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ATI 4th Quarter Review Latest
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ATI 4th Quarter ReviewVIDEO 1 -
*Board of Nursing- Gives and revokes nursing licenses.
*U need a nursing license for every state you will work in.
*JCHAO- Develops accreditation standard for healthcare facilities, they go to hospitals every 2
years of so, they check documenting,talk to people etc.
Medicare elegibility-
65 and older, have been receiving disability for 2 years, have ALS, have renal di sease and be on dialysis.
Part A- Inpatient hospital, limited skilled nursing facility care and home health care.
Part B- Outpatient care,Diagnostic services, outpatient care, outpatient occupational therapy and
outpatient physical therapy.
Part C- Combines part A and part B and is provided by private insurance, not required, it's something
optional pt's can purchase.
Part D - Drug coverage.
Medicaid elegibility- Based on household size and
income. VIDEO 2-
Inter professional team:
*Registered Dietitian- Helps Pt with nutritional needs.
*Lab technician - Helps with lab draws.
*Pharmacist- Review medication, put them on med record for administration.
*Physical therapist - Helps pt with mobility
*Occupational therapist- Helps patient regain their ability to perform activities of daily living (ADL's)
such as putting on socks, brushing teeth, etc. Sometimes OT and PT work together.
*Providers- Can be a Dr., Nurse practitioners, Physician assistants.
* Social workers - Identifies and coordinates community resources medical equipment
needed and other resources in order to be discharged from acute care.( Case managers do
this as well)
* Speech language pathologist - Help patients with speech, but super important to remember they
are the ones that do SWALLOWING ASSESMENTS!!
The 6 Nursing ethical principles
1. Autonomy- Pt has right to make his own decision even if not on their best inte rest (such as a
Jehovah's witness refusing a blood transfusion)
2. Beneficence - Doing whats best for the patient, like giving meds, helping that patient, doing good.
3. Fidelity- Keeping your promises ( if u tell a Pt you're gonna do something, you DO IT!)
*Justice- Providing fairness in care and allocation of resources, not disproportioning resources or
time against one segment of the population.
* Non Maleficence- Do no harm. ( If Dr. writes wrong/ too high dose/lethal prescription you would
question it and call Dr. before administering it)
6. Veracity - Telling the truth ( If pt. ask something about diagnosis or medical condition, then be honest and tell
the
truth)
Video
3-
Tortes
*Unintentional tortes
,Negligence- Pt is high risk for falls, u forgot to put bed alarm and they fell so that would be
negligence. Mal practice- Medication error, u gave wrong med or dose, and it negatively
impacted the patient.
*Intentional tortes-
Assault- to threaten the pt. (u tell the patient your gonna hit them if they don't take the meds)
, Battery- u follow the threat ( u actually hit them)
A way to remember these is A (for assault) comes before B (battery) so u threaten pt first and then
follow thru with the actual physical harm.
Restrains- Physical like wrist restraints or chemical like a
sedative. Informed consent-
Dr./ Surgeon responsibilities-
Communicates procedure to pt, gives description of procedure in pt native language, if needed
they will bring in translator. Will explain risk vs, benefits and will also explain other treatments
available.
Nurses responsibilities - We make sure Dr. gave all info they need to ^, we need to make sure patient
is competent (not high or drunk or mentally impaired in any way) to give informed consent. Make sure
pt signs. Tell Dr. if pt doesn't understand something so that Dr. can go back. (If youre having pt sign
consent and they start asking questions about the procedure then stop and ask Dr. to come back and
explain to opt info they are asking about).
Who can give informed consent?
*Competent adults can give constent about themselves.
*A minor's parents can give consent about their child.
* A DPOA (durable power of attorney) can provide informed constent for the pt if pt is incapacitated.
* Emancipated minors can consent for themselves.
Refusal of treatment-
A pt has the right to autonomy, they can refuse treatment if competent, provide document to sign that
states pt is refusing despite the risks of not getting treatment, if pt wants to leave hospital AMA
(against medical advice) notify Dr. right away, talk with pt and explain risks of leaving AMA, and have
them sign AMA form before they go.
Video 4-
Advanced directives-
*Living will- Legal documents that communicates their wishes if they were to become incapacitated.
*DPOA (durable power of attorney) someone who makes decision for pt if they become incapacitated.
* Dr's orders a prescription for DNR (do not resuscitate)or AND (allow natural death) pt tells Dr. what
they wish and Dr writes order up.
Id you suspect abuse (elder or child abuse) YOU
REPORT IT!! Also reports communicable disease.
If you notice a coworker that is impaired (looks high or drunk) report it (don't go investigate or gather more info,
just
report it to MANAGER).
Nursing documentation-
Objective- things u see, hear, feel or smell (don't include opinions or
interpretation) Subjective - Things u can't see but patient states,
document with quotation marks. Never leave blanks spaces.
Always include name and
title. Never use white out.
* If a med error or fall occurs you will need to do an incident report, but do NOT refer to incident
report on pt chart, so do NOT chart about it, it is NOT part of patients medical report.
Telephone orders-
Have second RN listening
tocall. Read back prscription.
Make sure Dr. signs prescription within 24 hrs.
HIPPA-
Only those responsible to pt's care can access their medical records, so only look at YOUR
patients records. Don't share passwords.
Don't pt info with unathorized people.
Ask pt if they want visitors to leave before speaking about medical condition in front of them.
U can use a "code system" patient gives u a "code" and if someone calls asking for info you may
provide info if they give u the correct "code" kinda like a password!
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