...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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...The nurses should take a systematic approach when it comes to investigating a 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...
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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 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...
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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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...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 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...
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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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...Professional Dynamics Details This course is a bridge course for the RN who is returning to formal education for the baccalaureate degree in nursing. The course focuses on differentiated nursing practice competencies, nursing conceptual models, professional accountability, integrating spirituality into practice, group dynamics, and critical thinking. Emphasis is also placed on writing and oral presentation skills. 3.0 None None Additional Material Textbook Conceptual Foundations: The Bridge to Professional Nursing Practice Cresaia, J., & Friberg, E. (2010). Conceptual foundations: The bridge to professional nursing practice (5th ed). St. Louis, MO: Elsevier. ISBN-13: 9780323068697 (Available as eBook) Important information about this text: All required GCU RN-to-BSN eBooks are accessible anywhere-anytime, with lifetime access via Evolve at (http://evolve.elsevier.com). Refer to “Pageburst/Evolve eBooks” for details on how to access the course’s required text. http://evolve.elsevier.com Topics Topic 1: Essentials of Baccalaureate Education Description: Objectives: 1. Identify uses of the various elements of the virtual classroom. 2. Identify best practices for conducting academic research. 3. Access the GCU online Library Catalog to access the journal databases and locate scholarly/peer-reviewed articles. 4. Define plagiarism and distinguish between plagiarism, paraphrasing, and summarizing. 5. Differentiate between academic and nonacademic writing. Topic Material: Electronic...
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...LEAN HOSPITALS “Mark Graban’s book has documented what is now happening in hospitals all across America as we learn to apply the Toyota Production System methodology to healthcare. This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins—these are the same type of wins that are happening at ThedaCare every day. I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.” — John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value “Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.” — Quint Studer, CEO, The Studer Group, author of Results that Last “Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standardized systems borrowed from reliable industries were implemented. Graban provides those trade secrets in an understandable and transparent fashion.” — Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman, Department of Medicine, University of Pennsylvania School of Medicine “There is an...
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...Services Specialization: Health Management and Policy Faculty Mentor: Dr. Robert Hoye, robert.hoye@waldenu.edu Faculty Assessor: Dr. Jim Goes, jim.goes@waldenu.edu Walden University May 10, 2013 Abstract Breadth Component In this age of rapidly evolving technological advances, many of the legal and ethical issues that are challenging the delivery of health care and the health care profession are new. As we confront the legal, moral, and ethical aspects of health care, we are seldom faced with decisions that require or are resolved by simple right or wrong answers (Edge & Kreiger, 1998). In the Breadth component of KAM VI, I focus on several ethical theories and how those theories influence the way ethical issues and concerns are addressed and managed in the allocation and delivery of health care services. I critically assess and evaluate those theories, concepts, and derivative principles as they impact important decisions and the implications of those decisions within the context of social change and with special emphasis on health care management and policy. In addition, I discuss the key assumptions on which the selected theories are constructed, compare and contrast the writers’ interpretations across theories, and conclude by providing a critical commentary on the merits of the selected theories. Abstract Depth Component In the Depth Component of KAM VI, I review and critically analyze selected articles on contemporary concepts and methods in ethical decision-making...
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...2012 Catalog Volume 20 Issue 1 March 5, 2012 – December 31, 2012 This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer...
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...Chapter Web resources for this chapter include • OM Tools Software • Animated Demo Quality Management In this chapter you will learn about . . . ● What is Quality? ● Quality Management System ● Quality Tools ● TQM and QMS ● The Focus of Quality Management-Customers ● The Role of Employees in Quality Improvement ● Quality in Services ● Six Sigma ● The Cost of Quality ● The Effect of Quality Management on Productivity ● Quality Awards ● ISO 9000 2 Problems • Internet Exercises • Online Practice Quizzes • Lecture Slides in PowerPoint • Virtual Tours • Company and Resource Weblinks www.wiley.com/college/russell Quality Management at GREEN MOUNTAIN COFFEE ike wine, coffee quality is judged on attributes like fragrance, aroma, acidity, body, flavor, balance, and finish. Coffee professionals use words like “lush,” “complex,” and “fruity” to describe their evaluations, which are based on precise sensory criteria. Coffee Review, one of the most respected and widely read coffee publications in the world, rates coffees based on a 100-point scale, similar to the one used in the wine industry. Coffee connoisseurs seek out coffees awarded a rating of 80 or above. Each year GREEN MOUNTAIN submits coffee to Coffee Review for independent reviews. On average, Green Mountain L Copyright © 2007 John Wiley & Sons Chapter 2 • Quality Management 53 coffees scored 88.8 points—significantly higher than their better-known west coast and European competitors—and...
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...OFFICIAL CATALOG This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer of admission and to dismiss from the...
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...Manager, Visual Research: Karen Sanatar Permissions Project Manager: Shannon Barbe Media Project Manager, Editorial: Denise Vaughn Media Project Manager, Production: Lisa Rinaldi Supplements Editor: Kelly Loftus Full-Service Project Management: PreMediaGlobal Composition: PreMediaGlobal Printer/Binder: Edwards Brothers Cover Printer: Lehigh-Phoenix Color/Hagerstown Text Font: Palatino Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on appropriate page within text. Microsoft® and Windows® are registered trademarks of the Microsoft Corporation in the U.S.A. and other countries. Screen shots and icons reprinted with permission from the Microsoft Corporation. This book is not sponsored or endorsed by or affiliated with the Microsoft Corporation. Copyright © 2011, 2009, 2007, 2005, 2002 Pearson Education, Inc., publishing as Prentice Hall, One Lake Street, Upper Saddle River, New Jersey 07458. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means,...
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... HOFFER . Warehousing Success 426 Data Warehouse Architectures 428 Generic Two-Level Architecture 428 Independent Data Mart Data Warehousing Environment 426 429 C O NTENTS Dependent Data Mart and Operational Data Store Architecture: A Three-Level Approach Logical Data Mart and Real-Time Data Warehouse Architecture 432 Three-Layer Data Architecture 435 Role of the Enterprise Data Model 435 Role of Metadata 436 Some Characteristics of Data Warehouse Data Status Versus Event Data 437 Transient Versus Periodic Data 438 An Example of Transient and Periodic Data 438 Transient Data 438 Periodic Data 439 Other Data VVarehouse Changes 440 The Reconciled Data Layer 441 Characteristics of Data after ETL 441 The ETL Process 442 Extract 442 Cleanse 444 Load and Index 446 Data Transformation 447 Data Transformation Functions 448 Record-Level Functions 448 Field-Level Functions 449 More Complex Transformations 451 Tools to Support Data Reconciliation 451 Data Quality Tools 451 Data Conversion Tools 452 Data Cleansing Tools 452 Selecting Tools 452 The Derived Data Layer 452 Characteristics of Derived Data 452 The Star Schema 453 Fact Tables and Dimension Tables 453 Example Star Schema 454 Surrogate Key 455 Grain of Fact Table 456 Duration of the Database 456 Size of the Fact Table 457 Modeling Date and Time 458 Variations of the Star Schema 458 Multiple Fact Tables 458 Factless Fact Tables 459 Normalizing Dimension Tables 460 Multivalued...
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...WILEY & SONS, INC. This book is printed on acid-free paper. Copyright © 2006 by PricewaterhouseCoopers LLP. PricewaterhouseCoopers refers to the individual member firms of the worldwide PricewaterhouseCoopers organization. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey. Published simultaneously in Canada. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, or on the Web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax 201-748-6008, or online at http://www.wiley.com/go/permissions. Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created...
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