...2010 Edition Nursing: Scope and Standards of Practice Second Edition [pic] American Nurses Association Silver Spring, Maryland 2010 Library of Congress Cataloging-in-Publication data The American Nurses Association (ANA) is a national professional association. This ANA publication ( Nursing: Scope and Standards of Practice) reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Nursing: Scope and Standards of Practice guides nurses in the application of their professional skills and responsibilities. Published by Nursesbooks.org The Publishing Program of ANA http://www.Nursesbooks.org/ American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492 1-800-274-4ANA http://www.NursingWorld.org Design: Typesetting: Printing: Editorial services: © 2010 American Nurses Association. All rights reserved. No part of this book may be reproduced or utilized in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher. Contents Contributors Overview of Content Foundational Documents of Professional Nursing Audience for This Publication Scope of Nursing Practice Definition of Nursing ...
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...yourself “is this task or procedure in my scope of practice”? Nurses are responsible and accountable for the quality nursing care. If a procedure has fallen beyond the nurse’s scope of practice, we would meet the MD and find out the reason why they would want nurses to implement the procedure. I would look into my board of nursing practice act and the policy and procedure of my facility. There is a 6 step decision- making model for determining the nursing scope of practice in the Texas Board of Nursing. “This decision-making flowchart was developed by the Texas Board of Nursing staff to assist nurses in making good professional judgments about nursing tasks or procedures”,(Texas Nursing Practice Act). I think this is a perfect model to use when investigating a procedure or a task. If you find “YES” to the answers for all 6 questions, you can continue the task or procedure but; any of those answers are “NO” you have to stop and go through the chain of command to make a good decision. “Change is inherent in nursing practice. However the nurse must take lead in the development of any new roles or procedures” (Trim, 2009). So, I would take leadership to bring this issue in front of the risk management and higher authorities. I will make sure all the nurses get enough education and arrange practice sections and competency skill check-off before they implement. Reference: Six-Step Decision-Making Model for Determining Nursing Scope of Practice, Retrieved on 26, Oct. 2013 from...
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...new procedure. Before you decide to implement a procedure you must ask yourself “is this task or procedure in my scope of practice”? Nurses are responsible and accountable for the quality nursing care. If a procedure has fallen beyond the nurse’s scope of practice, we would meet the MD and find out the reason why they would want nurses to implement the procedure. I would look into my board of nursing practice act and the policy and procedure of my facility. There is a 6 step decision- making model for determining the nursing scope of practice in the Texas Board of Nursing. “This decision-making flowchart was developed by the Texas Board of Nursing staff to assist nurses in making good professional judgments about nursing tasks or procedures”,(Texas Nursing Practice Act). I think this is a perfect model to use when investigating a procedure or a task. If you find “YES” to the answers for all 6 questions, you can continue the task or procedure but; any of those answers are “NO” you have to stop and go through the chain of command to make a good decision. “Change is inherent in nursing practice. However the nurse must take lead in the development of any new roles or procedures” (Trim, 2009). So, I would take leadership to bring this issue in front of the risk management and higher authorities. I will make sure all the nurses get enough education and arrange practice sections and competency skill check-off before they...
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...LPN to RN Role Transition: Differences and Strategies for Success Taylor Birleffi Indiana State University LPN to RN Role Transition: Differences and Strategies for Success The Licensed Practical Nurse (LPN/LVN) role has involved certain role expectations and behaviors that are similar to the nursing roles of the Registered Nurse (RN). Although many may recognize the similar roles these two nurses have, there are various differences that exist between the two particularly those trained at the Baccalaureate level. These role differences are demonstrated through written regulations, knowledge base and practice roles, and the skills and abilities of both professional roles. Both the LPN and RN have regulations at the state level...
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...to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses First, I would inform my direct supervisor about the request from the physician to implement a new procedure. If the request is approved by the nursing supervisor, I would further investigate the procedure in which the physician wants the nurses to adopt in the hospital, as it is imperative to determine whether the procedure is within the nursing scope of practice before deciding to adopt or implement it. I would do this by referring to my state board of nursing decision making flow chart. | 1. Is the function commonly recognized as nursing practice? NO YES ⇒ S.P. not required ⇓ | 2. Is it the standard of practice in the community that RNs perform this function in the clinical area for which it is being considered? NO YES ⇒ S.P. not required ⇓ | 3. Does the function require the nurse to: Diagnose disease, Prescribe medicine or treatment, or Penetrate or sever tissue? NO YES ⇒ S.P. required ⇓ | 4. Does safe performance of the function require judgment based on medical knowledge beyond that usually possessed by the competent RN in the area for which it is being considered? NO YES ⇒ S.P. required ⇓ S.P. not required | If the procedure falls into the nursing scope of practice, I would then look into the current policies...
