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BSNC 1020 MODULE 1-5 FINAL Test Answers 2024

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1. Professionalism: Behaviours, skills, and attributes required or expected of mem-bers of a profession.
- Conduct, aims or qualities that characterize or make up a profession or profession-al.
-Requires specialized knowledge, accountability, autonomy, inquiry, collegiality, col-laboration,
innovation & ethics and values
2. How do nurses display professionalism?: Provide quality care to patients thru:
- Commitment to profession led regulation
- Professional ethics
- Personal health & fitness to practice
- Legal & ethical dimensions to nursing
3. What year did nursing start in Canada?: 1639 - Hotel Dieu Quebec
4. Florence Nightingale: - founder of modern nursing and a reformer of hospitalsanitation methods
5. What did Florence Nightingale do?: - Insisted on better hygiene in field hospi-tals and founded the
first school of nursing
- Crimean war: reduced mortality from 42-2.2%.Hand-washing/nature working on patient's body was
her mainstay. First health statistician (collected & analyzed healthdata).
- improved standards of nursing care in the mid-nineteenth century
- known for reducing mortality during the Crimean war through improved sanitationmeasures
- triggered a shift in public attitudes towards the acceptability of women doing nursingoutside of the
home
6. Florence Nightingale and Crimean War: - She went to the war and helped turnthe mortality rate
around.
1854, she and 38 nurses entered the battlefield near Scutari, Turkey and cared forthe sick and injured.
They had few supplies and little outside help. She insisted on establishing sanitary conditions and
providing quality nursing care.This immediatelyreduced the mortality rate. Her dedicated service both
during the day and night whenshe and her nurses made rounds carrying oil lamps created a public
image if the lady with the lamp.
7. Nightingale Fund: - established by the English government to promote nurse'straining in England
- used to establish the first Nightingale school of Nursing, at St Thomas' Hospital inLondon
8. Nightingale System of Education (Nightingale Model): - 1860: Nightingale created a financially
independent school of nursing associated with St. Thomas'Hospital in London, England.

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- Became standard of nursing education in England and worldwide for next century.
-This was a hospital-based model overseen by a trained superintendent, trained staffmembers acting as
instructors, and a cadre of nursing students who provided the bulk of the care
9. What was the results of Nightingale's success in the public attitudes?: - Thistriggered a remarkable
shift in public attitudes toward the acceptability of women during nursing work outside the home.
Nursing became an instrument of women's emancipation against the prevailing middle-class
restrictions on women working outside the home.
10. What advocate role did Nightingale take on?: - the health of people
- health care reform
- education preparation for nursing

- She became an advocate for the health of people, healthcare reform, and educa-tional preparation
for nursing through voluminous writings and lobbying of membersof parliament to act on these views.
These views were from health data that she collected and analyzed.

-She responded viscerally to situations that frustrated and angered her including the lack of active role
for women in Victorian society and the lack of social action byreligious men and women in general.
11. Nightingale Model of Nursing Education: - Hospital based.
- Overseen by trained superintendent.
- Trained staff members who also acted as instructors.
- Many student nurses who performed bulk of nursing care.
- Nightingale model missing from new nursing schools because they had no financ-ing
- Nursing students had to provide care for hospitals in return for education & livingexpenses
- Result: Hospitals able to provide nursing care for minimal cost
12. Sister of Charity of Montreal: -1738
-Grey Nuns
- Formed by Marguerite D'Youville
-Basically the birth of home nursing
-Pledged their lives to helping the poor and the sick (home visits)
-Establish hospitals across Canada, making separate wings and establish a healthsystem.
- cared for both the poor and the wealthy

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13. What were the financial advantages of a hospital with a school of nurs- ing?: This gave the
institutions a competitive edge relative to others to which payingpatients may turn for care. A training
school provided security against incurring a financial loss if the number of paying patients dropped at
any point. Training schoolsattached to a hospital also ensured a higher standard of care than one
without a school.
14. Where was the first hospital diploma school in Canada?: -First HospitalDiploma School
This was at the St. Catherines Training School that opened in 1874 at the St.Catharines General and
Marine Hospital.
15. What were the admissions for the first diploma school for nurses and whatdid they teach?: -Plain
English education, good character and Christian motives.
-Learned about sanitary, science, physiology, anatomy, and hygiene.
-Taught to observe the patient for changes in temperature, skin condition, pulse,respirations, and
functions of orgrans
16. University of British Columbia: - first Canadian undergraduate nursing degreeprogram
- non-integrated (university did not control learning that took place in hospitals)
- apprenticeship-style training
17. First Canadian Undergraduate Nursing Degree: 1919: UBC
18. Alberta Task Force on Nursing Education: - 1975
- recommended that all new graduates be prepared at the baccalaureate level beforeentering
professional practice
-First entry to practice
19. Baccalaureate as entry-to-practice (BETP): - 1982
- CNA approved a resolution to have it by the year 2000
- said that all new graduates in nursing must be qualified at the baccalaureate levelwhen they enter
the professional practice of nursing
- implemented throughout Canada from 2000-2010
20. 1881-1894: - 1881: The school for nurses at the Toronto General Hospital wasestablished

