Guidelines towards Guidelines towards establishing Standardestablishing Standard of of Critical Care Nursing in Critical Care Nursing in

PalestinePalestine

JamilehJamileh Hamdan, BSN, Hamdan, BSN, High Diploma, High Diploma,

Makassed HospitalMakassed Hospital

What do Standards of What do Standards of care? care?

Standard of careStandard of care::

is a professionally agreed level is a professionally agreed level of performance appropriate to of performance appropriate to the population addressed which the population addressed which is achievable and desirable. is achievable and desirable.

What do Standards of What do Standards of care?care?

• Critical care nursing standards:Critical care nursing standards:

are statements that describe the level of are statements that describe the level of performance expected of registered nurses in performance expected of registered nurses in critical care practice critical care practice (Canadian Association of (Canadian Association of Critical Care Nurses, 2004).Critical Care Nurses, 2004).

• The Standards for Acute and Critical Care The Standards for Acute and Critical Care Nursing Practice:Nursing Practice:

are defined as authoritative statements that are defined as authoritative statements that describe a level of care or performance common describe a level of care or performance common to the profession of nursing by which the quality to the profession of nursing by which the quality of nursing practice can be judgedof nursing practice can be judged (The American (The American Association of Critical-Care Nurses, 2000).Association of Critical-Care Nurses, 2000).

The importance for having The importance for having Standards of PracticeStandards of Practice

Healthy work environment

Patient care outcomes Excellent nursing practice

The standards:The standards:

• Assure having Assure having the skills, resources, the skills, resources,

accountability and authority to make accountability and authority to make

decisionsdecisions excellent professional excellent professional

nursing practice nursing practice

• Guide in delivering Guide in delivering safe effective caresafe effective care, in , in a a

supportive and safe-working environmentsupportive and safe-working environment..

The standards:The standards:• Support Support professional development professional development

• Framework critical care Framework critical care

curriculum curriculum ++ assessment of clinical assessment of clinical

practice.. practice..

• Useful in the development of Useful in the development of

evaluation and orientation, continuing evaluation and orientation, continuing

education, and quality improvement education, and quality improvement

programsprograms

The Standard of Nursing The Standard of Nursing Practice document Practice document

Describe the practice of the nurse Describe the practice of the nurse

who cares for an acutely or critically who cares for an acutely or critically

ill patient. ill patient.

Define the philosophy, beliefs, and Define the philosophy, beliefs, and

values of individual hospitals.values of individual hospitals.

The Standard of Nursing The Standard of Nursing Practice documentPractice document

Comprehensive, realistic, and Comprehensive, realistic, and

easily understood. easily understood.

Clearly written. Clearly written.

The Standard of Nursing The Standard of Nursing Practice documentPractice document

Measurement criteria (how each Measurement criteria (how each standard is met) standard is met)

Revised and evaluated Revised and evaluated

frequentlyfrequently. .

How to develop Standards?How to develop Standards?Framed from the Framed from the general general

clinical nursing practice clinical nursing practice

standards. standards.

A A panelpanel of persons or of persons or

special special committeecommittee under the under the

supervisionsupervision of the Nursing of the Nursing

& Midwifery Association. & Midwifery Association.

How to develop Standards?How to develop Standards?

Drawn from Drawn from reportsreports from nurses from nurses and experts in healthcare and experts in healthcare organizations across the country.organizations across the country.

Expert reviewersExpert reviewers validate the validate the standards, its elements and standards, its elements and explanatory text.explanatory text.

Implementation of the Implementation of the standardsstandards

Adoption by the Nursing & Adoption by the Nursing & Midwifery AssociationMidwifery Association

Meaningful recognition by the Meaningful recognition by the Health System and Ministry of Health System and Ministry of Health. Health.

Implementation of the Implementation of the standardsstandards

A committed A committed partnershippartnership between nurses and their work between nurses and their work environment and environment and

their organizations. their organizations.

Effective decision makingEffective decision making

and strong leadership. and strong leadership.

Elements of the standards:Elements of the standards:

•Professional developmentProfessional development

•Behavioral skillsBehavioral skills

Elements of the standards:Elements of the standards:

American Association of Critical-American Association of Critical-Care Nurses (AACN) standards Care Nurses (AACN) standards

• Conceptualized from The Nursing Conceptualized from The Nursing ProcessProcess

• Include: Include:

- standards of care, - standards of care,

- standards of professional - standards of professional performance.performance.

Elements of the standards:Elements of the standards:

South African critical care South African critical care nursingnursing

Four main categories: Four main categories: • professional competence,professional competence,• cognitive competence, cognitive competence, • interpersonal skills,interpersonal skills,• critical care patterns of critical care patterns of

interaction.interaction.

Elements of the standards: Elements of the standards:

Standards of the Canadian Standards of the Canadian Association of Critical Care Association of Critical Care

Nurses (CACCN)Nurses (CACCN) Five major categories:Five major categories:

• Professional Behavior/ Ethics,Professional Behavior/ Ethics,• Continuing Competence and Continuing Competence and

Research,Research,• Client and Nurse Safety/ Risk Client and Nurse Safety/ Risk

Prevention,Prevention,• Therapeutic and Professional Therapeutic and Professional

Relationships/ Caring,Relationships/ Caring,• Clinical Skills, Knowledge, and Clinical Skills, Knowledge, and

Critical Thinking.Critical Thinking.

Standards of Care for Acute and Standards of Care for Acute and Critical Care Nursing (AACN)Critical Care Nursing (AACN)

Standard of Care:Standard of Care:

I.I. AssessmentAssessmentII.II. DiagnosisDiagnosisIII.III. Outcome IdentificationOutcome IdentificationIV.IV. Planning Planning V.V. ImplementationImplementationVI.VI. Evaluation Evaluation

Standards of Professional Practice Standards of Professional Practice for Acute and Critical Care for Acute and Critical Care

NursingNursing

Standard of Professional Practice:Standard of Professional Practice:

I.I. Quality of CareQuality of CareII.II. Individual Practice EvaluationIndividual Practice EvaluationIII.III. EducationEducationIV.IV. CollegialityCollegialityV.V. Ethics Ethics VI.VI. CollaborationCollaborationVII.VII. Research Research VIII.VIII.Resource Utilization Resource Utilization

Standards of Care for Acute and Critical Standards of Care for Acute and Critical Care NursingCare Nursing

Standard of Care I: AssessmentStandard of Care I: Assessment

The nurse caring for acute and critically ill The nurse caring for acute and critically ill patients collects relevant patient health data..patients collects relevant patient health data..

Measurement CriteriaMeasurement Criteria – Data collection involves the patient, family, Data collection involves the patient, family,

and other healthcare providers as appropriate and other healthcare providers as appropriate to develop a holistic picture of the patient’s to develop a holistic picture of the patient’s needs. needs.

– The priority of data collection activities is The priority of data collection activities is driven by the patient’s immediate condition driven by the patient’s immediate condition and/or anticipated needs. and/or anticipated needs.

– Data are collected using appropriate Data are collected using appropriate assessment techniques and instruments. assessment techniques and instruments.

– Data are documented in a retrievable form. Data are documented in a retrievable form. – Data collection process is systematic and Data collection process is systematic and

ongoing.ongoing.

THANK YOUTHANK YOU