Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care, 9th Edition
The first edition of this textbook, entitled Medical-Surgical Nursing: A Nursing Process Approach, was a groundbreaking work in many ways. The following eight editions built on that achievement and further solidified the book’s position as a major trendsetter for the practice of adult health nursing.
Now, in its ninth edition, “Iggy” charts the cutting-edge approach for the future of adult nursing practice—an approach reflected in its current title: Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. The focus of this new edition continues to help students learn how to provide safe, quality nursing care that is patient-centered, evidence-based, and interprofessionally collaborative. In addition to print formats as single- and two-volume texts, this edition is now available in a variety of electronic formats.
The subtitle for this ninth edition was carefully chosen to emphasize the interprofessional nature of today’s care, in which the nurse serves as a central role in collaboration with the patient, family, and members of the interprofessional health care team in acute care, community-based, and home settings. This approach reflects the National Academy of Medicine, The Joint Commission, the Quality and Safety Education for Nurses (QSEN) Institute, and the 2010 Future of Nursing report that unanimously have called for all health professionals to coordinate and deliver safe, evidencebased, patient-centered care as a collaborative team.
Key Themes for the 9th Edition
The key themes for this edition strengthen this text’s conceptual focus on safety, quality care, patient-centeredness, and clinical judgment to best prepare the student for interprofessional practice in medical-surgical health settings. Each theme is outlined and described below.
• Enhanced Focus on Professional Nursing and Health Concepts. This edition uniquely balances a focus on concepts, and a conceptual approach to teaching and learning, with important underpinnings of content. Prelicensure programs that embrace concept-based nursing curriculum, system-focused curriculum, or a hybrid approach will find this edition easy to use. To help students connect previously learned concepts with new information in the text, Chapters 1 and 2 addresses the main concepts used in this edition, giving a working definition upon which the students will reflect and build as they learn new material. These unique features build on basic concepts learned in nursing fundamentals courses, such as gas exchange and safety, to help students make connections between foundational concepts and interprofessional patient care for medical-surgical conditions. For continuity and reinforcement, a list of specific Priority and Interrelated Nursing Concepts is highlighted at the beginning of each chapter. This placement is specifically designed to help students better understand the priority and associated needs that the nurse will address when providing safe, evidence-based, patient-centered care for individuals with selected health problems. When these concepts are discussed in the body of each chapter, they are presented in small capital letters (e.g., IMMUNITY) to help students relate and apply essential concepts to provide more focused nursing care.
• Emphasis on Key Exemplars. For each priority concept listed in selected chapters, the authors have identified key exemplars. The nursing and interprofesional collaborative care for patients experiencing these exemplar diseases and illnesses is discussed through the lens of the priority and interrelated concepts. In addition, patient problems are presented as a collaborative problem list rather than merely presenting nursing diagnoses.
• Prioritized Focus on the Core Body of Knowledge and QSEN Competencies. This edition not only continues to emphasize need-to-know content for the RN level of practice but also includes a continuing emphasis on Quality and Safety Education for Nurses (QSEN) Institute core competencies. Clinical practice settings emphasize the critical need for safe practices and quality improvement to provide interprofessional patient-centered care that is evidence-based. Many hospitals and other health care agencies have formally adopted these QSEN competencies as core values and goals for patient care, and many nursing programs have used these same competencies to build prelicensure nursing curriculum. To help prepare students for the work environment as new graduates, as well as to highlight the foundational underpinning of safety and quality into all nursing actions, this edition prioritizes a focus on these competencies.
• Emphasis on Patient Safety. Patient safety is emphasized throughout this edition, not only in the narrative but also in Nursing Safety Priority boxes that enable students to immediately identify the most important care needed for patients with specific health problems. These highlighted features are further classified as an Action Alert, Drug Alert, or Critical Rescue. We also continue to include our leading-edge Best Practice for Patient Safety & Quality Care charts to emphasize the most important nursing care. Highlighted yellow text also demonstrates the application of The Joint Commission’s National Patient Safety Goals initiatives (http://www.jointcommission.org/standards_information/npsgs.aspx) and Core Measures content into everyday nursing practice. The Joint Commission’s National Patient Safety Goals initiatives are also set in boldface type for further emphasis.
• Focus on Patient-Centered Care. Patient-centered care is enhanced in the ninth edition in several ways. The ninth edition continues to use the term “patient” instead of “client” throughout.
