Approaches to Professional Nursing Practice Questions and Answers

Approaches to Professional Nursing Practice Questions and Answers Analysis Breaking things down so you can examine carefully and separately Synthesis Combining separate elements into a whole Informed consent * Can be impled, verbal or written * Must be freely and voluntarily given * Information must be accurate, non biased, comprehensive and in plain terms * Adults must be competent, able and have legal capacity to give consent * With exceptions of emergencies, consent without these requirements is not valid and HCP could be charged with battery Client's full access to medical records is determined on a case by case basis Ethics "Is about human potential, behaviour and expectations of what is good and socially worthy." "The study of what we ought to do." Ethics is not... * Professional etiquette or opinion * Hospital policy or medical authority * Religion or morality * Law * Gut feeling or intuition * Empirical data * Public opinion or consensus Ethical Principles AUTONOMY BENEFICENCE NON MALEFICENCE JUSTICE Ethical dilemmas * Rarely one clear cut answer * Refer to COE but still only a guide * Consult peers, supervisors * Consider from multiple angles, develop possible solutions, decide best solution * Reflect: Are any of your own strong views influencing your thinking * Complex situations rarely have simple solutions Ethical Dilemma Model E xamine the ethical dilemma T horoughly comprehend the possible alternatives H ypothesise ethical arguments I nvestigate, compare and evaluate arguments for each alternative C hoose the alternative A ct on your chosen alternative L ook at dilemma and examine outcomes while reflecting on the ethical decision Ethics and Law Ethics is about human potential, behaviour and expectations of what is good and socially worthy Law is about the rules and consequences or penalties imposed should someone fail to adhere to what society expects Confidentiality * All patient information is confidential. Only to be shared as neccessary with the treating team * Human right * Breaches are illegal as well as unethical * Requirements outlined in NMBA Code of Ethics, Code of Professional Conduct and National Competency Standards Confidentiality or Privacy? Confidentiality is the assurance that data about a person will not be disclosed without their permission Privacy is an individual's desire to control access to information about themselves Unsatisfactory Professional Conduct Significantly below standard reasonably expected of a practitioner of equivalent level and experience Professional Misconduct More serious impropriety and includes unprofessional conduct that is inconsistent with the practitioner being a fit and proper person to hold registration Scope of Practice Being aware of and remaining within areas in which you are competent Being aware of scope of practice of people to whom you are delegating tasks ... some tasks cannot be delegated Scope is dynamic. It changes with experience, new knowledge and skills, context Collaboration and delegation between RN, EN and AIN All roles collaborate but only RN can delegate Nurse heirarchy RN: - Registered with AHPRA - Supervise and delegate to EN and AIN - Develop care plans - Accountable for care decisions - Autonomous EN: - Accountable to RN - Registered with AHPRA - Contribute to care plan but cannot make decisions - EEN may administer medication AIN: - Accountable to RN - Support RN and EN - Not registered with AHPRA Resources available when making decisions about scope of practice Peers Code of ethics NMBA frameworks Transformative nursing Transforming through critical reflection and self awareness: 1. Self 2. Patients 3. Healthcare system So that we develop understanding, insight and knowledge Growth and development Education Events Lifelong learning Sociocultural influences Reflection Experience The Nursing Process ADPIE Five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating Evidence-based practice 1. Best research evidence 2. Clinical expertise 3. Individual patient needs Archie Cochrane 1972 Proposed an evidence hierarchy for weighing evidence John Hopkins PET 1. Practice questions 2. Evidence 3. Translation Levels of evidence 1. Systematic reviews 2. Randomised controlled trials 3. Case controlled studies 4. Non experimental designs 5. Expert opinion 6. Views of colleagues/peers Nursing research Tests commonly held knowledge or assumptions Widen understanding of phenomena Stimulate action and further research Inform EBP Explain why things happen in a certain way Enable predictions Subjective knowledge Interpersonal communication skills within context of therapeutic relationship to learn how patients feel about their condition Objective knowledge Measurable: BP, O2 sats,ECG etc Sources of knowledge Primary Secondary Peer reviewed Multidisciplinary team attributes Clear purpose Clear roles Good communication Mechanisms for conflict resolution Shared language Interdependence Cooperation Coordination of activities Division of tasks Successful MDT - Allow for flexibility within team and be alert to oppurtunities and strategies - Identify potential barriers and attempt to do something about them - Identify opportunities and strategies - Take advantage of team building and educational opportunities - Support people who find team work challenging