...Holistic Care of the Patient and Family...
...Objectives: 1. Discuss the impact of illness...
...of illness on the high-acuity patient and...
...illness on the high-acuity patient and family....
...2. Identify way the nurse can help...
...nurse can help high-acuity patients cope with...
...event. 3. Describe the principles of patient...
...family-centered care in the high-acuity environment as...
...care in the high-acuity environment as it...
...policies. 4. Discuss the importance of awareness...
...when caring for high-acuity patients. 5. Examine...
...patients. 5. Examine the role of palliative...
...palliative care in the high-acuity environment and...
...care in the high-acuity environment and discuss...
...in caring for high-acuity patients. 6. Identify...
...their impact on high-acuity patients and strategies...
...Illnesses can cause the patients to experience...
...might respond to the losses by passing...
...Nursing considerations 1. The family is an...
...important part of the patient’s health outcome....
...must participate in the care and recovery...
...2a. Needs of the Family of the...
...the Family of the Patient with High-Acuity...
...the Patient with High-Acuity Illness Information Comfort...
...Communication Requirements of the Family Openness Honesty...
...stress. Humor strengthens the bonds among the...
...the bonds among the patient, family, and...
...family, and nurse. The use of humor...
...facilitate sleep. (2) The vascular, muscular, and...
...encourages relaxation. (2) The patient is asked...
...use successfully in high-acuity situations 4a. Massage...
...soft tissues of the body using the...
...the body using the hands Can reduce...
...used to distract the patient from painful...
...a relationship with the patient facilitates trust...
...facilitates trust in the nurse and will...
...inhibit learning in the high-acuity patient. Obstacles...
...learning in the high-acuity patient. Obstacles to...
...communication and pain. The nurse must meet...
...nurse must meet the physiological needs of...
...physiological needs of the patient before attempting...
...(3) Acknowledgement of the past (4) Optimal...
...a) Transfer of the patient to a...
...transfer anxiety in the patient or family....
...or family. b) The anxiety is the...
...The anxiety is the result of a...
...of care allowing the patient and family...
...promote success of the transfer. d) Moving...
...transfer. d) Moving the patient during daytime...
...care units in the United States have...
...are unrestricted. 2. The visiting activities of...
...care units: a) The rationales for these...
...are concerns for the risk of infection...
...infection and for the emotional well-being of...
...emotional well-being of the child. b) In...
...child. b) In the event a family...
...identified benefits of the presence of the...
...the presence of the family during CPR....
...during CPR. 4. The care delivery model...
...delivery model embraces the presence of the...
...the presence of the family members at...
...family members at the bedside: a) Nursing...
...provide education to the family members regarding...
...should carefully address the facility’s stance toward...
...Slides 1. Educating the High-Acuity Patient Goals...
...1. Educating the High-Acuity Patient Goals Reduce...
...a relationship with the patient 2. Barriers...
...to Learning for the High-Acuity Patient Condition-related...
...Learning for the High-Acuity Patient Condition-related fatigue...
...making Acknowledgement of the past Optimal learning...
...on: Concerns for the risk of infection...
...emotional well-being of the child Should be...
...Presence during CPR The ability of the...
...The ability of the family to grasp...
...family to grasp the seriousness of the...
...the seriousness of the patient’s illness. Family...
...was done for the patient. Families move...
...more positively through the grieving process. Removal...
...is happening to the patient. Families experience...
...one. Facilitation of the grieving process by...
...letting them influence the care of patients...
...and acceptance for the patient’s culture. c)...
...includes sensitivity to the culture, race, gender,...
...economic status of the patients. 2. Other...
...competence 1. In the quest for developing...
...developing cultural competence, the nurse must give...
...will prevent stereotyping. The nurse must assess...
...must be in the language and at...
...language and at the level needed by...
...level needed by the patient. Judgment cannot...
...be made concerning the patient’s choices. The...
...the patient’s choices. The CRASH (culture, respect,...
...Economic status 2. The CRASH Model Consider...
...suffering and improving the quality of life....
...and symptoms. c) The program includes members...
...care models allow the needs of patients...
...of care. 2. High-Acuity Patients and Palliative...
...a) Cancer is the most common disorder...
...care exist for the high-acuity-care patient. b)...
...exist for the high-acuity-care patient. b) It...
...difficult to make the transition from a...
...palliative nature. c) The limited collaboration and...
...needed to facilitate the patient’s progression to...
...care path. b) The team will consist...
...will consist of the high-acuity nurse and...
...consist of the high-acuity nurse and personnel...
...End-of-Life Care in High-Acuity Settings: a) The...
