Ambulatory Care Nursing Certification Review Course AGENDA

Transcription

1 Ambulay Cae Nusi Cetification Review Couse AGENDA 8:00 am 8:15 am Exam Citeia and Cetification 8:15 am 8:35 am Ambulay Cae Nusi Oveview 8:35 am 9:15 am Plan of Cae & Cae Management 9:15 am 9:30 am Nusi Advocacy 9:30 am 9:40 am BREAK 9:40 am 11:30 am Clinical Pactice: Well Clients Peventive Cae Acutely Ill Clients Clients with Chonic Conditions Clients with Teminal Illness Clinical Skills 11:30 am 12:00 pm Telehealth & Telephone Tiage 12:00 pm 12:45 pm LUNCH 12:45 pm 1:25 pm Communication: Intepesonal Skills & Cusme Sevice Skills 1:25 pm 2:00 pm Regulations, Standads, Acceditation & Scope of Pactice 2:00 pm 2:15 pm Clinical Pactice: Medication Management Systems 2:15 pm 2:30 pm Systems Quality Management 2:30 pm 2:45 pm Systems Opeations 2:45 pm 2:55 pm BREAK Ameican Academy 2:55 pm 3:10 pm Documentation and Infomatics 3:10 pm 3:35 pm Education & Health Pomotion bulay Nusi 3:35 pm 3:55 pm Pofessional Issues: Legal & Ethical Issues 3:55 pm 4:35 pm Pofessional Issues: Pofessional Development & Leadeship 4:35 pm 4:50 pm Questions & Answes 4:50 pm 5:00 pm Wap-Up/Evaluation 2

2 CE Infomation and Disclosue Requiements fo Successful Completion Attend 90% of the couse offei in which contact hous ae eaned, complete the evaluation, and submit. Conflict of Inteest Disclosue No planne o speake discloses an actual o potential conflict of inteest in elation the pesentation. Sponsoship o Commecial Suppot Disclosue This pogam has not eceived commecial suppot o sponsoship. Leani Outcome Afte completi the Ambulay Cae Nusi Cetification Review Couse, the leane will be able use the pesentation einfoce knowledge of ambulae nusi, self-assess the content aeas whee they need futhe eview, and use the content pesented as pepaation fo taki the cetification exam. Acceditation This education activity offei fo 7.9 contact hous is jointly povided by Anthony J. Jannetti, Inc. (AJJ) and the Ameican Academy bulay Cae Nusi (AAACN). Anthony J. Jannetti, Inc. is accedited as a povide of continui education in nusi by the Ameican Nuses Cedentiali Cente s Commission on Acceditation. AAACN is a povide appoved by the Califonia Boad of Registeed Nusi, Povide Numbe CEP Ameican Academy bulay Nusi 3

3 13 Definition of Ambulay Cae Nusi 14 Chaacteistics bulay Nusi Pofessional ambulae nusi is a complex, multifaceted specialty that encompasses independent and collaboative pactice. Nuse aunomy, citical thinki, nusi pocess Patient advocacy, Ethics, holistic nusi cae (3d edition, AAACN Coe Cuiculum) INCLUDES: Patient and family decision maki and cae povides Clinical, Leadeship, Education and Reseach Activities Applies clinical expetise ooted in nusi pocess Includes clinical, oganizational, and pofessional activities fo individuals, goups, o populations who seek assistance with impovi health and/o seek cae fo health elated poblems Nuses ae accountable fo cae povided (Standads of Cae, Regulay Standads and Nuse Pactice Acts) 15 Skillful, apid nusi assessment, patient education, patient eagement Lo tem elationships that pomote patient/ family tust Ambulay Cae Nusi Defined in tems of: 16 Encountes ae episodic Less than 24 hous in duation Occu sily o in a seies Wellness o Functional Goals Patient expectations Settis and encountes Sites include: hospital based, schools, etail based, assisted livi, wokplace Encountes may occu: Face--face Telehealth (MyChat, patient potals) Othe communication devices smat phones, face-time, vitual clinics, biosensos, apps, etc. Cost aligns with effective ways maximize wellness, pevent illness, and minimize sympms of acute mino aliments Suppot patients and families in the management of chonic disease thoughout the lifespan 17 Definition bulay Cae Nusi Challees fo Ambulay Nusi 18 Evolve Fom: Definition of Ambulay Cae Nusi Conceptual famewok is a Inceasi volumes and patient acuity Communication, collaboation, delegation Cae coodination, cae management, continuity of cae Use of evidence based pocols (algoithms, pocols, etc.) Technology evolution face face encountes vs. telehealth, patient potals, video vitual clinics, biosensos, mobile apps) Team membe dynamics ovelappi oles guide/map that specifies: 7 Essential concepts and skills in an aea of pactice Relationships between majo content and skill aeas

