Iwan Dowie Senior Lecturer in Healthcare Law, University of South Wales, Pontypridd, Wales |
Standards | Definition | Measurement criteria |
I: quality of practice | The registered nurse systematically enhances the quality and effectiveness of nursing practice | 1. Demonstrates quality by documenting the application of the nursing process in a responsible, accountable and ethical manner. 2.Uses quality improvement activities to initiate changes in nursing practice and health care delivery system 3.Uses creativity and innovation to improve nursing care delivery 4. Incorporates new knowledge to initiate changes in nursing practice if desired outcomes are not achieved. 5. Participates in quality improvement activities. |
II: education | The nurse attains knowledge and competency that reflects current nursing practice | 1. Participates in ongoing educational activities related to clinical knowledge and professional issues. 2.Demonstrates commitment to life long learning 3.Seeks experiences to maintain clinical skills 4.Seeks knowledge and skills appropriate to the practice setting 5. Maintains professional records that provide evidence of competency and lifelong learning. |
III: Professional practice evaluation | The nurse evaluates one’s own nursing practice in relation to professional practice standards and guide line, relevant statutes, rules and regulations. | 1.Engage in self evaluation on a regular basis 2.Seeks constructive feedback regarding ones own practice 3.Takes action to achieve goals identified during the evaluation process 4.Participates in systematic peer review as appropriate 5.Practice reflects knowledge of current practice standards, laws and regulations 6.Provides age appropriate care in culturally and ethnically sensitive manner |
IV: collegiality | The nurse interacts with and contribute to the professional development of peers and other health care providers as colleagues | 1.Shares knowledge and skills with peers and colleagues 2.Provides peers with feedback regarding their practice 3.Interacts with peers and colleagues 4.To enhance ones own professional nursing practice 5.Maintains compassionate and caring relationships with peers and colleagues 6.Contributes to an environment that is conductive to clinical education nursing students as appropriate 7.Contributes to a supportive and healthy work environment |
V: Collaboration | The nurse collaborates with patient, family, and others in the conduct of nursing practice | 1.Communicates with the patient, significant others, and health care providers regarding patient care and nursing’s role in the provision of care 2.Collaborates with patient, family and others health care providers in the formulation of overall goals and the plan of care and in the decisions related to care and delivery of services 3.Partners with others to effect change and generate positive outcomes 4.Document referrals, including provisions for continuity of care, as needed |
VI: Ethics | The nurse integrates ethical provisions in all areas of practice | 1.Practice is guided by code of ethics for nurses with interpretive statement 2.Maintains therapeutic and professional patient-nurse relationship 3. Delivers care in the manner of that preserves patient autonomy, dignity, and rights. 4.Seeks available resourced in formulating ethical decisions 5.Reports illegal, incompetent or impaired practice 6. Maintain patient confidentiality within legal and regulatory parameters. |
VII: Research | The nurse integrates research findings in practice | 1.Utilize best available evidence including research findings to guide practice decisions 2.Participates in research activities as appropriate to the nurse’s education and position such as the following: 3.Identifying clinical problems suitable for nursing research a. Participating in data collection b. Participating in a unit, organization, or community research committee c. Sharing research activities with others conducting research d. Critiquing research for application to practice e. Uses research findings in the development of policies, procedures, and practice guidelines for patient care f. Incorporates research as a basis for learning |
VIII: Resource utilization | The nurse considers factors related to safety effectiveness, cost, and impact on practice in the planning and delivery of nursing services. | 1.Evaluates factors related to safety, effectiveness, availability and cost when practice options would result in the same expected patient outcome 2.Assists the patient and family in identifying and securing appropriate and available services to address health related needs 3.Assigns or delegates tasks as defined by the state nurse practice acts and according to the knowledge and skills of the designated care giver 4.Assigns or delegate tasks based on the needs and condition of the patient, the potential for harm, the stability of the patients condition, the complexity of the task, and the predictability of the outcome 5.Assists the patient and family in becoming informed consumers about the cost ,risks, and benefits of treatment and care |
IX: leadership | The nurse provides leadership in the professional practice setting and the profession | 1. Engages on team work. 2. Works to create and maintain healthy work environments. 3. Teach others to succeed through mentoring. 4. Exhibits creativity and flexibility during change. 5. Directs coordination of care across settings and care givers. 6. Serves in key roles in the work settings by participating on committees, councils, and administrative. 7. Promotes advancement of the profession. 8. Display the ability to define a clear vision, the associated goals, and a plan to implement and measure progress. 9. Demonstrates energy, excitement and a passion for quality work. 10. Willingly accepts mistakes by self and others, thereby creating a culture in which risk-taking is not only safe, but expected. |
Standards of care
The standards of care in the ANA nursing: Scopes and Standards of practice (2004) describe a competent level of nursing care. The levels of care are demonstrated through the nursing process. The nursing process is the foundation of clinical decision making and includes all significant actions taken by nurses in providing care to clients. Within these are the nursing responsibilities for diversity , safety, education, health promotion, treatment , self care, and planning for the continuity of care. Standards of care are important if a legal dispute arises over whether a nurse practiced appropriately in a particular case.
