📘 Chapter 5
Coggle 📘Chapters 5 and 6 - Coggle Diagram📊 Performance Improvement (PI)
• A method to check and improve health care processes. • Make care safer, better, and more effective for patients.
Improve your performance. Do your work.
Professor said: We look at all things we are doing to meet client needs. Assess and check what is happening, so you can make changes to improve. Every month the unit evaluates Performance Improvement, and they talk about how to improve.
Key Points: • Reviews what’s working or not in current practices. • Continuous effort → always trying to improve outcomes. • Uses data & trends → if problems are spotted, new actions are started. • Works with EBP (Evidence-Based Practice) → together they ensure high-quality care and better patient results.
👉 In short: PI = a continuous system of checking and improving nursing care to keep patients safe and get the best outcomes. Units often review PI monthly to discuss improvements.
🔹 Relationship between EBP, Research, and Performance Improvement
Evidence-Based Practice (EBP): • Uses research + best evidence to give safe, effective care. • improves patient outcomes. Research: • Systematic study → asks questions, solves problems. • Builds general nursing knowledge. • May or may not directly help patient care right away. Performance Improvement (PI): • Focus = local problems in a hospital/clinic. • Makes care safer, faster, more efficient. • Results usually stay local (not always generalizable to all hospitals).
Connection: • EBP + PI can reveal problems → these problems may lead to new research studies.
👉 In short: • Research = creates new knowledge. • EBP = uses best evidence for safe care. • PI = improves local processes for better outcomes. • All three work together to make nursing care better.
📌 Key Points: Evidence-Based Practice (EBP), Research, & PI
🔬 Evidence-Based Practice (EBP)
$Evidence Base Practice ↔ Your actions are base on science.
- Guides nurses with the best scientific & clinical evidence to solve problems.
- Ensures competent, safe, person-centered care.
- Steps of EBP:
📚 Levels of Evidence (Check the book)
- Highest: Systematic reviews, meta-analyses of RCTs, clinical guidelines.
- Lowest: Expert opinion.
👩⚕️ Using Evidence in Nursing
- Apply directly in patient care OR use for large practice changes in healthcare agencies.
📊 Research Process
- Six steps: identify problem → create a question → design a study → collect data → analyze it → share results.
🔢 Quantitative Research
- Uses numbers & statistics.
- Types: Experimental, Non-experimental, Surveys, Evaluation research.
💬 Qualitative Research
- Uses non-numerical data (interviews, observation).
- Types: Phenomenology, Ethnography, Grounded Theory.
- Focus = patients’ experiences & context.
🧪 Nursing Research
- Systematic process to generate new knowledge and build a scientific basis for nursing practice.
🔄 Translational Research
Translational research is the process of translating scientific discoveries from the laboratory, clinic, and community into practical applications that improve human health.
Translational research in nursing is conducted to promote the use of EBP by testing implementation strategies in real-world settings to determine which strategies work best among diverse patient groups.
- Tests implementation strategies in real settings.
- Goal: promote use of EBP with diverse patients.
📘 Chapter 6
🔹 Maslow’s Hierarchy of Needs (in nursing)
• Explains how basic human needs are connected. • All patients share these needs, but which need is most important changes depending on the situation. • In reality → patients’ needs don’t always follow the strict order of the pyramid. • Nurses must figure out which needs are a priority for each patient. Suicide patient, focus on safety, no on Basic needs
🪜 Maslow’s 5 Levels (from bottom to top):
1. Physiological – food, water, oxygen, sleep. 2. Safety – protection, security, stability. 3. Love/Belonging – family, relationships, support. 4. Esteem – respect, confidence, recognition. 5. Self-Actualization – achieving one’s full potential.
