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Elective 2- 2 development of standards

Elective 2- 2 development of standards






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    Elective 2- 2 development of standards Elective 2- 2 development of standards Presentation Transcript

    • Development of Standards 1
    • Standards• Predetermined level of excellence• Guide for practice 2
    • 3
    • Nursing leaders• Recognize roles & responsibilities that professional nursing organizations 4
    • Nursing organizations• Developed research-based outcome criteria• Standard based care plans• Course curricula• Guidelines for care and practice 5
    • These groups have established standards of care to set forth a legitimate: 1. scope of practice And 2. provide basis for organizing nursing practice philosophies and nursing process 6
    • Philippine setting… Philippine Nursing Act of 2002 Republic Act 9173 7
    • Characteristics of Standards 8
    • Characteristics of Standards 1. RealisticCan be followed or achieved with existing resources 9
    • Characteristics of Standards 2. ReliableSpecific intervention results in same outcome 10
    • Characteristics of Standards 3. Valid Based on scientific evidence Other acceptable experience 11
    • Characteristics of Standards 4. Clear Understood by allNot subject to distortion/misinterpretations 12
    • Characteristics of Standards 5. MeasurablePerformance can be assessed/ quantified 13
    • Standards of Care andStandards of Nursing Practice 14
    • We are required by law:to carry out in accordance with other reasonableprudent nurses would do in the same/similar circumstances. 16
    • Standards of Care…Serve as guidelines in evaluating nursing care for possible negligence 17
    • Standards of Care… Define acts permitted to be performed/prohibited from being performed. 18
    • Standards of Care… Give direction to nurses(what should/ should not do) 19
    • Standards of Care…Nurses who don’t meet the standards are found NEGLIGENT 20
    • Standards of Care… MALPRACTICELegal action a nurse may be charged 21
    • Standards of Practice…Provide a guide to KSA needed to practice safely. RN is responsible & accountable for indivclient for quality nursing care he receives. 22
    • Standards of Practice shall … 1. Considered as BASELINE for quality nursing care 23
    • Standards of Practice shall …2. Developed in relation to law governing nursing practice 24
    • Standards of Practice shall …3. Apply to RNs practicing in any setting 25
    • Standards of Practice shall …4. Govern the practice at all levels of practice 26
    • Standards of Practice…Standard 1: AssessmentStandard 2: DiagnosisStandard 3: Outcomes IdentificationStandard 4: PlanningStandard 5: ImplementationStandard 6: Evaluation 27
    • Standard 1: AssessmentMeasurement criteria: 1. Data collection is systemic and ongoing 28
    • Standard 1: AssessmentMeasurement criteria: 2. Data collection involves clients, partners and HCP when appropriate 29
    • Standard 1: AssessmentMeasurement criteria: 3. Priority of data collection activities is determined by client’s immediate condition or needs 30
    • Standard 1: AssessmentMeasurement criteria: 4. Pertinent data are collected using appropriate evidence- based assessment techniques 31
    • Standard 1: AssessmentMeasurement criteria: 5. Analytical models and problem-solving tools are used 32
    • Standard 1: AssessmentMeasurement criteria: 6. Patterns and variances are identified by Synthesizing relevant data and knowledge 33
    • Standard 1: AssessmentMeasurement criteria: 7. Relevant data are documented in a retrievable form. 34
    • Standard 2: DiagnosisMeasurement criteria: 1. Dxs are derived from assessment data 35
    • Standard 2: DiagnosisMeasurement criteria: 2. Dxs are validated with client, partners and HCP when possible 36
    • Standard 2: DiagnosisMeasurement criteria: 3. Dxs are documented that facilitates determination of expected outcomes and plan of care. 37
    • Standard 3: Outcomes identificationMeasurement criteria:1. Involves client, family and HCP 38
    • Standard 3: Outcomes identificationMeasurement criteria: 2. Outcomes are culturally appropriate and are derived from diagnoses 39
