards
    • Examples
    • Implications
  • American Nurses Association Correctional Nursing Standards
    • Purpose
    • Where they can be found
    • Implications
  • Nursing Standards
    • Purpose and Implications
    • Role of Nurse and Manager
    • Social Policy Statement
    • Safety of Patients
    • Code of Ethics
  • National Commission on Correctional Health Care Standards
    • Purpose
    • How Standards are Applied
    • Practice Implications
    • Standard of Care
  • American Correctional Association Standards
    • Purpose
    • Implications for Practice
  • Policies and Procedures
    • Purpose
    • Implications
    • Responsibility
  • Community Standards
    • How relates to Correctional Health
    • Implications for Nursing Practice
  • Risk Management
    • Documentation
    • Standards of Practice
    • Channeling Information
  • Reporting Process
    • Institutional
    • State Process
    • ANA Guidelines for Reporting
  • Nursing Practice
    • Clinical Competency
    • Clinical Orders/ Standing Orders/ Protocols
    • Nursing Acts and Law
    • Nursing Process
    • Research and Evidence
    • Critical Thinking / Emotional Intelligence
  • Professional Role and Responsibilities Standards and Regulatory Guidelines
    • Summary
    • Regulatory standards (state/federal)
    • Professional standards (ANA, NCCHC, ACA)
    • Policy and procedure (agency, organization)
    • Community standard (legal precedence, other)
  • Professional Role & Responsibilities Management and Leadership
  • Collaboration
    • Fostering collaborative relationship with correctional staff
    • Sharing medical information with custody
    • Consulting with other care providers
    • Conflict resolution principles
  • Collaborative Relationship with Correctional Staff
    • Establishing the common purpose
    • Involve in quality improvement efforts
    • Regular scheduled communication points
  • Collaboration vs. Involvement
    • Working together for a common goal
    • Mutual involvement in decision-making
    • Building consensus
    • Sharing information about what is happening
    • Involvement in or assignment of activities
    • One-way communication
  • Sharing Medical Information with Custody
    • Information must be important for security purposes
    • Provide only minimum information necessary
  • Consulting with Other Care Providers
    • Actively involving all disciplines necessary to provide optimum care
    • Team approach to patient care
    • Behavioral Health, Medical, Nursing, Dental, Pharmacy, etc
  • Conflict Resolution Principles
    • Think before reacting
    • Listen actively
    • Assure a fair process
    • Attack the problem
    • Use direct communication
    • Look for interests
    • Focus on the future
    • Options for mutual gain
      • - Dept of Navy
  • Professional Development
    • Peer Review – Competency Evaluation
    • Quality improvement processes
      • Process Studies
      • Outcome Studies
    • Accountability for continuing professional development
      • Maintaining licensure
      • Remaining current with practice changes
      • Proactively improve nursing skills
  • Professional Development Education
    • Health care staff
      • Orientation
      • Annual mandated inservices
      • Continuing Education
    • Custody Staff
      • Emergency health situations
      • Infection Control
      • Common healthcare issues
  • Supervising
    • Health care staff
    • Volunteers
    • Others
  • Professional Role and Responsibilities Management and Leadership
    • Summary
    • Collaboration is a major leadership principle
    • Use conflict resolution skills with custody officers and inmates
    • Nurses are responsible for continuous professional development
    • Nurses educate patients, other staff members and custody officers
  • Professional Role & Responsibilities Research
  • Participation in Research
    • Identifying research opportunities
      • Process Improvement
      • Patient Care Dilemmas
    • Creating research activities
      • CQI activities
      • Methodology
        • Random sample
        • Sample size
        • Statistical analysis
  • Research Process
    • Participating in research activities of others
    • Human subject protection
      • Informed consent
      • Confidentiality
      • Institutional Review Board (IRB)
  • Research Utilization Evidence Based Practice
    • Incorporation of relevant research findings into practice
    • Basing practice on best evidence available
    • Pressure Ulcer Example in Handout
  • Key Steps to Research Utilization
    • Identify a specific patient problem or situation that is in need of a better approach
    • Systematically search for research evidence that could be used to address the issue
    • Appraise the validity of the research evidence, and its relevance and applicability to your population and setting
  • Key Steps to Research Utilization
    • Integrate the research evidence with site information that might influence management of the issue
    • Thoughtfully implement the evidence-based practice decision
    • Evaluate the outcome of the decision
  • Professional Role and Responsibilities Research Summary
    • Nurses use research principles in quality improvement and process improvement activities
    • Human subject consent is necessary for research involving patients
    • Evidence-based practice is research utilization
  • Practice Questions #2
  • An inmate states "I'm not taking that medicine anymore" What is the best response from the nurse?
    • a."OK, whatever you want to do is fine"
    • "I'll mark that you refused it”
    • "Why don't you want to take the medicine?"
    • "I'll just have the doctor cancel it“
  • An inmate states "I'm not taking that medicine anymore" What is the best response from the nurse?
    • a."OK, whatever you want to do is fine"
    • "I'll mark that you refused it”
    • "Why don't you want to take the medicine?"
    • "I'll just have the doctor cancel it“
  • In which situation does the nurse have a duty to act?
    • A patient is brought to the infirmary with apparent heat stroke.
