1. Working to Full Scope of
Practice in unison with PN
Ethics: Wound Care,
Tracheostomy's, and
Drains
Presented By: Chandra Campbell, Lisa Gillespie, Danil
Zaytsev, Navjot Saini
2. OVERVIEW
1.What is PN ethics
2.The Code of ethics
3.Spheres of the scope of practice
4.Ethical Principles
5.Ethical Principles and Nursing Practice
6.Accepting Accountability
7.Tracheostomy’s
8.Wound Care
9.When things go beyond scope
10.Drains
11.Consultation for Assistance
3. What is PN Ethics?
Protects Clients
Code of ethics
Guide what is right and wrong
Motives behind determining
outcomes through those actions and
their consequences of those actions
on clients
Support guiding actions nursing
related
4. The Code of Ethics
The "Code of Ethics and Standards of Practice" for licensed
practical nurses of Alberta is a foundation of our profession
(CLPNA: Code of Ethics and Standards of Practice, 2008, p.2). It
serves us as a reference guide for building ethical relationships
with our colleagues and patients, it explains our responsibilities on
workplace, and directs our practice towards standards of law and
existing regulations. This ethical foundation also underlines the
role of philosophical values in our profession such as personal
obligations, individual commitments, and believes by establishing
ethical standards in order to match expectations of general public
and community. The code also serves us as a tool for self reflective
evaluation and it is essential for maintaining safe, companionate,
and ethical environment in our workplace (CLPNA: Code of Ethics
and Standards of Practice, 2008, p.2).
5. The Code of Ethics is based on several assumptions
such as promotion of health and well-being to all patients,
preserving their dignity, maintaining privacy and
confidentiality, promotion of justice, and accountability that
should never be compromised by any means
(Cassells & Gaul, 1998, p.10)
6. Spheres of the Scope of Practice
CLPNA
Institutional Policies
Student’s Scope
7. Ethical Principles
Through guiding principles as professionals we are able to :
make informed decisions
Deliver more competent care
Are in place to PROTECT THE RIGHTS of the individuals we
care for
These principles are the rights for clients:
1.Autonomy
2.Nonmaleficence
3.Justice
4.Fidelity
5.Veracity
6.Accountability
8. What these Principles mean in
current nursing practice
Autonomy-Right to make decisions that impact oneself and
take action from those decisions,
Nonmalificence-Do no harm
Beneficence-act in the best interest of others, includes
client advocacy, 3 parts: Promote good, prevent harm or
evil, Remove Harm or evil
Fedelity-Faithful to ethical principles, and code of ethics for
nursing, keeping commitments and promises made to
clients
Justice-Fair, equitable, and appropriate treatment, equal
distribution of resources
Veracity-To tell the truth
Accountability-Being answerable to self and others based on
action, includes responsibility for ones actions for
procedures performed as a nurse
13. Wound Care
beyond the dermis beyond
beyond the point in the nasal passages where they normally
narrow
the external ear canal
beyond the pharynx
beyond the opening of the urethra
beyond the labia majora
beyond the anal verge
into an artificial opening into the body.
http://peltons.com/
When to stop: Anatomical levels of reference
http://www.health.gov.bc.ca/professional-regulation/hpc/review/part-i/scope-
14. When Things Go Beyond
Scope of practice
When it is considered that the needs of the patient
go beyond the scope of practice of LPN, the RN would
take accountability for the client’s care, in open
discussion with RN practical nurse should decide which of
the following options would be the most appropriate:
• RN and LPN work together to provide the
required care
• LPN works under the supervision or guidance
of RN
(direct/indirect)
• LPN delegate the care for the client to RN
https://www.youtube.com/watch?v=uXBssToP4g
15. Drains:
Working within the LPN Scope .
Within Scope of
Practise
Outside Scope of
Practise
• Jackson Pratt Drain
• Nasogastric Tubes (NG Tubes)
• Hemovac Drain
• Blake Drain
• Davol Drain
• Flex-I Seal Rectal Tube
& Collecting System
• Penrose Drain
• Percutaneous Drain/
Stent:
Cook drain/ Pigtail drain/ CT
drain
• Malecot Drain
• T-Tube Drain
16. Purpose:
Seek clarification, assistance and exterior knowledge
to assist in decision making pertaining to critical thinking and
administration of care.
Resource's available:
• Fellow Staff Members
• Alberta Health Services Policy
• & Procedures Manual
• Unit In-Service/ Education Days
• Charge Nurse
• Specialized Nursing Staff (Wound Care)
• **Unit Educator**
Priority: Patient Safety!
17. From Us to You
Nursing comes with a price we all must pay and
the path is not always laid with gold.
Work hard to learn what you can as students’
knowledge is something we strive for to make us
not just better nurses but people as well.
It is the people we care for that teach us about
life, values, and form the experiences that help
us grow as individuals in our practice.
It’s our responsibility to ensure their safety in
our care as we grow, learn, laugh, and cry with
them through their experiences to apply it so
that the gold we weave can make a lasting
impact on the lives we will touch throughout our
careers.
18. Reference
Bow Valley College, BVC. (2014). Practical nursing program diploma curriculum. Calgary, AB: BVC
Canadian Council for Practical Nurse Regulation, CCPNR. (2013). Code of ethics for licensed practical nurses in
Canada. Retrieved from: http://www.clpna.com/wp-
content/uploads/2013/02/doc_CCPNR_CLPNA_Code_of_Ethics.pdf
College of Licenced Practical Nurses of Alberta. (2013). Pp. 04, 05. Retrieved from
http://www.clpna.com/wpcontent/uploads/2013/02/doc_CCPNR_CLPNA_Standards_of_ Practice.pds
College of Licensed Practical Nurses of Alberta, CLPNA. (2008). Code of ethics and standards of practice.