ANA Standards of practice
Standard | Measurement criteria |
I. Assessment The nurse collects comprehensive data pertinent to the patients health or situation |
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2. Diagnosis: The nurse analyzes the assessment data to determine the diagnoses or issues |
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3.Outcomes identification: The nurse identifies expected outcomes for a plan individualize to the patient or the situation |
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4:Planning: The nurse develops a plan that prescribes strategies and alternatives to attain expected out comes |
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5:Implementation The nurse implements the identified plan of care | 1.Interventions are consistent with the established plan of care 2.Implements interventions in a safe and appropriate manner, documents interventions 3. Utilizes evidence –based interventions and treatments specific to the diagnosis or problem. 4.Collaborates with nurse colleagues to implement the plan 5.Utilizes community resources and systems to implement the plan |
5A:Co-ordination of care. The registered nurse coordinates care delivery. 5B:Health teaching and health promotion 5C:consultation:the advanced practice registered nurse and the nursing role specialist provide consultation to influence the identified plan, enhance the abilities of others and effect change. 5D:Prescriptive Authority and Treatment :the advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations. 6:Evaluation The nurse evaluates progress towards attainment of outcomes | 1.Coordinates implementation of the plan. 2.Documentation of the care. 1.Provides health teaching that address such topics as healthy lifestyles , risk reducing behaviors, developmental needs, activities of daily living, and preventive self-care. 2. Uses health promotion and health teaching methods appropriate to the situation and the patient’s developmental level, learning needs , readiness, ability to learn , language preference , and culture. 3. Seeks opportunities for feedback and evaluation of the effectiveness of the strategies used . 1.Synthesizes clinical data, theoretical frameworks, and evidence when providing consultation. 2.Facilitates the effectiveness of a consultation by involving the patient in decision-making and negotiating role responsibilities. 3.Communicates consultation recommendations that facilitates change. 1.prescribes evidenced-based treatments , therapies, and procedures considering the patient’s comprehensive health care needs. 2.presribes pharmacological agents based on a current knowledge of pharmacology and physiology and based on clinical indicators, the patient’s status needs , and the results of diagnostic and laboratory tests. 3.Evaluates therapeutic and potential adverse effects and potential adverse effects of pharmacological and non pharmacological treatment. 4.Provides patients with information about intended effects and potential adverse effects of proposed prescriptive therapies. 5.Provides information about costs, alternative treatments and procedures , as appropriate. 1.Evaluation is systematic, ongoing and criterion-based 2.Involves the patient, significant others ,and the health care providers in the evaluation process, when appropriate 3.Uses ongoing assessment data to revise diagnoses, outcomes and plan of care as needed 4.documents revisions in diagnoses, outcomes, and the plan of care 5. evaluates the effectiveness of interventions in relation to outcomes. 6.Documents the patients response to interventions |
Code of ethics
Nursing has a code of ethics that defines the principles by which nurse provide care to their clients. In addition, nurses incorporate their own values and ethics into practice. The code of ethics for nurses with interpretive statements provides a guide for carrying out nursing responsibilities that provide quality nursing care and provides for the ethical obligations of the profession.
