week 2 nursing process

Lesson: Scope and Standards of Practice

  • Introduction to Standards of Professional Practice

    • Establish expectations for nursing practice.
    • Purpose:
    • Protect the nurse.
    • Protect the client.
    • Protect the facility (credit facility).
    • Characteristics:
    • Authoritative guidelines.
    • Protocols and benchmarks.
    • Define what is expected, reasonable, and safe in clinical duties.
    • Serve as legal and professional benchmarks for competent, evidence-based care.
    • Aim to improve patient outcomes and ensure consistency.

  • Clinical Duties Defined

    • Standards establish:
    • Who performs duties.
    • What duties are performed.
    • How duties are executed.
    • The American Nurses Association (ANA) is responsible for:
    • Establishing standards for nursing practice.
    • Establishing standards for professional performance.

  • Nursing Process

    • Defines competent level of care by nursing process, which includes:
    • Assessment:
      • Collecting comprehensive data.
    • Diagnosis:
      • Analyzing data to identify issues.
    • Outcome Identification:
      • Identifying expected outcomes.
    • Implementation:
      • Executing the care plan and coordinating care.
      • Teaching healthcare principles.
    • Evaluation:
      • Assessing progress towards outcomes.
    • Involves the critical thinking model, which includes:
    • Clinical reasoning processes.
    • Constant reassessment as patient conditions change.
    • Analyzing, synthesizing, and evaluating information.
    • Prioritizing urgent patient needs.
    • Adaptability in rapidly changing situations.

  • Nursing Practice Acts (NPAs)

    • Regulate nurses within each state and territory in the United States.
    • Executed by state boards of nursing.
    • Identify conditions necessary for nursing licensure.
    • Define nursing titles (e.g., RN, LPN, LVN, APN).
    • Two-step process for defining scope of practice:
    1. State legislatures pass NPAs regulating nursing practice.
    2. Establish state boards of nursing to enforce regulations.
    • NPAs provide general guidelines, but each state creates detailed rules and regulations.
    • Key components:
    • Definition of nursing and boundaries for practice (RN, LPN, LVN, etc.).
    • Establishment of licensure requirements.
    • Ground rules for disciplinary actions, penalties, and violation handling.

  • State-specific Regulations

    • Each state and territory has distinct NPAs to follow, which safeguard the public.
    • NPAs protect citizens from unsafe or incompetent nurses.
    • Courts and boards of nursing construct administrative rules to clarify or update practices.

  • Regulation of Nursing Education

    • Boards of nursing approve nursing education program standards, curricula, and clinical learning experiences.
    • Schools of nursing achieve national accreditation by meeting criteria set by national organizations.
    • Focus on public protection through safe, competent nursing practice.
    • Licensure eligibility requirements:
    • Successful completion of a regulated program.
    • Graduates must take the NCLEX licensing exam.
    • Regulatory standards evolve to meet workplace challenges, including distance education.
    • The National Council of State Boards of Nursing ensures standards are evidence-based, consistent, and transparent.

  • Quality and Safety Education for Nursing (QSEN) Institute

    • Established in 2005 to enhance the quality and safety of nursing practice.
    • Based on Institute of Medicine's 2003 core competencies for health clinicians.
    • Aim: Provide safe and quality care through essential attitudes, skills, and knowledge (KSAs).
    • QSEN Competencies:
    • Patient-centered care: Recognizes patients as central to care and partners in decision-making.
    • Teamwork and collaboration: Effective function within nursing and interprofessional teams.
    • Evidence-based practice (EBP): Integrates best current evidence with clinical expertise and patient preferences.
    • Quality improvement (QI): Uses data to improve practices to enhance patient outcomes (e.g., reducing infections via hand hygiene).
    • Safety: Minimizes risk of harm to patients and healthcare providers.
    • Informatics: Utilizes information and technology for knowledge management and support for decision-making.

  • Integrated Competencies in Nursing Education

    • NLN integrated competencies foster excellence in nursing education and strong workforce development.
    • Aim of NLN: Advance the health of the nation and global community by ensuring all pre-licensure nursing students are educated equally.
    • Four key NLN competencies:
    • Human flourishing: Advocacy for the patient's well-being.
    • Nursing judgment: Applying critical thinking in patient care.
    • Professional identity: Internalizing the values of the nursing profession.
    • Spirit of inquiry: Encouraging continuous learning and questioning in practice.

  • AACN Essential Components

    • Represents guidelines for BSN programs since 2023:
    • Outline ten essential competencies expected in pre-licensure nursing education:
    • Knowledge for nursing practice.
    • Patient-centered care.
    • Population health.
    • Scholarship for nursing discipline.
    • Quality and safety.
    • Interprofessional partnerships.
    • System-based practice.
    • Informatics and healthcare technology.
    • Professionalism.
    • Personal, professional, and leadership development.
    • Aims to prepare nurses for diverse roles and complex patient care, ensuring high-quality education and clinical readiness.
    • Emphasizes diversity, equity, and inclusion in nursing education and practice.

  • Licensed Practical/Vocational Nurses (LPNs/LVNs)

    • Standards set by the National Association for Practical Nurse Education and Service (NAPNES) related to LPN and LVN education.
    • LPNs act under the supervision of doctors and registered nurses and perform duties in diverse settings (e.g., hospitals, nursing homes, clinics).

  • Nursing Licensure

    • Legal authorization by the state required for nursing practice to protect clients.
    • Licensing involves periodic renewal and adherence to set standards.
    • Nursing Licensure Compact (NLC): Allows multistate practice under one license.
    • Key points about nursing licensure:
    • Establishes that individuals have met educational and competency standards.
    • Requires passing the NCLEX-RN or NCLEX-PN.
    • Ensures safe and ethical care.

  • Licensure and Certification Distinctions

    • Licensure:
    • Mandatory and government-issued for entry-level practice.
    • Certification:
    • Voluntary, issued by professional organizations validating specific nursing specialties.
    • Examples include specialty areas such as critical care nursing certification (CCRN).
    • Paths to demonstrate nursing proficiency include certificate programs and specific specialty certifications.

  • Credentialing in Healthcare

    • Defined as the verification process of a provider's education, training, experience, and licensure.
    • Essential for quality control in healthcare environments to ensure competent care.
    • Components undergoing verification include:
    • Education.
    • Residency training.
    • Board certifications.
    • Licenses and career history.
    • Background checks are necessary and can include malpractice checks and sanction checks.
    • Credentialing timelines can vary and require regular re-credentialing.
    • Prevention:
    • Aimed at ensuring only qualified professionals provide patient care, maintaining safety and high standards in healthcare settings.