Lectures 1 – 4
Lecture 1: Foundations of Professional Nursing Practice
Scope and Standards of Practice:
➢ American Nurses Association (ANA): provides parameters for nursing practice; contains 17 national standards of practice
and performance which define the who, what, where, when, why, & how of nursing practice; outlines key aspects of
nursing professional role and practice for any level, setting, population focus, or specialty
• Standards of Practice:
1. Assessment
2. Diagnosis
3. Outcomes Identification
4. Planning
5. Implementation
6. Evaluation
• Standards of Professional Performance:
7. Ethics
8. Education
9. EBP
10. Quality of Practice
11. Communication
12. Leadership
13. Collaboration
14. Professional Practice Evaluation
15. Resource Utilization
16. Environmental Health
17. Collegiality
Nursing Practice Acts: originated to protect the public from unsafe and unlicensed practice by regulating nursing practice and
nursing education; nurses are regulated by State Laws; they&
• Define: nursing
• Standards: set standards for the nursing profession
• Scope: give guidance regarding scope of practice issues
• General Statements: are not checklists; they contain general statements of appropriate professional nursing actions
• Legislation: are the single most important piece of legislation affecting nursing practice
o New York State Licensure: allows a nurse working in NY State to&
▪ Diagnose and treat a patient’s unique responses to diagnosed health problems
▪ Perform health assessments
▪ Teach and counsel Patients
▪ Execute Medical Regimens
▪ Plan and Implement (as a part of a Health Care Team)
Nursing Process:
➢ Purpose: a nurse follows the nursing process to organize and deliver nursing care
• Critical Thinking: integrates elements of critical thinking to make judgements and take actions based on reason
• Client-centered and Goal-oriented
• Variation of Scientific Reasoning: allows nurses to organize and systematize nursing practice
➢ Steps of nursing process:
1. Assessment: what’s the situation; vital signs, Is and Os
2. Nursing Diagnosis: what’s the problem; RN Diagnosis → pt has difficulty breathing; MD Diagnosis → pneumonia
3. Outcome identification and Planning: how to fix the problem; plan of action to solve diagnosed issue
4. Implementation: putting the plan into action
5. Evaluation: did the plan work
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, Nursing Theory: provides nurse with a distinct health care identity when collaborating with other healthcare professionals
➢ Florence Nightingale, 1820-1910: the first nursing theorist; <The Birth of Modern Nursing=
• Supportive Environment: was created to aid healing process; she manipulated the environment to specialize it for
care of the patients; saw incredible improvement in pt mortality rates
➢ Grand Theory: adjustment of living matter to other living things and to
environmental conditions; happens on three levels of the internal (self),
the social (others) and physical (biochemical reactions)
• Sister Callista Roy, 1974: Adaptation Model – identifying types of
demands placed on the client, assessing adaptation to demands,
helping client to adapt.
o Four adaptive modes:
• Physiological
• Self-concept-group identity
• Role function mode
• Interdependence mode
o Example: A 24 yo man is in a motorcycle accident and
becomes wheelchair bound; he must adapt to a new lifestyle
• Dorothea Orem, 1971: Self-Care Deficit Theory
o Theory of Self-Care: How and why people care for themselves
o Theory of Self-Care Deficit: why people can be helped through nursing
o Human Need: self-care is a human need; deficits require nursing actions
• Abraham Maslow: developed his theory of human needs; physical and psychosocial needs are
essential to human life rather than chronological age
• Middle Range Theory:
• Georgene Gaskill Eakes: Chronic Sorrow Theory – developed to help analyze individual responses of people
experiencing ongoing disparity due to chronic illness, caregiving responsibilities, loss of child, or bereavement
• Practice-Level Theory:
• Eun-Ok Im: Theory of Asian Immigrant Women’s Menopausal Symptom Experience in the US.
• Judy Dechscher: Theory of Transition Shock:
▪ Low level of abstraction, reflection of specific nursing phenomena, context, connection to research and/ or
practice, incorporation of diversities and limits in generalization
Model of Health Promotion and Illness Prevention:
• Primary: preventing health issues; e.g. weight loss, diet, exercise, smoking cessation, immunization, family safety safer sex
practices, prevent alcohol and illicit drugs, etc.
• Secondary: screening for health issues; (BP, CHOL, HIV, glaucoma, skin cancer) pap smears, mammograms, family
counseling, etc.
• Tertiary: treating health issues; medication, medical therapy, surgery, rehab, PT/OT, etc.
Never Events: (NQF – National Quality Forum) serious reportable events that are extremely rare medical errors that should never
happen; Center for Medicare and Medicaid Services (CMS) stopped reimbursement to hospitals for 8 never events:
1. Vascular catheter-associated infection (CLABSI)
2. Pressure ulcers
3. Surgical site infections
4. Hospital acquires injuries (falls, fractures, burns)
5. Objects left in body after surgery (sponges, towels, needles)
6. Blood incompatibility
7. Air embolism
8. Cather-associated urinary tract infection (CAUTI)
HIPAA: (Health Insurance Portability and Accountability Act, 2002) to protect and reduce the unauthorized access or release of an
individual's confidential health information
• PHI: (private health information) demographic data: health info, payment info, identifying info (address, DOB, SSN, etc.)
• Violations: of HIPAA could result in civil monetary penalties
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