1. Development of Standards
1

2. Standards
• Predetermined level of
excellence
• Guide for practice
2

3. 3

4. Nursing leaders
• Recognize roles & responsibilities that professional
nursing organizations
4

5. Nursing organizations
• Developed research-based outcome criteria
• Standard based care plans
• Course curricula
• Guidelines for care and practice
5

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. Philippine setting…
Philippine Nursing Act of 2002
Republic Act 9173
7

8. Characteristics of Standards
8

9. Characteristics of Standards
1. Realistic
Can be followed or achieved with existing
resources
9

10. Characteristics of Standards
2. Reliable
Specific intervention results in same outcome
10

11. Characteristics of Standards
3. Valid
Based on scientific evidence
Other acceptable experience
11

12. Characteristics of Standards
4. Clear
Understood by all
Not subject to distortion/misinterpretations
12

13. Characteristics of Standards
5. Measurable
Performance can be assessed/ quantified
13

14. Standards of Care
and
Standards of Nursing Practice
14

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. We are required by law:
to carry out in accordance
with other reasonable
prudent nurses would do
in the same/similar
circumstances.
16

17. Standards of Care…
Serve as guidelines
in evaluating
nursing care for
possible negligence
17

18. Standards of Care…
Define acts permitted to be performed/prohibited
from being performed.
18

19. Standards of Care…
Give direction to
nurses
(what should/ should
not do)
19

20. Standards of Care…
Nurses who don’t meet
the standards are
found
NEGLIGENT
20

21. Standards of Care…
MALPRACTICE
Legal action a nurse may
be charged
21

22. Standards of Practice…
Provide a guide to KSA
needed to practice
safely.
RN is responsible &
accountable for indiv
client for quality nursing
care he receives.
22

23. Standards of Practice shall …
1. Considered as
BASELINE for quality
nursing care
23

24. Standards of Practice shall …
2. Developed in relation to
law governing nursing
practice
24

25. Standards of Practice shall …
3. Apply to RNs practicing
in any setting
25

26. Standards of Practice shall …
4. Govern the practice at
all levels of practice
26

27. Standards of Practice…
Standard 1: Assessment
Standard 2: Diagnosis
Standard 3: Outcomes Identification
Standard 4: Planning
Standard 5: Implementation
Standard 6: Evaluation
27

28. Standard 1: Assessment
Measurement criteria:
1. Data collection is
systemic and ongoing
28

29. Standard 1: Assessment
Measurement criteria:
2. Data collection
involves clients, partners
and HCP when
appropriate
29

30. Standard 1: Assessment
Measurement criteria:
3. Priority of data
collection activities is
determined by client’s
immediate condition or
needs
30

31. Standard 1: Assessment
Measurement criteria:
4. Pertinent data are
collected using
appropriate evidence-
based assessment
techniques
31

32. Standard 1: Assessment
Measurement criteria:
5. Analytical models and
problem-solving tools
are used
32

33. Standard 1: Assessment
Measurement criteria:
6. Patterns and
variances are identified
by
Synthesizing relevant
data and knowledge
33

34. Standard 1: Assessment
Measurement criteria:
7. Relevant data are
documented in a
retrievable form.
34

35. Standard 2: Diagnosis
Measurement criteria:
1. Dxs are derived from
assessment data
35

36. Standard 2: Diagnosis
Measurement criteria:
2. Dxs are validated with
client, partners and HCP
when possible
36

37. Standard 2: Diagnosis
Measurement criteria:
3. Dxs are documented
that facilitates
determination of
expected outcomes and
plan of care.
37

38. Standard 3: Outcomes identification
Measurement criteria:
1. Involves client, family
and HCP
38

39. Standard 3: Outcomes identification
Measurement criteria:
2. Outcomes are
culturally appropriate
and are derived from
diagnoses
39

40. Standard 3: Outcomes identification
Measurement criteria:
3. Outcomes are formulated
considering:
Associated risks
Benefits
Costs
Current scientific evidence
Clinical expertise.
40

41. Standard 3: Outcomes identification
Measurement criteria:
4. Outcomes are defined on
client’s
Values
Ethical considerations
Environment
41

42. Standard 3: Outcomes identification
Measurement criteria:
5. Outcomes include a
time estimate for
attainment
42

43. Standard 3: Outcomes identification
Measurement criteria:
6. Outcomes provide
direction for continuity
of care
43

44. Standard 3: Outcomes identification
Measurement criteria:
7. Outcomes are
modified based on the
client’s status
44

45. Standard 3: Outcomes identification
Measurement criteria:
8. Outcomes are
documented as
measurable goals
45

46. Outcomes identification:
46

47. Standard 4: Planning
Measurement criteria: PLAN IS
1. Individualized to reflect
client’s characteristics and
needs
47

48. Standard 4: Planning
Measurement criteria: PLAN IS
2. Developed with client,
SO, HCP and other
personnel
48

49. Standard 4: Planning
Measurement criteria: PLAN IS
3. Reflects current nursing
practice
49

50. Standard 4: Planning
Measurement criteria: PLAN IS
4. documented
50

51. Standard 4: Planning
Measurement criteria: PLAN IS
5. Provides for continuity of
care
from the time of entry to
final discharge
51

52. Standard 4: Planning
Measurement criteria: PLAN IS
6. Provides for discharge
follow-up based on the
client’s need for health care
52

53. Standard 5: Implementation
Measurement criteria: Interventions are
1. Consistent with
established care plan.
53

54. Standard 5: Implementation
Measurement criteria: Interventions are
2. Implemented in a
safe, appropriate and
timely manner
54

55. Standard 5: Implementation
Measurement criteria: Interventions are
3. documented
55

56. Standard 6: Evaluation
Measurement criteria: Evaluation is
1. Systematic and ongoing
56

57. Standard 6: Evaluation
Measurement criteria:
2. client’s response are
documented.
57

58. Standard 6: Evaluation
Measurement criteria:
3. Effectiveness of
intervention is evaluated in
relation to outcomes
58

59. Standard 6: Evaluation
Measurement criteria:
4. Ongoing assessment
data are used to revised
the process
59

60. Standard 6: Evaluation
Measurement criteria:
5. client, SO, HCP are
involved in the evaluation
process
60

61. Models of Care Delivery
61

62. Care Delivery Model
Organizes the work for caring for client.
62

63. Care Delivery Models
1. Case method
2. Total patient care
3. Functional nursing
4. Team nursing
5. Primary nursing
6. Differentiated Practice
63

64. Case Method
1 nurse = 1 client
Total patient care = modern version of
case method
64

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. Total Patient Care
Disadvantage:
1. Nurse may not have same client everyday
Head
Nurse
2. Looks at client on shift-by-shift basis
3. Utilize high level of RN nursing hours to deliver care
4. Level of RN intensity is not necessary Staff Nurse
Patient
66

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. 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. Primary Nursing
Focus: on client needs than staff needs
69

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. Differentiated Practice
According 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