FlexEd Chpt 1- Scope of Practice

Authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. These standards define a competent level of nursing practice based on the critical thinking model known as the nursing process

ANA Standards of Professional Nursing Practice

Standards that describe a competent level of behavior in the professional role of the nurse including activities related to ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice, professional practice evaluation, resource utilization, and environmental health.

ANA Standards of Professional Performance

An RN who has a graduate degree and advanced knowledge

Advanced Practice Nurse (APRN)

Examples of Professional Nursing Organizations

American Nursing Association American Nurses Credentialing Center National League for Nursing Accreditation Commission for Education in Nursing Commission on Collegiate Nursing Education National Student Nurses' Association

national professional nursing organization, represents the interests of nurses in all 50 states of America while also promoting improved health care for everyone, states that it exists to advance the nursing profession, sets many standard of care for professional nurses

American Nursing Association (ANA)

Nurses also work with laboratory and radiology departments. Clinical laboratory departments provide a wide range of laboratory procedures that aid health care providers to diagnose, treat, and manage patients. These laboratories are staffed by medical technologists who test biological specimens collected from patients. Examples of laboratory tests performed include blood tests, blood banking, cultures, urine tests, and histopathology (changes in tissues caused by disease). Radiology departments use imaging to assist providers in diagnosing and treating diseases seen within the body. They perform diagnostic tests such as X-rays, CTs, MRIs, nuclear medicine, PET scans, and ultrasound scans.

Ancillary Department Members

Care that can be performed following a defined nursing procedure with minimal modification in which the responses of the patient to the nursing care are predictable.

Basic nursing care

The state-specific licensing and regulatory body that sets the standards for safe nursing care, decides the scope of practice for nurses within its jurisdiction, and issues licenses to qualified candidates.

Board of Nursing

A hierarchy of reporting relationships in an agency that establishes accountability and lays out lines of authority and decision-making power.

Chain of Command

A code that applies normative, moral guidance for nurses in terms of what they ought to do, be, and seek.

Code of Ethics

The American Nurses Association publishes the __________ which provides an ethical framework to help guide nursing practice across various roles and settings.

Code of Ethics for Nurses

provide care to patients with serious, complex, and acute illnesses or injuries that require very close monitoring and extensive medication protocols and therapies. most often work in intensive care units of hospitals.

Critical Care Nurses

assess, plan, implement, and evaluate interventions including those relating to dietary needs of those patients who need regular or therapeutic diets. They also provide dietary education and work with other members of the health care team when a client has dietary needs secondary to physical disorders such as dysphagia.

Dietician

To prove negligence or malpractice, the following elements must be established in a court of law:

Duty owed the patient Breach of duty owed the patient Foreseeability Causation Injury Damages

Impaired swallowing

Dysphasia

3 Pillars of Scope of Practice

Education, Certification, Licensure

12 Standards of Professional Performance

Ethics- The registered nurse integrates ethics in all aspects of practice. Advocacy- The registered nurse demonstrates advocacy in all roles and settings. Respectful and Equitable Practice- The registered nurse practices with cultural humility and inclusiveness. Communication- The registered nurse communicates effectively in all areas of professional practice. Collaboration- The registered nurse collaborates with the health care consumer and other key stakeholders. Leadership- The registered nurse leads within the profession and practice setting. Education- The registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Scholarly Inquiry- The registered nurse integrates scholarship, evidence, and research findings into practice. Quality of Practice- The registered nurse contributes to quality nursing practice. Professional Practice Evaluation- The registered nurse evaluates one's own and others' nursing practice. Resource Stewardship- The registered nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, financially responsible, and judiciously used. Environmental Health- The registered nurse practices in a manner that advances environmental safety and health.

The impaired ability to form words and speak.

Expressive Aphasia

Examples of nurses breach of duty that can be viewed as negligence include:

Failure to Assess: Nurses should assess for all potential nursing problems/diagnoses, not just those directly affected by the medical disease. For example, all patients should be assessed for fall risk and appropriate fall precautions implemented. Insufficient monitoring: Some conditions require frequent monitoring by the nurse, such as risk for falls, suicide risk, confusion, and self-injury. Failure to Communicate: Lack of documentation: A basic rule of thumb in a court of law is that if an assessment or action was not documented, it is considered not done. Nurses must document all assessments and interventions, in addition to the specific type of patient documentation called a nursing care plan. Lack of provider notification: Changes in patient condition should be urgently communicated to the health care provider based on patient status. Documentation of provider notification should include the date, time, and person notified and follow-up actions taken by the nurse. Failure to Follow Protocols: Agencies and states have rules for reporting certain behaviors or concerns. For example, a nurse is required to report suspicion of patient, child, or elder abuse based on data gathered during an assessment.

provide a variety of nursing services for chronically ill patients and their caregivers in the home, including end-of-life care

Home Health/Hospice Nurses

National Patient Safety Goals for hospitals include the following:

Identify Patients Correctly Improve Staff Communication Use Medicines Safely Use Alarms Safely Prevent Infection Identify Patient Safety Risks Prevent Mistakes in Surgery

An individual who has completed a state-approved practical or vocational nursing program, passed the NCLEX-PN examination, and is licensed by a state board of nursing to provide patient care. typically work under the supervision of a registered nurse, advanced practice registered nurse, or physician. provide "basic nursing care" and work with stable and/or chronically ill populations

Licenced Practical Nurse/Vocational Nurse (LPN/VN)

3 levels of nurses

Licensed Practical Nurse/Vocational Nurse (LPN/LVN) Registered Nurse (RN) Advanced Practice Nurse (APRN)

A "specific term that looks at a standard of care, as well as the professional status of the caregiver."

