NCS1101 Lecture Notes - Lecture 9: Professional Development, Nursing Care Plan, Decision-Making
5 Jun 2018
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WEEK 9 – SCOPE OF PRACTICE
What is the Decision making framework of nursing practice
• Identify client need or benefit – has their been an
comprehensive health assessment by nurse to establish clients
needs?
• Reflect on scope of practice and standards – is this activity
within the current scope, have legislative requirements and
qualification needs been met, is authorization from a regulatory
body needed to perform the action?
• Context of practice – is the activity supported by the
organisaition, if authorization is needed can it be obtained
before performing activity, is the skill mix in the organization
adequate for the level of supervision/support needed to
perform the activity, have the potential risks been identified
and strategies to avoid them been implemented?
• Appropriate competent person – have roles and responsibilities
of nurse been considered, does the person have the
knowledge/skills/authority/ability to do so without
supervision/support, is the required level of
education/supervision/support available?
• Either proceed or don’t or implement further action – if yes to
all you can perform activity, delegate to competent person or
document decision and actions
Importance of the framework in making clinical decisions
• Fosters consistency across jurisdictions by identifying agreed
foundation principles for decision making tools, demonstrates
the application of principles and concepts, regulates and
contributes to public safety, and facilitates flexibility in practice
• Scope of practice is determined – may require individuals to
update/increase their knowledge or competence to remain in
scope, decisions can be guided by the use of decision making
skills
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Components of the framework
• National principles – facilitate planning, negotiation and
implementation of changes in practice, enhances safety
and quality for consumers, work within requirements of
law, standards, evidence based practice, orgnisational
support and context of professional practice
1. Primary motivation is to meet clients health needs
2. Nurses accountable for making professional judgement
when activity is beyond their capacity/scope – initiate
consultation or referral
3. Nurses are accountable for making decisions about who is
the most appropriate person to perform an activity in the
nursing care plan
4. Nursing practice decisions are best made in collaborative
context of planning, risk management and evaluation
Template tools – policies and procedures, promote consistent
approach
How you recognize nurses and midwives are using the decision
making framework in their practice
• Staff aren’t stressed as they understand their scope
• Seek educational opportunities to inc scope – courses
giving qualification, reading professional publications,
self directed learning packages, seminars and
conferences, reflection
• Inc in staff competence
• Reduce errors
• If asked to function outside of scope they can use the
framework to demonstrate where this action is flawed
What happens if nurses and midwives are not using the decision
making framework in their practice
• Staff stress and anxiety
• Errors
• NMBA sanctions, fines, removal of registration
find more resources at oneclass.com
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