SCOPE OF PRACTICE DERMATOLOGY NURSINGDocument Transcript
SCOPE OF PRACTICE
Appreciation is extended to the following individuals who wrote, reviewed, and consulted with DNA in the develop-
ment and revision of the Dermatology Nursing Standards of Clinical Practice
Agnes Beachman, BSN, RN Christine M. Hickey, BS, RN Marrise M. Phillips, BS, RN, CCRC, DNC
Dorothea Caldwell-Brown, MPH, RN Linda LoPresti, BSN, RN Marie Santiago, RN, Ob/Gyn NP
Janice T. Chussil , MS, RNC, ANP Ann Marie Mlinaric, BSN, RN Doreen B. Siegel, MS, RNC, FNP
Dorothy J. del Bueno, EdD, RN Noreen Heer Nicol, MS, RN, FNC Robin Stupa, BSN, RN
he Dermatology Nurses’ Association (DNA), the developing issues, methodologies, and technologies in
professional organization of dermatology nurses, is the approach to health care and the practice of derma-
responsible for defining and establishing the scope tology nursing.
of professional dermatology nursing practice. In doing
so, the DNA, as a member of the Nursing Organizations Core
Alliance (NOA), acknowledges the role of the American The scope of dermatology nursing practice includes
Nurses Association (ANA) in defining the scope of prac- an emphasis on health promotion, accountability, assess-
tice for the nursing profession as a whole. ment, education, infection control, safety, psychosocial
The DNA supports the ANA Social Policy Statement. support, administration, and research. Holistic care aug-
This statement charges specialty nursing organizations mented with a multidisciplinary approach is utilized to
with defining their individual scope of practice and iden- assist the client, family, and/or significant other(s) to
tifying the characteristics within their unique specialty attain the optimal functioning ability.
area. Professional dermatology nursing practice incorpo-
The Dermatology Nurses’ Association Scope of rates both medical and nursing standards of care to for-
Practice document uses the same framework as the ANA’s mulate an individualized plan of nursing care, implement
Social Policy Statement: core, dimensions, boundaries, and the plan of care according to the priority of the identified
intersections. needs, and evaluate the process and outcomes of the
The core of dermatology nursing addresses the nursing interventions. The techniques of assessment,
essence of professional dermatology nursing practice, diagnosis, planning, treatment, and evaluation of per-
health promotion, the environment in which it occurs ceived, actual, or potential physical or psychosocial prob-
and the consumers of care throughout the life cycle. lem(s) that may result from a dermatologic problem are
The dimensions of professional dermatology nursing employed. The dermatology nurse applies measurable
practice specify those roles, behaviors, and processes outcomes and nursing interventions that are individual-
inherent in the range of diverse individual practice and ized and prioritized to meet the need(s) of the client, fam-
identify those characteristics unique to the specialty. ilies, and/or significant other(s) in his or her society.
The boundaries of dermatology nursing have both Dermatology nurses strive to include the client, fam-
internal and external limits; with the flexibility to respond ily, and/or significant other(s) in developing measurable
to changes mandated by social needs. Intersections client-centered outcomes of care using the nursing
describe the interface of dermatology nursing with other process. Recognition of the client’s needs and uniqueness
professional groups for the enhancement of the delivery as well as significance of the potential for psychosocial
of competent quality health care. Dermatology nursing is problems within the client’s relationships with significant
distinguished at the intersections by its unique knowl- others, society, and the medical community is included
edge, environment, and focus. within the framework of the plan. This ongoing practice
At this time in our society, there are ongoing changes identifies the client’s response to nursing and medical
with expanding complexity of today’s health care system. interventions.
