1.9: Key Terms

anonymity

state of being unknown; refers to a participant in a study whose identity is not disclosed

autonomy

right to make one’s own decisions related to treatment and care

beneficence

responsibility to act in the patient’s best interest

clinical decision-making

application of both critical thinking and clinical judgment to make decisions about nursing care

clinical judgment

process by which nurses make decisions about patient care on the basis of observations, assessments, and interpretations of relevant information

collaborative care model

approach to health care in which a team of providers works together to manage patient care more effectively and improve patient outcomes

critical thinking

multidimensional, systematic, and organized way of reasoning

data

pieces of information that help researchers answer questions and draw relevant conclusions

electronic health record (EHR)

digital version of a patient’s medical history; enables providers to immediately access information about a patient’s health, including conditions, medications, and test results

empirical evidence

objective data gathered by the senses from observations or experiments

ethics

study of right and wrong actions

evidence-based practice

process of making clinical decisions on the basis of the best available evidence from the most up-to-date research

full disclosure

process of providing a complete description of a study or medical procedure, including the risks and possible benefits

health equity

condition in which everyone has the same fair opportunities to attain the highest level of health outcomes

health inequities

disparities created by socioeconomic systems and the status of different populations

Health Insurance Portability and Accountability Act (HIPAA)

federal law to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge

health policy

laws and regulations that define the actions and decisions that promote a society’s health goals

health-care delivery system

individuals and organizations collectively responsible for providing and overseeing health care in an area

informed consent

legal document an individual signs to indicate a thorough understanding of a study, medical treatment, or procedure and to agree to participate

intercollaborative care

team-based approach that uses shared responsibilities, interactive planning, and collaborative decision-making to promote person-centered care and improve patient and health system outcomes

ISBAR

acronym that stands for Introduction, Safety, Background, Assessment, and Recommendation. The ISBAR format provides a structure of written communication that can be replicated by each team member to keep communication on track, create a workflow for the intercollaborative team, and promote patient safety

justice

principle that all patients should be treated fairly

macrosystem

culture or society that surrounds smaller systems and gives them structure

microsystem

relatively simple, localized system, such as the one in which a health-care provider directly works

nonmaleficence

responsibility to do no harm

Nurse Practice Act

law passed by a state’s legislature regulating nurses’ scope of practice

nursing informatics

specialty that uses information and technology to improve the efficiency of health care and its delivery

nursing research

inquiry that is systematically designed to provide knowledge for important issues relevant to the nursing profession

patient-centered care (PCC)

model of care that requires listening to patients to understand what they value most, then using the information as the catalyst for health-care decisions

PICOT

acronym based on the elements of a clinical research question: population or problem, intervention, comparison, outcome, time frame

primary prevention

health care intended to prevent disease before it occurs

qualitative research

inquiry that focuses on personal experiences obtained through observation and interaction with patients

Quality and Safety Education for Nurses (QSEN)

project focusing on the preparation of future nurses to promote the quality and safety of health-care systems

quality improvement (QI)

framework to improve patient care and outcomes systematically

quantitative research

inquiry that uses deduction and generalization from empirical evidence to draw conclusions

scope of practice

range of activities a licensed person is permitted to perform as part of their work

secondary prevention

health care that promotes early diagnosis and treatment to slow the progression of a disease or injury

social determinants of health (SDOH)

nonmedical factors that have an influence on health outcomes

systems-based practice

health care that considers the multiple systems involved in a patient’s condition and uses evidence about their interactions to develop a treatment plan that incorporates all the entities involved in the patient’s care

telehealth

use of digital communications technology to remotely provide health-care services

tertiary prevention

health care intended to decrease the impact of an ongoing illness or injury

The Joint Commission

independent, not-for-profit organization that sets standards for quality care, quality improvement, and patient safety for organizations and workers in the health-care industry

theory–practice gap

divide between theoretical knowledge acquired in academic settings and the practical application of that knowledge in real-world clinical settings

whole-person care

holistic care that focuses on all of a patient’s needs