Nursing Practice


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Nursing Practice

  1. 1. NURSES & PRACTICE Syed Amin Tabish FRCP (London), FRCP (Edin), FACP, FAMS, MHA (AIIMS) Postdoctoral Fellowship, University of Bristol (UK)
  2. 2. Nursing Services  Nursing profession is considered a caring profession  Nursing care is defined as the care of the patient with regard to nursing needs  with the ever increasing dimension of medical sciences quantitatively and qualitatively nursing care is becoming more and more complex with its management services.
  3. 3. Total health Includes all of the following aspects:  Physical Health  Social health. A sense of responsibility for the health and welfare of others.  Mental health. A mind that grows, reasons, and adjusts to life situations.  Emotional health. Feelings and actions that bring one satisfaction.  Spiritual health. Inner peace and security in one's spiritual faith.
  4. 4. Maslow’s Hierarchy of Needs
  5. 5. Nursing Service  Nursing service is the part of the total health organization which aims at satisfying the nursing needs of the patients/community.  The nurse works with the members of allied disciples such as dietetics, medical social service, pharmacy etc. in supplying a comprehensive program of patient care in the hospital.
  6. 6. Nursing Services  WHO defines the nursing services as the part of the total health organization which aims to satisfy major objective of the nursing services  to provide prevention of disease and promotion of health.
  7. 7. Health Service System Tertiary Secondary Care Primary Care Self Care, Self Reliance Primary Health Care University/Regional Hospital Provincial/General Hospital Health Center, PCU, Com. Hospital Village, CPHC
  8. 8. OBJECTIVE OF NURSING IN WARD  Maximum comfort and happiness by way of pleasant surroundings.  Qualitative/comprehensive care to the patient.  Care based on the patient’s needs.  Accurate assessment of illness.  Adequate material resources at all times.  Health education to the patient and attendants.  Managerial skills as and when required.  Privacy at all levels.
  9. 9. Entire nursing process  ASSESSMENT- not only initial but integral ongoing component of the whole nursing process.  PLANNIG AND IMPLEMENTATION- in this the nurse formulates and implements the care.  EVALUATION- decides whether the action taken has met the identified needs or not. This is the final step of care. Also, review of the whole care plan. Without this no quality care or comprehensive care is possible to provide. 
  10. 10. PLANNING NURSING SERVICES  Number and type of patient  Number of beds and type of ward  The services required.  Procedures/techniques necessary for care.  Number and type of personal needed to perform care effectively.  Physical facilities.  Provisional of equipment and supplies.
  11. 11. Problems  Lack of adequate training  Problem of personnel       management Inadequate number of nursing staff Lack of motivation Poor role model Non-nursing activities No research scope Professional risk/hazards
  12. 12. Scope of Nursing Practice  Nurses provide care for 3 types of clients:  • Individuals • Families • Communities Areas of Nursing Practice  PROMOTING HEALTH & WELLNESS  Wellness is a state of well-being. It means  engaging in attitudes and behavior that enhance the quality of life and maximize personal potential.  Health promotion is a behavior motivated by  the desire to increase well-being and actualize human health potential
  13. 13. Standards of Care  Standards of practice are guidelines used to determine what a nurse should or should not do.  Standards may be defined as “ a benchmark of achievement which is based on a desired level of excellence”.  Standards of care (SOC’s) measure the degree of excellence in nursing care and describe a competent level of nursing care.
  14. 14. The standards of practice shall: 1. Be considered as the baseline for quality nursing care 2. Be developed in relation to the law governing nursing practice 3. Apply to the registered nurse practicing in any setting 4. Govern the practice of the licensee at all levels of practice
  15. 15. Nursing standards are important 1. Outline what the profession expects of its members 2. Promote, guide, and direct professional nursing practice important for self-assessment and evaluation of practicing nurses 3. Aid in developing a better understanding and response for the various and complementary roles that nurses have
  16. 16. Nurses & Practice  The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning.  The nurse maintains a standard of personal health such that the ability to provide care is not compromised.
  17. 17. Nurses & Practice  The nurse uses judgment regarding individual competence when accepting and delegating responsibility.  The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence.  The nurse, in providing care, ensures that use of technology & scientific advances are compatible with the safety, dignity and rights of people.
  18. 18. Nurses & the Profession  The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, resea rch and education.
  19. 19. Levels of Care       Preventive Primary Secondary Tertiary Restorative Long-term
  20. 20. Health Care Providers  Physicians  Nurses  Physician Assistants  Specialized Care Providers  Technicians/Therapists  Other Providers
  21. 21. Health Care Settings  Acute Care Facilities  Short-Term Specialized Care Facilities  Long-Term Care Facilities  Ambulatory Care Sites  Rural Health Centers
  22. 22. Code of Conduct Professional conduct: standards for conduct, performanc e and ethics  In caring for patients, you must:  respect the patient or client as         an individual obtain consent before you give any treatment or care protect confidential information co-operate with others in the team maintain your professional knowledge and competence be trustworthy act to identify and minimise risk to patients and clients. These are the shared values of all the United Kingdom health care regulatory bodies.
  23. 23. Nursing in the New Millennium What has changed?  who delivers health care  what is provided  when and where Patients are seen
  24. 24. Nursing and the Environment Nursing interventions are directed toward preventing and minimizing the effects of environmental health problems on persons of all ages.
  25. 25. New Nursing Opportunities  Advanced Practice Nurses  Entrepreneurs  Data Management  Research
  26. 26. Nursing Skills            · · · · · · · · · · Physical Assessment Safety and Infection Control Patient Care and Comfort Basic Care Medication Administration Nutrition and Elimination Oxygenation Circulatory Skin Integrity and Wound Care Immobilization and Support Special Procedures
  27. 27. DFS Approved Curriculum-Unit 10 27
  28. 28. Vital Signs  Reflect the function of three body processes that are essential for life.  Regulation of body temperature  Heart function  Breathing DFS Approved Curriculum-Unit 10 28
  29. 29. Vital Signs  Measurement (taken at rest)  Temperature - measures body heat  Pulse - measures heart rate  Respiration - measures how often resident inhales and exhales  Blood Pressure - measures pressure against walls of arteries DFS Approved Curriculum-Unit 10 29
  30. 30. Qualities that make a person successful  desire, commitment, resp onsibility, hard work, power of persistence, giving more than you get, pride of performance and be willing to be a student.
  31. 31. Goal of Nursing  Nursing has long been described as an art and a science.  As nursing evolved as a profession, nursing leaders attempted to define nursing. Florence Nightingale wrote that the goal of nursing was “ to put the patient in the best condition for nature to act upon him”.
  32. 32. Conclusion  Nurses represent the major personnel expense in any hospital and are the most directly responsible for using supplies for patients.  Nurses are in a position to maintain quality in cost effective care. For effective patient care and greater satisfaction of patients, we should be sensitive and responsive to the needs of patients.  We must respect the patient rights.
  33. 33. Core Values of Nursing We must preserve core values of nursing – compassion, care, cour tesy, and empathy.
  34. 34. Core Values  We must also uphold basic virtues - hard work, generosity, kindness, punctuality, tolerance, perseverance, honesty, truthfulness, modesty, and politeness.
  35. 35. DFS Approved Curriculum-Unit 10 35