Elective 2- 2 development of standards

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Elective 2- 2 development of standards

  1. 1. Development of Standards 1
  2. 2. Standards• Predetermined level of excellence• Guide for practice 2
  3. 3. 3
  4. 4. Nursing leaders• Recognize roles & responsibilities that professional nursing organizations 4
  5. 5. Nursing organizations• Developed research-based outcome criteria• Standard based care plans• Course curricula• Guidelines for care and practice 5
  6. 6. 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
  7. 7. Philippine setting… Philippine Nursing Act of 2002 Republic Act 9173 7
  8. 8. Characteristics of Standards 8
  9. 9. Characteristics of Standards 1. RealisticCan be followed or achieved with existing resources 9
  10. 10. Characteristics of Standards 2. ReliableSpecific intervention results in same outcome 10
  11. 11. Characteristics of Standards 3. Valid Based on scientific evidence Other acceptable experience 11
  12. 12. Characteristics of Standards 4. Clear Understood by allNot subject to distortion/misinterpretations 12
  13. 13. Characteristics of Standards 5. MeasurablePerformance can be assessed/ quantified 13
  14. 14. Standards of Care andStandards of Nursing Practice 14
  15. 15. Standards of Care… For practice of nursing RULES OR DEFINITION FOR WHAT IT MEANS TO PROVIDE COMPETENT CARE AS A REGISTERED NURSE 15
  16. 16. We are required by law:to carry out in accordance with other reasonableprudent nurses would do in the same/similar circumstances. 16
  17. 17. Standards of Care…Serve as guidelines in evaluating nursing care for possible negligence 17
  18. 18. Standards of Care… Define acts permitted to be performed/prohibited from being performed. 18
  19. 19. Standards of Care… Give direction to nurses(what should/ should not do) 19
  20. 20. Standards of Care…Nurses who don’t meet the standards are found NEGLIGENT 20
  21. 21. Standards of Care… MALPRACTICELegal action a nurse may be charged 21
  22. 22. 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
  23. 23. Standards of Practice shall … 1. Considered as BASELINE for quality nursing care 23
  24. 24. Standards of Practice shall …2. Developed in relation to law governing nursing practice 24
  25. 25. Standards of Practice shall …3. Apply to RNs practicing in any setting 25
  26. 26. Standards of Practice shall …4. Govern the practice at all levels of practice 26
  27. 27. Standards of Practice…Standard 1: AssessmentStandard 2: DiagnosisStandard 3: Outcomes IdentificationStandard 4: PlanningStandard 5: ImplementationStandard 6: Evaluation 27
  28. 28. Standard 1: AssessmentMeasurement criteria: 1. Data collection is systemic and ongoing 28
  29. 29. Standard 1: AssessmentMeasurement criteria: 2. Data collection involves clients, partners and HCP when appropriate 29
  30. 30. Standard 1: AssessmentMeasurement criteria: 3. Priority of data collection activities is determined by client’s immediate condition or needs 30
  31. 31. Standard 1: AssessmentMeasurement criteria: 4. Pertinent data are collected using appropriate evidence- based assessment techniques 31
  32. 32. Standard 1: AssessmentMeasurement criteria: 5. Analytical models and problem-solving tools are used 32
  33. 33. Standard 1: AssessmentMeasurement criteria: 6. Patterns and variances are identified by Synthesizing relevant data and knowledge 33
  34. 34. Standard 1: AssessmentMeasurement criteria: 7. Relevant data are documented in a retrievable form. 34
  35. 35. Standard 2: DiagnosisMeasurement criteria: 1. Dxs are derived from assessment data 35
  36. 36. Standard 2: DiagnosisMeasurement criteria: 2. Dxs are validated with client, partners and HCP when possible 36
  37. 37. Standard 2: DiagnosisMeasurement criteria: 3. Dxs are documented that facilitates determination of expected outcomes and plan of care. 37
  38. 38. Standard 3: Outcomes identificationMeasurement criteria:1. Involves client, family and HCP 38
  39. 39. Standard 3: Outcomes identificationMeasurement criteria: 2. Outcomes are culturally appropriate and are derived from diagnoses 39
  40. 40. Standard 3: Outcomes identificationMeasurement criteria:3. Outcomes are formulated considering: Associated risks Benefits Costs Current scientific evidence Clinical expertise. 40
  41. 41. Standard 3: Outcomes identificationMeasurement criteria: 4. Outcomes are defined on client’s Values Ethical considerations Environment 41
  42. 42. Standard 3: Outcomes identificationMeasurement criteria: 5. Outcomes include a time estimate for attainment 42
  43. 43. Standard 3: Outcomes identificationMeasurement criteria: 6. Outcomes provide direction for continuity of care 43
  44. 44. Standard 3: Outcomes identificationMeasurement criteria: 7. Outcomes are modified based on the client’s status 44
  45. 45. Standard 3: Outcomes identificationMeasurement criteria: 8. Outcomes are documented as measurable goals 45
  46. 46. Outcomes identification: 46
  47. 47. Standard 4: PlanningMeasurement criteria: PLAN IS1. Individualized to reflectclient’s characteristics and needs 47
  48. 48. Standard 4: PlanningMeasurement criteria: PLAN IS 2. Developed with client, SO, HCP and other personnel 48
  49. 49. Standard 4: PlanningMeasurement criteria: PLAN IS3. Reflects current nursing practice 49
  50. 50. Standard 4: PlanningMeasurement criteria: PLAN IS 4. documented 50
  51. 51. Standard 4: PlanningMeasurement criteria: PLAN IS5. Provides for continuity of care from the time of entry to final discharge 51
  52. 52. Standard 4: PlanningMeasurement criteria: PLAN IS 6. Provides for discharge follow-up based on theclient’s need for health care 52
  53. 53. Standard 5: Implementation Measurement criteria: Interventions are 1. Consistent with established care plan. 53
  54. 54. Standard 5: Implementation Measurement criteria: Interventions are 2. Implemented in a safe, appropriate and timely manner 54
  55. 55. Standard 5: Implementation Measurement criteria: Interventions are 3. documented 55
  56. 56. Standard 6: Evaluation Measurement criteria: Evaluation is1. Systematic and ongoing 56
  57. 57. Standard 6: EvaluationMeasurement criteria: 2. client’s response are documented. 57
  58. 58. Standard 6: EvaluationMeasurement criteria: 3. Effectiveness ofintervention is evaluated in relation to outcomes 58
  59. 59. Standard 6: EvaluationMeasurement criteria: 4. Ongoing assessment data are used to revised the process 59
  60. 60. Standard 6: EvaluationMeasurement criteria: 5. client, SO, HCP are involved in the evaluation process 60
  61. 61. Models of Care Delivery 61
  62. 62. Care Delivery ModelOrganizes the work for caring for client. 62
  63. 63. Care Delivery Models1. Case method2. Total patient care3. Functional nursing4. Team nursing5. Primary nursing6. Differentiated Practice 63
  64. 64. Case Method1 nurse = 1 clientTotal patient care = modern version of case method 64
  65. 65. 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
  66. 66. 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
  67. 67. 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
  68. 68. 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
  69. 69. Primary Nursing Focus: on client needs than staff needs 69
  70. 70. 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
  71. 71. 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

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