d.). “The model recognizes the contributions of professional and specialty nursing organizations, educational institutions, credentialing and accrediting organizations, and regulatory agencies; clarifies the role of workplace policies and procedures; and confirms the individual nurse’s ultimate responsibility and accountability for defining nursing practice” (ANA, n.d.). There are 5 essential entities that are involved with developing a standard of practice. They are knowledge, role validation, competence and skill, environment, and ethics (Klein, 2005). As a standard of practice is being developed, there are questions for each entity that can be asked.
For example:
Knowledge—“Did I complete a program that prepared me to see this population (family, adult, pediatric) of patients?” (Klein, 2005) Role Validation—“Is additional licensure or certification required to do this skill on an ongoing or specialized basis?” (Klein, 2005) Competence and Skill—“How have I maintained competence?” (Klein, 2005) Enviroment—“Does the environment that I work in support this scope or practice through structures such as staffing, consultation, policies and procedures, protocols, and community standards?” (Klein, 2005) Ethics—“What are the potential consequences of accepting treatment responsibility for this patient?” (Klein, 2005) In conclusion, the board of nursing wants the practicing nurse to be fully competent in their work. This is a direction of how they determine the standards of practice that we follow. Nursing Standards of Practice Essay
American Nurses Association. Determining Scope of Practice for Advanced Practice Registered Nurses.Retrieved August 6, 2014, from http://www.nursingworld.org/ScopeofPractice Klein, T. A. (2005). Scope of Practice and the Nurse Practitioner: Regulation, Competency, Expansion and
Evolution. 1-2.
The nursing process is more than a method that nurses use to diagnose and treat actual and potential health problems. The American Nurses Association (ANA) Standards of Nursing Practice provides a basis for practice and recognition of the patient; in addition, nurses also must adhere to the profession’s ethical code as well. “Nurses are committed to respect human beings with an unbiased approach of care to differences socially, economically, culturally, racially, and other human attributes” (Saucier, 2005, p. 80). It is the responsibility of the professional nurse to engrain ethics as an essential part of the foundation of nursing. The International Council for Nurses (ICN) identifies that the need for nursing is universal and that “nurses have four fundamental responsibilities: to promote health, prevent illness, restore health, and alleviate suffering” (Tomey, 2004, p. 75). From the beginning of nursing Florence Nightingale stated it so eloquently in the original Nightingale Pledge: Nursing Standards of Practice Essay
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was originally created to ensure the privacy of individuals and it holds those individuals accountable that might acquire sensitive information in regards to medical records (Garrett, Baillie, & Garrett, 2010, p. 117). However, there are also some gray areas where a nurse is often not sure whether the information that is being handed out is acceptable, or whether the person that is asking for the information is authorized to have it. When these kinds of situations take place, confusion can arise and it can make it difficult for nurses to do the job properly without fear of retaliation. Not only is confidentiality an ethical issue, but a legal requirement.
In chapter five, Principles of Confidentiality and Truthfulness, the terms obligation and secrets was used. Having the understanding and knowing the difference between the types of secrets and an awareness of harm or possible harm to the patient, family, or profession is key. This information is directly related to the Nursing Scope and Standards of Practice, Standard 12. Ethics, The registered nurse integrates ethical provisions in all areas of practice. The measurement criteria for the registered nurse state: “Maintains patient confidentiality within legal and regulatory parameters, maintains a therapeutic and professional patient-nurse relationship with appropriate professional boundaries, and uses Code of Ethics for Nurses with Interpretive Statements to guide practice” (American Nurses Association [ANA], 2004, p. 39). Specifically, ethic 3.2 Confidentiality, that is encompassed in the standard that states “the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient” (American Nurses Association [ANA], 2001, p. 12). Trust and well-being of the patient are key in the area of confidentiality; keeping in mind, that when working within a multi-disciplinary team, the nurse must only share relevant information on a need to know bases. Nursing Standards of Practice Essay
As an example, the emergency room nurses’ cousin was admitted to the emergency room during the shift at the hospital. He is in critical condition. The nurses’ mother is very concerned about him, but she has not been able to reach the nurses aunt and uncle. The nurse is aware of the cousin’s condition. With the standards and ethics does she tell her mom? No, this is probably the hardest of situations, but the nurse must not tell. She must not even let on that she has any information. Instead, encourage her mother to keep calling your aunt. The nurse might even see if her aunt is at the hospital and arrange for her to call mom. Even doctors can only release information to the immediate family-in this case, the cousin’s parents. It is up to the aunt and uncle to inform the rest of the family. That way, they can determine how much information family members should have.