- 1884: Mary Agnes Snively was appointed superintendent of the school for nursesat the Toronto
General Hospital

- 1896: Mary Agnes Snively introduced a 3 year course at Toronto General Hospitalwith 84 hours of
practical nursing and 119 hours of instruction by the medical staff

- 1887: The Winnipeg General Hospital initiated the first training school for Nurses

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in Western Canada. 134 of its graduates served as nurses in WWI

-1890: By this point hospitals in Montreal, Fredricton, Saint John, Halifax, andCharlottetown had
opened schools of nursing

-1891: Vancouver General Hospital began a school of nursing

-1894: Medicine Hat opened a school of nursing


21. Timeline of Nursing Education:: - St. Catherine's Diploma, integrated (1874)
- UBC non integrated Diploma (1919)
-1975 Alberta Task force recommended bachelor degree programs
- 1982 - Entry to practice programs
-2000s-2010: All must have bachelor degree.
22. What is the Victorian Order of Nurses?: - Established in 1898
- This signified a professional standard of education for Canadian nurses that recognized the
need not only for altruism and compassion but also for nursingknowledge

- was formed by the National Council of Women under the presidency of Lady IshbelAberdeen following
the discovery of the plight of women in Western Canada who had to give birth in remote locations
with no assistance.
23. What is the International Council of Nurses?: -Founded in 1899 by: BedfordFenwick
- Britain, Germany, USA member organizations
- This started as a small organization in the broader context of the women's move- ment with the
goals of professional welfare of nurses, the interests of women, and the improvement of the people's
health.
- Goals: professional welfare of nurses, interests of women and improvement ofpeople's health
24. Purpose of the code of ethics: - provide meaningful guidelines for nursesexperiencing ethical
conflicts in daily practice
25. What is a CNA?: - National voice of registered nurses in Canada
- Advance nursing excellence
- Positive health outcomes
- Promote profession-led regulation
26. History of Canadian Nurses Association (CNA): - Registration of nursesestablished through
legislation in each province.
- 1924: Canadian National Association of Trained Nurses (CNATN) changed to CNA
- 1930: Became federation of provincial associations

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CNA (2)
-Nurses formed provincial nurses' associations
- Sought legislation for educational standards & improve nursing care
- 1910: Nova Scotia first province to gain legislation
27. Factors influencing missionary nursing in China: - China's defeat in theOpium Wars
- the women's suffrage movement
- the establishment of professional nursing education
- advances in transportation
- student missionary movement
28. Nurses role in remote nursing: - people living in regions considered too smallor too remote for
hospitals and physicians depended on nurses

- experienced high levels of independence and many duties beyond nursing care
29. Weir Report: - found there to be insufficient classroom instruction and a lack ofvariety in clinical
experience
30. Recommendations of the Weir report: - nurse preparation should be trans-ferred from the
hospitals to the general education system
- nurses receive adequate liberal arts as well as technical education at the degreelevel
- recommendations were not well-received (1960 - 95% of nurses were still beingtrained in
hospitals)
31. Royal Commission on Health Services: - Justice Emmett Hall
- called for separation of nursing education from hospital services
- two-tiered education system with baccalaureate-prepared leaders and diplo-ma-prepared
bedside nurses
- launched the demise of hospital training schools and addition of 10 Ba nursingprograms
32. Education reform of the 1960s: - better prepared faculty in schools
- high quality and standards as priorities in nursing education programs
- more integrated programs
- more university
-based opportunities for students
33. Nursing schools in the 1960s: - two-year nursing programs
- diploma education based in community colleges
34. What set the admission criteria and curricula for nursing schools?: Thiswas set by rules
governing the registration and discipline of practicing nurses
35. Why were provincial governments reluctant to endorse the baccalaureatestandard for entry to
the practice of nursing?: This reflected the fact that equality

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in education for women in nursing did not come easily. This occurred over twodecades
36. Where were the first two-year programs of nursing to appear?: This oc- curred in Ontario,
Quebec, and Saskatchewan where a system of diploma educationbased entirely in community colleges
37. What was the standard for nursing education between 1874 and the 1930s?: Nursing students
were the primary means of staffing hospitals where they were provided a low-cost education in
return for low-cost service. There were growing concerns about the quality of nursing education and
exploitation of nursingstudents which led to a nationwide study on nursing education that was jointly
fundedby the CNA and the Canadian Medical Association
38. Integrated Degree Programs (Education and Clinical Practice): - Universi-ties resisted because
costs of low teacher/student ratios for clinical training
- Cheaper to allow hospital to finance clinical training
- Meant universities granted degrees for work done that they had no control over
- 1964: Royal Commission on Health Services castigated the universities for thispractice
39. Nursing Education Today: - New curricula & collaborative baccalaureate pro-grams

-country attest to profession's commitment to high standards & responding tosociety's change
in health care needs

-Standards for nursing education monitored provincially

- Ensure quality and response to changing needs in health care

- Nurses must: acquire, maintain, enhance knowledge, skills, attitudes & judgmentnecessary to meet
patient needs

