Module 3: Standards of Care

Standards for CLINICAL Gerontological Nursing PRACTICE

competent level of nursing practice through the nursing process

Assessment

– data collection

Diagnosis

– creation of nursing diagnosis

Outcome Identification

– creation of a plan of care that includes goal setting

Planning

– a plan of nursing that includes setting priorities and measures to achieve goals

Implementation

– using nursing actions

Evaluation

– includes the process attained in the achievement of goals

• Health Promotion

• Health Maintenance

• Disease Prevention

• Self-care

Standards of PROFESSIONAL Gerontological Nursing PERFORMANCE

describe a competent level of behavior in the professional role, including activities related ethics, education, evidence-based practice and research, quality of practice, communication, leadership, collaboration, professional practice evaluation, resource utilization

Quality of Care

A nurse consistently follows evidence-based protocols for wound care, resulting in reduced infection rates and faster healing times for post-operative patients.

Performance Appraisal

During an annual review, a nurse’s supervisor evaluates competencies, skills, clinical communication and patient outcomes. Constructive feedback is given, and goals for the next year are set.

Education

A nurse attends a continuing education workshop on diabetic foot care and implements new techniques on the ward.

Collegiality

A senior nurse mentors a newly hired graduate nurse, offering guidance and support during patient rounds.

Ethics

A nurse advocates for a terminally ill patient’s wish not to be resuscitated, ensuring the DNR order is respected despite family pressure.

Collaboration

A nurse participates in interdisciplinary rounds, contributing nursing assessments and coordinating with physicians, social workers, and physiotherapists.

Research

A nurse engages in a hospital-led study on pain management techniques, helping collect data and applying findings to practice.

Resource Utilization

A nurse ensures cost-effective use of supplies by avoiding waste and choosing the most appropriate products for patient needs.

FUNCTIONS OF A NURSE

• Guiding

• Eliminating

• Respecting

• Observing

• Noticing

• Teaching

• Opening Channels

• Listening

• Offering

• Generating

• Implementing

• Coordinating

• Assessing

• Linking

• Nurturing

• Understanding

• Recognizing

• Supporting

Standard of Care

is a guideline for nursing practice and establishes an expectation for the nurse to provide safe, effective, and appropriate care.

The Patient Self-Determination Act'° (PSDA), 1991 (USA)

• The intent of this law is to ensure that patients are given information about the extent to which their rights are protected under state law.

• It's focus on education and communication. The requires hospitals, PSDA nursing facilities, and other health care providers who receive federal funds, such as Medicare or Medicaid, to give patients written information explaining their legal options for refusing or accepting treatment should they become incapacitated.

• In the Philippines, we have the Patient Bill of Rights to protect our patients in general.

Legal tools and instruments

help people plan for future decision making so that their wishes can be carried out even when they are no longer able to speak for themselves.

key ethical principles

• justice

• self-determination

• beneficence

Autonomy

• Or self-determination

• It's common for geriatric patients to arrive in the ER, or the nursing home, no longer mentally capable of making those judgments. At this point, it becomes important to determine what their wishes are, or would have been.

Beneficence & Non-Maleficence

• The charge to do good, and to "first, do no harm," comes naturally.

• Elder care, however, can challenge these seemingly simple directives. When a patient in the final stages of dementia requires a feeding tube, for example, the person giving care might wonder if it is kinder to go through the insertion procedure and prolong life, or to simply let nature take its course.

Justice

• (allocation of resources)

• This ethical principle, which deals with health care as a resource, sometimes seems like a subject for theoretical debate.

• Should medical care be made available to those whom it most benefits, or to those who need it most? Note that the two positions are not the same. In the first, "utilitarian" view, health care would be skewed toward those who are most likely to recover, whereas in the second, "idealistic" stance, it would go to those in dire need, regardless of whether or not it would save them.

Veracity

• the principle of telling the truth and is related to the principle of autonomy.

• It is the basis of the trust relationship established between a patient and a health care provider.

• Being direct and honest empowers patients to make best and sound decisions that best fit their medical, personal, cultural, and moral needs.

Senior Citizens Act 9257

• Expanded Senior Citizens Act of 2003, an act granting additional benefits and privileges to senior citizens

• Amending for the purpose , Republic Act No. 7432, otherwise known as "An act to maximize the contribution of senior citizens to nation building, grant benefits and special privileges and for other purposes

• provided for the expansion of coverage of benefits and privileges that the elderly may acquire, including medically necessary services.

Republic Act No. 9994

• Expanded Senior Citizens Act of 2010, an act granting additional benefits and privileges to senior citizens, further amending Republic Act No. 7432, as amended, otherwise known as "An act to maximize the contribution of senior citizens to nation building, grant benefits and special privileges and for other purposes"

• One of the provisions of RA 9994 or the Expanded Senior Citizens act of 2010 is for the DOH to administer free vaccination against the influenza virus and pneumococcal diseases for indigent senior citizens.

• The DOH in coordination with local government units (LGUs), NGOs and POs for senior citizens shall institute a national health program and shall provide an integrated health service for senior citizens.

• It shall train community – based health workers among senior citizens health personnel to specialize in the geriatric care and health problems of senior citizens

Republic Act No. 7876

• Senior Citizens Center Act of the Philippines, an act establishing a senior citizens center in all cities and municipalities of the Philippines, and appropriating funds therefore.

• House Bill No. 834 mandates the establishment of a senior citizen's center in all cities and municipalities to serve as a venue for educational, recreational, social and health programs and activities for senior citizens.

RA 10868

• “AN ACT HONORING AND GRANTING ADDITIONAL BENEFITS AND PRIVILEGES TO FILIPINO CENTENARIANS AND FOR OTHER PURPOSES”,

• Centenarians Act of 2010, grant 50 percent discount and value added tax (VAT) exemption on goods and services for Filipino citizens who reach the age of 100 years and above.

• A centenarian shall receive a Letter of Felicitation and cash gift of 100,000.00 php through DSWD

Republic Act 11982

• the Centenarian Act of 2016 was amended in February 2023.

• known as the Act Granting Benefits to Filipino Octogenarians and Nonagenarians, as an adaptation of the existing benefits for Filipino senior citizens.

• This grants P10,000 to elderly Filipinos—whether living in the country or abroad—upon reaching 80 and every five years after that. Under the new law, Filipinos, upon reaching the age of 80, shall receive a cash gift of 10 thousand pesos and every five years thereafter and upon reaching the age of 85, 90, and until 95.

• Centenarians or those who are one hundred (100) years old will continue to receive the P100,000 cash benefit from the Philippine government.

• The awards and incentives are eligible to natural-born and dual citizen Filipinos living in the Philippines or abroad. On the contrary, former Filipinos or naturalized citizens of another country are not qualified to receive the benefits.