There appears to be a transition from the disease-orient- Continuity of care is promoted by building collabora-
ed system to a health-oriented system of care. The needs tive inpatient and/or ambulatory programs of care and by
of the consumer in today’s health care system demon- sharing dermatologic nursing expertise with the client,
strated the need for dermatology nurses to facilitate care family, significant other(s), other members of the health
and educate clients in the prevention/treatment of der- care team, and the community. The goal of the nurse-
matologic problems. This turmoil within the current client interaction is to promote wellness and to progress
health care system has necessitated a statement clarifying from illness to wellness along the health care continuum.
the scope of professional dermatological nursing practice. Individual professional accountability, incorporation of
Given the rapid changes in health care delivery trends research advances, and participation in continuing educa-
and technologies, the task of defining this scope is com- tion and professional development activities are the nucle-
plex. This document allows for flexibility in recognition of us of the professional dermatology nurses’ daily practice.
The unique knowledge base regarding dermatologic and/or significant other(s) to care for self, or to be
illness and wellness promotion, the respective individual- cared for. The client, family, and/or significant
ized interventions, the physiological and psychological other(s) are taught the knowledge, skills, and/or
responses to these interventions, and the psychosocial behaviors necessary to initiate health and wellness
consequences of dermatologic disease are incorporated promotion, for self-care and/or making informed
into the daily practice of the professional dermatology choices. Teaching, counseling, referral to other health
nurse. Dermatology nurses are committed to problem care professionals or self-help groups, physical care,
solving, creativity, self-direction, and accountability for and/or other therapeutic behaviors are techniques
their own actions. To this end we hold the beliefs and val- used in this phase.
ues that support the contribution of nurses to health care, 5) Implementation Phase — The role of the dermatology
education, research, and community service. nurse during this phase focuses on actualization of
The environment includes but is not limited to: the nursing care plan. The dermatology nurse may
• Ambulatory Care Settings implement the plan of care alone or delegate parts of
• Inpatient Settings it to the client, another health care provider, or a
• Day Treatment Centers member of the client’s family or significant other(s).
• The Community 6) Analysis Phase — During this phase the dermatology
nurse focuses on examining the effectiveness of the
Dimensions mutually chosen interventions that identify the
client’s, family’s, and/or significant other(s) response
Dermatology nursing is multidimensional. These to nursing and medical intervention(s). Nursing diag-
dimensions include the responsibilities, functions, roles, noses or problem list and strategies for achieving
tasks, and skills that involve a specific body of knowledge nursing goals are modified, and the overall quality of
and are manifested through dermatology nursing nursing care is judged based on evaluation of out-
processes and behaviors. Characteristics unique to der- come criteria.
matology nursing practice are: Nursing’s roles include those of community,
I ) Inquiry Phase — The dermatology nursing role focus- client/family and/or significant other(s), environmental
es on identifying potential or actual physical and/or assessment, consultation, case management, research,
emotional problems that the client, family, and/or administration, supervision, education, consultation, and
significant other(s) exhibit in his/her society and envi- consumer advocacy. The specialty practice of dermatol-
ronment. Needs related to health promotion are ogy nursing is defined through the implementation of
identified. The client may be a “community” and/or specific role functions that are outlined in the
an individual or group. Data are collected from Dermatology Nursing Standards of Practice.
clients, their family and/or significant other(s), appro- Dermatology nursing practice is systematic in nature
priate health care personnel, and from results of lab- and includes nursing process decision making, analytical
oratory and diagnostic tests. Information for the deci- and scientific thinking, and inquiry.
sion making process is gathered through interview Professional behaviors inherent in dermatology nurs-
and assessment techniques. ing practice are the acquisition and application of spe-
2) Identification Phase — The role of the dermatology cialized knowledge, and skills, accountability and respon-
nurse during this phase focuses on the identified data sibility, communication, autonomy, and collaborative
and evaluates the relevance of the data collected. relationships with others.