- Responsibility for educational support shared among individual nurses, profession-al nursing
associations, educational institution & governments
40. 1930's and 1950's for ethnicity in nursing: -1930s started allowing Asianpeople into nursing,
1950 allowed non-white nurses
-1950s separation of race in different wards.
41. How does BCCNM get its authority?: Through the Health Professions Act toregulate the practice
of practical nursing, psychiatric nursing, and nursing.
42. What are the names of the Act and the Regulation that provides BCCNMits authority?: Health
professionals act, enacted by Legislative Assembly of BC

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in 1990, makes the decision whether a particular profession will be regulated by acollege under the
Health Professions Act.
43. What are the differences between the Act and the Regulation ?: Govern- ment, through cabinet
with approval from lieutenant governor, makes decisions whether a particular profession will be
regulated by a college under the Health Pro-fessions Act. The Health Professions Act gives BCCNM its
authority to regulate thefour distinct professions: licensed practical nursing, psychiatric nursing,
registered nursing, nurse practitioners and Midwives.
44. What's the difference between BCCNM and the Health Professions Act?: -BCCNM is the
regulatory body, and the Health Professions Act is the authoritativebody.
45. Professional Regulation of Nursing
Who gives us authority to practice?: - BCCNM gives us a registration
- Governed by CNA
- If moved provinces would have to register under their province-specific college
46. Under what conditions can someone call themselves a Nurse in BC?: Indi-viduals who have met
the requirement for registrations.
47. What does regulation assure?What
does regulation define?
How do nurses practice in self regulation?: - Assures the public that they arereceiving safe and ethical
care from safe and competent nurses.

- Regulation defines the practice and boundaries of the nursing profession, includingself-requirements
and qualifications to practice.

-When they accept responsibility to practice according to professional standards andCode of Ethics for
Registered Nurses.
48. BC College of Nursing Midwives (BCCNM): - Regulates & registers nursesand nursing practice
- Protect public through regulation of nursing professionals
- Sets standards of practice
- Assesses nursing education in BC
- Addresses complaints about nurses in BC
49. BCNU: - Act of behalf of workers
- Secure salary
- Benefits & working conditions
- Leading advocate for publicly funded health care
- Professional voice of nursing

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50. Nurses & Nurse Practitioners of British Columbia (NNPBC): -Assoication
-Lobbying
- Acts on behalf of nursing
- Advance profession
- Influence health and social policy
51. BCCNM 6 Main Regulatory Functions: 1. Quality Assurance: Determine con-ditions/requirements
for registration with BCCNM
2. Education Program Review: Recognize education programs in BC
3. Inquiry and Discipline: Establish, monitor & enforce standards of practice &professional
ethics for nurses
4. Registration, inquiry, discipline procedures
5. Policy: Collaboration with other organizations in the health sector
6. Practice support and regulatory learning: Interprofessional collaboration betweennurses and other
health care professionals
52. What are the six main "duty and objects" of BCCNM?: 1. Establishing theconditions or
requirements for registrations with BCCNM.
2. Recognizing education programs and courses in BC for each of the three profes-sions.
3. Monitoring, establishing and enforcing standards of practice and professionalethics for nurses
4. Employing, and establishing registration. inquiry and discipline procedures thatare transparent,
objective and impartial and fair.
5 Promoting and enhancing collaborative relations with other organizations in thehealth sector
6. Interprofessional Collaborative practice between nurses and other HCP
53. What is scope of practice?: Activities that RNs are educated and authorized to perform. Activities
are established through legislated definition and by standards,limits and conditions.
54. What is the purpose of standards of practice?: guide and direct nurse's practice. They set out
levels of performance that BCCNM registrants require to achieve their level of practice. (Know
boundaries in nurse-client relationships, doc-umentation, privacy and confidentiality)
55. Who does the BCCNM protect?: Public
56. What are the four professional standards from BCCNM?: 1) Professionalresponsibility and
accountability
2) Knowledge-based practice
3) Client-based Provision of Care
4) Ethical Practice

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57. What are the three BCCNM practice standards we need to know?: 1) Bound-aries in the Nurse-
Client Relationship
2) Documentation
3) Privacy and Confidentiality
58. What are the reasons for the BCCNM professional standards?: These pro-vide an overall
framework for the practice of nursing in BC. They set out minimum levels of performance that nurses
are required to achieve in their practice
59. BCCNM Practice Standard: Boundaries in the nurse-client relationship: -Nurse
determines/maintains professional boundaries with the client via. clinical judgment
- Begin, maintain, end relationship
- Don't enter into a friendship/relationship
- No sexual relations
- Careful of socializing with previous clients/their friends/family
- Report violations that other nurses might violate
- Dual role carefully (care for friend/family)
- Disclose personal info only if helpful/appropriate
- No accepting gifts/money
60. What are examples of violation of the boundaries in the nurse-client relationship?: Violations
include behaviour such as favoritism, physical contact,friendship, socializing, gifts, dating, intimacy,
disclosure, chastising, and coercion
61. BCCNM Practice Standard: Documentation: - Communication tool with otherhealth care pros
- Safe & appropriate nursing care: Health care pros review & determine their goalsfor care
- Research & workload management
- Professional & legal standards: demonstrates how nurse used knowledge, skills,judgment
- Can be evidence in legal matter
62. BCCNM Practice Standard Privacy & Confidentiality: - Knowledge of legis- lation; collect info on
"need to know" basis; ensure the client's aware of rights; sharerelevant information with health care
team; respect request to view documentation;respect request to correct information; obligation to
divulge information if client in danger or danger of others being hurt; disclosure of information if warrant,
subpoena,court order; only access information needed for professional responsibility.
63. Maintaining Privacy & Confidentiality: - Disclose information on "need toknow" basis
- Only disclose what's needed

