Lewis: Medical-Surgical Nursing, 9

th
Edition
Chapter 1
Professional Nursing Practice
KEY POINTS
PROFESSIONAL NRSIN! PRACTICE
Nursing is the (1) protection, promotion, and optimization of health and abilities; ()
pre!ention of illness and in"ur#; ($) alle!iation of suffering through the diagnosis and
treatment of human response; and (%) ad!ocac# in the care of indi!iduals, families,
communities, and populations&
Nurses offer s'illed care to those recuperating from illness or in"ur#, ad!ocate for
patients( rights, teach patients so that the# can ma'e informed decisions, support patients
at critical times, and help them na!igate the increasingl# comple) health care s#stem&
*ertification in nursing specialties, such as ambulator# care, critical care, geriatric,
emergenc#, ps#chiatric and mental health, and communit# health nursing, is offered
through a !ariet# of nursing organizations&
Entr#+le!el nurses with an associate or baccalaureate degree in nursing are prepared to
function as generalists& ,ith additional preparation, nurses can assume roles such as
clinical nurse specialist and nurse practitioner&
INFLENCES ON PROFESSIONAL NRSIN! PRACTICE
-apidl# changing technolog# and dramaticall# e)panding 'nowledge are adding to the
comple)it# of health care en!ironments& .he health care en!ironment is influenced b#
changes in the structure and financing of health care s#stems, e!er+changing laws and
regulations, and the increasing !oice that patients ha!e in their care&
Healthy People is a broad+based program that in!ol!es go!ernment, pri!ate, public, and
nonprofit organizations in pre!enting disease and promoting health&
/ecause nurses pla# such a !ital role in pro!iding safe care, ma"or nursing organizations
promote research into the causes of errors, de!elop strategies to pre!ent future errors, and
address nursing wor' en!ironments that affect patient safet#&
PATIENT"CENTERE# CARE
0ealth and nursing care are deli!ered b# a !ariet# of models& .he nurse(s role in most
cases is one of 1interdependence and coparticipation2 with the patient and other health
care team members&
*omple) health care en!ironments re3uire that #ou use critical thin'ing4b# appl#ing the
cogniti!e s'ills of anal#zing, appl#ing standards, discriminating, information see'ing,
logical reasoning, predicting, and transforming 'nowledge4to ma'e decisions that lead
to best patient outcomes&
.he fi!e elements of the nursing process are assessment, diagnosis, planning,
implementation, and e!aluation& .hree standardized nursing languages are used to
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Key Points 1-2
document the nursing process& 9sing these languages facilitates professional nursing
practice and pro!ides the nurse with a consistent wa# to communicate nursing
'nowledge&

INFOR$ATICS AN# TEC%NOLO!Y
:s a nurse, #ou must be able to help patients access and use appropriate health
information and to e!aluate information as it relates to #our own practice&
Nursing informatics is a specialt# that integrates nursing science, computer science, and
information science in identif#ing, collecting, processing, and managing data and
information to support nursing practice, administration, education, and research&
,hen nursing terminologies are used in information s#stems for documentation of
nursing practice, nurses can trac' and report on the effecti!eness of nursing care&
E&I#ENCE"'ASE# PRACTICE
Evidence-based practice (E/;) is a problem+sol!ing approach to clinical decision+
ma'ing that in!ol!es the use of the best a!ailable e!idence in combination with clinician
e)pertise and patient preferences and !alues to achie!e desired patient outcomes&
E/; is a process that in!ol!es finding, e)amining, and using research conducted b#
others in efforts to answer a specific clinical 3uestion&

SAFETY AN# (ALITY I$PRO&E$ENT
/# implementing !arious procedures and s#stems to impro!e communication and health
care deli!er# to meet safet# goals, health care s#stems create a culture of safet# that
minimizes the ris' of harm to the patient&
Nurses are a !ital part of promoting this culture of safet# b# pro!iding care in a manner
that reduces errors and acti!el# promotes patient safet#& <ther roles e)pected of #ou are
to coordinate and integrate multiple aspects of patient care, including care deli!ered b#
others, identif# issues that are associated with poor 3ualit# and unsafe care, and
implement inter!entions to impro!e 3ualit# of care&

TEA$)ORK AN# COLLA'ORATION
Delegation of nursing inter!entions to licensed practical nurses=licensed !ocational
nurses (L;Ns=L>Ns) and unlicensed assisti!e personnel (9:;) is an important function
of the professional nurse&
Assignment is the distribution of wor' that each staff member is responsible for during a
gi!en wor' period& :ssignments are fre3uentl# performed when the nurse directs other
nurses, L;Ns, and 9:;s to perform care that is within their scope of practice&
Supervision includes guidance and direction, o!ersight, e!aluation, and follow+up b# the
-N& ,hen #ou delegate, #ou are responsible for super!ision of the 9:; or L;N&
*op#right 5 61% b# 7osb#, an imprint of Else!ier 8nc&