Tentative nursing problems or diagnoses are either
accepted or rejected based on the information
reviewed. The nursing problem list or nursing diag- Boundaries
nosis delineates the client’s health needs and prob- The scope of dermatology nursing practice has both
lems that require nursing intervention. internal and external boundaries. Internal boundaries
3) Planning Phase — The role of the dermatology nurse include recognized forces within the practice of profes-
during this phase focuses on problem solving; identi- sional nursing such as ANA Standards of Clinical Nursing
fying potential interventions that include health pro- Practice, the ANA guidelines for practice such as the Social
motion, health maintenance, self-care, and health Policy Statement, the Scope of Nursing Practice, and the
teaching while promoting the optimal function of the Dermatology Nursing Standards of Practice. Other actions
client, family, and/or significant other(s) throughout that influence our own professional practice are quality
the health care continuum. For each of the nursing improvement monitoring activities and risk management
diagnoses or nursing problems identified in the pre- activities.
ceding step, the dermatology nurse specifies the The external boundaries include state and federal leg-
desired resolution or goal collaboratively with the islation and/or regulation, societal needs, economic
client, family, and/or significant other(s). The goals changes, and health care delivery trends. Individual state
are converted into measurable client-centered out- nurse practice acts are examples of legal boundaries used
comes using the nursing process. These are defined to provide the basis for interpretation of safe nursing
as observable client behaviors, but may also be other practice. Rules and regulations that evolve from these acts
client characteristics, such as decreased redness of are used as guidelines by state boards of nursing to issue
the skin. licenses and ensure the public safety.
4) Education Phase — The role of the dermatology nurse Examples of the legislative/regulatory factors are fed-
in this phase focuses on preparing the client, family, eral and state health codes and mandated reporting
requirements, the Joint Commission for Accreditation of Surgery, Society for Investigative Dermatology, and
Health Care Organizations (JCAHO), and the Professional American College of Mohs Micro-graphic Surgery and
Standards Review Organization (PSRO). The current trend Cutaneous Oncology. Intersection is not limited to these
toward an ambulatory community-based setting for serv- groups, however, and may occur with any group.
ice delivery is an example of economic change as a These health care professions interact with a com-
response to societal needs. The rapidly worsening finan- mon overall mission to positively influence the provisions
cial climate has driven the health care delivery system to of dermatologic care rendered to society. Dermatology
reduce costs while providing team care, collaboration, nurses bring their unique knowledge, focus, and perspec-
and consultation. Health care delivery trends, such as an tive to unite all participants in the process and outcome
increased number of ambulatory care centers, client par- of these intersections.
ticipation in health maintenance organizations (HMOs),
and preferred provider organizations (PPOs) all influence Summary
the delivery of dermatologic care.
The intent of this document is to conceptualize prac-
tice and provide education to practitioners, educators,
Intersections researchers, and administrators, and to inform other
The dermatology nurse interacts with a variety of pro- health professionals, legislators, and the public about the
fessions for the common purpose of advancing dermato- participation in and contribution to health care by der-
logic care through education, administration, consulta- matology nursing. Through articulation of the elements
tion, and collaboration in practice, research, and policy of care, dimensions, boundaries, and intersection, the
making. Within these roles, dermatology nurses commu- Dermatology Nursing Scope of Practice document defines
nicate, network, and share resources, information, the specialty practice of dermatology nursing.
research, technology, and expertise. This is done to
address common concerns such as ethical issues, human- Bibliography
ism, psychosocial needs of clients, trends, management
American Academy of Ambulatory Care Nursing. (2000).
of client care, and alternative care modalities.
Ambulatory care nursing administration and practice stan-
The dermatology nurse, via the DNA, collaborates dards. Pitman, NJ: Author.
with other professional groups within the province of American Nephrology Nurses’ Association. (1999). Standards
nursing such as the American Nurses Association (ANA), and guidelines of clinical practice for nephrology nursing.
the National League for Nursing (NLN), and the many Pitman, NJ: Author.
specialty groups represented in the Nursing American Nurses Association. (1988). Code of ethics with inter-
Organizations Alliance (NOA). The DNA also maintains a pretative statements Kansas City, MO: Author.
collaborative relationship with the American Academy of American Nurses Association. (1995). Nursing’s social policy
Dermatology, American Society for Dermatologic statement. Washington, DC: Author.
STANDARDS OF CLINICAL PRACTICE
Introduction to Dermatology meet the needs of specific clients, families, and/or signifi-
cant others. Dermatology Nursing Standards outlined are
Nursing Standards directed at delineation of outcome behaviors.