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- Advocate for patient's access to health records
- Don't access health records that aren't necessary
64. Privacy vs. Confidentiality: - Privacy is the right of an individual to have some control over how his
or her personal information (or personal health information) iscollected, used, and/or disclosed.

- Confidentiality is the duty to ensure information is kept secret only to the extentpossible.
65. BCCNM Practice Standards
Definition: - Practice standards set out requirements related to specific aspects ofnursing practice.
- Link with other standards, policies, by-laws of BCCNM as well as other legislationrelevant to nursing
practice
66. What does the document say about nursing students and regulation?: - Registration is
mandatory for all nursing students employed as an employee studentnurse in a BC health care setting.
67. What are the requirements that registrants must complete as part of BC- CNM quality
assurance program?: The purpose of QA program is to promote practice standards as part of
ensuring clients continually receive competent and ethical care, and to support nurses to engage in
annual professional development.
68. When are BCCNM registrants and other health care professional requiredto make a report to
BCCNM or another college?: Nurses in all professional set-tings have a legal and ethical responsibility
to report impaired or unethical conductof regulated health professionals. It is important for nurses to
understand when to report, what to report, and how to report, and know what is ethically required.
69. What are the seven values in the CNA code of ethics?: 1) Providing safe,compassionate,
competent and ethical care.
2) Promoting health and well-being
3) Promoting and respecting informed decision-making
4) Honouring dignity
5) Maintaining privacy and confidentiality
6) Promoting justice
7) Being accountable
70. Under the section "Purpose of the Code" - list four purposes/intentions of the code.: 1) Designed
to inform everyone about the ethical values and subsequentresponsibilities
2) A regulatory tool to serve and protect the public
3) Provides guidance for ethical relationships, behaviours, and decision making,

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works in accordance to other nursing legislation
4) Provides guidances for nurses through ethical situations that arise
71. List two ethical responsibilities nurse/student nurses have under the valueof providing safe,
compassionate and competent care.: 1) Nurses have the responsibility to conduct themselves
according to the ethical responsibilities outlinedcode of ethics and practice standards with person
receiving care and other health care team.

2) Nurses engage in compassionate care in their speech and body language andtheir efforts to
understand and care about health needs.
72. List two ethical responsibilities nurses/students nurses have under the value of promoting and
respecting informed decision making: 1) Nurses pro-vide persons receiving care with the
information they need to make informed andautonomous decisions related to their health and well-
being.

2) Nurses respect the wishes of a capable persons receiving care to declineinformation about their
health conditions.
73. List two ethical responsibilities nurses/student nurses have under the value of preserving
dignity.: 1. Nurses, in their professional capacity, relate to allpersons receiving care with respect.

2. Nurses support persons receiving care in maintaining their dignity and integrity.
74. List two ethical responsibilities nurses/student nurses have under the val-ue of "maintaining
privacy and confidentiality":: 1) Nurses respect the interestsof persons receiving care in the lawful
collection, use, access and disclosure of personal information.

2) When nurses are conversing with persons receiving care, they take reasonable measures to prevent
confidential information in the conversation from being over-heard.
75. What is the BCNU's mission statement?: The BC nurse's union protects and advances the health,
social and economic well-being of our members, our professionand our communities.
76. What is BCNU's vision statement?: The BC Nurse's union will be the champi- on for our members,
the professional voice of nursing and the leading advocate forpublicly funded health care.
77. Canadian Nurses Protective Society (CNPS): Legal society available to nurs- es requiring help
relating to their profession

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78. What is self-regulation?: Self regulation recognizes that a profession is in thebest position to
determine standards for education and practice and to ensure thatthese standards are met. This
"safeguards and champions patient safety" by clearlydetermining the competencies and qualifications
required by individual nurses. Theprofession governs itself through a regulatory body and with the
involvement of its professionals. All practicing nurses participate in self regulation when they accept
responsibility to practice according to professional standards and the code of ethicsfor registered
nurses.
79. What are the four levels of Control on Practice?: Level 1: LegislationLevel 2: BCCNM
standards, Limits and Conditions
Level 3: Organization/Employer
Level 4: Individual Nurse Competence
80. Evolution of Canada Health Act: - Universal hospital insurance plan

- Hospital Insurance and Diagnostic Services Act

- Medical Care Insurance Act

- Federal Medical Care Act

- Federal Provincial Fiscal Arrangements and Established Programs Financing Act

- Canada Health ActHall


Commission
81. Canada Health Act (1984): - 1984
Helped ban extra-billing and user fees and has 5 principles.

