module one Flashcards
summary timeline of NZ history of nursing
17th century
1617- ladies of charity. many convents were closing so women were recruited into nursing instead of going to jail
19th century
1836- first small nursing training school attached to a hospital in germany
1851-1869- florence nightingale. founded modern nursing during the Crimean war. promoted sanitation, cleanliness, nourishment, ventilation, nutrition and routines
1864- first trained nurse in australia. Lucy osbum was hospital trained in England. founded the florence nightingale school of nursing in australia in 1868
1884- first training school in NZ
20th century
1901- nursing registration act. NZ was the first country to regulate nurses internationally
1925- nurses and midwives board founded
1860s-1930s- germ theory. louis pasteur linked microorganisms to disease. alexander Fleming discovered penicillin
1934- what is now NZNO was formed
1938- social security act resulted in free hospital care
1970s- move from hospital based training to education providers
1971- nursing council of new Zealand established
1992- college of nurses aotearoa founded
what are influential moments in nursing history
- florence nightingale 1854
- first nightingale trained nurse arrived to australia 1864
- hospital based training late 19th century
- germ theory early 20th century
- regulated workforce 1930s
- education structure changed late 20th century
NZ nursing history
- evolved from influences of florence nightingale and england
- first hospitals were Auckland 1845, Wellington 1846, Dunedin 1852 and Christchurch 1862. no nursing services, untrained male attendants or untrained, uneducated women.
- 1924 first nurse tutors introduced in wellington hospital
- late 1890s grace neill (london trained nurse)
- employed as assistant inspector of hospitals
- recognised need to introduce, maintain standards
- 1899- foundation member of ICN
- representations resulted in nurses registration act of 1901 - nurses registration act of 1901
- provided for 3 years training course and state exam followed by registration
- NZ first country to regulate nurses nationally
- ellen Dougherty first RN in NZ
who is florence nightingale 1851 onwards
first great nursing pioneer, she believed that well educated women could dramatically improve the care of sick patients. saved many lives in the war by making sure men had fresh sheets, fresh air and healthy and clean food and water.
what is germ theory
realisation that many illnesses were caused by bacteria
what is the international council of nurses
a federation of more than 130 national nurses associations representing more than 20 million nurses worldwide. they represent all nurses around the world.
elizabeth grace neill 1846-1926s (london trained nurse)
- NZs first woman in government
- she expressed concerns that young nurses were not committed to high standards in the nursing service
- drafted the NZ nurses registration act in 1901
nurse registration act of 1901 (Grace neill)
- provided for 3 year training course and state exam followed by registration
- NZ first country to regulate nurses nationally
- ellen dougherty first RN in NZ
definition of nursing
nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people.
hester mclean 1859-1932
- conservative viewpoint
- fought hard for nursing to be regulated by NURSES
- established first nursing journal in 1923
- redrafted the NZ nurses registration act in 1925
- first NZ nurse to move nursing education away from being taught by doctors to being taught by nurses
health practitioner competency assurance act 2003
- administered by the ministry of health as the governing authority
- to protect the health and safety of all members of the public by providing mechanisms to ensure life long competence of all health practitioners
- ensure competence of all registered health practitioners
how is the NZ health system structured
ministry of health (governing authority)- health practitioner competency assurance act 2003- nursing council of NZ (regulatory authority)- nurse
what does the nursing council of NZ do
- regulatory authority for nurses in NZ
- responsible for the registration of nurses
- protect the health and safety of members of the public by ensuring that nurses are competent and fit to practice
- receive and acts on complaints about a nurse
- they regulate 3 scopes of practice
- provide guidelines and standards for practice
what are competencies
pre determined statements that registered nurses held accountable to.
what are the NCNZ 3 scopes of practice
- enrolled nurses
- registered nurses
- nurse practitioner
registered nurse scope of practice
- utilising knowledge
- comprehensive judgement of others
- responsible for our own actions
- work within the community
what are domains of competence
what nurses need to demonstrate as evidence of safety to practice as a registered nurse
what are the 4 domains of competency
- professional responsibility- showing professional, legal and ethical responsibilities and cultural safety
- management of nursing care- assessing and managing health consumer care, which is responsive to the consumers needs and is supported by nursing knowledge and evidence based research
- interpersonal relationships- interpersonal and therapeutic communication with health consumers, other nursing staff and interprofessional communication and documentation
- interprofessional health care and quality improvement- the nurse evaluates the effectiveness of care and promotes a nursing perspective within the interprofessional activities of the team
what is the purpose of the privacy act (2020)
- promote and protect individual privacy
- regulate the ways individuals personal information is handled
- controls and guides how agencies collect, use, disclose and store personal information
what is the purpose of the health information privacy code (2020)
agencies must know why they are collecting health information and collect only the information they need.
