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CALL TO ACTION:NURSING SCOPE AND STANDARDS

OF PRACTICE

NOVEMBER 6, 2015

Boise, ID

HEATHER HEALY, MS, RN, FNP-BC, NEA-BCheather@nurisngpro.com

NURSING SCOPE AND STANDARDS REVISION WORKGROUP

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Heather Healy

BSN – Arizona State University, 1996MSN – Arizona State University, 2006

Family Practice Nurse Practitioner

CNO, Deaconess Hospital Spokane, WAAdvisory Board Member – Gonzaga SON, Washington State SON and Spokane Community Health Advisory Board

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I have no conflicts of interest or disclosures to disclose.

Conflict of Interest

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The learner will be able to:Identify three key messages integrated within the definition of nursing

Describe the framework for the Standards of Practice

Address the importance of the Standards of Professional Performance

Name the final decision-maker represented in the professional regulation pyramid

Learning Objectives

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Definition of Nursing

Nursing is the:Protection, promotion, and optimization of health and abilities,Prevention of illness and injury,Facilitation of healing,Alleviation of suffering through the diagnosis and treatment of human response, andAdvocacy in the care of individuals, families, groups, communities, and populations.

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Nursing: Scope and Standards of Practice, Third Edition

Scope of Practice Statement Describes– Who - All RNs, including graduate level-

prepared RNs and advanced practice RNs (APRNs), educated, titled, and actively licensed to practice nursing .

– What - The definition of nursing provides a succinct, inclusive, and descriptive characterization of nursing.

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Nursing: Scope and Standards of Practice, Third Edition

Scope of Practice Statement Describes– When and Where – Whenever there is a need

for nursing knowledge, wisdom, caring, leadership, practice, or education – anytime, anywhere.

– Why – Nursing’s response to the changing needs of society to achieve positive healthcare outcomes in keeping with nursing’s social contract with and obligation to society.

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Nursing: Scope and Standards of Practice, Third Edition

Scope of Practice Statement Describes– How – The ways, means, methods, and

manners nurses use to practice professionally.

– Adherence to the nine provisions of the 2015 Code of Ethics for Nurses With Interpretive Statements

– Application of the nursing process

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Standards of Professional Nursing Practice

Standards are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform

Include Standards of Practice and Standards of Professional Performance

Each standard is accompanied by competencies for all registered nurses, with additional competencies for graduate-level prepared registered nurses and APRNs

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Standards of Practice

Addresses the use of the nursing processStandard 1 AssessmentStandard 2 Diagnosis (Expanded for APRNs)Standard 3 Outcomes IdentificationStandard 4 PlanningStandard 5 Implementation– Standard 5A Coordination of Care– Standard 5B Health Teaching and Health Promotion– Standard 5C Consultation – Standard 5D Prescriptive Authority and Treatment

Standard 6 Evaluation

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Standard 5 ImplementationThe registered nurse implements the identified plan.

CompetenciesThe registered nurse:

Partners with the healthcare consumer to implement the plan …. Integrates interprofessional team partners in implementation of the plan ….Demonstrates caring behaviors to develop therapeutic relationships.Provides culturally congruent, holistic care that …. Uses evidence-based interventions and strategies to achieve ….Integrates critical thinking and technology solutions to implement ….Delegates according to the health, safety, and welfare of ….Documents implementation and any modifications ….

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Standard 5 Implementation - Continued

Additional Competencies for the Graduate-level Prepared Registered NurseIn addition to the competencies of the registered nurse, the graduate-level registered nurse:

Uses systems, organizations, and community resources to lead effective change and implement the plan.Applies quality principles while articulating methods, tools, …. Translates evidence into practice.Leads interprofessional teams to communicate, collaborate, ….Demonstrates leadership skills that emphasize ethical ….Serves as a consultant to provide additional insight and potential solutions.Uses theory driven approaches to effect organizational or system change.

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Standard 5 Implementation - Continued

Additional Competencies for the Advanced Practice Registered NurseIn addition to the competencies of the registered nurse and the graduate-level prepared registered nurse, the advanced practice registered nurse:

Uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations.Prescribes traditional and integrative evidence-based treatments, therapies, and procedures that are compatible with the healthcare consumer’s cultural preferences and norms.Prescribes evidence-based pharmacological agents and treatments according to clinical indicators and results of diagnostic and laboratory tests.Provides clinical consultation for healthcare consumers and professionals related to complex clinical cases to improve care and patient outcomes.

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Standards of Professional Performance

Standard 7 EthicsStandard 8 Culturally Congruent Practice - NEWStandard 9 CommunicationStandard 10 CollaborationStandard 11 LeadershipStandard 12 EducationStandard 13 Evidence-based Practice & ResearchStandard 14 Quality of PracticeStandard 15 Professional Practice EvaluationStandard 16 Resource UtilizationStandard 17 Environmental Health

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Standard 8 Culturally Congruent Practice

The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles.CompetenciesThe registered nurse:

Demonstrates respect, equity, and empathy in actions and interactions with all healthcare consumers. Participates in life-long activities to understand cultural preferences….Creates an inventory of one’s own values, beliefs, and cultural heritage.Applies knowledge of variations in health beliefs, practices, ….Identifies the stage of the consumer’s acculturation….Considers the effects and impact of discrimination and oppression ….Uses skills and tools that are appropriately vetted for the culture, …. Additional competency statements ….

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Professional Practice Regulation

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Added Resources & ContentAppendix A – Nursing: Scope and Standards of Practice, Second Edition (2010)Appendix B – Nursing’s Social Policy Statement: The Essence of the Profession (2010)Appendix C – ANA Position Statement: Professional Role Competence (2014)Appendix D – The Development of Essential Nursing Documents and Professional Nursing Appendix E – Selected Nurse TheoristsAppendix F – Culturally Congruent Practice Resources

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Elizabeth (Libby) Thomas, Chairperson – for her insight, laughter and support as we pulled this work together – she always kept us on track and on timeCarol Bickford, ANA Staff – Content editor – for her tireless commitment to detail and to the written word. Carol was an inspiration to all of usMary Jo Assi, Eric Wurzbacher and Yvonne Humes for keeping us moving forward and providing input, resources and expertise just when we needed it.

Special thanks …

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Publication Format

Print VersionPart of Essentials PackageElectronic Version AvailableInstitutional Purchase for Intranet Posting

www.Nursesbooks.org or 1-800-637-0323

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Call to Action – RAISE the bar

Reading Nursing: Scope and Standards of Practice, 3rd Ed

Assessing the document and contemplating what it means to you and your practice

Integrating Scope and Standards of Practice, 3rd Ed into practice by developing culturally congruent care in every situation and setting

Sharing the word and encouraging other nurses to integrate Scope and Standards of Practice, 3rd Ed into practice

Excelling in using knowledge and conducting and applying research to achieve the highest quality, evidence-based care

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So…What Actions Will You Complete?

What Questions Remain?

Heather Healy, MS, RN, FNP-BC, NEA-BCheather@nurisngpro.com / 208-949-3267