👉 In short: Maslow helps nurses prioritize care by focusing on the most urgent patient needs first (like breathing and safety) before higher needs (like self-esteem). 🔹 Holistic Health Model
- Considers emotional, spiritual, social, cultural, physical aspects of wellness
🧩 Models of Health & Illness
- Help explain complex concepts like health, illness, behaviors
🧠 Health Beliefs
- Person’s ideas, convictions, and attitudes about health & illness
- May be based on facts ✅, misinformation ❌, or past experiences
- Can influence behaviors positively or negatively
🔹 Health Belief Model
- Explains relationship between beliefs & behaviors
- Focus: What people perceive as risk + their likelihood of taking preventive action
🔹 Health Promotion Model
- Focus: Increasing well-being
- Describes multidimensional nature of people interacting with environment to pursue health
⚙️ Variables Influencing Health & Health Practices
🔹 Internal Variables (Inside You)
- 👶 Developmental stage
- 🧠 Intellectual background
- 👀 Perception of functioning
- ❤️ Emotional factors
- ✝️ Spiritual factors
🔹 External Variables (Outside of you)
- 👨👩👧 Family role & practices
- 🌍 Social determinants of health
- 🎭 Culture
🌱 Health Promotion, Education, & Illness Prevention
• Health Promotion: Keep or improve general health (e.g., exercise, healthy diet). • Health Education: Teach people to understand and manage their health better. • Illness Prevention: Protects against diseases (e.g., vaccines, screenings).
🛡 Three Levels of Prevention
1. Primary Prevention (before illness happens, general) Stop disease before it starts. Examples: Immunizations, health classes, fitness programs, and wearing seatbelts.
2. Secondary Prevention (early detection, specific conditions) Find and treat the disease early. • Examples: Screenings (BP checks, mammograms, Pap smears), treating infections quickly.
3. Tertiary Prevention (prevent complications, long-term illness) Manage long-term illness or disability, prevent complications, rehab. • Examples: Cardiac rehab after heart attack, support groups, physical therapy after stroke.
👉 In short:
• Primary = Prevent in general. • Secondary = Catch it early. Prevent specific illness. • Tertiary = Manage it long-term. Prevent more complications.
🔹 Risk Factors
• Things that increase chance of illness or accident. Types: • 🧬 Nonmodifiable = can’t change (age, sex, genetics, family history). • 🍔 Modifiable = can change (diet, lifestyle, exercise, smoking) • 🌎 Environment = (pollution, unsafe conditions)
• Once risks are known → offer health education & counseling (advice). • Healthy lifestyles prevent hospitalization, lower costs.
🔹 Transtheoretical Model of Change (Stages)
1. Precontemplation – no plan to change. 2. Contemplation – thinking about change. 3. Preparation – making small steps. 4. Action – actively changing behavior. (6 months) 5. Maintenance – keeping the change long-term. (More than 6 months)
Professor’s notes: When you are in the community, who is the first person ready to help you? A community helper.
If a patient says, “I smoke,” the first step is to address smoking cessation. Smoking triggers short-term sensations of relief, but as nicotine levels drop, it leads to withdrawal symptoms such as anxiety and irritability. These symptoms reinforce the cycle of addiction.
🔹 Illness vs Disease
• Disease → A medical condition with specific symptoms that cause distress. • Illness → The whole person's response (physical, emotional, social, spiritual) to being impaired. Health is also self-defined → shaped by values, personality, lifestyle
🔹 Reactions to Illness
• People respond emotionally, mentally, and behaviorally to illness. • These responses are influenced by culture, psychology, and personal beliefs.
🔹 Types of Illness
• Acute Illness → Short duration, severe, and sudden onset (examples: flu, appendicitis). • Chronic Illness → Lasts >6 months, ongoing, often requires long-term management (examples: diabetes, hypertension).
COPD during respiratory distress is an acute problem as a result of a chronic disease.
Affective reaction = feelings/how a person feels emotionally in response to illness, stress, or a situation.
👉 In short: • Disease = The medical condition itself. • Illness = How the person experiences the condition. • Acute = Short & severe. Chronic = Long-term.
🔹 Impact of Illness on Patient & Family
- 😔 Behavioral & emotional changes
- 🪞 Body image changes
- 🧠 Self-concept (how they see themselves)
- 👨👩👧 Family roles (who takes care of who)
- 🤝 Family dynamics (relationships, stress)
💙 Caring for Yourself (Nurse Wellness)
Professor said: If you can’t take care of yourself as a nurse, how can you take care of other people? I recommend you to join the Nursing Students’ Association.
- 🥗 Nutritious diet
- 😴 Adequate sleep
- 🏃 Exercise & relaxation
- ⚖️ Work–family balance
- 🎨 Engage in nonwork activities
- 🧘 Develop coping skills & allow time for grieving
- ✝️ Focus on spiritual health
- 👩🏫 Find a mentor
👉 In short: • Risk factors affect health → some can be changed, some cannot. • Stages of change help guide behavior change. • Illness impacts both patient & family. • Nurses must also care for themselves to care for others.