what is the purpose of the health and disability commissioner act (1994)
promoting and protecting the rights of health and disability services consumers
what is the purpose of the code of health and disability services consumers rights (1996)
- establishes the rights of consumers, and obligations and duties of providers to comply with the code
- when a person uses a health or disability service in new Zealand they have the protection of a code of rights
- the code provides consumers 10 rights
what is the purpose of the NCNZ code of conduct (2012)
- to set standards defined by NCNZ describing the behaviour or conduct that nurses are expected to uphold
- nurses are expected to uphold exemplary standards of conduct while undertaking their professional role
what is the relevance of the NCNZ code of conduct to my beginning practice
because as i go out on placement and practice in my labs I need to know about these codes of conduct so I am aware of the nursing standards I must uphold
what is the role of a health and disability commissioner
- provides a voice to health and disability services consumers
- resolves complaints
- holds providers to account
- !! to promote and protect the rights of consumers as set out in the code of health and disability services consumers rights
what are the 10 HDC consumer rights (1996)
- to be treated with respect
- to be treated fairly
- to dignity and independence
- to receive good care and support that suits your need
- to be told things in a way you understand
- to be told everything you need to know about your care and support
- to make choices about your care and support
- to have support
- to decide if you want to be part of training, teaching or research
- to make a complaint
what is the disciplinary action
-where proceedings are brought against health practitioners. all complaints are heard and investigated and then a disciplinary action will be taken
what are the 4 code of conduct values
- respect
- trust
- partnership
- integrity
what is the purpose of the NCNZ professional boundaries guidelines (2012)
- contains standards of behaviour from the code of conduct for nurses and more advice on professional boundary issues and how they should be managed
what is the purpose of NCNZ social media guidelines (2012)
provides advice to nurses on using social media and other forms of electronic communication responsibly to maintain their professional and legal obligations
what is the purpose of the NZNO code of ethics guideline (2019)
describes ethical values of the nursing profession and assists with ethical decision making
what are the major ethical principles within the ethics guideline
- autonomy (having authority to make decisions)
- beneficence (kindness and charity)
- non maleficence (doing no harm)
- justice (being fair)
- confidentiality (Keep things in confidence)
- veracity (being honest)
- fidelity (being faithful, keeping a promise)
why are these guidelines relevance to my practice
understanding and applying good ethical and safe practice will help me understand the issues at stake. if i understand the debate, then i can participate and influence the outcome
definition of professionhood
on going development and renewal of self
what is under involvement and over involvement in nursing practice
under - not paying attention to what the patient is saying
over - getting into a relationship with the patient, offering to do things for them outside of the working environment
who is the governing authority and what key documents did they make
Ministry of health
- HPCA act
- privacy act (HIPC)
- health and disability commissioners act
who is the regulatory authority and what key documents did they make
NCNZ (nursing council of new zealand)
- competencies (4 domains)
- guidelines; code of conduct (professional boundaries, social media and electronic communication)
who is the professional organisation and what key documents did they make
NZNO (new zealand nursing organisation)
- code of ethics
- social expectations
what is the importance of quality in healthcare delivery
so that healthcare services provide patients with improved desired health outcomes in a safe, effective, timely, efficient and people centred way
what is the importance of safety in healthcare delivery
the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum
local and global healthcare safety initiatives
- annual national patient safety campaign (HQSC)- commitment to patients that our health care services strive to provide the best and safest care possible
- annual world patient safety day (WHO)- create awareness of patient safety
- speak up campaign (the joint commission)- help patients and their advocates become active in their care
- fellowship programme (ISQUA )- offers learners to be mentored by global experts in healthcare quality and safety
what is the importance of safety and quality in healthcare delivery
improved quality, safety and experience of care for people and their family.
quality and safety improvements mean fewer people are harmed, more lives saved, and financial savings within the sector
what is the importance of safety in a healthcare setting
patient safety is the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum
patient safety indicators
freedom from accidental injury caused by medical care, errors can include problems in practice, products, procedures and systems
what are some of NZ’s safety standards
- reduction in surgical site infections
- reduce risks of hospital acquired infections
- falls risk reduction
- pressure injury prevention
what is the role of the health quality and safety commission
- monitoring and improving the quality and safety of health and disability support services
- helping providers across the health and disability sector to improve the quality and safety of health and disability support services.
historical issues that have shaped the contemporary nurse in New Zealand
19th century
- nursing became subordinate to medicine, with some maintaining their own independence such as chemists and dentists
- the provision of a nationally formalised health care system
the socio- political factors influencing nursing in contemporary new zealand
- nursing is influenced and shaped by social, political, scientific and inter professional changes and processes
- income, education, gender, family structure
- politics is a means for nurses to advocate for patients
what are national factors that have and are contributing to the professionalism of nursing in NZ
- cultural issues
- age of nurses
- sharing information between DHBs
- election year
- merging of DHBs
what are international factors that have and are contributing to the professionalism of nursing in NZ
- access to the internet
- global pandemic
- sustainability
- boundaries of nursing eg. pharmacists giving flu vaccines
- increase in communicable diseases
what key pieces of legislation, codes and standards govern nursing practice
- code of conduct
- HDC consumer rights
- code of conduct values
- health and disability commissioners act
- privacy act
- health information privacy code
- RN competencies
what is professional practice
how health professions practice, collaborate, communicate and develop professionally to provide the highest quality care for patients
what are the code of conduct principles
- respect the dignity and individuality of health consumers
- respect the cultural needs and values of health consumers
- work in partnership with health consumers to promote and protect their well being
- maintain health consumer trust by providing safe and competent care
- respect health consumers privacy and confidentiality
- work respectfully with colleagues to best meet health consumers needs
- act with integrity to justify health consumers trust
- maintain public trust and confidence in the nursing profession