4 25 Alcohol Misuse Sceeni Obesity Sceeni 26 Offe counseli and behavioal inteventions pomote sustained weight loss fo obese adults Risky o hazadous dinki Women: moe than 7 dinks pe week (1 pe day) o moe than 3 dinks pe occasion Cental adiposity inceases isk fo cadiovascula and othe diseases independent of obesity Men: moe than 14 dinks pe week (2 pe day) o moe than 4 dinks pe occasion Sceen all adults and childen fo obesity Waist cicumfeence can be a measue of cental adiposity Hamful dinki Body Measuement: Body Mass Index (NHLBI, 2017) Expeienci physical, social, o psychological ham fom alcohol use but do not meet citeia fo dependence Wt in kg/ht in metes Reliable and valid fo identifyi adults at inceased isk fo motality and mobidity 2 Nomal BMI Oveweight BMI Obese BMI Exteme obesity Sceeni ols: National Institute on Alcohol Abuse & Alcoholism = = = = >40 Recommended Immunization Schedule 27 Recommended Immunization Schedule Tetanus, diphtheia, (Td) - one evey 10 yeas Afte age 19 it is ecommended exchae a Tdap in place of one Td boost the petussis Example: Patient age 30 = Td 1980, Td 1990, Td 2000, Tdap 2010, Td Meniococcal Vaccine 1 o moe doses povide ecommendation All pe-teens and teens Fist-yea college students livi in domiies Othes at isk Human papillomavius (HPV) 3 doses though age 26 Stat ages Pneumococcal polysacchaide 2 doses between the age of Afte the age of 65-1 dose Influenza Annual all ages >6 months (2016) Zoste 1 dose > 60 y. Measles, mumps, ubella (MMR) 2 doses pio school enty Adults bon dui o afte 1957, give >1 dose Childhood Immunizations 29 National Childhood Vaccine Injuy Act of 1986 Requies a Vaccine Infomation Sheet VIS be povided fo immunization administation eveyone pio eceivi the vaccine Includes the ight efuse Requies epoti of advese event of vaccines and xoids U.S. Dept. of Health and Human Sevice childhood immunization potein subunits, o killed oganisms schedules in poduce a weake but still effective syllabus antibody esponse Influenza Tetanus polio Vaccine fo Childen Pogam 30 Live, attenuated vaccines A live weakened cultivated vesion of the oganism closely elated but less daeous than the oganism itself. alets the immune system poduce a stoe antibody esponse Hepes Zoste Vaicella Study hint: MMR See ealy and late Inactivated vaccines Ae poduced and contain xoids, Hepatitis B Can be given 1month adult yeas 3 doses cdc.gov Vaicella If no immunity by 12 months 2 doses Hepatitis A Can be given at 12 months adult 2 doses Vaccines acquied though public puchasi must epot local, county and/o state health depatments ccines/ecs/default.htm 22

5 Assessment Tips 98 Rely upon audiy, vebal and emotional cues communicated though speech Talk Identification of appopiate level of cae Teat Timely esponse phone messages is essential patient safety Avoid Calle s peception of the nuse s cai and confident attitude often is basis of tust and open disclosue about concens, condition and compliance the patient wheneve possible each calle like the fist call of the day bei judgmental Claify what the calle is sayi/aski Use open-ended questions when appopiate Clinical Decision Suppot Tools 100 inteactive pocess between nuse and patient that involves identification of the natue and ugency of the patient s health cae needs and detemination of the appopiate disposition GUIDELINE An based on patten ecognition, encouagi the RN use citical-thinki skills, context, and patten matchi detemine a disposition Recommended pactice diect the nuse in developi an individualized plan of cae. Flexible, allows some discetion, use of nusi judgment and expeience while etaini a standad of cae, implementation, o use. 101 Disadvantage lack of consistency. Clinical Pactice Guidelines 102 statements that include ecommendations, intended optimize patient cae, that ae infomed by a systematic eview of evidence and an assessment of the benefits and hams of altenative cae options" (IOM) ecommendations fo clinicians about the cae of patients with specific conditions based upon the best available eseach evidence and pactice expeience. Set of ules fo solvi a poblem in a finite numbe of steps Flow chat of clinical questions, usually answeed by the patient with a yes o no, guidi decisions in a step-by-step, logical sequence in ode each a final disposition. PROTOCOL What is Telephone Tiage? ALGORITHM 99 Telehealth Assessment 97 Cadiology Nusi Citical Cae Obstetics and Gynecology Emegency Medicine Oncology Family Pactice Othopedic Sugey Geiatics Pediatics Infectious Diseases Physical Medicine and Rehabilitation Psychiaty Sugey Available on mobile o tablet devices 34 Actions ae scipted, be followed without deviation Guidelines ae oganized by clinical specialty aeas Intenal Medicine AHRQs National Guideline Cleaihouse is a public esouce fo summaies of evidence-based clinical pactice guidelines. Plan fo cayi out a patient s teatment egimen