Malpractice

Personal values, character, or conduct of individuals within communities and societies.

Morality

A "general term that denotes conduct lacking in due care, carelessness; and a deviation from the standard of care that a reasonable person would use in a particular set of circumstances."

Negligence

Allows a nurse to have one multistate license with the ability to practice in the home state and other compact states.

Nursing Licensure Compact (NLC)

allows a nurse who lives in Iowa to travel to Wisconsin and also practice within that state

Nursing Licensure Compact (NLC)

Legislation enacted by each state that establishes regulations for nursing practice within that state by defining the requirements for licensure as well as the scope of nursing practice.

Nursing Practice Act (NPA)

assess, plan, implement, and evaluate interventions, including those that facilitate the patient's ability to achieve their highest possible level of independence in their activities of daily living such as bathing, grooming, eating, and dressing. They also provide patients adaptive devices such as long shoe horns so the patient can put their shoes on, sock pulls so they can independently pull on socks, adaptive silverware to facilitate independent eating, grabbers so the patient can pick items up from the floor, and special devices to manipulate buttoning so the person can dress and button their clothing independently. also assess the home for safety and the need for assistive devices when the patient is discharged home. They may recommend modifications to the home environment such as ramps, grab rails, and handrails to ensure safety and independence. practice in all health care environments including the home, hospital, and rehabilitation centers.

Occupational Therapists (OT)

provide health screening, wellness programs and other health teaching, minor treatments, and disease/medication management services to people in the workplace. The focus is on promotion and restoration of health, prevention of illness and injury, and protection from work-related and environmental hazards.

Occupational/Employee Health Nurses

care for patients with various types of cancer, administering chemotherapy and providing follow-up care, teaching, and monitoring. work in hospitals, outpatient clinics, and patients' homes.

Oncology Nurses

Keeping your patient's Protected Health Information (PHI) protected and known only by those health care team members directly providing care for the patient.

Patient Confidentiality

provide preoperative and postoperative care to patients undergoing anesthesia or assist with surgical procedures by selecting and handling instruments, controlling bleeding, and suturing incisions. These nurses work in hospitals and outpatient surgical centers.

Perioperative/Operating Room Nurses

ensure the safe prescribing and dispensing of medication and are a vital resource for nurses with questions or concerns about medications they are administering to patients. ensure that patients not only get the correct medication and dosing, but also have the guidance they need to use the medication safely and effectively.

Pharmacist

are licensed health care professionals who assess, plan, implement, and evaluate interventions including those related to the patient's functional abilities in terms of their strength, mobility, balance, gait, coordination, and joint range of motion. They supervise prescribed exercise activities according to a patient's condition and also provide and teach patients how to use assistive aids like walkers and canes and exercise regimens. practice in all health care environments including the home, hospital, and rehabilitation centers.

Physical Therapists (PT)

provide care and services to patients who have foot problems. They often work with diabetic patients to clip toenails and provide foot care to prevent complications.

Podiatrist

A nurse is providing education to a group of elementary students regarding the importance of using sunscreen and sun protection when outdoors. This is an example of a nurse providing what level of care?

Primary Care

Care that is provided to patients to promote wellness and prevent disease from occurring. This includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations.

Primary Care

type of care that is provided to promote wellness and prevent disease.

Primary Care

design, fit, and supply the patient with an artificial body part such as a leg or arm prosthesis. They adjust prosthesis to ensure proper fit, patient comfort, and functioning.

Prosthetist

A precise and detailed written plan for a regimen of therapy

Protocol

specialize in mental and behavioral health problems and provide nursing care to individuals with psychiatric disorders. work in hospitals, outpatient clinics, and private offices.

Psychiatric/Mental Health Nurses

provide mental health and psychiatric services to patients with mental health disorders and provide psychological support to family members and significant others as indicated.

Psychologists and Psychiatrists

work to promote and protect the health of populations based on knowledge from nursing, social, and public health sciences. most often work in municipal and state health departments.

Public Health Nurses

defined as the combined and unceasing efforts of everyone - health care professionals, patients and their families, researchers, payers, planners, and educators - to make the changes that will lead to optimal patient outcomes (health), improved system performance (care), and enhanced professional development (learning)

Quality improvement

An individual who has graduated from a state-approved school of nursing, passed the NCLEX-RN examination and is licensed by a state board of nursing to provide patient care. use the nursing process as a critical thinking model as they make decisions and use clinical judgment regarding patient care. may be delegated tasks from providers or may delegate tasks to LPNs and UAPs with supervision

RN

care for patients with temporary and permanent disabilities within inpatient and outpatient settings such as clinics and home health care.

