The document discusses the importance of standards in nursing practice and healthcare. It outlines a methodology for developing standards, including identifying key functions or systems, forming a working group, defining quality characteristics, developing or adopting standards, creating indicators, and assessing the standards. Standards help outline expectations, guide professional practice, and provide a framework for competencies. They can focus on structure, processes, or outcomes. The document also reviews examples of nursing standards and ethical cases involving patients' rights and responsibilities.

1. QUALITY HEALTH CARE
NURSING
1

2. “QUALITY HEALTH
CARE NURSING”
2

3. Standards
Statements of
expectations
3

4. Inputs, processes, behaviors and outcomes of health
system
4

5. Standards
our quest for
quality care
5

6. IMPORTANT
To address issues.
6

7. IMPORTANT
Guide the nursing practice
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8. IMPORTANT
Validate the quality of services
rendered by health organization.
8

9. STANDARD OPERATING PROCEDURE
PROTOCOLS
(SOP)
GUIDELINES SPECIFICATION
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10. PROTOCOL
Detailed plan
Sequence of actions
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11. Expected Manner
Method
Process
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12. Specifications
12

13. Ex. Guidelines for vascular injury
in frostbite cases
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14. Ensures staff are up-
to-date
&
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15. What are the importance of
standards?
15

16. Importance
of standards
Outlines
expectations
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17. Importance
of standards
Guides and directs
professional nursing
practice
17

18. Importance
of standards
Framework for developing
competencies
18

19. Importance
of standards
19

20. Methodology for Setting
Standards
20

21. 1. Identify a function or system
Ex. Primary:
• Acute respiratory infection mgt
• Maternal and child care services
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22. Hospital-based:
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23. 2 Steps Screening Approach
1. Identify
High-volume
High-risk
Problem prone
2. Select additional criteria
Importance & feasibility
23

24. 2. Identify a team to address standards
1. Select individuals/groups
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25. 2. Identify a team to address standards
2. Organize the working
group
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26. 2. Identify a team to address standards
3. Develop approval
process for the
standards
26

27. 3. Identify inputs, process, or outcomes of the function or system
and define the quality characteristics
a. Define area of topic
b. Identify methods &
desired outcomes
c. State scope of care and identify important aspects of care
d. State the level of health care system for which the stds are being
developed
27

28. 4. Develop or Adopt Standards
Can be:
1. Case management plans
3. Clinical Care Protocols
2. Critical paths
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29.  Outline the anticipated/ standard length of stay
 Expected clinical outcomes, goals and interventions
involved in the care of a given case of client.
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30. Critical Path
Sequencing and timing of
interventions
Designed to minimize delays in
services and resources used
maximize the quality of care.
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31. Clinical Care Protocol
guidelines that are explicit, criteria-
based plans
31

32. 5. Develop indicators
Measurable terms
IMPORTANT
Monitoring of compliance to the standard
32

33. 6. Assess the appropriateness
of standards
Assess for VALIDITY
Assess for RELIABILITY
Assess for CLARITY
Assess for APPLICABILITY
33

34. 7. Frames of Reference
for Developing Standards
Structure
standards
1. Physical characteristic
2. Org’l structure
3. resources
34

35. 7. Frames of Reference
for Developing Standards
Process
standards
Behavior if
nurses
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36. 7. Frames of Reference
for Developing Standards
Outcome standards
Changes that should occur as
a result of the intervention
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37. Types of Nursing Standards
37

38. Standards of Practice Standards of Care
Focuses on provider of care - nurse Focuses on recipient of care –
patient/client
What he does What he expect/ receive
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39. Patients’ Bill of Rights
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40. Case 1
An 80-year old woman is in a persistent vegetative state
as a result of cardiovascular accident.
She has always talked about signing a living will
requesting that heroic measures not be taken, but her
family wants “everything that can be done to be
done.”
Whose wishes should prevail?
What ethical principles would come into play in this
decision process?
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41. Case 2
One night, Maria called her friend, Jade, at home to tell
her that she had just tested positive for HIV. Jade is a
nurse at a local community health center and works
with Liza, Maria’s sister. The next day, Jade sees Liza
and assuming she knows about Maria’s HIV test.” She
does not have Maria’s written consent for this
disclosure.
Did Jade violate the confidentiality law?
Why do you say so?
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42. Patient’s Bill of Rights
1. RIGHT TO COMPETENT CARE
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43. Patient’s Bill of Rights
2. FREEDOM FROM HARM
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44. Patient’s Bill of Rights
3. RIGHT TO INFORMED
CONSENT
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45. Patient’s Bill of Rights
4. RIGHT TO WITHDRAW FROM
PARTICIPATION
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46. Patient’s Bill of Rights
5. RIGHT TO CONFIDENTIALITY OF
INFORMATION
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47. Patient’s Bill of Rights
6. RIGHT TO BE TREATED WITH DIGNITY AND
RESPECT
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48. PATIENTS’ RESPONSIBILITIES
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49. 1. Providing accurate
information
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50. 2. Complying with
instructions
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51. 3. Informing the physician of
refusal of treatment
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52. 4. Paying hospital
charges
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53. 5. Following hospital
rules and regulations
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54. 6. Showing respect and
consideration
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