1. Standards Definition of standards Types of standards Purposes of standards Characteristics of standards How to write a standard Alexandria University Faculty of Nursing

2. Definition of standards Is a generally accepted written expectation, amenable to measurement through the development of specific behaviors (indicators) against which actual performance can be judged Indicators: activities which demonstrate how standard can be applied Is a written descriptive statement of desired or agreed level of Performance Against which the quality of (structure, process and outcome criteria ) can be measured Criteria Are predetermined measurable elements that will indicate if the standard is met, and to what extent it was met.

3. Approaches of standards: Different approaches can be used to develop and implement the standards. The most common approaches are: Structure : Involve the ‘setup’ of the organization, philosophy, goals and objectives, structure of the organization, facilities and equipment, qualification of employees. Process : Involve the activities concerned with the delivery of patient care. They measure nursing actions or lack of actions. Outcome : They reflect effectiveness and results rather than the process of giving care, i.e. evaluate patient status.

4. Resources What you need It includes evaluation of: Physical environment & building. Policies, procedures, roles & regulations. Job description. Staff number and mix, orientation and in- service schedules. Equipment. Ancillary & paramedical services What has to be done It includes evaluation of: Assessment techniques & procedures. Methods of delivering nursing care. Methods of patient education. Methods of documenting. The competence of staff carrying out nursing care. What actually achieved It includes: Recovery rate. Mortality rate. Patient’s satisfaction. Patient’s behavior. Patient’s knowledge. Patient’s self-care. Structure Process Outcomes Action Results

5. Example for standard of care: A problem concerning staff safety. Staff, both nursing and non nursing have received an injury from disposed, used sharps. Standard statement: All sharps will be disposed of without injury to members of staff. In order to meet this standard, there are some essential structure, process and outcome criteria: Structure criteria: Policy for sharps disposal.Staff have knowledge of this policy. Sharps safe box, polythene bag and label. Process criteria: The nurse places all used sharps in the sharps safe box immediately. The container is closed when it is three-quarters full. The container is placed in a polythene bag and labeled for incineration. Outcome criteria: All sharps are successfully incinerated. No injuries to staff from sharps reported.

6. Types of standards:- The nature and scope of nursing practice are addressed in two dimensions: standards of care, and standards of professional practice. Standard of care (practice): It is an authoritative statement that describes a competent level of clinical nursing practice demonstrated through assessment, diagnosis, outcome identification, planning, implementation, and evaluation. These standards emphasize the nurse's practice in caring for the client regardless of the nurse's educational background. Standard of professional performance: It is an authoritative statement that describes a competent level of behavior in the professional role, including activities related to quality of care, performance appraisal, education, collegiality, ethics, collaboration, research, and resource utilization.

7. ACADEMIC REFRENCE STANDARS: Specific standards decided by the institution, informed by external references and including the minimum level of knowledge and skills to be gained by the graduates from an academic educational program and fulfilling the mission of the institution Purposes of standards Improve the quality of nursing care. Decrease the cost of nursing care. Provide a basis for determining nursing negligence To safeguard practice in nursing and nursing manpower utilization. Internal evaluation and quality improvement.

8. Basic standards: Are expressed by a "must", this means that the standard must be met by every health agency and fulfillment demonstrated during evaluation of the Agency Standards for quality development: Are expressed by a "should", this means that the standard is in accordance with international consensus about best practice for health agency

9. Characteristics of standards 1- Directed toward an ideal 2- Realistic 3- Attainable 4- Acceptable 5- Understandable 6- Developed by experts in the domain 7- Based on current knowledge 8- Phrased in positive terms 9- Indicative of acceptable performance 10- Relevant to the domain under study 11- Amenable to measurement

10. How to write standards 1.Develop a committee 2-Review international standards 3-First draft of National standards 4-Distribute first draft to stakeholders 5-Received the comments on the standards How to write standards 1.Develop a committee 2-Review international standards 3-First draft of National standards 4-Distribute first draft to stakeholders 5-Received the comments on the standards

11. Role of nurse Advocator Clinician Collaborator Researcher Educator Manager Leader

12. Professional standards Standard1. Quality of Practice Standard2. Education Standard3. Professional Practice Evaluation Standard4. Collegiality

13. Standard5. Collaboration Standard6. Ethics Standard7. Research Standard8. Resource Utilization Standard9. Leadership

14. Standard1. Quality of Practice The nurse systematically enhances the quality and effectiveness of nursing practice. Participation in class discussions/projects Delivering the best care possible based on their level in the curriculum. Maintain the standards and requirements of professional practice. Demonstrate the ability to deliver quality patient/ client centered care

15. Standard4. Collegiality The nurse interacts with and contributes to the professional development of peers and colleagues. Participates in peer evaluative processes Actively participates in course discussions Providing other student nurses formal feedback regarding performance through peer evaluation processes Being prepared and actively participating in clinical or course discussions Demonstrate the principles of effective team-working

16. Practical skills Standard 1. Assessment Standard 2. Diagnosis and Outcome Identification Standard 3. Planning

17. Standard 4. Implementation Standard 5A: Coordination of Care Standard 5B: Health Teaching and Health Promotion Standard 6: Evaluation

18. Standard 1. Assessment The nurse collects comprehensive data pertinent to the patient’s health or the situation. Gather relevant information Adopt systematic approaches to analyzing and evaluating the information collected Communicate effectively with the client/patient Use a range of assessment techniques Consider psychological, social and cultural needs/problems Recognize the place and contribution of his/her assessment within the total health care profile/package