- To protect, promote and restore the physical and mental well-being of residents ofCanada and to
facilitate reasonable access to health services without financial or other barriers.

- Puts controls on SDoH


82. Universal Hospital Insurance Plan: - 1947 (1)

- Tommy Douglas: first major federal initiative for hospital insurance


83. Hospital Insurance and Diagnostic Services Act (HIDSA): - 1947 (2)

- First major federal initiative for national hospital insurance

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- Provided federal funding to cover half of service costs for residents (hospitals only)
84. Medical Care Insurance Act: - 1962 (3)

- provided federal funding to cover half of provincial medical services costs (bothinside and outside
of the hospital)

- opposed by physicians

- led to RCHS recommendation


85. What are everyday ethics in nursing?: This is how nurses pay attention to ethics in carrying out
their common daily interactions, including how they approachtheir practice and reflect on their ethical
commitments to persons receiving care orwith health-care needs.
86. Hall Commission Report: - 1964

- conducted a study on the hospital and medical care of Canadians

- found that strong federal government leadership and financial support for medicalcare was needed
(similar to HIDSA)
87. (federal) Medical Care Act: - 1966 (4)

- result of the Hall Commission Report

- federal grants were awarded to provinces on a cost-sharing basis for programsmeeting coverage
criteria for hospitals and physician services

- all provinces and territories received the same amount of money


88. Federal Provincial Fiscal Arrangements and Established Programs Financ-ing Act: - 1977 (5)

-Replaced cost-sharing with block transfer of funds (provinces get different amounts)

- decreased Federal contributions , which led some provinces to allow extra billingof patients by
hospitals and providers above Medicare coverage
89. What is a social safety net?: Are networks of national, provincial, and territorialsocial programs
(remains in place to protect the most vulnerable members of Canadian Society (Since 1960s)

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- is provision of hospital and medical insurance: Medicare is funded by generaltaxation.
90. Define Ethics:: - Moral philosophy that encompasses the study or examinationof morality and
moral behaviour
- System of morals or a moral code for determining right or wrong and for makingjudgements about
what should be done
- Process involving critical thought and action
91. What are some examples of everyday ethics in nursing?: Advanced Careplanning
Resource accessibility and allocationWhistle-
blowing
Fitness to practice
Competency Capacity or incapacity
92. Ethical Sensitivity:: Helps us recognize when there is an ethical problem ordilemma.
93. Ethical Reflection and Analysis: enables us to think critically about our ethicalobligations and
priorities.
94. Ethical Decision Making: Is a method for ensuring that the action we take iswell reasoned and
can be justified.
95. Ethical Principles:: A general guide, basic truth, or assumption that can be used with judgement to
help determine a course of action. Professional ethics refersto the ethical standards and expectations
of a particular profession. Professions have held a privileged role in society, their members are often held
to a high standardof ethics.
96. Medicare: - 1972: Medicare = Canadians have free access to hospital andmedical care
- Part of Canada's Social Safety Net
- 10 provincial and 3 territorial insurance plans that provide reasonable pre-paidaccess to HC
services for Canadians

- funded by taxation
97. Funding of Medicare: - taxes (majority)
- payments to government
- private insurance premiums
- direct out-of-pocket fees of varying types and amounts
98. Role & influence of the Canada Health Act in establishing "healthcare asa right for all
Canadians": - Principles apply to all insured Canadians
- First Nations/Inuits health services receive special considerations
- Main role: protect, promote & restore the physical and mental well-being of

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residents
- Offer reasonable access to HC without financial/other barriers
99. Principles of Canada Health Act: - public administration
- comprehensiveness
- universality
- accessibility
- portability
100. Public administration: Provincial and territorial HC plans operate on a
non-profit basis through a public authority. (Regional authorities and some agencies(Cancer) are
entrusted with the delivery of programs and services)

- All administration of provincial health insurance must be carried out by a publicauthority on a


non-profit basis.
101. Comprehensiveness: HC plans cover all medically necessary services byhospitals, physicians,
and dentists must be insured. (performed in hospital)

- Determines medically necessary services (not defined in the act)(differs from

province to province)
102. Universality: Care is free from discrimination based on race, gender, ethnicityor religion

All residents are covered


103. Portability: Canadians are able to receive care in any province or territory withno cost or penalty

Can live in a new province for 3 months w/ old province health card
104. Accessibility: Provides insured residents reasonable access to HC providers,regardless of ability
to pay
105. Provincial responsibilities: - develop and administer its own HC insuranceplan in alignment
with Canada Health Act principles

- determine organization and location of HC facilities

- reimburse physician and hospital expenses and provide co-payment with users forselect rehab and
LTC services

- provide supplemental coverage to certain groups of people (e.g., seniors andchildren)

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106. Federal responsibilities: - set and administer Canada Health Act principles

- assist in financing provincial and territorial health through transfer payments

- deliver and co-deliver HC for targeted groups

- provide nation policy and programming to promote health and prevent disease
107. Who is responsible for the delivery of health care in Canada?: This is primarily the
responsibility of the provincial or territorial level with the federal gov- ernment delivering services only
to specific target groups (RCMP, military, refugees,Indigenous).
108. Regional health authorities and the delivery of health care in Canada: Re-gional health
authorities:
- Govern, plan, and deliver health care services within their geographical area
- Streamline health services; reduce fragmentation; respond to local needs; improvepublic
participation.
- Address continuum of health care services from disease/injury prevention andhealth promotion
to curative, supportive, restorative and palliative treatments.
109. Why is the provincial and territorial plan unique?: It is unique because eachhave different
outlines for coverage, such as for drugs taken outside of hospitals, ambulance services, and home
care.
110. Lalonde Report (1974): - Medical approach to behavioral approach regardinghealth.