Maintaining confidentiality is an important aspect of professional behavior. It is essential that a nurse safeguard the patient’s right to privacy by carefully protecting information of a sensitive, private nature. Sharing personal information or gossiping about others violates nursing ethical codes and practice standards. It sends a message that the nurse cannot be trusted and damages interpersonal relationships. Nursing Standards of Practice Essay
Informed consent
Nurses are obligated to tell all patients, regardless of whether or not they are capable or incapable of giving consent, about the care or treatments before it is given. Nurses are obligated to assist patients understand the nature of their health problems and assist them to receive the information and support they need to make informed decisions. A key principle studied in chapter two, Principles of Autonomy and Informed Consent, that all medical care requires the consent of the patient (or someone who is authorized to consent for the patient) before the care plan is carried out. An assumption is made that informed consent recognizes that a patient needs to know about a procedure, surgery, or treatment, before they decide to have it. Standard 14.Resource Utilization in the ANA Scope and Standards of Practice explicitly denotes that nurses should “assists the patient and family in becoming informed consumers about options, costs, risks, and benefits of treatment and care. Informed consent may have a multitude of legal ramifications, but its core and most controversial function lies in the idea of patients actually participating in medical decision making. It may be at this point that the physician (or autonomist) and the nurse most tend to butt heads. Fortunately for nurses there is Ethics Code 1.4. The concept of informed consent is fundamental to the delivery of health care. The nurse’s responsibility is vital in ensuring that patients are fully informed and understand their options; “each nurse has an obligation to be knowledgeable about the moral and legal rights of all patients to self-determination” (ANA, 2001, p. 8). Informed consent is more than just signing a paper, is specific patient right.
An example case of a patient with angina who was considered for a coronary bypass surgery demonstrates the issue of informed consent. Ethical and legal aspects of achieving consent must be considered. Physicians may have personal biases, which may lead to coerced consent, or may overwhelm the patient with information on potential complications of a proposed procedure. Patient preconceived notion or misinformation may lead to misunderstood consent. The patient’s request to put back the decision to the physician raises the question of whether such requested paternalism violates patient self-determination and invalidates consent or is it an exercise of the patient’s right to have his physician decides (Garrett et al., 2010, p. 32)?
Quality and safety
Providing basic nursing care for the individual patient is an important nursing value supported by professional mandates and by codes of nursing ethics. Referring again to Standard 14.Resouce Utilization that states, “the registered nurse considers factors related to safety, effectiveness, cost, and impact on practice in the planning and delivery of nursing services” (ANA, 2004, p. 42). It is easy to tie the concept directly from the ANA standards of performance to the nursing code of ethics 8 that states “the nursing profession is committed to promoting health, welfare, and safety of all people” (ANA, 2001, p. 23). In reading from chapter six, there was discussion that quality care can be achieved by high tech equipment, credentialing, licensing, skill, knowledge, and protocols; however, a key point in judging quality stated “professions lead the effort to enhance and protect quality in the professions” (Garrett et al., 2010, p. 134). If employment conditions, agency regulations, or hospital policies create undesirable working conditions that limit the quality of nursing care that can be provided, nurses become concerned. Since nurses value quality of patient care, they also value those conditions that allow quality patient care. Nursing Standards of Practice Essay
When nurses attempt to balance the value of quality of patient care with issues involving their quality of life the action of a possible strike may come into question. While the nurse’s value being able to guarantee high quality care they may realize in the short term many patients may not receive the highest of quality care while a strike is in effect. When putting ethical decisions first, nurses should work through their professional organizations and promote positive mechanisms for negotiations with employers. If nurses can gain responsibility for, and control over, the quality of care delivered, they will have gained great benefit for the health of the community.
