1. develops over time and is responsive to its members & their familial and social environments
2. Its members learn it and share it.
3. It is essential for survival and acceptance
4. It changes with difficulty

• becoming a competent participant in the dominant culture
• involuntary process
• forced to learn the new culture to survive
• extremely difficult
• usual course takes three generations; the adult grandchild of an immigrant is considered fully Americanized

situations and feelings of passive betweenness when peole exist between 2 different cultures and do not perceive themselves as centrally belonging to either one;

example: an adolescent who moved here a year or two ago

• tendency of an individual or group to impose their values, beliefs, and practices on another culture for varied reasons
• such practices constitute a major concern in nursing
• a largely unrecognized problem as a result of cultural ignorance, blindness, ethnocentric tendencies, biases, racism or other factors

• the process in which the HC provider continuously strives to achive the ability to effectively work within the cultural context of a client
• model involves
• awareness: self-examination
• knowledge
• skill
• encounters
• desire

• a process of human interaction within organizations
• permeates all orgs, workplaces, legislatures, professions, even families
• e.g., a kid learning to ask mom for things instead of dad
• political activism should be an unwritten rule in nursing

• commonly used in recent years, esp. in nursing lit related to admin & mgmt
• highly relevant to clinical practice
• the process of exercising one's own power
• consistent with contemporary view of leadership: facilitator, coach, teacher, collaborator
• power is exercised making professional judgments in daily work
• the process by which power is shared with colleagues and patients as part of the nurse's exercise of power, in contrast to traditional ideas of patriarchal power (coercion, hierarchy, authority, control, force)
• Viewed through a feminist perspective, empowerment is supported through collaboration not competition and power plays

• groups of individuals or orgs that join together temporarily around a common goal (often an effort to effect change)
• results from networking, often at leadership level, often through formal mechanisms such as letters
• coalitions of professionals and consumers are powerful in influencing public policy related to HC

• bargaining
• a critically important skill for organizational and political power
• process of making trade-offs
• children are natural negotiators
• often people ask for more than they want and negotiate down to what they want
• negotiators must be able to discuss the pros and cons of both positions

• the ability to influence others in an effort to achieve goals
• once a taboo issue in nursing since exercising power conflicted with feminine stereotypes
• essential to the effective implementation of both the clinical & managerial roles of nurses
• contemporary views on power
• power as influence & a force for collaboration rather than coercion
• an infinite quality rather than a finite quality

1. position
2. perceived
3. expert
4. personal
5. information
6. connection

• recording, processing and using data and info for the purpose of delivering and documenting patient care
• refers to computers & programs used to manage data & info

• need good data and information to provide effective and efficient patient care
• knowledge work requires considerable cognitive activity and critical thinking
• nurses are knowledge workers
• not routine or repetitive

• essential data to be collected on all patients

1. nursing diagnosis
2. nursing intervention
3. nursing outcome
4. intensity of nursing care

1. establish comparability of patient care data across clinical populations, settings, geographic areas & time
2. describe the care of patients and families in various settings
3. provide a means to makr the trends in the care provided and the allocation of nursing resources based on health problems or nursing diagnosis
4. stimulate nursing research through links to existing data
5. provide data about nursing care to influence and faciliate healthcare policy decision making

• Nursing Care Elements
• Personal Identifcation
• DOB
• Sex
• Race & ethnicity
• Residency
• Service elements
• Unique facility or service agency #
• Unique health record #
• Unique # of the principal RN provider
• Episode/admission/encounter date
• Discharge/termination date
• Disposition of pt
• Expected payer for most of the bill

• we lack uniform/unified structured nursing term., which makes collecting some of the NMDS elements difficult (the nursing elements; the other ones are usually collected at admission)
• 13 classifications systems have been recognized by the ANA]

• an extension of WL (wireless) technology that enables hands-free communication among mobile hospital workers
• wear a pendant-like badge around the neck; press a button & connect to the person they want to talk to by stating their name or function

• also "computer speech recogntion"
• converts spoken word into machine-readable input
• examples: voice dialing, call routing, simple data entry, preparation of radiology report
• enter data without touching a computer
• must use staccato like speech, pausing between each clearing spoken word
• system must be programmed for each user
• recognizes large # of words but is still immature

• a science that combines a domain science, computer science, info science and cognitive science
• "nursing informatics" first named in 1980
• the application of computer tech. to all fields of nursing (services, education, research)
• consists of 3 core components: data, information, knowledge

• clinical computer system, app or process that helps HC professionals make clinical decisions to enhance pt care
• most common: drug dosing calculators

• interactive computer programs designed to assist health pros with decision-making tasks by mimicking the inductive or deductive reasoning of a human expert
• basic components: knowledge base & an inferencing mechanism (set of rules derived from experts & EBP; controls the application of the knowledge using logic)

1. ask a clinical question
2. acquire the evidence
3. appraise the evidence
4. apply the evidence
5. assess the outcomes

• informatics can play an important role in 4 of the 5

• can be an effective mechanism for improving pt safety
• new errors possible, though, need safeguards

• some use it as a global concept, with EMR being the discrete localized record
• longitudinal electronic record of pt health info generated across encounters in any care delivery setting
• coordinate the storage & retrieval of individual records with aid of computers; may be used from many locations/sources
• contains HC info for an individual from birth to death

1. biomedical tech
2. info tech
3. knowledge tech

• credit card-like devices that store a limited # of pages of data on a computer chip
• serves as a bridge between the clinician terminal and the central repository, making pt info available to the caregiver quickly and cheaply at the pt of service because the pts bring it with them
• different providers' care & notes can be brought together in any combination at any place