Dermatology nursing practice shall be based on indi-
vidualized client care utilizing prevailing accepted med- Key Terms
ical/nursing standards of care while incorporating
advances in research and education into daily practice. Definitions of key terms will assist in using this docu-
Dermatology nurses are therefore encouraged to be ment. Other definitions are found in the glossary at the end
involved in problem solving, creative, self-directed, and of this document.1
accountable for their own actions. To this end, DNA holds Assessment: A systematic, dynamic process by which
beliefs and values that support the contribution of nurses the nurse, through interaction with the client, significant
to health care, education, research, and community serv- others, and health care providers, collects and analyzes
ice. data about the client. Data may include the following
The purpose of these standards is to provide defini- dimensions: physical, psychological, psychosocial, cultural,
tive direction for the provision of care and professional spiritual, cognitive, functional abilities, developmental, eco-
role activities of dermatology nurses while building upon nomic, and lifestyle.
the broad American Nurses’ Association Standards of Diagnosis: A clinical judgment about the client’s
Clinical Nursing Practice. response to actual or potential health conditions or needs.
The Dermatology Nursing Standards of Clinical Practice Diagnoses provide the basis for determining a plan of care
are intended to provide a framework upon which the to achieve expected outcomes.
dermatology nurse shall build his/her practice with assess- Evaluation: The process of determining the client’s
ment, measurable outcomes, and nursing interventions progress toward the attainment of expected outcomes and
that are customized to meet the need(s) of the individual the effectiveness of nursing care.
in his/her society. These Dermatology Nursing Standards of Implementation: May include any or all of these activi-
Practice differentiate and articulate the dermatology ties: intervening, delegating, and coordinating. Client, sig-
nurse’s specialized practice to provide quality dermato- nificant others, or health care providers may be designated
logic client centered care. Professional nurses who prac- to implement interventions within the plan of care.
tice dermatology nursing shall use these standards of Outcomes: Measurable expected client focused goals.
practice to define the desired outcomes of client care for Plan of Care: Comprehensive outline of care to be
the practice of dermatology nursing and to clarify the delivered to attain expected outcomes.
standards of professional practice essential to provide a Client: Recipient of nursing actions. When the client is
basis on which to build an understanding of dermatology an individual, the focus is on the health state, problems, or
client needs. needs of a single person. When the client is a family or
Dermatology nurses strive to include the client/fami- group, the focus is on the health state of the unit as a
ly/significant others in developing measurable client cen- whole or the reciprocal effects of an individual’s health state
tered outcomes of care based on the nursing process. on the other members of the unit. When the client is a
This ongoing practice identifies the client’s response to community, the focus is on personal and environmental
nursing as well as medical intervention(s). Continuity of health and the health risks of population groups. Nursing’s
care is promoted by building collaborative inpatient actions toward clients may focus on disease or injury pre-
and/or ambulatory programs of care and by sharing our vention, health promotion, health restoration, or health
expertise with the client, family, significant others, other maintenance.
members of the health care team, and the community. Health Care Providers: Individuals with special expert-
The goal of the nurse-client interface is to promote well- ise who provide health care services or assistance to clients.
ness and to progress along the health care continuum They may include nurses, physicians, psychologists, social
from illness to wellness. workers, nutritionists/dietitians, and various therapists.
The language used to compose the Dermatology Providers may also include service organizations and ven-
Nursing Standards of Clinical Practice is intended to focus dors.
on global nursing care approaches related to the derma- Significant Others: Family members and/or those sig-
tologic client. Specific nursing approaches and interven- nificant to the client.
tions will need to be individualized and prioritized to
continued on page 5
The Dermatology Nursing Scope of Practice and the Standards of Clinical Practice were revised in 2002.
Definitions adapted from Standards of Clinical Nursing Practice, 1998. American Nurses Association, Washington, DC.
STANDARDS OF CARE III. OUTCOME IDENTIFICATION
Standard of Care
I. ASSESSMENT The dermatology nurse identifies expected individual-
Standard of Care ized outcomes for the client.
