Uploaded byLudy Mae Nalzaro,BSM,BSN,MN
Elective 2- 2 development of standards
1. Nursing leaders have established standards of care and nursing practice to define the scope and quality of nursing. These standards are based on research, aim to be realistic, reliable, valid, clear, and measurable. 2. Standards of care provide guidelines for evaluating nursing care and determine if negligence has occurred. They define what nurses can and cannot do. Failure to meet standards of care could result in malpractice charges. 3. Standards of nursing practice provide a baseline for quality care and apply to all nursing specialties and settings. They govern nursing practice and assessment, diagnosis, care planning, intervention, and evaluation.
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Similar to Elective 2- 2 development of standards
Elective 2- 2 development of standards
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- 2. Standards • Predetermined levelof excellence • Guide for practice 2
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- 4. Nursing leaders • Recognizeroles & responsibilities that professional nursing organizations 4
- 5. Nursing organizations • Developedresearch-based outcome criteria • Standard based care plans • Course curricula • Guidelines for care and practice 5
- 6. These groups haveestablished 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
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- 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 requiredby law: to carry out in accordance with other reasonable prudent nurses would do in the same/similar circumstances. 16
- 17. Standards of Care… Serveas 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… Nurseswho 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… Providea guide to KSA needed to practice safely. RN is responsible & accountable for indiv client for quality nursing care he receives. 22
- 23. Standards of Practiceshall … 1. Considered as BASELINE for quality nursing care 23
- 24. Standards of Practiceshall … 2. Developed in relation to law governing nursing practice 24
- 25. Standards of Practiceshall … 3. Apply to RNs practicing in any setting 25
- 26. Standards of Practiceshall … 4. Govern the practice at all levels of practice 26
- 27. Standards of Practice… Standard1: Assessment Standard 2: Diagnosis Standard 3: Outcomes Identification Standard 4: Planning Standard 5: Implementation Standard 6: Evaluation 27
- 28. Standard 1: Assessment Measurementcriteria: 1. Data collection is systemic and ongoing 28
- 29. Standard 1: Assessment Measurementcriteria: 2. Data collection involves clients, partners and HCP when appropriate 29
- 30. Standard 1: Assessment Measurementcriteria: 3. Priority of data collection activities is determined by client’s immediate condition or needs 30
- 31. Standard 1: Assessment Measurementcriteria: 4. Pertinent data are collected using appropriate evidence- based assessment techniques 31
- 32. Standard 1: Assessment Measurementcriteria: 5. Analytical models and problem-solving tools are used 32
- 33. Standard 1: Assessment Measurementcriteria: 6. Patterns and variances are identified by Synthesizing relevant data and knowledge 33
- 34. Standard 1: Assessment Measurementcriteria: 7. Relevant data are documented in a retrievable form. 34
- 35. Standard 2: Diagnosis Measurementcriteria: 1. Dxs are derived from assessment data 35
- 36. Standard 2: Diagnosis Measurementcriteria: 2. Dxs are validated with client, partners and HCP when possible 36
- 37. Standard 2: Diagnosis Measurementcriteria: 3. Dxs are documented that facilitates determination of expected outcomes and plan of care. 37
- 38. Standard 3: Outcomesidentification Measurement criteria: 1. Involves client, family and HCP 38
- 39. Standard 3: Outcomesidentification Measurement criteria: 2. Outcomes are culturally appropriate and are derived from diagnoses 39
- 40. Standard 3: Outcomesidentification Measurement criteria: 3. Outcomes are formulated considering: Associated risks Benefits Costs Current scientific evidence Clinical expertise. 40
- 41. Standard 3: Outcomesidentification Measurement criteria: 4. Outcomes are defined on client’s Values Ethical considerations Environment 41
- 42. Standard 3: Outcomesidentification Measurement criteria: 5. Outcomes include a time estimate for attainment 42
- 43. Standard 3: Outcomesidentification Measurement criteria: 6. Outcomes provide direction for continuity of care 43
- 44. Standard 3: Outcomesidentification Measurement criteria: 7. Outcomes are modified based on the client’s status 44
- 45. Standard 3: Outcomesidentification Measurement criteria: 8. Outcomes are documented as measurable goals 45
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- 47. Standard 4: Planning Measurementcriteria: PLAN IS 1. Individualized to reflect client’s characteristics and needs 47
- 48. Standard 4: Planning Measurementcriteria: PLAN IS 2. Developed with client, SO, HCP and other personnel 48
- 49. Standard 4: Planning Measurementcriteria: PLAN IS 3. Reflects current nursing practice 49
- 50. Standard 4: Planning Measurementcriteria: PLAN IS 4. documented 50
- 51. Standard 4: Planning Measurementcriteria: PLAN IS 5. Provides for continuity of care from the time of entry to final discharge 51
- 52. Standard 4: Planning Measurementcriteria: 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 Measurementcriteria: 2. client’s response are documented. 57
- 58. Standard 6: Evaluation Measurementcriteria: 3. Effectiveness of intervention is evaluated in relation to outcomes 58
- 59. Standard 6: Evaluation Measurementcriteria: 4. Ongoing assessment data are used to revised the process 59
- 60. Standard 6: Evaluation Measurementcriteria: 5. client, SO, HCP are involved in the evaluation process 60
- 61. Models of CareDelivery 61
- 62. Care Delivery Model Organizesthe 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 toidentified 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