Professional practice

Professional practice的思维导图，How nurses practice, collaborate, communicate, and develop professionally to provide the highest-quality care for those served by the organization.

Professional practice

• Define
  • How nurses practice, collaborate, communicate, and develop professionally to provide the highest-quality care for those served by the organization.
• Governed by
  • The Australian Health Practitioner Regulation Agency (Ahpra) regulates
  • The Nursing and Midwifery Board of Australia (NMBA)
• Professional practice framework element 1
  • Code of professional conduct
    • 1.Nurses practise in a safe and competent manner
    • 2. Nurses practise in accordance with the standards of the profession and broader health system.
    • 3.Nurses practise and conduct themselves in accordance with laws relevant to the profession and practice of nursing.
    • 4. Nurses respect the dignity, culture, ethnicity, values and beliefs of people receiving care and treatment, and of their colleagues.
    • 5. Nurses treat personal information obtained in a professional capacity as private and confidential
    • 6. Nurses provide impartial, honest and accurate information in relation to nursing care and health care products.
    • 7.Nurses support the health, wellbeing and informed decision-making of people requiring or receiving care.
    • 8.Nurses promote and preserve the trust and privilege inherent in the relationship between nurses and people receiving care.
    • 9.Nurses maintain and build on the community's trust and confidence in the nursing profession.
    • 10. Nurses practise nursing reflectively and ethically.
• Professional practice framework element 2
  • Code of conduct for nurses
    • Domain: Practise legally
      • Principle 1: Legal compliance
        • Nurses respect and adhere to professional obligations under the National Law, and abide by relevant laws .
          • 1.1 Obligations
          • 1.2 Lawful behaviour
          • 1.3 Mandatory reporting
    • Domain: Practise safely, effectively and collaboratively
      • Principle 2: Person-centred practice
        • Nurses provide safe, person-centred, evidence-based practice for the health and wellbeing of people and, in partnership with the person, promote shared decision-making and care delivery between the person, nominated partners, family, friends and health professionals.
          • 2.1 Nursing practice
          • 2.2Decision-making
          • 2.3 Informed consent
          • 2.4 Adverse events and open disclosure
      • Principle 3: Cultural practice and respectful relationships
        • Nurses engage with people as individuals in a culturally safe and respectful way, foster open, honest and compassionate professional relationships, and adhere to their obligations about privacy and confidentiality.
          • 3.1 Aboriginal and/or Torres Strait Islander peoples' health
          • 3.2 Culturally safe and respectful practice
          • 3.3Effective communication
          • 3.4 Bullying and harassment
          • 3.5 Confidentiality and privacy
          • 3.6 End-of-life care
    • Domain: Act with professional integrity
      • Principle 4: Professional behaviour
        • Nurses embody integrity, honesty, respect and compassion.
          • 4.1 Professional boundaries
          • 4.2 Advertising and professional representation
          • 4.3 Legal, insurance and other assessments
          • 4.4 Conflicts of interest
          • 4.5 Financial arrangements and gifts
      • Principle 5: Teaching, supervising and assessing
        • Nurses commit to teaching, supervising and assessing students and other nurses in order to develop the nursing workforce across all contexts of practice.
          • 5.1Teaching and supervising
          • 5.2 Assessing colleagues and student
      • Principle 6: Research in health
        • Nurses recognise the vital role of research to inform quality healthcare and policy development, conduct research ethically and support the decision-making of people who participate in research.
          • 6.1 Rights and responsibilities
    • Domain: Promote health and wellbeing
      • Principle 7: Health and wellbeing
        • Nurses promote health and wellbeing for people and their families, colleagues, the broader community and themselves and in a way that addresses health inequality.
          • 7.1 Your and your colleagues' health
          • 7.2 Health advocacy
• Professional practice framework element 3
  • Registered nurse (RN)standards for practice
    • 1.Thinks critically and analyses nursing practice
      • RNs use a variety of thinking strategies and the best available evidence in making decisions and providing safe, quality nursing practice within person-centred and evidence-based frameworks.
    • 2.Engages in therapeutic and professional relationships.
      • RN practice is based on purposefully engaging in effective therapeutic and professional relationships. This includes collegial generosity in the context of mutual trust and respect in professional relationships
    • 3.Maintains the capability for practice
      • RNs, as regulated health professionals, are responsible and accountable for ensuring they are safe, and have the capability for practice. This includes ongoing self- management and responding when there is concern about other health professionals’ capability for practice. RNs are responsible for their professional development and contribute to the development of others. They are also responsible for providing information and education to enable people to make decisions and take action in relation to their health.
    • 4. Comprehensively conducts assessments
