This ppt covers the pratical aspects of ethics and patient care standards in nursing

1. ETHICS AND PATIENT
CARE STANDARDS
MRS. PARVATHY GOPI

2. SNAP SHORT
• Ethics - definition , needs, ICN code
• Application of ethics in improving patient care
• Standards of nursing
• ANA nursing standard model
• Patient satisfaction model for nurse managers
• Tips to improve patient satisfaction

3. DEFINITION
• Ethics refers to the moral code for nursing and is
based on obligation to service and respect for
human life .
CODE OF ETHICS
• A code of ethics is a set of ethical principles that
are accepted by all members of the profession.
POTTER AND PERRY

4. NEED FOR NURSING ETHICS

5. 1. Patients and service users, and those who care for
them, can use it to provide feedback to nurses
and midwives about the care they receive.

6. 2. Nurses and midwives can use it to promote safe
and effective practice in their place of work.

7. 3. Employer organizations can support their staff in
upholding the standards in their professional
Code as part of providing the quality and safety
expected by service users and regulators.

8. 4.Educators can use the Code to help students
understand what it means to be a registered
professional nurse and how keeping to the Code
helps to achieve that.

9. INTERNATIONAL COUNCIL OF
NURSES

10. • Operated by nurses and leading nursing
internationally, ICN works to ensure quality
nursing care for all and sound health policies
globally.
• Introduced in the year of 1953 code has been
revised and reaffirmed at various levels and the
latest been at 2012.

11. ETHICS
NURSES AND
PEOPLE
NURSES AND
PRACTICE
NURSES AND
PROFESSION
NURSES AND
CO WORKERS

12. WORKING ELEMENT OF ICN CODE
OF ETHICS .
• Study the standards under each
element of code.
• Analyze the application of code in
each domain .
• Discuss the code with co workers.
• Work in groups to clarify ethical
decisions .
• Collaborate with national
associations.

13. –NURSES AND PEOPLE
MANAGERS
• Provide care that
respects human rights
and is sensitive to
values , customs and
beliefs of the people
• Provide CNE on
ethical issues
• Informed consent and
right to choose or deny
• Using recording and
MIS to ensure
confidentiality
• Environmental safety
in work place
EDUCATORS
• Include reference of
human rights,
equity and justice
in curriculum
• Knowledge about
informed consent
• Concept of
professional values
• Sensitize the
importance of
social action in
current concerns
ASSOCIATION
• Develop guidelines and
statements that
supports human rights
and ethical standards
• Involvement of nurses
in ethical committee
• Organize CNE related
to ethical issues and
informed consent
• Incorporate
confidentiality into
national code of ethics
for nurses.
• Advocate for safe and
healthy environment .

14. NURSES AND
PRACTICE
MANAGERS
• Establish
standards of care
and a work setting
that promotes the
quality of care
• Professional
appraisal , CNE
and renewal of
practice
• Monitor and
promote personal
health of nursing
staff
EDUCATORS
• Provide learning
experiences that
foster life long
• Promote the
importance of
personal health
and illustrates its
relation to other
values
ASSOCIATION
• Provide access to
CNE , journals
conferences ,
distance education
etc
• Lobby for healthy
work places and
services

15. NURSES AND
PROFESSION
MANAGERS
• Set standards of
practice .
• Workplace
support for the
utilization of
research
• Promote
participation in
national nurses
associations
EDUCATORS
• Sensitize the
learners the
importance of
nursing
associations
ASSOCIATIONS
• Collaboration
to set the
standards with
other
organisations.

16. NURSES AND CO
WORKERS
MANAGERS
• Create strategies for
conflict
management.
• Develop workplaces
which support
ethical system .
• Develop
mechanisms to safe
guard individual ,
family and
community when
care is endangered
by health care
personnel.
EDUCATORS
• Understanding the
role of other health
care workers
• Communicate
nursing ethics to
other professions
ASSOCIATIONS
• Stimulate
cooperation with
other related
disciplines Develop
awareness of ethical
issues of other
professions

17. APPLICATION OF ETHICS IN
IMPROVING PATIENT CARE

18. 4 P’s
PRIORITISE PEOPLE
PRACTISE EFFECTIVELY
PRESERVE SAFETY
PROMOTE PROFESSIONALISM
AND TRUST

19. PRIORTISE PEOPLE –
1.TREAT PEOPLE AS INDIVIDUALS AND
UPHOLD THEIR DIGNITY.
• Treat people with kindness , respect and
compassion .
• Make sure to deliver fundamentals of care
effectively .
• Avoid making assumptions and recognize
diversity and individual choice .
• Respect and uphold patients rights.
• Deliver care / treatment for which you are
responsible and has to be delivered with out
any delay.

20. 2. LISTEN TO PEOPLE AND RESPOND TO
THEIR PREFERENCE AND CONCERNS
• Recognize and respect the contribution the
people can make to their own health .
• Encourage and empower people to share
decisions about their treatment .
• Respect , support and document a persons
right to accept or refuse care and treatment.
.
• Recognize when people are anxious or
distress and respond compassionately and
politely .

