PATIENT CARE STANDARDS

Presented to Dr. Betty Polido In Partial Fulfillment for the Course N 414-F Santander, Irene Y. Sayson, Nishiura Grace D.

July 10, 2012

Define the different organizations and their standards of care. Describe the importance of patient care standards. Discuss the different patient care standards of different health provider organization. Analyze and synthesize information from diverse patient-care standards in a manner consistent with the demands of clinical setting. Identify the impact of the patient care standards toward s the patients level of satisfaction upon the setting health care organizations.

I. LEARNING OBJECTIVES

II. INTRODUCTION

Nursing is a helping, independent profession that provides services that contributes to the health of the people.

The care aspect is more than to take care of it is also caring about. Caring is relational and requires you as a nurse to understand the patients needs at a level that permits individualization of nursing therapies.

In the practice setting it is important to have objective guidelines for providing and evaluating nursing care. Standards of nursing care are developed and established on the basis of strong scientific research and the work of clinical nurse experts. The purpose of a standard of care is to describe the common level of professional nursing care in order to judge the quality of nursing practice (Dean Baar, 2001). An organization sometimes adopts a general set of standards for nursing care, such as organizational protocols, policies, or procedures.

The standards (a) reflect the values and priorities of the nursing profession (b)provide direction for professional nursing practice, (c) provide a framework for the evaluation of nursing practice (d) define the professions accountability to the public and the client outcomes for which nurses are responsible.

In 1991, the American Nurses Association (ANA) developed standards of clinical nursing practice of nursing that are generic in nature and provide for the practice regardless of area of specialization.
Various specialty nursing organizations have further developed specific standards of nursing practice in their area.

ANA Standards of Practice

Assessment The nurse collects comprehensive data pertinent to the patients health or the situation. Measurement Criteria Data collection involves the patient and health care providers. The patients immediate condition or needs determine the priority of data collection. Collect pertinent data using appropriate assessment techniques. Document relevant data using appropriate assessment in a retrievable form. The data collection process is systematic and ongoing.

Nursing Diagnosis The nurse analyzes the assessment data to determine the diagnoses or issues. Measurement Criteria Derives diagnoses from the assessment data. Validate the diagnoses with the patient and the healthcare team, when possible. Documents diagnoses in a manner that facilitates the determination of expected outcomes and plan of care.

Outcomes Identification The nurse identifies expected outcomes for a plan individualized to the patient or the situation. Measurement Criteria Formulates outcomes mutually with the patient, significant others and health care providers, when possible. Outcomes are culturally appropriate and realistic in relation to the patients present and potential capabilities. Outcomes are attainable in relation to resources available to patient. Outcomes include a time estimate for attainment and provide direction for continuity of care. Documents outcomes as measurable goals.

Planning The nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. Measurement Criteria The plan is individualized to the patients condition or needs. Develops the plan with the patient, significant others, and health care providers, when appropriate. The plan reflects current nursing practice. The plan provides continuity of care. Consider economic impact of the plan. Establish priorities for care. Document the plan.

Implementation The nurse implements the identified plan of care.

Measurement Criteria Interventions are consistent with the established plan of care. Implement interventions in a safe and appropriate manner. Collaborate with the nurse colleagues to implement the plan. Utilize community resources and systems to implement the plan.

Evaluation The nurse evaluates progress toward attainment of outcomes. Measurement Criteria Evaluation is systematic, ongoing and criterion-based. Involves the patient, significant others, and health care providers in the evaluation process, when appropriate. Uses ongoing assessment data to revise diagnoses, outcomes, and the plan of care as needed. Document revisions in diagnoses, outcomes, and the plan of care. Evaluate the effectiveness of interventions in relation to outcomes. Document the patients responses to interventions.

Following review of their protocols for scientific quality and the protection of research subjects, clinical investigators design and implement their research efforts with the goal of generalizable knowledge that may benefit future patients with disease, if not the research subjects themselves. In 2000, the Medical Executive Committee developed Standards for Clinical Research to assure high-quality intramural clinical research programs. In 2006, the Medical Executive Committee approved and adopted the following Standards for Patient Care to foster commitment across the NIH institutes and centers to excellence in the care of patients while they are serving as research subjects at the NIH Clinical Center.