Rehabilitation Nurses

treat respiratory-related conditions in patients. Their specialized respiratory care includes managing oxygen therapy; drawing arterial blood gases; managing patients on specialized oxygenation devices such as mechanical ventilators, CPAP, and Bi-PAP machines; administering respiratory medications like inhalers and nebulizers; intubating patients; assisting with bronchoscopy and other respiratory-related diagnostic tests; performing pulmonary hygiene measures like chest physiotherapy; and serving an integral role during cardiac and respiratory arrests.

Respiratory Therapist

A culture established within healthcare agencies that empowers nurses, nursing students and other staff members to speak up about risks to patients and to report errors and near misses, all of which drive improvement in patient care and reduce the incident of patient harm.

Safety Culture

provide health assessment, intervention, and follow-up to maintain school compliance with health care policies and ensure the health and safety of staff and students. They administer medications and refer students for additional services when hearing, vision, and other issues become inhibitors to successful learning.

School Nurses

services that a trained health professional is deemed competent to perform and permitted to undertake according to the terms of their professional nursing license. provides a framework and structured guidance for activities one can perform based on their nursing license

Scope of Practice

A 36 year old woman is suffering from urinary frequency, urgency, bladder spasms, and foul smelling urine. She visits her local urgent care to see a healthcare provider. This type of care experience is reflective of what level of care?

Secondary Care

Care that occurs when a person has contracted an illness or injury and is in need of medical care.

Secondary care (acute care)

counsel patients and provide psychological support, help set up community resources according to patients' financial needs, and serve as part of the team that ensures continuity of care after the person is discharged.

Social Worker

assess, diagnose, and treat communication and swallowing disorders. For example, speech therapists help patients with a disorder called expressive aphasia. They also assist patients with using word boards and other electronic devices to facilitate communication. They assess patients with swallowing disorders called dysphagia and treat them in collaboration with other members of the health care team including nurses, dieticians, and health care providers.

Speech Therapist

The ANA __________ describe the first six national standards that reflect competent nursing care by utilization of the nursing process to guide critical thinking.

Standards of Professional Nursing Practice

The ANA ________ describe eleven standards to reflect competent behavior in a nurse's professional role.

Standards of Professional Performance

A patient with Alzheimer's disease is being cared for at a long-term memory care facility. This facility is an example of what type care setting?

Tertiary Care

type of care to address long-term effects from chronic illness

Tertiary Care

A type of care that deals with the long-term effects from chronic illness or condition, with the purpose to restore physical and mental function that may have been lost. The goal is to achieve the highest level of functioning possible with this chronic illness.

Tertiary care

establishes an ethical framework for nursing practice across all roles, levels, and settings

The Code of Ethics for Nurses

ANA publishes two resources that set standards and guide professional nursing practice in the United States:

The Code of Ethics for Nurses Nursing: Scope and Standards of Practice

a national organization that accredits and certifies over 20,000 health care organizations in the United States. sets standards for providing safe, high-quality health care. establishes annual National Patient Safety Goals for various types of agencies based on data regarding current national safety concerns

The Joint Commission (TJC)

describes a professional nurse's scope of practice and defines the who, what, where, when, why, and how of nursing. It also sets 18 standards of professional practice that all registered nurses are expected to perform competently

The Nursing: Scope and Standards of Practice

Individual nursing practice must be conducted in accordance with federal regulations, state nursing practice acts, professional nursing standards, and employer policy and procedure. True or False?

True

Any unlicensed person, regardless of title, who performs tasks delegated by a nurse. This includes certified nursing aides/assistants (CNAs), patient care assistants (PCAs), patient care technicians (PCTs), state tested nursing assistants (STNAs), nursing assistants-registered (NA/Rs) or certified medication aides/assistants (MA-Cs). Certification of UAPs varies between jurisdictions.

Unlicensed Assistive Personnel

The mission of which of the following organizations is to "improve health care for the public by inspiring organizations to excel in providing safe, effective, and high quality health care". a. Centers for Disease Control (CDC) b. Joint Commission c. Centers for Medicare and Medicaid (CMS) d. National Institute of Health (NIH)

b. Joint Commision

four categories of Advanced Practice Nurse

certified nurse-midwife (CNM) clinical nurse specialist (CNS) certified nurse practitioner (CNP) certified registered nurse anesthetist (CRNA) These nurses can diagnose illnesses and prescribe treatments and medications.

Requirements for LPN/LVN

complete a one-year nursing program, pass the NCLEX-PN exam, and apply to your state board of nursing

Requirements for RN

obtain either a two-year associate degree (ADN) or a four-year baccalaureate of science in nursing degree (BSN), pass the NCLEX-RN to apply for a registered nursing license from their state's Board of Nursing