DQ: Outline the process for the development of nursing standards of practice for Carlifonia State
DQ: Outline the process for the development of nursing standards of practice for Carlifonia State
In the post-anesthesia care unit (PACU), the five components of the nursing process are utilized (Dean, 2018). An example of this would be a patient who presents to the PACU after a shoulder arthroscopy. An initial assessment of the patient shows the patient to be moaning, wincing, as well as tachycardia and hypertensive; this is the first step in the nursing process. The second step would be to provide a diagnosis. What is the problem? The patient reports pain (as 8 on a scale of 0-10) as a result of surgery as seen by increased heart rate and blood pressure as well as pain score. The third step is planning/outcomes, what can the nurse implement as far as interventions and possible pharmacologic strategies to alleviate the patient’s pain and what could the outcomes of said implementations be? The fourth step is implementation. The nurse carries out the intervention that was previously evaluated, in this case the nurse decides to dim the lights, quiet the room, and provide the patient with pain medication per orders given by provider. The last step is evaluation. Did the intervention work? Is the patient’s pain alleviated? This step often requires another assessment to determine the effectiveness of the intervention. The Standards of Practice set forth by the BON guides this nurse process in that the nurse is able to evaluate the problem, consider options for implementing interventions then evaluating the outcomes, all based on the appropriate standards of care put in place.
The California Nursing Practice Act mandates the Board of Registered Nursing (BRN) and sets out the responsibilities and scope of practice for registered nurses and depicts clear rules and regulations for all nurses practicing with as a California registered nurse. The very first California Nursing Practice Act was enacted by the Department of Public health and signed by the California governor in the California capital, Sacramento, on July 17th, 1939 and went into effect Sept. 19th 1939. This set of governed laws was established to outline what the scope of practice for licensed C.A registered nurses was and has been amended over the years to outline what an RN in C.a. can and can’t do, also known as scope of practice. This was developed to help protect nurses and patients to better delineate what nurses were taught to do and to make sure they followed the rules and regulations while caring for patients. The rules that are outlined are considered to be state laws and have the strength and power equal to another laws governed in that state. The United States Congress is another entity involved with creating statutes that are formally regulated by state and federal legislators that more specifically define rules and regulations of the duty of the nurse. The nursing process is a decision-making process and provides the foundation for the profession’s problem-solving abilities. The nursing process implies the use of critical thinking, clinical reasoning, and clinical judgment. This critical thinking and reasoning model adopted by the American Nurses Association, prevails in all ANA standards and scopes of practices (ANA, 2015). As nurses we know that the nursing process starts with assessment, then diagnosis, planning, implementation, and evaluation. The California Nursing Practice act and California BRN standards of practice influence my specialty area and nursing process on a daily basis. For example nurses are not allowed to intubate a patient if an artificial air way is needed, a MD must perform that intervention. When it comes to the placement of an epidural for a laboring woman, the MD must place that although it is in the scope of practice for an RN to remove an epidural with a doctors order. While assessing RN’s are not allowed to perform invasive procedures, that must be done by an MD. In the nursing process RN’s must use a nursing diagnosis such as “ineffective airway clearance”, RN’s cannot medically diagnose patients with disease. When RN’s are implementing and performing interventions they must practice under the doctors orders and practice within their scope of practice.
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The process for developing standard of practices uses the who, where, when, why, and how of nursing practice. All standard of practice provides a guide to knowledge, skills, judgement and attitudes. Professional standards ensure that the highest level of quality nursing care is promoted and that nurses follow high ethical standards. The nurse evaluates one’s own nursing practice. Keep in mind current knowledge and current quality nursing care is beneficial while giving maximum care to the patient.
Standards of care are found at the state level. State boards of nursing develop standards of care at the state level and enforce those standards. The American Nurse Credentialing Centre work on the national level. The standards of practice for the RN are created by the state board of nursing that the nurse belongs to. It is each nurse’s responsibility to know and abide by their standards of practice for their state. Each state develops their standards of practice by following guidelines that the American Nurses Association (ANA) provides. The ANA has a committee on Nursing Practice Standards and Guidelines that has a duty to clarify the role and relationships that are associated with regulation of all nursing practice.
There are 5 essential entities that are involved with developing a standard of practice. They are knowledge, role validation, competence and skill, environment, and ethics (Klein, 2005). Before practicing Nursing, I must know whether I am capable to carry out this practices as per state policy. After passing Nursing, one should get the license to practice nursing from the state wherever she intends to practice. For example: whether I am able to implement my knowledge when taking care of adults or children (Klein, 2005).
Licensure or certification may be necessary to show nursing skill and competence (Klein, 2005).
I must check that the work environment is suitable and within the scope of my practice. One must consider the potential ethical consequences of accepting responsibility for a patient’s treatment. It is mandatory that the practicing nurse be fully competent in their work.
American Nursing Association. Scope of practice. https://www.nursingworld.org/practice-policy/scope-of-practice/
Klein, T. A. (2005). Scope of practice and the nurse practitioner: Regulation, competency, expansion, and evolution. Topics in Advanced Practice Nursing eJournal, 5(2), 1-8.
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