    • A patient develops chest pain but does not tell anyone.
    • Another nurse is incorrectly administering eye drops across the yard in the segregation treatment room.
    • The inmate barber used the same blade among 10 different inmates.
  • In which situation does the nurse have a duty to act?
    • A patient is brought to the infirmary with apparent heat stroke.
    • A patient develops chest pain but does not tell anyone.
    • Another nurse is incorrectly administering eye drops across the yard in the segregation treatment room.
    • The inmate barber used the same blade among 10 different inmates.
  • An inmate approaches the nurse and says “Can I talk to you?". What is the best response by the nurse?
    • "Not right now, can't you see I am busy?“
    • "If you have a problem tell the manager“
    • "Is it important enough to stop the med line to talk now?“
    • "Let's find a private area where we can talk"
  • An inmate approaches the nurse and says “Can I talk to you?". What is the best response by the nurse?
    • "Not right now, can't you see I am busy?“
    • "If you have a problem tell the manager“
    • "Is it important enough to stop the med line to talk now?“
    • "Let's find a private area where we can talk"
  • An inmate has just been diagnosed with active tuberculosis. Which action should the nurse take as a safety measure?
    • Tell everyone that the inmate has tuberculosis
    • Isolate the inmate in a negative pressure room
    • Keep the inmate in population since antibiotics have been started
    • Advise only the medical staff of this inmate’s condition
  • An inmate has just been diagnosed with active tuberculosis. Which action should the nurse take as a safety measure?
    • Tell everyone that the inmate has tuberculosis
    • Isolate the inmate in a negative pressure room
    • Keep the inmate in population since antibiotics have been started
    • Advise only the medical staff of this inmate’s condition
  • You see a nurse in the medical clinic who has a pair of scissors hanging from their uniform in plain sight. Your best response would be:
    • Do nothing; they might need the scissors to provide treatments to inmates
    • Take the nurse aside and advise them that scissors may be a weapon and should not be visible
    • Go directly to the Warden and advise them of what you observed
    • Write an incident report on the nurse because you feel they are creating an unsafe environment
  • You see a nurse in the medical clinic who has a pair of scissors hanging from their uniform in plain sight. Your best response would be:
    • Do nothing; they might need the scissors to provide treatments to inmates
    • Take the nurse aside and advise them that scissors may be a weapon and should not be visible
    • Go directly to the Warden and advise them of what you observed
    • Write an incident report on the nurse because you feel they are creating an unsafe environment
  • The most important aspect to responding to a "man-down" call is to:
    • Be aware of your medical responsibilities
    • Run as fast as you can to the location
    • Initiate the facility disaster plan
    • Advise correctional staff to call "911" immediately
  • The most important aspect to responding to a "man-down" call is to:
    • Be aware of your medical responsibilities
    • Run as fast as you can to the location
    • Initiate the facility disaster plan
    • Advise correctional staff to call "911" immediately
  • An officer comes to the nurse and asks if Inmate Smith has HIV. What is the best response by the nurse?
    • "I don't know. Ask the inmate yourself“
    • “ Using standard precautions will prevent transmission of the HIV virus.”
    • "I know but I won't tell you”
    • "Why do you want to know so bad?"
  • An officer comes to the nurse and asks if Inmate Smith has HIV. What is the best response by the nurse?
    • "I don't know. Ask the inmate yourself“
    • “ Using standard precautions will prevent transmission of the HIV virus.”
    • "I know but I won't tell you”
    • "Why do you want to know so bad?"
  • Which of the following is the best resource to guide professional nursing practice?
    • Institutional Policies and Procedures
    • Nurse Practice Act
    • Current Job Description
    • Physician-Approved Nursing Protocols
  • Which of the following is the best resource to guide professional nursing practice?
    • Institutional Policies and Procedures
    • Nurse Practice Act
    • Current Job Description
    • Physician-Approved Nursing Protocols
  • Which of the following actions indicates a correct understanding of research principles?
    • Select three intake charts from every Monday in a 30 day period.
    • Audit 100% of MARs from the first day of the month
    • Select every third chart from the infirmary log until reaching 30.
    • Audit 100% of charting from the evening shift
  • Which of the following actions indicates a correct understanding of research principles?
    • Select three intake charts from every Monday in a 30 day period.
    • Audit 100% of MARs from the first day of the month
    • Select every third chart from the infirmary log until reaching 30.
    • Audit 100% of charting from the evening shift
  • Test Taking Personality
  • Exam Performance
    • Knowledge Base 60%-70%
    • Test Taking Skills 25% - 30%
    • Personal Issues 10% - 15%
  • Personal Issues
    • Adopt an ‘I can’ attitude
    • Take control
    • Think positively
    • Persevere
    • Know your test-taking personality and prepare accordingly
  • Personal Issues Test Taking Personalities
    • The Rusher
    • The Turtle
    • The Personalizer
    • The Squisher
    • The Philosopher
    • The Second Guesser
    • The Lawyer
  • Keep it all in perspective
    • What the exam really means
    • The meaning of success and failure
    • Déjà vu all over again
    • Knowledge, Skills, Confidence
  • CCHP-RN Certification Review Course www.slideshare.net/CCHPRN [email_address]