Chapter Two Flashcards
Purpose of Nursing
To provide care and education to the acutely ill, patient’s, family, and the community about medical conditions, and to provide advice and emotional support to patients and their families.
Participating in health and wellness activities.
Delegation
Advanced practice nurses are prepared to diagnose, advanced assessments, and have prescriptive authority.
Standards of Nursing Practice
Reflect the values and priorities of the Nursing Profession
Provide direction for professional nursing practice
Provide a framework for the evaluation of nursing practice
Define the profession’s accountability to the public and the client outcomes for which nurses are responsible.
The American Nurses Association (ANA) sets standards for Professional Nursing Practice in the US.
Ethics American Nurses Association ANA
Ethics are fundamental to the integrity of the nursing profession. Every day, nurses support each other to fulfill their ethical obligations to the patient’s and to the public (ANA, 2017).
Ethics and Values
Professional practices which guide the provisions of care within state and national mandate
State Nurse Practice Act
American Nurse Association (ANA)
Standards of Professional Nursing Practice
State Nurse Practice Act
Each state has their own nursing act, regulating a nurse’s scope of practice in which he/she are licensed to work
These laws protect patients from harm
Protects the public by legally defining and describing the scope of nursing practice
Controls nursing practice through licensing requirements and education
Nurses shall adhere to their state Nurse Practice Act
Mandatory reporting of unsafe practice and/or unprofessional conduct
ANA Standards of Professional Nursing practice
American Nursing Association Standards of Professional Practice
The scope of practice describes:
Competent to perform within the terms of their license
Describes the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice
American Nursing Association Standards of Professional Practice
The “who” indicates the individual that has met the educational and licensing requirements needed to maintain active licensure to practice.
The “what” represents the protection, promotion, and optimization of health and abilities to prevent illness and injury, facilitate healing and avoid suffering, advocacy in the care of individuals, families, groups, communities, and populations.
The “where” represents the area the patient is in need of care
The “when” represents whenever the need for nursing knowledge, compassion and expertise is needed
The ”why” is knowing that the profession exists to achieve positive outcomes
Criminal Law Violations
Patient abuse Physical Psychological Verbal Sexual Euthanasia Substance Abuse Practicing without a License Assisted Suicide Defined as Assault and battery or Attempt Murder in most states Only legal in Oregon, Montana, Vermont, and Washington
Assisted Suicide / Euthanasia
The ANA recognizes that nurses play a role in end-of-life care.
Nurses manage the bio-psychosocial and spiritual needs of patients and families both independently and in collaboration with other members of the inter-professional healthcare team
The American Nurse Association, ANA, prohibits nurses’ participation in assisted suicide / euthanasia as this is a violation of the Code of Ethics.
Negligence
Negligence (malpractice) is “the failure to use ordinary care” through either an act or omission.
Negligence occurs when all four of the following elements are present:
Duty: failure to provide care and/or protect patients/clients against reasonable risks
Breach of Duty: failure to perform according to the established standard of conduct in providing nursing care
Injury/damages: failure to meet standards of care therefore causing an actual injury or damage to the patient/client. May be mental or physical
Causation: a connection between conduct and the resulting injury. Expert testimony is necessary to establish this element
Malpractice
Negligence that result in malpractice: Failure to follow: Standards of Care To use equipment in a responsible way To communicate To document To assess and monitor, ie: following institutional protocols To act as a patient advocate
Defamation
Defamation of character includes both libel and slander.
Libel: This is the written word
Slander: This is the spoken work
The Scope of Nursing Practice
Nursing Scope of Practice, depicts the duties and responsibilities that a nurse is deemed competent and qualified to perform in keeping within the terms of their professional licensure.
The Nursing Scope and Standards of Practicedescribe the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice.
5 steps in Delegation
1 Task 2 Delegated 3 Clear communication 4 Reaching a mutual agreement 5 Evaluation
What is the definition of evidence based practice?
Conscientious use of current best evidence in making decisions about patient care
What is evidence based practice?
Integration of best current evidence, clinical expertise, and patient values to deliver quality health care, and nursing actions that meet this competency, such as:
- following policies and procedures
- Keeping up with current literature in your area of expertise
- Know clinical practice guidelines
SBAR
Situation-Background-Assessment-Recommendation
Effective communication
Provides a framework for communication between health care professionals about a patient’s condition
S = Situation(a concise statement of the problem)
B = Background(pertinent and brief information related to the situation)
A = Assessment(analysis and considerations of options — what you found/think)
R = Recommendation(action requested/recommended — what you want)
Major cause of medical malpractice litigation
ineffective communication, poor documentation, and short cuts that are unsafe short cuts.
Professional negligence = Malpractice
The National Council of State Boards of Nursing (NCSBN)
Mission:
Provides education, service, and research through collaborative leadership to promote evidence-based regulatory excellence for patient safety and public protection.
Nurse Practice Act
Unique to each State;
Education and specific scope of practice vary from state to state.
A duty to protect those who receive nursing care. Safe, competent nursing practice is grounded in the Nurse Practice Act.
The standards and scope of nursing practice are aligned with the nursing process.
A comprehensive nursing assessment based on biologic, psychological, and social aspects of the patient’s condition
Collaboration colleagues
Patient-centered health care
Standards of Practice for Nursing
ANA Standards of Practice: Assessment Diagnosis Outcomes Identification Planning Implementation Coordination of Care Health Teaching and Health Promotion 6 Evaluation Standards of Professional Performance Ethics Culturally Congruent Practice Communication Collaboration Leadership Education Evidence-based Practice and Research Quality of Practice Professional Practice Evaluation Resource Utilization Environmental Health