The dermatology nurse collects client health data.
Measurement Criteria The dermatology nurse:
The dermatology nurse: 1. Derives client outcome(s) goals from the diag-
1. Initiates the identification of the client’s nosis.
needs/problems utilizing a logical and/or sci- 2. Formulates mutual client outcome(s) goals
entific process, in a timely, organized, system- with input from the client/family/significant
atic, and ongoing manner. Nursing data base others and other members of the health care
may include: team.
a) Biophysical assessment. 3. Articulates client outcome(s) which:
b) Personal and family health history. a) Are clearly written and measurable.
c) Psychosocial assessment to include the b) Are prioritized.
client/family/ significant other(s). c) Include a time estimate for attainment.
d) Patterns of coping with skin manifesta- d) Provide direction for continuation of care.
tions of disease process; patterns of social e) Are recorded and communicated to
interaction. appropriate persons.
e) Self-care abilities. 4. Derives client outcome(s) goals that are realis-
f) Client’s perception of health status and tic in context with the individual’s present and
their health goals. potential capabilities and the human and
g) Input from client/family/significant others, material resources available.
h) Environmental factors. IV. PLANNING
i) Discharge planning factors. Standard of Care
2. Prioritizes data collection as determined by the The dermatology nurse develops a plan of care that
immediate health care problems of the client defines interventions to attain expected outcomes.
to determine current health status, past med-
ical history, and family and social history that Measurement Criteria
require nursing intervention. The dermatology nurse:
3. Determines the scope of data collection as 1. Formulates a client care plan based on the
determined by the health status of the client analysis of collected data to identify individu-
as it relates to the individual’s illness. reaction alized needs of the client/family/significant
to illness, and/or wellness promotion. others utilizing the nursing process.
4. Collects data from the client, family, significant 2. Engages the client/family/significant others
others, health care personnel, or individuals in and other health care team members in mutu-
the community and systemically records all al planning for diagnostic testing, treatments,
pertinent data in the client’s permanent med- home care, psychosocial support, followup
ical record in a format that is accessible, care, and any other appropriate interven-
retrievable, and confidential. tion(s).
3. Documents a plan of care for all clients.
II. DIAGNOSIS 4. Participates in client centered multidisciplinary
Standard of Care discharge planning or follow-ups, as appropri-
The dermatology nurse analyzes the assessment data ate.
in determining diagnoses. 5. Collaborates with other health care providers,
as appropriate, to help define and implement
Measurement Criteria client education and information needs that
The dermatology nurse: may include some or all of the following:
1. Derives diagnoses from the assessment data. a) The client’s disease process.
2. Validates the identified problems as they relate b) The client’s therapeutic regimen.
to the individual’s illness, reaction to illness, c) Nursing responsibilities.
and wellness promotion with the client/fami- d) The client’s and family’s responsibilities
ly/significant others, as appropriate. and options.
3. Communicates client problems as either nurs- e) Recommendations for ongoing and/or fol-
ing diagnoses or client care needs. lowup care.
4. Records findings in a manner that facilitates f) Wellness promotion.
the determination of client outcome goals, g) Available support groups and other
planning, and intervention. resources.
5. Collaborates with other professionals to vali- h) Financial concerns.
V. IMPLEMENTATION itored such as high-risk and high-volume
Standard of Care client populations.
The dermatology nurse implements nursing interven- b) Collection of quality improvement data.
tions that are consistent with the identified plan of c) Participation with multidisciplinary teams
care. that evaluate clinical practice or health
services that affect client care.
Measurement Criteria 2. Utilizes the results of quality improvement
The dermatology nurse: activities to initiate appropriate modification of
1. Implements interventions which may encom- their practice to create/maintain a safe, com-
pass biophysical and psychosocial manifesta- fortable, and therapeutic environment for
tions of skin disease. clients, visitors, and staff.
2. Implements interventions in a safe and timely 3. Collaborates with other disciplines and services
manner. as appropriate, to assure that the facility is con-
3. Documents the implementation of nursing structed, equipped, and operated in a manner
intervention in the medical record. that protects clients, visitors, and personnel
VI. EVALUATION a) Fire hazard.
Standard of Care b) Electrical hazard.