Conclusion
If not nurses, who will advocate for the chronically ill (both young and old), the under and uninsured, and the most vulnerable with complex health needs? Who will question the rightness or wrongness of aggressive care, technological advancements, and determinations of quality of life? Who will address patient concerns related to informed consent, surrogate decision-making, and the risks and benefits of treatment or research? And who will challenge ineffective or inefficient nursing, physician, and administrative leadership standards and styles that underestimate the significance of ethical problems on patient outcomes and nurse productivity and retention? These philosophical questions are at the core of our deeply held values and beliefs about who we are as a discipline. Without adequate ethical knowledge and competence; however, it is difficult to bring together nursing on central ethical concepts in the provision of nursing care. The nurse, as a patient advocate presents difficult challenges; however, the key principles of ethics will allow all nurses to persevere in understanding the scope and limits of their professional responsibilities.
The decision making framework was developed by the ANMC to assist nurses to recognise their scope and to consider their knowledge and experience when making care decisions. The purpose of the framework is aimed to ensure that nurses/enrolled nurses’ work safely and within their scope and make consistent decisions. Nursing Standards of Practice Essay
When using the decision-making framework, differences in education, experience, individual competence and the context of practice must be taken into consideration. In other words, what we do in our day-to-day work must ‘fit’ within our own individual level of education, our competence, within the context of where we are practicing, and within the legal and professional framework. It is vital to understand the standard of principles when using the practice framework as it may be called to account for in some practice decisions circumstances.
The National Framework also includes decision-making tools which can be used to provide guidance and support for enrolled nurses to makes decisions about and within their scope of practice. It also enables the nurse to stimulate discussion regarding emerging issues and contribute in group discussions.
As an Enrolled Nurse there codes, guidelines and ANMC Competency Standards that must be followed. These codes and guidelines provide us with the framework for assessing our competence, as well as informing us of what behaviours, attitudes and the general conduct that we will be expected. Therefore it is important that we understand the professional codes and guidelines that govern the nursing profession before participating in the delivery of nursing care to patients and residents. Nursing Standards of Practice Essay
Together, these codes, guidelines and standards make up a framework for accountable and responsible nursing practice and ensure that the individual nurse maintains his or her competence to practice and act within the legal and ethical basis.
CONTINUING PROFESSIONAL DEVELOPMENT (CPD) STANDARDS
A. The Nursing and Midwifery Continuing Profession Development Registration Standard document outlines the requirements necessary to meet the continuing professional development standards.
The document contributes to our life-long learning by encouraging the development of nurses and other health professions. In order to continue professional development, all nurses are required to:
Participate in at least 20 hours of continuing nursing professional development per year.
One hour of active learning will equal one hour of CPD; examples of CPD include involvement in a professional body or interest groups, courses or further education or research.
Keep written documentation of CPD that demonstrates evidence of completion of a minimum of 20 hours of CPD per year.
It is our responsibility as nurses to maintain, improve and broaden our knowledge, expertise and competence, and develop the personal and professional qualities required throughout our professional lives. Not only does this benefit us as nurses, but also our patients or clients and other professionals. Nursing Standards of Practice Essay
With the understanding of this document and continuing professional development we are able keep up to date with the rapidly changing health care environment and extend our career further as nurses.
B. IMPORTANCE OF NURSING THEORIES
Nursing theory is important to nursing practice as it provides a foundation for establishing evidence-based practice in nursing care. It aids and guides nurses in assessing, identifying the needs and problems of the patient, or explaining patient conditions. Nursing theory has many useful purposes for nursing practice such as assessment, establishing a care plan, implementation of medical interventions and evaluation and directing nursing research.