21. 3. ASSESS THE PATIENTS PHYSICAL ,SOCIAL
AND PSYCOLOGICAL NEEDS .
• Recognise and respond compassionately to
the needs of those who are in the end stage of
their life.
• Act as an advocate for the vulnerable
,challenging poor practice and
discriminatory attitude and behavior relating
to their care.

22. 4. ACT IN THE BEST INTEREST OF PEOPLE
ALL TIMES.
• Make sure of receiving properly taken
informed consent and document it before
carrying any information .
• Keep to all laws related to mental
capacity of the country in which you are
practicing.
• Inform colleagues , managers and the
patient receiving care that if you have an
objection to a particular procedure and
arrange for a suitably qualified colleague
to take over the responsibility for that
persons care.

23. 5. RESPECT PEOPLES RIGHT TO
PRIVACY AND CONFIDENTIALITY
• Respects persons right to privacy in all
aspects of care.
• Make sure that persons are aware of how
and why information is used and shared by
those who are practicing care.
• Respect that the patients right to privacy
will continue after the death of the patient .
• Share the information with other agencies
and professionals when the interest of
patient safety and public protection override
the need of confidentiality.

25. PRACTICE EFFECTIVELY

26. 6. ALWAYS PRACTICE IN LINE WITH
THE BEST AVAILABLE EVIDENCE
• Make sure that information given is evidence
based .
• Maintain the knowledge and skills you need for
safe and effective practice .

27. 7. COMMUNICATE CLEARLY
• Use terms that people in your care ,
colleagues and public understands.
• Take reasonable steps to understand
people’s language and communication
needs , providing where ever possible
assistance to those who need to
communicate.
• Use a range of verbal or non verbal
communication methods and be aware
of cultural sensitivities.

30. 8. WORK COOPERATIVELY
• Respect the skills , contributions and
expertise of your colleagues , referring
matters to them when appropriate.
• Work in cooperation with your colleagues....
• Keep your colleagues informed when you
are sharing an information with other health
care professionals and staffs.
• Evaluate the quality of care with your
colleagues.

31. Contd…..
• Share information to reduce the risk.
• Be supportive to colleagues if they are suffering
with health or performance problems.

32. 9. SHARE YOUR SKILLS ,
KNOWLEDGE AND EXPERINENCE
FOR THE BENEFIT OF PEOPLE
RECEIVING CARE AND YOUR
COLLEGUES.

33. 10. KEEP CLEAR AND ACCURATE
RECORDS RELEVANT TO YOUR
PRACTICE.

34. 11.BE ACCOUNATBLE FOR YOUR
DECISIONS TO DELEGATE TASKS AND
DUTIES TO OTHER PEOPLE
• Only delegate tasks and duties which are
within other persons scope of competence
, making sure that they will fully
understand your instructions.
• Make sure that everyone you delegate
task is adequately supervised and
supported
• Confirm that the outcome of task
delegated meets the required standards .

35. PRESERVE SAFETY

36. 12. RECOGNISE AND WORK WITHIN
THE LIMITS OF YOUR COMPETENCE.

37. 13. BE OPEN AND CANDID WITH ALL
SERVICE USERS ABOUT ALLASPECTS OF
CARE AND TREATMENT, INCLUDING WHEN
ALL MISTAKES OR HARM HAVE TAKEN
PLACE.

38. 14. ALWAYS OFFER HELP IN CASE OF AN
EMERGENCY IN YOUR WORK PLACE OR
ANYWHERE ELSE.

39. 15.ACT WITHOUT DELAY IF YOU
BELIEVE THAT THERE IS A RISK
TO PATIENTS SAFETY OR
PUBLIC PROTECTION.

40. PROMOTE
PROFESSIONALISM AND
TRUST.

41. 16.UPHOLD THE REPUTATION OF YOUR
PROFESSION AT ALL TIMES
• Keep the standards set by the code in all times.
• Act with honesty and integrity all times
• Treat people in way that will not take an
advantage on their vulnerability.
• Stay objective and have a clear professional
boundary with the patient and their family
members.
• Do not impose your personal or religious belief
on your patient.

42. Contd….
• Act as a role model to nursing students and
newly qualified nurses to aspire to
• Maintain the level of health you need to carry
out your professional role .
• Use all forms of spoken , written and digital
communication including social media platforms
responsibly respecting the privacy of the
patients.

43. 17.UPHOLD THE POSITION OF RN
AND RM
• Refuse all gifts , hospitality or favors from
the patient .
• Never ask for or accept loans from anyone
in your care or anyone close to them.
• Act with honesty and integrity in any
financial dealing you have with everyone
you have professional relationship with
• Cooperate with media only when it is
appropriate .

44. 18. COOPERATE WITH
INVESTIGATIONS AND AUDITS

45. 19. RESPOND TO ANY COMPLAINTE
MADE AGAINST YOU PROFESSIONALLY
• Never allow someone's complaint to affect the
care that is provided to them.
• Use all complaints as a form of feedback and an
opportunity for reflection and learning to
improve practice.