Retrieved from: http://www.clpna.com/wp- content/uploads/2013 /02/doc_CLPNAEthics-Standards.pdf
Cassells, J., & Gaul, A. (1998). An ethical assessment framework for nursing practice. Maryland Nurse, 17(1), 9-
12.
Hogan A. (2012). Comprehensive review for NCLEX-PN Reviews & Rationales (2nd ed.), Amherst: Pearson
Education Inc.
Kozier, B., Erb, G., Berman, A., Snyder, S., Bouchal, D. S. R., Hirst, S., et al. (2010).
Fundamentals of Canadian nursing: Concepts, process, and practice (2nd Canadian ed.). Toronto: Pearson
Education
Linton A. (2012). Introduction to medical-surgical nursing. (5th ed.), Philadelphia: Saunders Elsevier
Editor's Notes
Autonomy is the freedom to make critical thinking decisions that impact oneself and to take action for those decisions'includes: respect for others, ability to determin personal goals, complete understandng of choices, and the abilityto implement that plan or choiceExample-understanding before operations therisks, impact, and consequences of the surgery and recovery prior to undergoingthe surgery, the right to be able to decide as a patient what you want to do and how it will impact your lifeNonmaleficence, to do no harm whether it be unintentional or intentionalEXample- to critically think regardingmedication administration if that dose will harm the client, and if giving pain medicationunderstanding and monitoring for respiratorydestress preventing the client from harm afteradministration of narcotics.Beneficence=Acting in the best intersest of patients-to do good by prooting good, preventing harm or evil, understanding of choicesand the freedom to implement plans or choicesExample: Enacting care plans based off researchto help promote health and healing in patientsrecovering from new or old illnesses such asdiabetic teaching to prevent harm and howto prevent wounds on their feet due to decreasedneuropathyFidelity-Faithful to ethical principles, and the code of ethics for nursing-Guidelines to prevent harm for our clients that we follow as nursesVeracity-To tell the truth,Example-If a client has gone septic, is no longer responsive to treatment and asksif they are going to die you tell them thetruth that yes they are and help them as muchas they can with their needs before passing.Accountability- Being responsible for ones actionsto yourself and others as a nurse, knowing why you are doing procedures, administeringmedication 7 rights and ensuring safetly safepractice as a professionalAutonomy is the freedom to make critical thinking decisions that impact oneself and to take action for those decisions'includes: respect for others, ability to determin personal goals, complete understandng of choices, and the abilityto implement that plan or choiceExample-understanding before operations therisks, impact, and consequences of the surgery and recovery prior to undergoingthe surgery, the right to be able to decide as a patient what you want to do and how it will impact your lifeNonmaleficence, to do no harm whether it be unintentional or intentionalEXample- to critically think regardingmedication administration if that dose will harm the client, and if giving pain medicationunderstanding and monitoring for respiratorydestress preventing the client from harm afteradministration of narcotics.Beneficence=Acting in the best intersest of patients-to do good by prooting good, preventing harm or evil, understanding of choicesand the freedom to implement plans or choicesExample: Enacting care plans based off researchto help promote health and healing in patientsrecovering from new or old illnesses such asdiabetic teaching to prevent harm and howto prevent wounds on their feet due to decreasedneuropathyFidelity-Faithful to ethical principles, and the code of ethics for nursing-Guidelines to prevent harm for our clients that we follow as nursesVeracity-To tell the truth,Example-If a client has gone septic, is no longer responsive to treatment and asksif they are going to die you tell them thetruth that yes they are and help them as muchas they can with their needs before passing.Accountability- Being responsible for ones actionsto yourself and others as a nurse, knowing why you are doing procedures, administeringmedication 7 rights and ensuring safetly safepractice as a professionalAutonomy is the freedom to make critical thinking decisions that impact oneself and to take action for those decisions'includes: respect for others, ability to determin personal goals, complete understandng of choices, and the abilityto implement that plan or choiceExample-understanding before operations therisks, impact, and consequences of the surgery and recovery prior to undergoingthe surgery, the right to be able to decide as a patient what you want to do and how it will impact your lifeNonmaleficence, to do no harm whether it be unintentional or intentionalEXample- to critically think regardingmedication administration if that dose will harm the client, and if giving pain medicationunderstanding and monitoring for respiratorydestress preventing the client from harm afteradministration of narcotics.Beneficence=Acting in the best intersest of patients-to do good by prooting good, preventing harm or evil, understanding of choicesand the freedom to implement plans or choicesExample: Enacting care plans based off researchto help promote health and healing in patientsrecovering from new or old illnesses such asdiabetic teaching to prevent harm and howto prevent wounds on their feet due to decreasedneuropathyFidelity-Faithful to ethical principles, and the code of ethics for nursing-Guidelines to prevent harm for our clients that we follow as nursesVeracity-To tell the truth,Example-If a client has gone septic, is no longer responsive to treatment and asksif they are going to die you tell them thetruth that yes they are and help them as muchas they can with their needs before passing.Accountability- Being responsible for ones actionsto yourself and others as a nurse, knowing why you are doing procedures, administeringmedication 7 rights and ensuring safetly safepractice as a professional