Canadian Nurses Association Standards for Nursing Practice Nursing practice requires that a conceptual model(s) for nursing be the basis for that practice. Nursing practice requires the effective use of the nursing process. Nursing practice requires that the helping relationship be the nature of the client-nurse interaction.

Nursing practice requires nurses to fulfill professional responsibilities.

Standards 1. Credentialing and Privileging The branch chiefs or section heads of the NIH institutes and centers will use a Clinical Competency Assessment form to document continued competence at the time of recredentialing. The practitioners clinical director must review this form before its submission to the Credentials Committee.

2. Preadmission Preparation The clinical staff will conduct preadmission planning for each scheduled admission of patients. These discussions should address patient schedules and special needs (e.g., language or mobility). Physicians, dentists, and other licensed independent practitioners, nursing staff (including the nurse manager), research nurses, and protocol coordinators may participate in these meetings, which also may involve social workers, nutritionists, pharmacists, and other members of the multidisciplinary care team.

3. Multidisciplinary Patient Care Rounds The purpose of these multidisciplinary clinical rounds is to discuss patient data, progress in the protocol, problems relating to the patients care, evaluations by specialists, and recommendations for management. The primary care team can then use this information to devise treatment plans, prepare patient education, and formulate recommendations for referring physicians.

4. Patient Management and Treatment Guidelines The medical staff will have access to treatment guidelines endorsed by national organizations. We encourage investigators and consultants, when appropriate, to consider practice guidelines in developing their recommendations for patient management. In addition, we encourage multi-specialty teams to develop patient management and treatment guidelines for supportive care of patients in clinical research protocols that are based on clinical trial data and expert opinions.

5. Patient Discharge and Referring Physician Interface Care teams that may include the attending physician or dentist, fellows, other licensed independent health-care practitioners, research nurses, and patient-care unit nursing staff will meet with patients (with a translator, if necessary, and with family or others, if requested) at the time of their discharge to explain their evaluation, treatment, and management recommendations as well as the follow-up that may be required at the Clinical Center.

6. Quality Assurance/Quality Improvement To review the occurrences and complications of procedures that causedor had the potential to causepatient harm, the institutes and centers should conduct Quality Assurance/Performance Improvement Rounds on a regular basis.

7. Great Teachers Lectures and Medical and Ethics Grand Rounds The Clinical Center will continue to invite outstanding clinicians and ethicists to conduct the Wednesday noon Grand Rounds presentations with CME credits available to the staff attending. The leadership of the institutes and centers will encourage staff attendance.

UNIVERSITY HOSPITAL ALBERT B. CHANDLER MEDICAL CENTER LEXINGTON, KENTUCKY STANDARDS IN PATIENT CARE

Principle A Each patient shall be treated as a whole, irreplaceable, unique, and worthy person.
Principle B The patients safety, health, or welfare shall be protected and shall not be subordinated to organizational staff, educational, or research interests or to any other end.

Principle C The privacy of the patient and the confidentiality of every case and record shall be maintained.

Principle D Patients and/or responsible family shall be informed at all stages of care about personnel responsible for the patients care; treatment plans and activities for the patient; facilities; services available to the patient; and responsibilities of the patient and family (referred to collectively below as patients care).

Principle E Behavior reflecting the dignity, responsibility, and service orientation of health care professionals, worthy of the publics respect and confidence, shall be practiced by all individuals. Principle F Each patient shall have a responsible attending physician.

LESSONS LEARNED

As nursing students we have learned that each organization has developed their own standards and protocols to render safe and quality nursing care and to guide them morally in the practice of their profession. We have learned that each organization adopts protocols and guidelines in order to judge the quality of care they offer. We are made aware of the various specialty nursing organizations further developed specific standards of nursing practice in their area and the benefits they are giving to the clients such as safe and quality nursing care. The Standards for Patient Care address essential principles and processes for the clinical care of the patient volunteers to participate in clinical research, thus becoming an advantage to the patient since they are viewed as a whole. These standards developed by health care providers offer guidance on such components as the objective measure of medical staff competence, preadmission planning, and multidisciplinary patient care, and the importance of clear and timely communication with referring physicians. Through the standards developed by different organizations, we will be able to evaluate nursing care. We have also learned that the overreaching goal of patient care standards is to give excellent care.