46. 20. PROVIDE LEADERSHIP TO MAKE SURE
PEOPLES WELLBEING IS PROTECTED.
• Identify the priorities manages time, staff and
resources effectively.
• Support any staffs that you may be responsible to
follow the code .

48. QUICK
BRAINSTORMING
SECTION

49. Q no 1 :- A nurse is not trained to do the procedure
of IV cannulation , still she tries to do the
procedure . You are the colleague of this nurse.
What will be your action?
• A – You should tell that nurse to not to do this
again
• B – You should report the incident to someone in
authority
• C – You must threaten the nurse, that you will
report this to the authority
• D – You should ignore her act

50. Q no. 2 A mentally capable client in a critical
condition is supposed to receive blood transfusion.
But client strongly refuses the blood product to be
transfused. What would be the best response of the
nurse?
• Accept the client’s decision and give information
on the consequences of his actions.
• Let the family decide
• Administer the blood product against the patients
decision
• The doctor will decide

51. Q No 3. A police officer approached the nurses’
station asking for information on a specific client.
The nurse knows that the she can give the
necessary information if:
• The police shows his identification
• The police officer has the right to such
information
• There is a clear risk of safety and potential harm
to the public
• The hospital manager authorized to give the
information

52. STANDARDS OF
PROFESSIONAL NURSING
PRACTICE

53. NURSING STANDARDS
• Nursing standards reflect a desired and achievable
level of performance against which actual
performance can be compared. Their main
purpose is to promote, guide and direct
professional nursing practice.
(Registered Nurses Association of BC (2003) & the
College of Nurses of Ontario (2002)

54. WHY STANDARDS ARE IMPORTANT
• Outlines what the profession expects of its
members.
• Promotes guides and directs professional nursing
practice – important for self-assessment and
evaluation of practice by employers, clients and
other stakeholders.
• Provides nurses with a framework for developing
competencies
• Aids in developing a better understanding &
respect for the various & complimentary roles
that nurses have.

55. STANDARDS OF NURSING
STANDARDS OF
PRACTICE
STANDARDS OF
PROFESSIONAL
PERFORMANCE

56. HEALTHY WORK ENVIRONMENT FOR
NURSING PRACTICE
SKILLED COMMUNICATION
TRUE COLLABORATION
EFFECTIVE DECISSION
MAKING
EFFECTIVE STAFFING
MEANINGFUL
RECOGNISATION
AUTHENTIC LEADERSHIP

57. MODEL OF PROFESSIONAL NURSING
PRACTICE REGULATION- ANA 2006

58. ANA STANDARDS OF PRACTICE

59. ANA STANDARDS OF PROFESSION
ETHICS
EDUCATION
EBP
QUALITY OF
PRACTICE
COMMUNICATION
LEADERSHIP
COLLABORATION
PRACTICE
EVALUATION
RESOURCE
ULTILISATION
ENVIRONMENTAL
HEALTH

60. PATIENT SATISFACTION MODEL FOR
NURSE MANAGERS
Patient flow
Customer service
and patient
satisfaction
Hiring pratices Safety
Financial goals
Medical staff
performance
Work
environment
Plans to boost
performance

61. 1. PATIENT FLOW
• Was the patient spoken with respect when calling in for
an appointment?
• Was the patient greeted by the receptionist with
courtesy and respect?
• How long did the patient wait to see the doctor?
• Did the nurse and doctor explain the details of the
services provided to the patient?
• Did the nurse and doctor answer all the patient's
questions?

62. CONTD…
• Did the patient receive excellent customer service?
• Was the exam room clean, comfortable and
prepared?
• Was the waiting area safe, clean and spacious?

63. 2. CUSTOMER SERVICE AND PATIENT
SATISFACTION.
• Develop and distribute Patient Satisfaction Surveys.
• Sit in the waiting area and observe what goes on
from that point of view.
• Put yourself through the entire process.
• Talk to your staff and find out what problems they
may be aware of.

64. 3. HIRING PRACTICES
• CRIMINAL BACKGROUND CHECK
• REFERENCE CHECK
• HEALTH CHECK UP
• VERIFICATION OF CREDENTIALS.

65. 4.. SAFETY
• OCCUPATION AND ENVIRONMENT
SAFETY
• PATIENT SAFETY

66. 5. FINANCIAL GOALS
• RISING OPERATING COSTS
• MAXIMISING INSURANCE
REIMBURSEMENTS

67. 6. MEDICAL STAFF
PERFORMANCE
• COMPLIANCE
• COMMUNICATION
• MOTIVATION
• DEVELOPMENT

68. 7.WORK ENVIRONMENT

69. 8. PLANS TO BOOST
PERFORMANCES

70. TIPS TO IMPROVE PATIENT SATISFACTION
– NURSES PERSPECTIVE
Scripting
Supplies
Uniform
Hourly
Rounding
Sitting Down
Patient
Education
Bed Side
Report
Nurse Led
Initiatives
Nurse
Empowerment
Demonstrate
Caring

71. THANK YOU !!!!