A great example is Florence Nightingale. She is the most recognised name in the history of nursing. Her theories focused on the holistic approach to patient care, emphasizing on the patient’s psychological and human needs and providing a clean environment for the patient.
To utilize this theory in the nursing practice, the nurse would provide clean environment and maintain hygiene to prevent infection.
Although so many aspects of nursing have changed since Florence Nightingale’s era, her theories and many other theories will also remain an integral part of nursing and healthcare today. Nursing Standards of Practice Essay
C. ROLES OF PROFESSIONAL NURSING ORGANISATION
Nursing and Midwifery Board of Australia (NMBA)
The Nursing Midwifery Board of Australia (NMBA) is the legally constituted body in Australia responsible for:
Registering nursing and midwifery practitioners and students
Developing standards, codes and guidelines for the nursing and midwifery professions
Handling notifications, complaints, investigations and disciplinary hearings
Assessing overseas trained practitioners who wish to practise in Australia and,
Approving accreditation standards and accredited courses of study.
The National Board works in partnership with the Australian Health Practitioner Regulation Agency (AHPRA) to keep the public safe by ensuring that the public has access to qualified and competent nurses and midwives to provide nursing and midwifery care. Nursing Standards of Practice Essay
Australian Nursing and Midwifery Accreditation Council (ANMAC)
The Australian Nursing and Midwifery Accreditation Council is the accreditation authority responsible for accrediting education providers and programs of study for the nursing and midwifery profession.
Australian Nursing Federation (ANF)
The ANF is the national union for nurses, midwives and assistants in nursing. It advocates for nurses, midwives and assistants in nursing who face challenges such as a frustration with the health system, not enough money, underfunded hospitals, not enough nurses, midwives or beds, and not enough time to spend with patients and residents. Nursing Standards of Practice Essay
Royal College of Nursing Australia (RCNA)
ACN is a national membership organisation open to nurses and nursing students in all areas of the profession.
ACN contributes to the enhancement of the nursing profession in many ways, including:
Supporting members in their continuing professional development
Keeping members up-to-date with critical issues affecting the nursing professions
Administering over $20 million in Australian Government and ACN-funded scholarships every year to address nursing workforce issues, promote the importance of professional development activities and create ongoing educational opportunities for nurses and nursing students across Australia
Offering a series of honours and awards to recognise excellence within the nursing profession. Nursing Standards of Practice Essay
D. IDENTIFY AND DESCRIBE MAIN PURPOSE OF DOCUMENTS
National competency standards for the enrolled nurse
The national competency standards for the enrolled nurse are the core competency standards by which your performance may be assessed to retain your license to practice as an enrolled nurse in Australia.
These core competency standards also provide a framework for enrolled nurses in assessing their performance. They may also be used to assess nurses returning to work after breaks in service and assessing nurses in professional conduct.
Code of ethics for nurses in Australia
This Code of ethics outlines the importance of nurses “recognising, respecting, actively promoting and safeguarding the right of all people to the highest attainable standard of health as a fundamental human right”. NMBA
It contains eight value statements which all nurses and students of nursing are encouraged to use as a guide when reflecting on clinical practice.Nursing Standards of Practice Essay
The purpose of the Code of Ethics for Nurses in Australia is to:
Identify the fundamental ethical standards and values to which the nursing profession is committed, and that are incorporated in other endorsed professional nursing guidelines and standards of conduct
Provide nurses with a reference point from which to reflect on the conduct of themselves and others
Guide ethical decision making and practice
Indicate to the community the human rights standards and ethical values it can expect nurses to uphold.
Code of professional conduct for nurses in Australia
The Code of Professional Conduct for Nurses is the standard in which a person should behave in the nursing profession. The nursing profession expects that nurses will conduct themselves personally and professionally in a way that will maintain public trust and con¬dence in the profession.
