PROFESSIONAL NURSING PRACTICE

ByPurwaningsih

Definition of Nursing

• Nurses’ unique function is to help individuals, both sick and well, perform activities that contribute to their health or recovery (or facilitate a peaceful death) that they would perform unaided if they had the necessary strength, will, or knowledge, and to accomplish this function in such a way as to help individuals gain independence.

V. Henderson, 1960

ANA Definition of Nursing

• Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering though the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations.

ANA, 2003

Characteristics of a Profession

• Requires an extended education of its members

• Has a theoretical body of knowledge leading to skills, abilities and norms- Based on a scientific foundation

• Provides a specific service• Maintains autonomy in decision making and

practice• Has a code of ethics

Foundation of Nursing

• Theories of nursing• Scientific knowledge• Relevance to basic social values• Professional autonomy• A sense of commitment• A sense of community• A code of ethics

Characteristics of Expert Clinical Practice

• Application of knowledge and clinical expertise

• Expertise to interpret clinical situations and make complex decisions

• Critical thinking is essential and on going• Life long learning is essential due to the

continuing changes in nursing knowledge• Experts practice evidence based nursing care.

Scope & Standards of Practice

• Standards of Practice

• Standards of Professional Performance

• Code of Ethics

Professional Nursing Practice

• Nurse Practice Acts

• Licensure and Certification

• Science and Art of Nursing practice

Education

• Associates Degree 3-4 years• Baccalaureate Degree 5-6 years• Masters Degree 1-2 years– Nursing Education– Nurse Practitioner– Clinical Nurse Specialist– Nurse Anesthetist– Nurse Midwife– Nursing Administration

• PhD/ DNS/EdD 4-8 years

ANAStandards of Professional Performance

• Quality of practice• Professional Practice Evaluation• Education• Collegiality• Ethics• Collaboration• Research• Resource Utilization• Leadership

Nursing Today

• Registered Nurse• Licensed Practical Nurse• Nurse Practitioner• Clinical Nurse Specialist• Nurse Midwife

Current Trends & Issues in Healthcare

• Excess number of nurses• The quality of nursing education• Patient Satisfaction • Managed Care• Transcultural Nursing• National Patient Safety Initiatives• Evidence-Based Practice• Information Age• Globalization of Health• Aging Population

Patient Satisfaction

• Press ganey surveys• Good customer

service • Patient Bill of Rights• Treat patients like

family• Healthcare is a

business

Managed Care

• Goal is to keep length of stay (LOS) down• Capitation• Patients are discharged sooner• Patient acuity higher• Health Care Plans• Case manager work closely with physicians

and insurance companies

Evidence Based Practice

• Goal is to achieve cost-effective, high quality patient care based on scientific inquiry

• Nurses need to understand research process involved

• Nursing care should not be based on opinions, past practices, but on the results of scientific research

• Clinical journals• Practice guidelines• Nursing research

Process ofKnowledge Development

Globalization of Health

• Healthcare has become a global issue

• People are mobile, diseases can travel

• Nurses need to have an understanding of the issues pertaining to global health

Practice Settings for Nurses

• Hospital

• Community Based Practice Settings

Hospital Based Nursing

• Acute care is where largest group of nurses practice

• Different Staffing Patterns• Skill Mix Changing • Increase in skilled nursing facilities due to

aging population and increase in chronic disease

Community Based Nursing

• Focus on health promotion, maintenance, education

• Community Health Centers, Clinics• School Nursing• Occupational Health• Home Health• Physicians Office• Managed Care Organizations• Forensics Nursing

Nursing Roles

• Caregiver• Clinical Decision Maker• Client Advocate• Rehabilitator• Comforter• Communicator• Collaborator• Teacher

Professional Roles & Responsibilities

• Autonomy & Accountability• Caregiver• Client Advocate• Educator• Manager/Clinical Decision Maker• Communicator• Collaborator• Career Development

Autonomy & Accountability

• Autonomy is the essential element of professional nursing

• Person is reasonably independent and self-governing in decision making & practice

• Increased autonomy=Increased responsibility• Accountability- nurse is responsible professionally &

legally for type & quality of care provided• Regulated through Standards of Practice and Nurse

Practice Act

Clinical Decision Maker

• Utilizes critical thinking skills and the nursing process

• Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Professional Accountability

• Responsibility that one assumes for their practice

• Obligation to report or account for their actions – To the profession, public, and themselves

Accountability• Begins with preconditions – Ability– Responsibility– Authority– Ends in accountability

• Alliance for Nursing Accreditation (ANA)

Client Advocate

• Nurse protects the clients human and legal rights

• Providing information to assist in decision making

• Patient Bill of Rights

Comforter Role

• Caring for client as a human being

• Role is traditional to nursing

• Care is directed to whole person, not just a body part

• Demonstration of care and concern

Communicator Role

• Role is central to all other roles• Involves communication with client, family,

healthcare team members, resource people, and the community

• Without clear, concise communication it will be difficult to give effective care

Teacher/Educator Role

• Explains concepts and facts about health, demonstrates procedures, reinforces learning, determines understanding, and evaluates progress of learning

• Unplanned or informal education• Planned or formal education

Nursing Career Roles

• Clinician• Nurse Educator• Advanced Practice Nurse• Nurse Administrator• Nurse Researcher• Military Nurse• Forensic Nursing

Issues in Health Care Delivery

• Rising health care costs

• Evidence based practice

• Nursing and biomedical research

• Excess number of nurses

Advanced Nursing Roles

• Nurse administrator/manager• Nurse education• Nurse practitioner• Nurse anesthetist• Nurse midwife• Nurse researcher

Professional Workforce in the 21st Century

Future Trends in Nursing

• Expansion of nursing opportunities• Public perception of nursing• Nursing’s impact on politics and health policy

TERIMAKASIH