...High-Acuity Settings: a) The Patient Self-Determination Act...
...advanced directives. b) The American Association of...
...and appreciation of the collaborative role of...
...team members. c) The Patient Self-Determination Act...
...term implies that the patient is dying...
...done to keep the patient comfortable and...
...comfortable and allow the dying process to...
...occur naturally. (2) The goal of AND...
...individuals already in the workforce as well...
...Fragmented care 5. The Palliative Care Team...
...spiritual needs Includes the high-acuity nurse and...
...needs Includes the high-acuity nurse and other...
...Conferences are instrumental The care plan must...
...be comprehensive 6. The Patient Self-Determination Act...
...Act Part of the Omnibus Budget Reconciliation...
...given information about the right to formulate...
...Environmental characteristics of the high-acuity care unit...
...characteristics of the high-acuity care unit have...
...significant impact on the patient. b) The...
...the patient. b) The patient is at...
...and deprivation. c) The individual’s normal stimuli...
...are interrupted, and the senses simultaneously are...
...unresponsive are at the greatest risk for...
...alterations (SPAs). e) The nurse must recognize...
...nurse must recognize the stressors presented by...
...stressors presented by the environment and promote...
...unnecessary noises: (1) The Environmental Protection Agency...
...disorganized thinking. b) The nurse must assess...
...assess and identify the cause of the...
...the cause of the delirium. c) Causes...
...vary. Once determined, the underlying causes must...
...are compromised in the high-acuity unit. b)...
...compromised in the high-acuity unit. b) The...
...high-acuity unit. b) The changes in the...
...The changes in the light/dark cycle, pain,...
...are caused by the inability to speak....
...When caring for the patient who cannot...
...who cannot speak, the nurse must act...
...patient advocate. (1) The nurse will need...
...provide support for the decision of the...
...the decision of the patient or designated...
...with those of the health care provider...
...Environmental Stressors in High-Acuity Care Units Sensory...
...by Environmental Stressors The aged population Very...
...2. Role of the Nurse Caring for...
...Nurse Caring for the High-Acuity Patient Assess...
...Caring for the High-Acuity Patient Assess the...
...High-Acuity Patient Assess the patient’s normal environmental...
...Environmental Stimuli and the Unconscious Patient An...
...An assessment of the normal stimuli for...
...normal stimuli for the unconscious patient must...
...must be completed. The nurse might need...
...normal stimuli for the patient. 5a. Delirium...
...5d. Role of the Nurse Caring for...
...Nurse Caring for the Patient Experiencing Delirium...
...6a. Alterations of the Rest and Sleep...
...with changes in the light/dark cycle Causes:...
...6b. Alterations of the Rest and Sleep...
...to prevent SPA. The inability to verbally...
...behaviors needed. 8. The Patient Who Cannot...
...Nurse must represent the patient or patient...
...in-class review. Divide the class into small...
...care plans addressing the education needs of...
...education needs of the acutely ill patient....
...short time for the exercise. Once complete,...
...Once complete, ask the student groups to...
...their work with the entire class. Having...
...entire class. Having the correct learning environment...
...for educating for the acutely ill patient...
...their concepts of the optimal learning environment....
...Clinical Activities Discuss the implications of ensuring...
...considered to be high acuity. During the...
...high acuity. During the clinical post conference,...
...post conference, ask the students to determine...
...which Suchman stage the patient they cared...
...to visit with the clinical group. Ask...
...clinical group. Ask the massage therapist to...
...therapist to discuss the use of massage...
...Resource Manual for High-Acuity Nursing, 6th Edition...

... High-Acuity Nursing Objectives: 1....
...Objectives: 1. Discuss the various health care...
...environments in which high-acuity patients receive care....
...care. 2. Identify the need for resource...
...staffing strategies for high-acuity patients. 3. Examine...
...patients. 3. Examine the use of technology...
...of technology in high-acuity environments. 4. Identify...
...environments. 4. Identify the components of a...
...environment. 5. Discuss the importance of patient...
...patient safety in the high-acuity environment. I....
...safety in the high-acuity environment. I. High-Acuity...
...high-acuity environment. I. High-Acuity Environment A. Historical...
...were developed in the 1960s. Medical advances...
...advances resulted in the initiation of these...
...these units. a) The implementation of CPR...
...and shock c) The implementation of emergency...
...Technological advances e) The advancement of renal...
...services B. Determining the level of care...
...triage approach for high-acuity patients aids in...
...aids in giving the most efficient and...
...Ability to manage the potentially serious health...
...care needs of the patient whose condition...