The dermatology nurse evaluates the client’s progress c) Exposure to hazardous chemicals.
toward the attainment of mutually set goals and out- d) Exposure to infectious agents.
comes. 4. Reports and documents hazardous situations
Measurement Criteria 5. Contributes to the development of a compre-
The dermatology nurse: hensive infection control program, as appro-
1. Evaluates in a systematic and ongoing basis. priate to their position and practice environ-
2. Collaborates with the client/family/significant ment, that requires:
others and other health care team members in a) Written policies and procedures for the pre-
the evaluation process and revises the plan of vention and control of infection among
care, as appropriate. clients, personnel, and visitors.
3. Provides ongoing evaluation of b) Compliance with local, state, and federal
client/family/significant others’ knowledge of agency regulations.
the client’s illness, diagnostic and treatment c) Ongoing system for reporting, reviewing,
plans, anticipated outcomes, and self-care and evaluating infections within the prac-
activities and revises the plan of care, as appro- tice setting.
4. Evaluates the client/family/significant others’ II. PERFORMANCE APPRAISAL
perceptions and appraisals of the care he/she Standard of Professional Performance
receives. The dermatology nurse evaluates her/his nursing prac-
5. Documents client progress toward treatment tice in relation to professional practice standards.
goal(s) and makes revisions to the diagnosis
and plan of care. Measurement Criteria
6. Evaluates systematically the quality, timeliness, The dermatology nurse:
and cost effectiveness of care in relation to 1. Participates in a formal mechanism of per-
client outcomes and nursing process. formance appraisal on a regular basis which
7. Participates in evaluation of care for groups of may include self-review/peer review to identi-
clients, which is conducted as part of a quality fy areas of strength as well as areas for profes-
improvement program. sional/practice development.
2. Seeks constructive feedback regarding own
STANDARDS OF PROFESSIONAL PERFORMANCE 3. Takes action to achieve the goals identified
during ongoing and formal performance
I. QUALITY OF CARE appraisal.
Standard of Professional Performance 4. Participates in peer performance evaluations.
The dermatology nurse systematically evaluates the
quality and effectiveness of nursing practice. III. EDUCATION
Standard of Professional Performance
Measurement Criteria The dermatology nurse acquires and maintains current
The dermatology nurse: knowledge of Dermatology Nursing practice.
1. Participates in quality improvement activities
as appropriate for her/his position and prac- Measurement Criteria
tice environment. Such activities may include: The dermatology nurse:
a) Identification of the indicators3 to be mon- 1. Seeks to update her/his knowledge and skills
on an ongoing basis to ensure clinical compe- the health care team and the community, as
tence. Such activities may include: appropriate.
a) Attending dermatology nursing education- 6. Seeks available resources to help formulate
al offerings and/or other professional meet- ethical decisions.
b) Reading the Dermatology Nursing journal Vl. COLLABORATION
as well as other nursing/professional jour- Standard of Professional Performance
nals which pertain to the practice of der- The dermatology nurse collaborates with the client,
matology nursing. significant others, and health care providers in provid-
c) Participating in other pertinent continuing ing client care.
2. Attains knowledge and skills as needed to Measurement Criteria
deliver culturally competent care. The dermatology nurse:
3. Communicates with colleagues and others 1. Communicates with the client, significant oth-
about new or updated knowledge, skills, and ers, and health care providers regarding client
health promotional behavior. care and nursing role in the provision of care.
4. Promotes dermatology nursing as a specialty 2. Consults with health care providers for client
nursing practice. care as needed.
5. Promotes public awareness of the specialty of 3. Makes referrals including provisions for conti-
dermatology nursing. nuity of care as needed.
6. Acquires certification to validate knowledge
and expertise in dermatology nursing. Vll. RESEARCH
Standard of Professional Performance
IV. COLLEGIALITY The dermatology nurse uses research findings in prac-
Standard of Professional Performance tice.
