Competency number 7: Emphasis is placed on the system of care delivery that (1) prevents errors; (2) learns from

the errors that do occur; and (3) is built on a culture of safety that involves health care professionals, organizations, and patients. The most critical contribution of nursing to patient safety, in any setting, is the ability to coordinate and integrate the multiple aspects of quality within the care directly provided by nursing, and across the care delivered by others in the setting. Patient safety is the cornerstone of high-quality health care. Much of the work defining patient safety and practices that prevent harm have focused on negative outcomes of care, such as mortality and morbidity. Nurses are critical to the surveillance and coordination that reduce such adverse outcomes. Safety and Quality The first key area of nursing responsibility focuses on providing nursing care that is safe and of high quality. Under this key area, core competencies include demonstrating knowledge about the health status and illness of a patient; making appropriate decisions when caring for patients and their families; and ensuring patient safety, privacy and comfort. Competencies also include setting appropriate priorities in patient care, working with the medical team to ensure stability of care, effectively administering medications and other treatment modalities and performing assessments and nursing services against a background of established nursing guidelines. The nurse also works with the medical team and patient's family to develop a plan of care. Identifying the goals of care and evaluating progress toward those goals are also core competencies within this key area Ref: Core Competencies Under the Eleven Key of Responsibility of Nursing | eHow.com http://www.ehow.com/list_7361952_core-eleven-key-responsibility-nursing.html#ixzz1Tb2fCNtb Core Competency 7: Utilizes the nursing process as framework for nursing 7.1 Performs comprehensive and systematic nursing assessment Obtains informed consent Completes appropriate assessment forms Performs appropriate assessment techniques Obtains comprehensive client information Maintains privacy and confidentiality Identifies health needs 7.2 Formulates a plan of care in collaboration with clients and other members of the health team Includes client and his family in careplanning Collaborates with other members of the health team States expected outcomes of nursing intervention maximizing clientscompetence Develops comprehensive client care plan maximizing opportunities for prevention of problems and/or enhancing wellness response Accomplishes client-centered discharge plan 7.3 Implements planned nursing care to achieve identified outcomes Explains interventions to clients and family before carrying them out to achieve identified outcomes Implements nursing intervention that is safe and comfortable Acts to improve clients health condition or human response Performs nursing activities effectively and in a timely manner

Uses the participatory approach to enhance client-partners empowering potential for healthy lifestyle/wellness 7.4 Evaluates progress toward expected outcomes Monitors effectiveness of nursing interventions Revises care plan based on expected outcomes Reference: http://www.scribd.com/doc/22312097/11-Core-Competencies-Part-1-to-Part-2

Critical Thinking: To Think Like A Nurse (Penny Heaslip, 1993, Revised 2008 Thompson Rivers University, Box 3010, 900 McGill Road, Kamloops, BC Canada, V2C 5N3 pheaslip@tru.ca ) To become a professional nurse requires that you learn to think like a nurse. What makes the thinking of a nurse different from a doctor, a dentist or an engineer? It is how we view the client and the type of problems we deal with in practice when we engage in client care. To think like a nurse requires that we learn the content of nursing; the ideas, concepts and theories of nursing and develop our intellectual capacities and skills so that we become disciplined, self-directed, critical thinkers. Critical thinking is the disciplined, intellectual process of applying skilful reasoning as a guide to belief or action (Paul, Ennis & Norris). In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care (Heaslip). Critical thinking when developed in the practitioner includes adherence to intellectual standards, proficiency in using reasoning, a commitment to develop and maintain intellectual traits of the mind and habits of thought and the competent use of thinking skills and abilities for sound clinical judgements and safe decision-making. Reference:http://www.criticalthinking.org/resources/HE/ctandnursing.cfm

Professional standards and nursing process Professional standards ensure that the highest level of quality nursing care is promoted. Excellent nursing practice is a reflection of sound ethical standards. Client care requires more than just the application of scientific knowledge. A nurse must be able to think critically, solve problems, and find the best solution for clients needs to assist clients in maintaining, regaining, or improving their health. Critical thinking requires the use of scientifically based and practicebased criteria for making clinical judgments. These criteria may be scientifically based on research findings or practice based on standards developed by clinical experts and quality improvement initiatives. Standards of care The standards of care in the ANA nursing: Scopes and Standards of practice (2004) describe a competent level of nursing care. The levels of care are demonstrated through the nursing process. The nursing process is the foundation of clinical decision making and includes all significant actions taken by nurses in providing care to clients. Within these are the nursing responsibilities for diversity , safety, education, health promotion, treatment , self care, and planning for the continuity of care. Standards of care are important if a legal dispute arises over whether a nurse practiced appropriately in a particular case. Reference: http://currentnursing.com/nursing_management/nursing_standards.html