...too complex for the traditional medical-surgical floor...
...triage and determine the level of care...
...acutely ill patients. The model divides patient...
...a) Priority 1: The patient is acutely...
...available outside of the intensive care unit....
...b) Priority 2: The patient is seriously...
...ill and has the potential to require...
...c) Priority 3: The patient is critically...
...limits placed on the amount of life-saving...
...Their inclusion into the ICU will depend...
...decision based on the appropriate use of...
...care units 1. The American College of...
...resources available to the hospital: a) Level...
...D. Profile of the high-acuity nurse 1....
...Profile of the high-acuity nurse 1. Able...
...5. Role of the nurse in the...
...the nurse in the management of the...
...the management of the high-acuity environment: a)...
...management of the high-acuity environment: a) Review...
...environment: a) Review the patient’s clinical condition...
...too complex for the traditional medical surgical...
...terminally ill 4. The Registered Nurse in...
...Registered Nurse in High-Acuity Settings Continual assessment...
...Continual assessment of the patient’s status Implementation...
...status Implementation of the plan of care...
...Factors linked to the nursing shortage include:...
...in nurses leaving the workforce (2) Aging...
...(2) Aging of the registered nurse workforce...
...health services b) The reduction in the...
...The reduction in the number of professional...
...an increase in the nurse–patient ratio. c)...
...nurse–patient ratio. c) The Academy of Medical...
...does not support the development of exact...
...are attractive to the retention of professional...
...direct care. a) The UAP provides care...
...provides care under the direction of the...
...the direction of the professional nurse. B....
...an ICU? a) The health care needs...
...care needs of the patient and the...
...the patient and the skill mix available...
...available must be the deciding factors. b)...
...deciding factors. b) The assignment of patients...
...those patients requiring the greatest level of...
...cared for in the intensive care unit....
...controversial variables in the assignment of intensive...
...1. Nursing Shortage The nursing shortage has...
...Factors linked to the nursing shortage include:...
...satisfaction Aging of the nursing workforce Limited...
...as a career The increasing number of...
...care Work under the direct supervision of...
...direct supervision of the professional nurse 5....
...Goals involve ensuring the most favorable use...
...of Technology in High-Acuity Environments A. Benefits...
...A. Benefits 1. The use of technology...
...of technology in the intensive care unit...
...close monitoring of the patient. 2. The...
...the patient. 2. The technology is a...
...for placement in the intensive care unit....
...care unit. 3. The use of computers...
...when machines become the focus of care...
...of care of the high-acuity patient. 2....
...care of the high-acuity patient. 2. Technical...
...impediments to touching the patient. 3. Little...
...overreliance issues 1. The potential for increased...
...increased stress on the nurse as a...
...on technology by the nurse. D. Finding...
...a Balance 1. The skilled nurse who...
...practices in a high-acuity setting must be...
...able to bridge the gap between complex...
...complex technology and the art of caring....
...of Technology in the ICU Allows for...
...close monitoring of the patient Provides a...
...Technology Depersonalization of the patient Overload Over-reliance...
...work environment 1. The American Association of...
...of community allows the nurse the ability...
...allows the nurse the ability to share...
...factors that improve the ability of the...
...the ability of the nurse to manage...
...Patient Safety in High-Acuity Environments A. The...
...High-Acuity Environments A. The culture 1. Studies...
...patient outcomes: a) High levels of teamwork...
...decreased mortality. 2. The current culture is...
...Patient safety 1. The Joint Commission (TJC)...
...To receive accreditation, the applying organization must...
...it is meeting the outlined safety goals....
...prevent errors a) The computerized provider order...
...drug names b) The barcode point-of-care (BPOC)...
...badges and then the patient wristbands to...
...orientation will help the high-acuity nurse provide...
...will help the high-acuity nurse provide a...
...systems improvement. 2. The Joint Commission (TJC)...
...as to whether the patients being referenced...
...are suitable to the ICU, IMC, or...
...medical–surgical unit. Determine the students’ interest level....
...interest level. Ask the students if they...
...What factors do the students cite as...
...students cite as the reasons behind their...
...its policies concerning the steps taken when...
...steps taken when the intensive care units...
...Clinical Activities During the clinical post conference,...
...post conference, ask the students to evaluate...
...were appropriate for the ICU, IMC, or...
...4 patient. Provide the clinical group rotation...
...rotation opportunities to the ICU and the...
...the ICU and the IMC. Ask the...
...the IMC. Ask the students to develop...
...a listing of the noted differences between...
...noted differences between the units. Wagner et...
...Resource Manual for High-Acuity Nursing, 6th Edition...