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...Nursing Practice Act Rules Cindy Hersey Fortis College November 05, 2013 A professional nurse who lacks the knowledge, ability to understand, and competence to delegate care appropriately not only Puts the patient at risk for injury, but also puts his or hers license in jeopardy. The practice of nursing requires specialized Knowledge, skill, and independent decision making. The purpose of delegation was put into perspective when Corazzini et al. (2010) said delegation by RNs is a primary mechanism for ensuring that professional nursing standards of care reach the Bedside. RNs must be made aware of which nursing tasks can be delegated and which cannot. Most importantly , they must know that basic delegation skills will be expected in their first nursing job (Huston, 2008). Nursing Practice Acts are set up in each state to protect individuals who are being taken care of by nurses from unprofessional or unsafe nursing practices. Although the Nursing Practice Acts vary from state to state they all include information on the board of nursing, education standards, requirements for titles and licenses and grounds for disciplinary action. Also included are the standards and scope of nursing practice, these are the sections that will be focused on here (Nurse Practice Act Rules and Regulations, 2013). In the nursing field delegation is the process of transferring a selected task to another individual who is competent to perform the selected task. It is very...
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...Understanding Responsibility, Authority, and Accountability Christine Mueller, PhD, RN, FAAN, and Amy Vogelsmeier, PhD, RN The obligation to provide safe, quality care creates challenges and concerns when registered nurses (RNs) delegate duties to unlicensed assistive personnel. These challenges and concerns are magnified in today’s health care environment of shrinking resources; patients with complex, chronic conditions; health care settings with high patient acuity rates; and the use of sophisticated technology. To make safe, effective delegation decisions, RNs must understand the responsibility, authority, and accountability related to delegation. Delegation decisions must be based on the fundamental principle of public protection. This article describes effective delegation by presenting the factors affecting delegation, explaining when and what an RN can delegate, and describing the delegation process. Learning Objectives ⦁ ⦁ ⦁ Identify three factors that affect delegation. Discuss what registered nurses can and cannot delegate. Explain the steps of the delegation process. N ursing’s Social Policy Statement (American Nurses Association [ANA], 2010), the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001), and individual state nurse practice acts (NPAs) underscore the responsibility, authority, and accountability of registered nurses (RNs) for their nursing practice. The RN’s obligation to provide safe, quality care creates distinct challenges...
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...change? Two important patterns have been identified for success: “first, useful change tends to be associated with a multi-step process that creates power and motivation sufficient to overwhelm all the sources on inertia”, and second, this process is never employed effectively unless it is driven by high quality leadership” (Kotter, 1996, p. 20-21). Strategic planning, which should include identifying the change model to be followed, outlining the role of leadership, and planning for how to overcome potential barriers and sustain the change, all play a vital role in a successful change initiative. The purpose of this paper is to first identify a specific organization that could benefit from a change initiative that would improve their effectiveness, and then outline strategies and processes that would influence the adoption of the change initiative. The Need for Change The Army Nurse Corps has a program geared toward new graduate Registered Nurses (RNs) that are entering the military health care system called the Clinical Nurse Transition Program. It is a discipline specific, (clinical nursing) structured, 6 month program that is mandatory for all new graduate Army Nurse (AN) officers. Some of the goals of the program include: providing an environment for continued learning that helps the new RN graduate transition into independent clinical practice; developing clinical leadership capabilities and...
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...Delegation Example in a Health Care Setting Presentation * The delegation model or process * The delegation issue in your work place * The stakeholders in their different health care roles * How you choose the right stakeholder for the job At the completion of this presentation the learner will know the delegation model process, be capable of identify issues in the workplace, how to choose the appropriate stakeholder to complete the job, and the stake holders in their different health care roles. By using a possible occurrence that can happen in the work place as an example we will walk through the delegation process. * How you communicate with the stakeholders * How you resolve conflict * How you know when to give feedback * How you evaluate the problem solved * Relevant recommendations With communication being the most important aspect of delegation, we will discuss how to communicate with the stakeholders, resolving conflict, different ways to know when to give feedback, different evaluation methods to problem solve and relevant recommendations. * Know Your World * Know Yourself * Know What Needs To Be Done * Know Your Delegate * Communicate * Resolve Conflict * Feedback/Evaluate First, we will need to know what the definition of delegation is. According to Hansten and Jackson (2009), the National Council of State Boards of Nursing states that delegation is the “transferring to a competent individual...