Standard nursing care: An Asset
In order to ensure quality care the nursing care needs some standards. Standards are degree of excellence. The aim of standard nursing care is to support and contribute to excellent practices. The role of nurse is constantly changing to meet the growing needs of health services.
Objectives
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Plan
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Holistic Approach
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Appropriate Diagnosis
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Realistic Goal
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Selecting Appropriate Media
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Quality Care rather than quantity
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Economize Time, Material, Energy
Types of standard care
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Structure -- Things we use
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Process -- Things we do
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Outcome -- The result
Characteristics of standard care
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Dynamic
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Reflects Changes
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Not Static
Brief description of methods and procedure
S - Successful termination of helping relationship for client.
T - To have clear idea or conception of the distinct goal, nursing the patient and health needs of society.
A - Assertive planning.
N - Nature of client nurse interaction.
D - Directing others.
A - Analytical thinking.
R - Respect status and policies.
D - Data collection in accordance with goal.
Standard: Nursing practice requires that a conceptual model for nursing be the basis for the independent part of that practice.
Elements: Nurses are required to have clear idea or conception of the distinct goal nursing, the patient, the health needs of the society, the source of client difficulty, the focus, and modes of nursing intervention and the expected consequences of nursing activities.
Standard: Nursing practice requires the effective use of the nursing process.
Elements: Nurses are required to collect data in accordance with their conception of the goal of nursing, client, the source of client difficulty, the four and modes of intervention conceptual models for nursing.
Standard: Nursing practice requires that the helping relationship be the nature of client nurse interaction.
Elements: Nurses are required to increase the likelihood that the client will perceive the health service experience as understandable, manageable and meaningful at the outset.
Nurses are required to ensure a successful termination of the helping relationship.
Standard: Nursing practice requires nurses to fulfill professional responsibilities.
Elements: Nurses are required to respect status and policies relevant to the profession and the practice setting. Nurses are required to comply with the code of ethics of their profession. Nurses are required to function as members of a health team.
Standards in Nursing Practice
Professional Responsibilities
- Health team member
- Ethics
- Policies
Conceptual
- Health needs of society
- Nursing intervention
Effective use of nursing process
- Data collection
- Diagnosis
- Goal
- Intervention
- Evaluation
Unity
- Setting standards
- Planning individual patient care
- Monitoring and evaluating patient and environment
- Coordinating services to the patient
CONCLUSION
“Nursing Standards of Care” pertain to professional nursing activities that are demonstrated by the nurse through the nursing process. These involve assessment, diagnosis, outcome identification, planning implementation, and evaluation. The nursing process is the foundation of clinical decision making and encompasses all significant action taken by nurses in providing care to all consumers. While “Nursing Standards of Professional Performance” describe the roles of all professional nurses, there are many other responsibilities that are hallmarks of professional nursing. These nurses should be self-directed and purposeful in seeking necessary knowledge and skills to enhance career goals. Other activities-such as membership in professional organizations, certification in specialty or advanced practice, continuing education and further academic education, are desirable methods of enhancing the nurse’s professionalism. Accountability for one’s practice as a professional rests with the individual nurse.
REFERENCES
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Potter PA, Perry AG. Fundamentals of Nursing. 6th edn. Mosby ;st Louis.2005.
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Creasia J L, Parker B. Conceptual framework of professional practice.2nd edn. Mosby;St.Loius.1996.
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Hall JK. Nursing ethics &law. W.B Saunders company;Philadelphia.1996.
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Lillies C, Taylor C et al. Fundamentals of Nursing: The art & science of nursing care. Lippincott publications; Philadelphia.2005.
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Potter PA, Perry AG. Basic Nursing; Essentials for practice. 6th edn. Mosby ;st Louis.2007.
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Kockrow EO, Christensen BL. Foundatios of Nursing.4th edn.mosby.2003.
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Danasu R. Standard nursing care: An Asset. The Nursing Journal of India. June 2007. VOL. XCVIII No. 6.
This page was last updated on: 09/12/2020