The purpose of the Code of Professional Conduct for Nurses in Australia is to:
Set an expected national standard of conduct for the nursing profession,
Inform the community of the standards for professional conduct of nurses in Australia, and
Provide consumer, regulatory, employing and professional bodies with a basis for decisions regarding standards of professional conduct. Nursing Standards of Practice Essay
Principles for the Assessment of National Competency Standards
The purpose of this document is to provide a resource for people assessing the competence
of nurses and for nurses whose performance is undergoing assessment. The information
provided in this document is designed to give guidance when assessing competence against
the Australian Nursing Council National Competency Standards for Registered and Enrolled
Nurses.
The assessment process is important in:
Determining the eligibility for registration or enrolment of people who have undertaken nursing courses in Australia;
Determine the eligibility for registration or enrolment of people who wish to practice in Australia but have undertaken nursing courses elsewhere;
Assess nurses who wish to return to work after being out of the workforce for a defined period; and
Assessing qualified nurses who are required to show they are fit to continue working. Nursing Standards of Practice Essay
E. IDENTIFY AND DESCRIBE MAIN PURPOSE OF DOCUMENTS
Australian Nursing and Midwifery Accreditation Council (ANMAC)
Enrolled Nurse Accreditation Standards
This document outlines the standards and criteria for the Accreditation of Nursing and Midwifery Courses Leading to Registration, Enrolment and Authorisation in Australia. The framework establishes a process, within which courses are granted recognition and approval.
National Accreditation Framework
The purposes of a framework for professional course accreditation:
The primary purpose of external professional accreditation of nursing and midwifery courses is to ensure that graduates who have achieved agreed professional standards, and to provide assurance that every graduate has in fact achieved the agreed standards. A secondary purpose of professional course accreditation is to enable continuous improvement in the quality of professional education. Nursing Standards of Practice Essay
The purpose of the National Accreditation Framework:
Creating a process for accrediting courses that is nationally consistent or that operates within a national framework and facilitating the consistency in assessing overseas applicants for registration or enrolment with criteria for local graduates in all Australian jurisdictions. Nursing Standards of Practice Essay
Australian Nursing Federation (ANF)
Performance review
Performance review and development systems are sets of guidelines for enhancing employee performance, identifying and strengthening staff development activities, cultivating management and staff relationships, and identifying career development opportunities for staff. Nursing Standards of Practice Essay
Higher Education Indicator Framework
Discuss about the Australian Government’s agenda for higher education and its support of these proposed measures to form an indicator framework for higher education performance:
• To increase the number of Australians with bachelor-level qualifications
• To increase the higher education participation of people from underrepresented groups
• To enhance engagement and thus improve student outcomes, and
• To improve the quality of learning and teaching.
Royal College of Nursing Australia (RCNA)
Privacy Policy
Purpose is to ensure the College collects, manages, uses and discloses personal information in accordance with all relevant legislation and standards as outlined in the document.Nursing Standards of Practice Essay
Safe Working Practices in Clinical rooms.
Purpose is to minimise work place injuries within the clinical rooms. They are set up to resemble a typical hospital environment and, as such, are prone to similar hazards that can occur in a hospital environment. This policy is applicable to all staff and students who undertake classes in the Clinical rooms.
2. PROFESSIONAL SKILLS DEVELOPMENT
Employment Opportunities
– Health services websites/ directing calling the organisation
– Department of Health website
– Recruitment Agencies
– Nursing Agencies. Nursing Standards of Practice Essay
Requirements for Curriculum Vitae (CV)
Examples of possible interview questions
– What made you choose nursing as a career?
– How has your training prepared you for a nursing career?
– What do you find difficult about being a nurse?
– How would you handle a patient who constantly complains about pain? Nursing Standards of Practice Essay
Professional development opportunities for an EN
– Many employers offer in-service programs
– Short courses and educational forums through public and private providers
– For nurses wishing to specialise there are a range of postgraduate courses available. Nursing Standards of Practice Essay