- Traditional medical approach inadequate.

- First document in western world to acknowledge inadequacy of strictly biomedicalhealth care system

- Defined health determinants broadly as: lifestyle, environment, human biology, &organization of
health care.
111. Who funds the Canadian health care system?: Canadian pay, directly, or indirectly, for every
aspect of our health care system through a combination of taxes,payments to government, private
insurance premiums, and direct out-of-pocket feesof varying types and amount.
(Romanow)
112. Canada Health Transfer: The Canadian Health Transfer is the largest federal transfer that
provides predictable funding for health care that includes cash and tax point transfers and helps
support the 5 principles of the Canada health act.

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- Provinces and Territories receive additional federal funding support for health care through other
fiscal transfer

- Money the federal government sends to the provinces and territories to help pay for health care,
which is a provincial responsibility.

-Is the money the federal government sends to the provinces and territories to help pay for health
care, which is a provincial responsibility.
113. What is safety?: Minimize risk of harm to patients and providers through both system
effectiveness and individual performance.
114. What is Quality of Care?: the degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are consis- tent with current professional
knowledge.
115. Canadian Patient Safety Institute (CPSI): - provide tools and resources to enhance patient
safety

- host safety events

- offer safety programs and education

- identifies 4 priority areas of safety


116. Who do CPSI work with?: - works with governments, health organizations,leaders, patients
and HC providers to promote patient safety and quality of care
117. CPSI priority areas of safety (4): - medication safety (Med safety and Medincident) (revent
harm due to medication error.)

- surgical care safety (Post-procedure infections and surgical care safety) (Surgical checklist, surgical
site infection.)

- infection prevention and control (Hand hygiene and Antimicrobial resistance)

- home care safety (Falls and Home care safety)


118. Whom do the BC patient safety and quality council work with? What do they offer?: -with
health authorities, patients, and HC workers to promote a patient

- offers professional development programs


119. BC Patient Safety and Quality Council: - " A sustainable health care systembuilt on a foundation
of quality."

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BSNC 1020 MODULE 1-5 FINAL

- "To Provide system-wide leadership through collaboration with patients, the publicand those working
within the health system in relentless pursuit of quality"

-centered approach to quality of care

- lists many safety resources for different clinical areas

- focus on cultural safety

- defines quality using 7 dimensions of quality in BC Health Quality matrix


120. What are the 7 dimension of quality in BC Health Quality matrix?: Respect,Safety, Accessibility,
Appropriateness, Effectiveness, Equity and Efficiency.
121. What is the BC Health Quality Matrix Handbook?: - This provides a frame-work for defining the
quality of care and helps student nurses, nurses and other health care professionals evaluate the
quality of health care that is provided in BC.
- By paying attention to the dimensions of quality, outlined in the matrix, we considerthe client
experience in our health care system from both an individual and a population perspective.
- We also use the dimensions of quality to measure the performance of the systemin which health
care services are delivered
122. Dimensions of quality based on system performance (2): - Equity: fairdistribution of
services and benefits according to population needs

- Efficiency: optimal and sustainable use of financial, environmental, and humanresources to yield
maximal health and wellness services
123. Dimensions of quality based on client experience (5): - Effectiveness: carethat is known to
achieve intended outcomes

- Respect: honoring a person's choices, needs and values

- Accessibility: the extent to which people can obtain care when they need it

- Appropriateness: care that is specific to a person's community or context

- Safety: avoiding actual or perceived physical, cultural or psychological harm


124. Romanow report: - medicare is sustainable and must be preserved becauseit represents
Canadian's core values

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- Create a new diagnostic service fund, Build info technology infrastructure, Improveaccess,
Insure/measure quality and Strengthen & expand homecare

- proposed initiative such as drug coverage for all

- focus on health promotion and health as a right for all Canadians


125. Kirby report: - medicare is not sustainable and stronger private sector involve-ment is required in
health care delivery

- proposed funding for hospitals to a service-based model

- focus on health promotion and health as a right for all Canadians

- Giving more responsibility to regional health authorities


126. Primary Health Care: - Focus on health promotion; disease prevention; devel-opment of healthy
public policies.

- providing an entry point of contact into the health care system as well as being thevehicle for
continuity of care

- Looks at broader population

- Promotes patient participation in their health care


127. What is the goal of primary health care?: - Addressing equity issues for health, providing
patient- and community-relevant and accessible health servicesand programs, situating health
intersectionally, Building collaborative models for program and policy dialogues and Embedding
patient, stakeholder, and partner participation
128. Levels of Care (5): 1. Health Promotion
2. Disease and Injury Prevention
3. Diagnosis and treatment
4. Rehabilitation
5. Supportive Care
129. What are the 4 pillar of PHC?: Team, Access, Information and Healthy Living
130. Describe Teams in PHC: PHC interdisciplinary teams or networks deliver patient-centered care,
which improves access through collaboration, coordination,continuity, and quality.

