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PROFESSIONAL NURSING PRACTICE
By Purwaningsih
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Definition of Nursing Nurses’ unique function is to help individuals, both sick and well, perform activities that contribute to their health or recovery (or facilitate a peaceful death) that they would perform unaided if they had the necessary strength, will, or knowledge, and to accomplish this function in such a way as to help individuals gain independence. V. Henderson, 1960
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ANA Definition of Nursing
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering though the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations. ANA, 2003
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Characteristics of a Profession
Requires an extended education of its members Has a theoretical body of knowledge leading to skills, abilities and norms- Based on a scientific foundation Provides a specific service Maintains autonomy in decision making and practice Has a code of ethics
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Foundation of Nursing Theories of nursing Scientific knowledge
Relevance to basic social values Professional autonomy A sense of commitment A sense of community A code of ethics
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Characteristics of Expert Clinical Practice
Application of knowledge and clinical expertise Expertise to interpret clinical situations and make complex decisions Critical thinking is essential and on going Life long learning is essential due to the continuing changes in nursing knowledge Experts practice evidence based nursing care.
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Scope & Standards of Practice
Standards of Professional Performance Code of Ethics
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Professional Nursing Practice
Nurse Practice Acts Licensure and Certification Science and Art of Nursing practice
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Education Associates Degree 3-4 years Baccalaureate Degree 5-6 years
Masters Degree 1-2 years Nursing Education Nurse Practitioner Clinical Nurse Specialist Nurse Anesthetist Nurse Midwife Nursing Administration PhD/ DNS/EdD 4-8 years
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ANA Standards of Professional Performance
Quality of practice Professional Practice Evaluation Education Collegiality Ethics Collaboration Research Resource Utilization Leadership
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Nursing Today Registered Nurse Licensed Practical Nurse
Nurse Practitioner Clinical Nurse Specialist Nurse Midwife
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Current Trends & Issues in Healthcare
Excess number of nurses The quality of nursing education Patient Satisfaction Managed Care Transcultural Nursing National Patient Safety Initiatives Evidence-Based Practice Information Age Globalization of Health Aging Population
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Patient Satisfaction Press ganey surveys Good customer service
Patient Bill of Rights Treat patients like family Healthcare is a business
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Managed Care Goal is to keep length of stay (LOS) down Capitation
Patients are discharged sooner Patient acuity higher Health Care Plans Case manager work closely with physicians and insurance companies
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Evidence Based Practice
Goal is to achieve cost-effective, high quality patient care based on scientific inquiry Nurses need to understand research process involved Nursing care should not be based on opinions, past practices, but on the results of scientific research Clinical journals Practice guidelines Nursing research
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Process of Knowledge Development
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Globalization of Health
Healthcare has become a global issue People are mobile, diseases can travel Nurses need to have an understanding of the issues pertaining to global health
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Practice Settings for Nurses
Hospital Community Based Practice Settings
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Hospital Based Nursing
Acute care is where largest group of nurses practice Different Staffing Patterns Skill Mix Changing Increase in skilled nursing facilities due to aging population and increase in chronic disease
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Community Based Nursing
Focus on health promotion, maintenance, education Community Health Centers, Clinics School Nursing Occupational Health Home Health Physicians Office Managed Care Organizations Forensics Nursing
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Nursing Roles Caregiver Clinical Decision Maker Client Advocate
Rehabilitator Comforter Communicator Collaborator Teacher
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Professional Roles & Responsibilities
Autonomy & Accountability Caregiver Client Advocate Educator Manager/Clinical Decision Maker Communicator Collaborator Career Development
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Autonomy & Accountability
Autonomy is the essential element of professional nursing Person is reasonably independent and self-governing in decision making & practice Increased autonomy=Increased responsibility Accountability- nurse is responsible professionally & legally for type & quality of care provided Regulated through Standards of Practice and Nurse Practice Act
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Clinical Decision Maker
Utilizes critical thinking skills and the nursing process Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation
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Professional Accountability
Responsibility that one assumes for their practice Obligation to report or account for their actions To the profession, public, and themselves
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Accountability Begins with preconditions
Responsibility Authority Ends in accountability Alliance for Nursing Accreditation (ANA)
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Client Advocate Nurse protects the clients human and legal rights
Providing information to assist in decision making Patient Bill of Rights
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Comforter Role Caring for client as a human being
Role is traditional to nursing Care is directed to whole person, not just a body part Demonstration of care and concern
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Communicator Role Role is central to all other roles
Involves communication with client, family, healthcare team members, resource people, and the community Without clear, concise communication it will be difficult to give effective care
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Teacher/Educator Role
Explains concepts and facts about health, demonstrates procedures, reinforces learning, determines understanding, and evaluates progress of learning Unplanned or informal education Planned or formal education
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Nursing Career Roles Clinician Nurse Educator Advanced Practice Nurse
Nurse Administrator Nurse Researcher Military Nurse Forensic Nursing
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Issues in Health Care Delivery
Rising health care costs Evidence based practice Nursing and biomedical research Excess number of nurses
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Advanced Nursing Roles
Nurse administrator/manager Nurse education Nurse practitioner Nurse anesthetist Nurse midwife Nurse researcher
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Professional Workforce in the 21st Century
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Future Trends in Nursing
Expansion of nursing opportunities Public perception of nursing Nursing’s impact on politics and health policy
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TERIMAKASIH
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