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...I believe all healthcare professionals should be licensed in their own discipline, assuring that they have met educational requirements, received a minimal number of hours of training, and passed the exams. Licensing is a mandatory credentialing process established by a state government board and requires us to meet the set standards. State boards write healthcare credentialing and scope of practice laws to protect the public (Allen, 2013). These laws sets the legal boundaries that each profession is authorized to perform. Today, to alleviate the stress resulting from the presence of sicker patients, fewer RNs and numerous cost and budgetary restrictions, healthcare organizations are utilizing the services of unlicensed assistive personnel...
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...You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. The Registered Nurse scope of practice is determined by specialty and level at which you are practicing. Therefore, the initial step to take in investigating the new procedure that will be introduced is to be aware of the scope of practice of the stakeholders as well as the policy and procedures of the facility. This is done to ensure that the new policy falls within the scope of practice and is in compliance with the policies and procedure of the facility. The scope of practice defines the who, what, where, when, why and how of nursing practice (rn.com). Following the verification regarding scope of practice I would take the following steps: * Meet with hospital administration to brief them on the physician’s request and give them a time line in which I plan to present to them my findings on the procedure. * Follow up with the the state board to ensure that this is within the nursing process of: : • Assessment—gathering and validating client health data, strengths, risks, and concerns • Diagnosis—analyzing and processing client data to identify appropriate nursing diagnoses∗ • Planning—developing interventions to solve identified problems and build...
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...Max Points: 15.0 You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. When it comes to investigating a new procedure, a systematic approach should be applied. It is imperative to determine whether a given procedure is within the nursing scope of practice before deciding to adopt or implement it. Some standard steps that must always be followed are based on the Nurse Practice Act, the ANA Standards of Practice, rights of patients, and safe nursing practice. According to Anderson (2013), determining if a new procedure is within the scope of nursing practice can be accomplished in three steps. First, define the issue, which means clarifying what exactly is being asked and what the new procedure entails. This step also includes gathering any additional information such as conducting a competency assessment to perform the task, as well as any previous experience, current knowledge and skill. Evidence-based practice and nursing research must also support the adoption of any new procedure. Secondly, since evidence is not the only component, the Nurse Practice Act and the policies of the workplace must also be considered. Nurses may be limited by the facility policies/standards to perform certain tasks even though the tasks...
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...to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. The nurses should take a systematic approach when it comes to investigating a new procedure. When investigating a new procedure my main goal will be to identify the benefits and risks of this procedure if it is done by the nurses. To investigate a new procedure I will assess the procedure to find out if the new procedure comes under nurse’s scope of practice. I would contact the state board of nursing to get their advice and I will gather the information from ANA to follow guidelines provided by them. Then my next step will be to find out if the hospital policy allows the nurse to carry out the new procedure. If it comes under the nurse’s scope of practice and the hospital policy allows the nurse to carry out the new procedure the next step is to find out if the nurses can do the procedure safely after adequate training. I will collect opinions from fellow nurses about their thoughts on us adopting a new procedure. If the nurses are confident to do the procedure I will have them demonstrate the procedure. After this I will contact the administrator and doctors to organize a mandatory meeting with the nurse so the nurse can clear their doubts. I will make sure all the nurses get enough education and arrange practice sections and competency skill check-off...
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...Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in a wide diversity of practice areas with a different scope of practice and level of prescriber authority in each. Many nurses provide care within the ordering scope of physicians, and this traditional role has come to shape the historic public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing. Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family and other team members, that focuses on treating illness to improve quality of life. In the U.S., advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe medications and other therapies, depending on individual state regulations. Nurses may help coordinate the patient care performed by other members of an interdisciplinary health care team such as therapists...
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...to provide quality care and safety to patients in an affordable manner in today’s world. The 2010 Report on the FUTURE OF NURSING: Leading Change, Advancing Health released by the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) gives a detailed discussion with recommendations on Transforming the health care system at the Nurses level. This paper discusses the impact of the IOM report on Education, Practice, and Leadership for nurses. IMPACT ON EDUCATION According to the report of the IOM health care system requires a comprehensive transformation to provide quality, safety, accessibility, patient as the center of focus at the same time it should be affordable to the common man. The 2010 Affordable Care Act is the biggest transformation since the creation of Medicare and Medicaid programs in 1965. To make a difference in this nursing education needs to be improved at all levels. Nursing education is an ongoing process and it should be made available to all practicing nurses whether an LPN/LVN, ADN or BSN. The report determines the fact that all nurses achieve an optimum level of training and education from an education system that caters to the academic requirements of nurses. Today’s health related chronic conditions like hypertension, cardiovascular disease, diabetes, and mental health are increasing in numbers. The United States Health system was originally created to treat injuries and illness, which was a challenge in the 20th century. The...
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