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131. Describe Access in PHC:: Ease to which one can access a regular familydoctor. Urban settings
= interprofessional teams often work to bring PHC to thestreets
132. Describe Information in PHC:: Using technology to improve efficiency and quality is a critical
part of health care renewal in 80% of information seekers reporting convenience, easy access to
recent health information, and anonymity asthe primary reasons for online access.
133. Describe Healthy Living in PHC:: PHC embraces strategies of prevention,chronic illness
management, and self-care while recognizing factors outside the health care system.
134. What does the CNA position statement on PHC say are the 5 essential principles of PHC?: 1.
Accessibility

2. Active Public Participation

3. Health promotion and chronic disease prevention/management

4. The use of appropriate technology and innovation

5. Intersectoral cooperation and collaboration.


135. According to the same position statement, what are the 4 reasons that Canada should adopt
PHC?: 1. The current global recession.

2. Consistent recommendations from a myriad of national commissions calling forhealth-system


reform.

3. Slipping performance relative to international comparisons on health and systemsindicators.

4. Ageing of our population.


136. What is one way that RNs are showing their PHC leadership ( as part of interprofessional
collaborative teams)?: RNs are showing their primary healthcare leadership in the following ways:

- Strengthing our publicly funded, not-for-profit health system to ensure timely andequitable access
to quality care for all Canadains when and where it is needed.

- Championing social justice and health equity principles.

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- Encouraging actions that consider the broader DOH to help increase healthresources at
individual, community and population levels.
137. Level 1: Health Promotion: Focuses on "enabling people to increase controlover to improve
their health"
138. Level 2: Disease and Injury Prevention: Illness prevention services to helppatients, families,
and communities reduce risk factors for disease and injury.
139. Level 3: Diagnosis and Treatment: Focus on recognizing and managingindividuals patients'
existing health problems
140. In this Level 3: Diagnosis and Treatment, what are the 3 sublevels ofcare?: sublevels:
primary, secondary, and tertiary.
141. Primary Care (PC): The first contact of a patient with the health care systemleads to a decision
regarding a course of action to resolve any actual or potential health problem.

- provider include physicians and NPs

-Focus on early detection, routine care, and education to prevent recurrences.

-Primary care refers to the delivery of community-based clinical health-care serviceswith providers
coordinating the care of individuals and enabling equitable and timelyaccess to other health-care
services and providers. This focuses on preventing, diagnosing, treating, and managing health
conditions as well as promoting health
142. Secondary Care: Occurs in hospital or home settings and involves specializedmedical service by a
physician specialist or hospital on referral from PC practitioner.

- Considers definitive or extended diagnosis.


143. Tertiary Care: Specialized technical care in diagnosing and treating complicat-ed health problems.

- Occurs in regional, teaching, uni, or specialized hospitals that house sophisticateddiagnostic


equipment.
144. Level 4: Rehabilitation: Occurs after a physical or mental health illness, injury,or chemical
addiction or is related to begins the moment a patient enters a health care setting for treatment as
part of an interdisciplinary effort.

- Assists patients in returning to their previous level of function or reaching an optimal level of function,
thereby enhancing quality of life while promoting independence andself care.

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145. Level 5: Supportive Care: Consists of health, personal, and social servicesprovided over a
prolonged period
146. Other federal health-related functions: - regulation of products (e.g., medicaldevices, food ,
pharmaceuticals, cell phones)

- supports health research, health promotion/protection, disease monitoring/preven-tion

- tax support for health-related costs (e.g., disability, tax rebates to public institutions,deductions for
private health insurance premiums for self-employed)
147. Federally targeted groups: - First Nations people living on reserves

- Inuit

- serving members of the Canadian Forces

- eligible veterans

- inmates in federal penitentiaries some groups of refugee claimants


148. Ottawa Charter for Health Promotion: was developed from the social model of health and
defines health promotion as 'the process of enabling people to increase control over, and to improve,
their health' (WHO 1998).

Identifies three basic strategies for health promotion, which are enabling, mediating,and advocacy.
149. What are the five action strategies for health promotion? Ottawa Charter of Health Promotion:
building healthy
* public policy
* creating supportive environments
* strengthening community action
* developing personal skills
* reorienting health care services

- details how health care providers enable patients to make decisions that affect theirhealth
150. Regionalization: - idea of having many separate health authorities

- failed (move towards recentralization)

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151. Health authorities in BC: - Vancouver Costal Health
- Fraser Health
- First Nations Health Authority
152. Types of healthcare delivery agencies (Sectors): Community, Institutionaland Private
153. Institutional sector: - hospitals
- long-term care facilities
- psychiatric facilities
- rehabilitation centres

* all offer inpatient services and most offer outpatient services


154. Community sector: public health, physician office, community health centres,assisted living,
home care, adult day care enters, community/voluntary agencies, occupational heath, hospices,
school
155. Municipality Act: - rural communities has difficult attracting and paying physi-cians
- in response, this act gave communities the power to level taxes to pay for physicians
156. Professional jurisdiction: - for health professions that are not self-regulatedand thus are
regulated by the government or other regulatory mechanisms

- e.g., emergency medical technicians in Ontario


157. Public health acts: - enacted by provinces to establish local boards of healthto hire medical
health officers and sanitation inspectors
158. Explain the difference between primary care and PHC - identify at least 3differences.: Primary
Care:
- Focus on personal health (individuals), specific term for smaller range of ser-
vice/providers/functions/goals, primarily medical care of family practice, often basedon caring for those
sick/injured, based on medical care.