      • RNs accurately conduct comprehensive and systematic assessments. They analyse information and data and communicate outcomes as the basis for practice.
    • 5.Develops a plan for nursing practice
      • RNs are responsible for the planning and communication of nursing practice. Agreed plans are developed in partnership. They are based on the RNs appraisal of comprehensive, relevant information, and evidence that is documented and communicated.
    • 6. Provides safe, appropriate and responsive quality nursing practice
      • RNs provide and may delegate, quality and ethical goal- directed actions. These are based on comprehensive and systematic assessment, and the best available evidence to achieve planned and agreed outcomes.
    • 7.Evaluates outcomes to inform nursing practice
      • RNs take responsibility for the evaluation of practice based on agreed priorities, goals, plans and outcomes and revises practice accordingly.
• Professional practice framework element 4
  • Framework for assessing standards for practice for registered nurses, enrolled nurses and midwives
    • Principles for assessment
      • 1: Principle of accountability
      • 2: Principle of performance-based assessment
      • 3: Principle of evidence-based assessment
      • 4. Principle of validity and reliability in assessment
      • 5: Principle of participation and collaboration
    • Critical issues in assessing performance
      • Accountability
      • Performance assessment
      • Context-based assessment
      • Evidence-based assessment
    • Key elements in the assessment model
      • Self-assessment by the nurse and/or midwife candidate provides vital data for the assessor. Self-assessment is a skill that is central to the nurse and/or midwife’s continuing professional development.
      • Observation by the assessor should be of sufficient duration and performed in a reasonable variety of contexts to achieve valid and reliable assessment.
      • Interviewing skills of the assessor should be highly developed. The assessor needs to establish relationships with other individuals in the practice setting in order to source adequate and essential information. This information is essential in validating assessor inferences and judgements about competence.
      • Documentation recording assessors' observations and other evidence is necessary for analysis and interpretation and ultimately. This ensures a reliable and valid assessment judgement.
      • Enhancing the validity and reliability of assessment – Using the professional judgement of a person with experience in nursing and/or midwifery, and who possesses a comprehensive knowledge base to assess performance, enhances the validity and reliability of the assessment.
      • Validity in the assessment process is the extent to which assessment meets the intended outcomes. The assessment process therefore measures the performance of the nurse and/or midwife candidate against the NMBA practice standards.
      • Reliability in the assessment process refers to the consistency or accuracy of the assessment process outcomes. Assessors' understanding of the expected standards and their knowledge and skill are the crucial elements that enhance the reliability of the assessment process.
      • Participation and collaboration – Establishing a participative and collaborative relationship based on confidentiality, accountability and impartiality between the nurse and/or midwife candidate and the assessor builds confidence in the assessment methods.
• Application
  • Patient
    • Elliot, a 14 years old boy
    • Hited by a car
    • Suspect Elliot has a ruptured spleen
    • Need a surgery
    • Needs a bllod transfusion before surgery
    • conscious and responsive to questions when arrived hospital
    • does not agree with his parent's religious beliefs
    • Elliot's fears of dying
  • Family
    • Jehovah's witnesses
    • agree for surgery but refuse blood transfusion due to religious beliefs
  • Nurses
    • Ethical Considerations
      • Patient Autonomy
      • Beneficence
      • Non-maleficence
    • Legal Considerations
      • consent
      • capacity
      • confidentiality
    • Professionalism
      • communicationn
        • Reassurance and Support
        • Explaining the Situation to the Healthcare Team
      • advocacy
        • Representing Patient's Interests
        • Balancing Patient's Autonomy and Best Interests
      • collaboration
    • Patient-Centered care
      • Assessment
        • Signs of internal bleeding
        • Emotional state (fear of dying)
      • Communication
        • patient's concens- fear and request for blood transfusion
        • patient's disagreement with parents' views and religious beliefs
      • Informed consent
        • Patient's parents give consent for surgery
    • Ethical Dilemma
      • Autonomy
        • patient's right to decide (blood transfusion)
      • Beneficence
        • best interests of the patient (blood transfusion)
      • Non-maleficence
        • No harm
      • Justice
        • as fairness
    • legal farmwork
      • consent
        • Parental Consent for Surgery
        • Capacity Assessment
      • confidentiality
        • Duty to Maintain Privacy
    • Parental Consent vs. Patient Autonomy
      • Conflict Resolution
        • Discussing Options with Parents
        • Ensuring Patient's Wishes Are Respected
      • Ethical Decision-Making
        • Weighing Autonomy, Beneficence, justice and Non-maleficence
    • Decision making process
      • Informed Decision
        • Implications of Blood Transfusion Refusal
        • Patient's Understanding of Blood Transfusion