The dermatology nurse contributes toward the profes-
sional development of peers, colleagues, and other Measurement Criteria
members of the health care team. The dermatology nurse:
1. Uses interventions substantiated by research
Measurement Criteria as appropriate to the individual’s position,
The dermatology nurse: education, and practice environment.
l. Shares clinical expertise with colleagues and 2. Participates in research activities, as appropri-
other members of the health care team. ate to the individual’s position, education, and
2. Provides colleagues constructive feedback practice environment. Such activities may
regarding their professional practice. include:
3. Contributes to dermatologic learning experi- a) Identification of clinical problems suitable
ences for nursing students and other health for nursing research.
care providers in all areas of practice (hospital, b) Participation in data collection.
community, etc.). c) Participation in a unit, organization, or
community research committee or pro-
V. ETHICS gram.
Standard of Professional Performance d) Sharing of research activities with others.
The dermatology nurse’s decisions and actions on e) Conducting research.
behalf of the client will be provided in an environment f) Critiquing research for application to prac-
that is respectful and in accord with professional codes tice.
of ethics related to delivery of health care. g) Using research findings in the develop-
ment of policies, procedures, and guide-
Measurement Criteria lines for client care.
The dermatology nurse: 3. Encourages and supports nursing colleagues
1. Provides care that is consistent with American and other professionals engaged in dermatol-
Nurses Association Ethical Code for Nurses ogy research.
(ANA, 1976). 4. Acts to protect the rights of human subjects.
2. Maintains client privacy and confidentiality.
3. Respects the client’s right to be an active part- VIII. RESOURCE UTILIZATION
ner in health care decision-making and pre- Standard of Professional Performance
serves client autonomy, dignity, and rights. The dermatology nurse considers factors related to
4. Respects differences in values, lifestyle, coping safety, effectiveness, and cost in planning and deliver-
skills, and health care practices; care to be ing client care.
delivered in a nonjudgmental and nondiscrim-
inatory manner. Measurement Criteria
5. Serves as a client advocate and may act as a The dermatology nurse:
liaison for the client with other members of 1. Considers and evaluates multiple factors relat-
ed to effectiveness, safety, and cost in plan-
ning, delegating, and/or delivering care for
the client/family/significant others.
2. Assigns tasks or delegates care based on the
individualized client needs and the knowledge
and skills of the provider selected.
3. Assists the client and significant others in iden-
tifying and securing appropriate services avail-
able to address health-related needs.
Continuity of Care: An interdisciplinary process that
includes clients and significant others in the develop-
ment of a coordinated plan of care. This process facili-
tates the client’s transition between settings, based on
changing needs and available resources.
Criteria: Relevant, measurable indicators of the stan-
dards of clinical nursing practice.
Guidelines: Describe a process of client care manage-
ment which has the potential of improving the quality
of clinical and consumer decision making. They are
systematically developed statements based on avail-
able scientific evidence and expert opinion.
Nursing: The diagnosis and treatment of human
responses to actual or potential health problems (ANA,
Nursing’s Social Policy Statement).
Standard: Authoritative statement enunciated and
promulgated by the profession by which the quality of
practice, service, or education can be judged.
Standards of Nursing Practice: An authoritative state-
ment that describes a level of care or performance
common to the profession of nursing by which the
quality of nursing practice can be judged. Standards of
clinical nursing practice include both standards of care
and standards of professional performance.
Standards of Care: Authoritative statements that
describe a competent level of clinical nursing practice
demonstrated through assessment, diagnosis, out-
come identification, planning, implementation, and
Standards of Professional Performance: Authoritative
statements that describe a competent level of behavior
in the professional role, including activities related to
quality of care, performance appraisal, education, col-
legiality, ethics, collaboration, research, and resource
American Nurses Association. (1995). Nursing’s social policy
statement. Washington, DC: Author.
American Nurses Association Standards of Clinical Nursing
Practice Second Edition. (1998). Washington, DC:
American Nurses Association.
Ethical Code for Nurse. (1976). Washington, DC: American