Primary Health Care:


- Focused on community. Broader term, wider range of providers, services, functions and goals. Includes
health education, nutrition, maternal and child health care, family planning, immunizations. Considers
DOH.
159. What are individual barriers to PHC?: - Lack of role clarity and trust, oftenattributed to limited
knowledge of other team member's abilities/skills.
160. Practice-level Barriers to PHC?: Linked to hierarchical issues at the level ofgovernance and
leadership, as well as to strategic team attributes and skills.
161. System level barriers to PHC?: Lack of interprofessional education, appropri-ate funding, and
monitoring and evaluation.

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162. What are the important reports that influenced the delivery and focus ofhealth care in
Canada?: The Ottawa Charter for Health Promotion (1986) Achieving Health for All: A Framework for
Health Promotion - the "Epp report" (1986)Jakarta Declaration on Health Promotion into the 21st
Century (1997)
Bangkok Charter for Health Promotion in a Globalized World (2005)Toronto Charter
on the Social Determinants of Health (2009)
163. What is Health Canada's goal?: Canada to be among the countries with thehealthiest people in
the world
164. What does Health Canada say about how they will achieve their goal?: -
-Relies on high-quality scientific research as the basis for our work

-Conducts ongoing consultations with Canadians to determine how to best meettheir long-term
healthcare needs

-Communicate information about disease prevention to protect Canadians fromavoidable risk

-Encourages Canadians to take an active role in their health, such as increasingtheir level of
physical activity and eating well
165. How do determinants of health influence health care delivery?: Most top-performing
countries have achieve better health outcomes through actions on
the broader determinants of health such as environmental stewardship and health promotion
programs focusing on changes in lifestyle including smoking cessation, increased activity, healthier diet,
and safer driving habits. Also looks at education, early childhood development, income, and social status
to improve health outcomes.The link between the social determinants of health and health outcomes is
central to PHC and reflects the impact of social inequality on health at the individual, community, and
population levels
166. Concept of Advocacy: - To speak on behalf of another person
- To speak on behalf of or recommend a policy

Advocacy consists of taking action on behalf of a person, or supporting an individualor group in getting
what they need.
167. What do nurses advocate towards eliminating social inequities?: Theseinclude protecting the
patient's right to choice by providing information, obtaining informed consent for all nursing care,
and respecting patients' decisions
168. How do nurses protect patients' right to dignity through advocacy?: They advocate for
appropriate use of interventions in order to minimize suffering, interven- ing if other people fail to
respect the dignity of the patient, and working to promote

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health and social conditions that allow patients to live and die with dignity. Need toprotect right to
privacy and confidentiality by helping the patient access their healthrecords (subject to legal
requirements), intervening if other members of the health care team fail to respect the patient's
privacy, and following policies that protect thepatients privacy.
169. How do nurses advocate on ethical issues?: Nurses advocate for the dis- cussion of ethical
issues among health care team members, patients, and families,and nurses should advocate for health
policies that enable fair and inclusive alloca-tion of resources
170. What is required for advocacy by a nurse?: Advocacy requires that nurseshave a strong
awareness of the context in which situations arise as well as an understanding of the influence of
power and politics on how they make decisions
171. What is constrained moral agency?: This is a feeling of powerlessness to actfor what you think is
right or if you believe your actions will not effect change. This can lead to difficulty being an effective
advocate.
172. What is the ethical responsibility of advocacy in nursing?: This meansacting on behalf of
another person, speaking for persons who cannot speak for themselves, or intervening to ensure
that views are heard
173. What are the characteristics of advocacy?: - Engaging others, exercisingvoice, mobilizing
evidence to influence nursing practice and policy.

- It means speaking out against inequity and inequality

- Involved participating directly and indirectly in political processes and acknowl-edges the
important roles of evidence, power and politics in advancing policy options.
174. Lobbying vs. Advocacy: There is no limit to the amount of non-lobbying advocacy your
organization can do, while lobbying activities may be restricted toa percentage of your operating
budget.

Lobbying involves attempts to influence specific legislation while advocacy is fo-cused on educating
about a specific issue.

advocacy is "the act or process of supporting a cause or proposal." On the other hand, to lobby is
defined as "to promote (something, such as a project) or secure the passage of (legislation) by
influencing public officials."
175. Lobbying: Engaging in activities aimed at influencing public officials, especial- ly legislators, and
the policies they enact.

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