Lewis: Medical-Surgical Nursing, 9th Edition

Chapter 1
Professional Nursing Practice
KEY POINTS

PROFESSIONAL NURSING PRACTICE

Nursing is the (1) protection, promotion, and optimization of health and abilities; (2)
prevention of illness and injury; (3) alleviation of suffering through the diagnosis and
treatment of human response; and (4) advocacy in the care of individuals, families,
communities, and populations.
Nurses offer skilled care to those recuperating from illness or injury, advocate for
patients rights, teach patients so that they can make informed decisions, support patients
at critical times, and help them navigate the increasingly complex health care system.
Certification in nursing specialties, such as ambulatory care, critical care, geriatric,
emergency, psychiatric and mental health, and community health nursing, is offered
through a variety of nursing organizations.
Entry-level nurses with an associate or baccalaureate degree in nursing are prepared to
function as generalists. With additional preparation, nurses can assume roles such as
clinical nurse specialist and nurse practitioner.
INFLUENCES ON PROFESSIONAL NURSING PRACTICE
Rapidly changing technology and dramatically expanding knowledge are adding to the
complexity of health care environments. The health care environment is influenced by
changes in the structure and financing of health care systems, ever-changing laws and
regulations, and the increasing voice that patients have in their care.
Healthy People is a broad-based program that involves government, private, public, and
nonprofit organizations in preventing disease and promoting health.
Because nurses play such a vital role in providing safe care, major nursing organizations
promote research into the causes of errors, develop strategies to prevent future errors, and
address nursing work environments that affect patient safety.
PATIENT-CENTERED CARE
Health and nursing care are delivered by a variety of models. The nurses role in most
cases is one of interdependence and coparticipation with the patient and other health
care team members.
Complex health care environments require that you use critical thinkingby applying the
cognitive skills of analyzing, applying standards, discriminating, information seeking,
logical reasoning, predicting, and transforming knowledgeto make decisions that lead
to best patient outcomes.
The five elements of the nursing process are assessment, diagnosis, planning,
implementation, and evaluation. Three standardized nursing languages are used to
Copyright 2014 by Mosby, an imprint of Elsevier Inc.

Key Points

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document the nursing process. Using these languages facilitates professional nursing
practice and provides the nurse with a consistent way to communicate nursing
knowledge.
INFORMATICS AND TECHNOLOGY
As a nurse, you must be able to help patients access and use appropriate health
information and to evaluate information as it relates to your own practice.
Nursing informatics is a specialty that integrates nursing science, computer science, and
information science in identifying, collecting, processing, and managing data and
information to support nursing practice, administration, education, and research.
When nursing terminologies are used in information systems for documentation of
nursing practice, nurses can track and report on the effectiveness of nursing care.
EVIDENCE-BASED PRACTICE
Evidence-based practice (EBP) is a problem-solving approach to clinical decisionmaking that involves the use of the best available evidence in combination with clinician
expertise and patient preferences and values to achieve desired patient outcomes.
EBP is a process that involves finding, examining, and using research conducted by
others in efforts to answer a specific clinical question.
SAFETY AND QUALITY IMPROVEMENT
By implementing various procedures and systems to improve communication and health
care delivery to meet safety goals, health care systems create a culture of safety that
minimizes the risk of harm to the patient.
Nurses are a vital part of promoting this culture of safety by providing care in a manner
that reduces errors and actively promotes patient safety. Other roles expected of you are
to coordinate and integrate multiple aspects of patient care, including care delivered by
others, identify issues that are associated with poor quality and unsafe care, and
implement interventions to improve quality of care.
TEAMWORK AND COLLABORATION
Delegation of nursing interventions to licensed practical nurses/licensed vocational
nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP) is an important function
of the professional nurse.
Assignment is the distribution of work that each staff member is responsible for during a
given work period. Assignments are frequently performed when the nurse directs other
nurses, LPNs, and UAPs to perform care that is within their scope of practice.
Supervision includes guidance and direction, oversight, evaluation, and follow-up by the
RN. When you delegate, you are responsible for supervision of the UAP or LPN.

Copyright 2014 by Mosby, an imprint of Elsevier Inc.