Although the use of these terms remains a subject of discussion among nursing educators and health care organizations, we have not defined the patient as a dependent person. Rather, the patient can be an individual, a family, or a group—all of whom have rights that are respected in a mutually trusting nurse-patient relationship. Most health care agencies and professional organizations use “patient” in their practice and publications, and most professional nursing organizations support the term.
• Focus on Gender Considerations. To increase our emphasis on patient-centered care, Gender 55 Health Considerations focus on important gender-associated information that impacts nursing care. Differences in patient values, preferences, and beliefs are addressed in Chapter 73, Care of Transgender Patients. Along with other individuals in the LGBTQ population, the health needs of transgender patients have gained national attention through their inclusion in Healthy People 2020 and The Joint Commission’s standards. This chapter, first introduced in the eighth edition, continues to provide tools to help prepare students and faculty to provide safe, evidence-based, patient-centered care for transgender patients who are considering or who have undergone the gender transition process.
• Emphasis on Evidence-Based Practice. The ninth edition focuses again on the importance of using best current evidence in nursing practice and how to locate and use this evidence to improve patient care. Evidence-Based Practice boxes offer a solid foundation in this essential component of nursing practice. Each box summarizes a useful research article and explains the implications of its findings for practice and further research, as well as a rating of the level of evidence based on a well-respected scale.
• Focus on Quality Improvement. The QSEN Institute emphasizes, and clinical practice agencies require, that all nurses have quality improvement knowledge, skills, and attitudes. To help prepare students for that role, this edition includes unique Quality Improvement boxes. Each box summarizes a quality improvement project published in the literature and discusses the implications of the project’s success in improving nursing care. The inclusion of these boxes disseminates information and research and helps students understand that quality improvement begins at the bedside as the nurse identifies potential evidence-based solutions to practice problems.
• Emphasis on Clinical Judgment. Stressing the importance of clinical judgment skills via prioritization and delegation helps to best prepare students for practice and the NCLEX ® Examination. As in the eighth edition, the ninth edition emphasizes the importance of nursing clinical judgment to make timely and appropriate decisions and prioritize care. To help achieve that focus, all-new case-based Clinical Judgment Challenges based primarily on QSEN core competencies are integrated throughout the text. Selected Clinical Judgment Challenges highlight ethical dilemmas, as well as delegation and supervision issues. These exercises provide clinical situations in which students can use evolving nursing clinical judgment to help prepare them for the fast-paced world of medical-surgical nursing. Suggested answer guidelines for these Clinical Judgment Challenges are provided on the companion Evolve website (http://evolve.elsevier.com/Iggy/). Dr. Christine Tanner’s clinical judgment framework (Tanner, 2006) is integrated more deeply in this edition to help students apply selected concepts in the Disorders chapters. The components of this model match Tanner’s terminology to each nursing process heading, thereby helping students use nursing judgment to provide safe, quality care by:
• Assessment: Noticing
• Analysis: Interpreting
• Planning: Implementation and Responding
• Evaluation: Reflecting
• Emphasis on Preparation for the NCLEX
® Examination. An enhanced emphasis on the NCLEX Examination and consistency with the 2016 NCLEX-RN® test plan has been refined in this edition.
The ninth edition emphasizes “readiness”—readiness for the NCLEX Examination, readiness for disaster and mass casualty events, readiness for safe drug administration, and readiness for the continually evolving world of genetics and genomics. An increased number of new NCLEX Examination Challenges are interspersed throughout the text to allow students the opportunity to practice test-taking and decision making. Answers to these Challenges are provided in the back of the book, and their rationales are provided on the Evolve website 56 (http://evolve.elsevier.com/Iggy). In a world that needs more nurses than ever before, it is more critical than ever that students be ready to pass the licensure examination on the first try. To help students and faculty achieve that outcome, Learning Outcomes at the beginning of each chapter continue to be consistent with the competencies outlined in the detailed 2016 NCLEX-RN® Test Plan. The ninth edition continues to include an innovative end-of-chapter feature called Get Ready for the NCLEX ® Examination! This unique and effective learning aid consists of a list of Key Points organized by Client Needs Category as found in the NCLEX-RN Test Plan. Relevant QSEN and Nurse of the Future competency categories are identified for selected Key Points.
• New Focus on Care Coordination and Transition Management. This edition includes a priority focus on continuity of care via a Care Coordination and Transition Management section in each Disorders chapter. Literature continues to emphasize the importance of care coordination and transition management between acute care and community-based care (Lattavo, 2014). To help students prepare for this role, the ninth edition of our text provides coverage focusing on Home Care Management, Self-Management Education, and Health Care Resources.
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