    • Standard 3: Outcomes identificationMeasurement criteria:3. Outcomes are formulated considering: Associated risks Benefits Costs Current scientific evidence Clinical expertise. 40
    • Standard 3: Outcomes identificationMeasurement criteria: 4. Outcomes are defined on client’s Values Ethical considerations Environment 41
    • Standard 3: Outcomes identificationMeasurement criteria: 5. Outcomes include a time estimate for attainment 42
    • Standard 3: Outcomes identificationMeasurement criteria: 6. Outcomes provide direction for continuity of care 43
    • Standard 3: Outcomes identificationMeasurement criteria: 7. Outcomes are modified based on the client’s status 44
    • Standard 3: Outcomes identificationMeasurement criteria: 8. Outcomes are documented as measurable goals 45
    • Outcomes identification: 46
    • Standard 4: PlanningMeasurement criteria: PLAN IS1. Individualized to reflectclient’s characteristics and needs 47
    • Standard 4: PlanningMeasurement criteria: PLAN IS 2. Developed with client, SO, HCP and other personnel 48
    • Standard 4: PlanningMeasurement criteria: PLAN IS3. Reflects current nursing practice 49
    • Standard 4: PlanningMeasurement criteria: PLAN IS 4. documented 50
    • Standard 4: PlanningMeasurement criteria: PLAN IS5. Provides for continuity of care from the time of entry to final discharge 51
    • Standard 4: PlanningMeasurement criteria: PLAN IS 6. Provides for discharge follow-up based on theclient’s need for health care 52
    • Standard 5: Implementation Measurement criteria: Interventions are 1. Consistent with established care plan. 53
    • Standard 5: Implementation Measurement criteria: Interventions are 2. Implemented in a safe, appropriate and timely manner 54
    • Standard 5: Implementation Measurement criteria: Interventions are 3. documented 55
    • Standard 6: Evaluation Measurement criteria: Evaluation is1. Systematic and ongoing 56
    • Standard 6: EvaluationMeasurement criteria: 2. client’s response are documented. 57
    • Standard 6: EvaluationMeasurement criteria: 3. Effectiveness ofintervention is evaluated in relation to outcomes 58
    • Standard 6: EvaluationMeasurement criteria: 4. Ongoing assessment data are used to revised the process 59
    • Standard 6: EvaluationMeasurement criteria: 5. client, SO, HCP are involved in the evaluation process 60
    • Models of Care Delivery 61
    • Care Delivery ModelOrganizes the work for caring for client. 62
    • Care Delivery Models1. Case method2. Total patient care3. Functional nursing4. Team nursing5. Primary nursing6. Differentiated Practice 63
    • Case Method1 nurse = 1 clientTotal patient care = modern version of case method 64
    • Total Patient Care 1 nurse = 1 client per shift Advantage: Head 1. Consistency of 1 individual caring for an entire shift Nurse 2. Enables trusting relationship 3. More time to observe and monitor the progress of client Staff Nurse Patient 65
    • Total Patient CareDisadvantage:1. Nurse may not have same client everyday Head Nurse2. Looks at client on shift-by-shift basis3. Utilize high level of RN nursing hours to deliver care4. Level of RN intensity is not necessary Staff Nurse Patient 66
    • Functional Nursing Can deliver large # of clients Good when there’s shortage of RN *to client, the care feel disjointed *client become the sum of tasks of care than an integrated whole. 67
    • Team Nursing Modular Nursing Team led by a RN Advantage: RN is able to get work done thru others Disadvantage: Fragmented, depersonalized care Responsibility and accountability are shared 68
    • Primary Nursing Focus: on client needs than staff needs 69
    • Primary Nursing Required care & services are brought to client All client services are decentralized to client area (radiology, pharmacy) Staffing is based on client needs Care teams are established for a group of client - respiratoy/PT in 1 place in hospital Advantage: Most convenient –direct service Disadvantage: costly 70
    • Differentiated PracticeAccording to identified criteria: education: BSN, MAN, MN clinical experience competence: technical communication mgt of care leadership skills Advantage: Allows RN to work in specialized roles for which they were educated, leading to career satisfaction, appropriate recognition and rewards 71