ethics and patient care standards
TRANSCRIPT
ETHICS AND PATIENT
CARE STANDARDS
MRS. PARVATHY GOPI
SNAP SHORT • Ethics - definition , needs, ICN code
• Application of ethics in improving patient care
• Standards of nursing
• ANA nursing standard model
• Patient satisfaction model for nurse managers
• Tips to improve patient satisfaction
DEFINITION
• Ethics refers to the moral code for nursing and is
based on obligation to service and respect for
human life .
CODE OF ETHICS
• A code of ethics is a set of ethical principles that
are accepted by all members of the profession.
POTTER AND PERRY
NEED FOR NURSING ETHICS
1. Patients and service users, and those who care for
them, can use it to provide feedback to nurses
and midwives about the care they receive.
2. Nurses and midwives can use it to promote safe
and effective practice in their place of work.
3. Employer organizations can support their staff in
upholding the standards in their professional
Code as part of providing the quality and safety
expected by service users and regulators.
4.Educators can use the Code to help students
understand what it means to be a registered
professional nurse and how keeping to the Code
helps to achieve that.
INTERNATIONAL COUNCIL OF
NURSES
• Operated by nurses and leading nursing
internationally, ICN works to ensure quality
nursing care for all and sound health policies
globally.
• Introduced in the year of 1953 code has been
revised and reaffirmed at various levels and the
latest been at 2012.
ETHICS
NURSES AND PEOPLE
NURSES AND PRACTICE
NURSES AND PROFESSION
NURSES AND CO WORKERS
WORKING ELEMENT OF ICN CODE
OF ETHICS . • Study the standards under each
element of code.
• Analyze the application of code in
each domain .
• Discuss the code with co workers.
• Work in groups to clarify ethical
decisions .
• Collaborate with national
associations.
–NURSES AND PEOPLE
MANAGERS
• Provide care that respects human rights and is sensitive to values , customs and beliefs of the people
• Provide CNE on ethical issues
• Informed consent and right to choose or deny
• Using recording and MIS to ensure confidentiality
• Environmental safety in work place
EDUCATORS
• Include reference of human rights, equity and justice in curriculum
• Knowledge about informed consent
• Concept of professional values
• Sensitize the importance of social action in current concerns
ASSOCIATION
• Develop guidelines and statements that supports human rights and ethical standards
• Involvement of nurses in ethical committee
• Organize CNE related to ethical issues and informed consent
• Incorporate confidentiality into national code of ethics for nurses.
• Advocate for safe and healthy environment .
NURSES AND
PRACTICE
MANAGERS
• Establish standards of care and a work setting that promotes the quality of care
• Professional appraisal , CNE and renewal of practice
• Monitor and promote personal health of nursing staff
EDUCATORS
• Provide learning experiences that foster life long
• Promote the importance of personal health and illustrates its relation to other values
ASSOCIATION
• Provide access to CNE , journals conferences , distance education etc
• Lobby for healthy work places and services
NURSES AND
PROFESSION
MANAGERS
• Set standards of practice .
• Workplace support for the utilization of research
• Promote participation in national nurses associations
EDUCATORS
• Sensitize the learners the importance of nursing associations
ASSOCIATIONS
• Collaboration to set the standards with other organisations.
NURSES AND CO
WORKERS
MANAGERS
• Create strategies for conflict management.
• Develop workplaces which support ethical system .
• Develop mechanisms to safe guard individual , family and community when care is endangered by health care personnel.
EDUCATORS
• Understanding the role of other health care workers
• Communicate nursing ethics to other professions
ASSOCIATIONS
• Stimulate cooperation with other related disciplines Develop awareness of ethical issues of other professions
APPLICATION OF ETHICS IN
IMPROVING PATIENT CARE
4 P’s
PRIORITISE PEOPLE
PRACTISE EFFECTIVELY
PRESERVE SAFETY
PROMOTE PROFESSIONALISM AND TRUST
PRIORTISE PEOPLE –
1.TREAT PEOPLE AS INDIVIDUALS AND
UPHOLD THEIR DIGNITY.
• Treat people with kindness , respect and compassion .
• Make sure to deliver fundamentals of care effectively .
• Avoid making assumptions and recognize diversity and individual choice .
• Respect and uphold patients rights.
• Deliver care / treatment for which you are responsible and has to be delivered with out any delay.
2. LISTEN TO PEOPLE AND RESPOND TO
THEIR PREFERENCE AND CONCERNS
• Recognize and respect the contribution the people can make to their own health .
• Encourage and empower people to share decisions about their treatment .
• Respect , support and document a persons right to accept or refuse care and treatment. .
• Recognize when people are anxious or distress and respond compassionately and politely .
3. ASSESS THE PATIENTS PHYSICAL ,SOCIAL
AND PSYCOLOGICAL NEEDS .
• Recognise and respond compassionately to
the needs of those who are in the end stage of
their life.
• Act as an advocate for the vulnerable
,challenging poor practice and
discriminatory attitude and behavior relating
to their care.
4. ACT IN THE BEST INTEREST OF PEOPLE
ALL TIMES.
• Make sure of receiving properly taken informed consent and document it before carrying any information .
• Keep to all laws related to mental capacity of the country in which you are practicing.
• Inform colleagues , managers and the patient receiving care that if you have an objection to a particular procedure and arrange for a suitably qualified colleague to take over the responsibility for that persons care.
5. RESPECT PEOPLES RIGHT TO
PRIVACY AND CONFIDENTIALITY
• Respects persons right to privacy in all
aspects of care.
• Make sure that persons are aware of how
and why information is used and shared by
those who are practicing care.
• Respect that the patients right to privacy
will continue after the death of the patient .
• Share the information with other agencies
and professionals when the interest of
patient safety and public protection override
the need of confidentiality.
PRACTICE EFFECTIVELY
6. ALWAYS PRACTICE IN LINE WITH
THE BEST AVAILABLE EVIDENCE
• Make sure that information given is evidence
based .
• Maintain the knowledge and skills you need for
safe and effective practice .
7. COMMUNICATE CLEARLY
• Use terms that people in your care , colleagues and public understands.
• Take reasonable steps to understand people’s language and communication needs , providing where ever possible assistance to those who need to communicate.
• Use a range of verbal or non verbal communication methods and be aware of cultural sensitivities.
8. WORK COOPERATIVELY
• Respect the skills , contributions and expertise of your colleagues , referring matters to them when appropriate.
• Work in cooperation with your colleagues....
• Keep your colleagues informed when you are sharing an information with other health care professionals and staffs.
• Evaluate the quality of care with your colleagues.
Contd…..
• Share information to reduce the risk.
• Be supportive to colleagues if they are suffering
with health or performance problems.
9. SHARE YOUR SKILLS ,
KNOWLEDGE AND EXPERINENCE
FOR THE BENEFIT OF PEOPLE
RECEIVING CARE AND YOUR
COLLEGUES.
10. KEEP CLEAR AND ACCURATE
RECORDS RELEVANT TO YOUR
PRACTICE.
11.BE ACCOUNATBLE FOR YOUR
DECISIONS TO DELEGATE TASKS AND
DUTIES TO OTHER PEOPLE• Only delegate tasks and duties which are
within other persons scope of competence , making sure that they will fully understand your instructions.
• Make sure that everyone you delegate task is adequately supervised and supported
• Confirm that the outcome of task delegated meets the required standards .
PRESERVE SAFETY
12. RECOGNISE AND WORK WITHIN
THE LIMITS OF YOUR COMPETENCE.
13. BE OPEN AND CANDID WITH ALL
SERVICE USERS ABOUT ALL ASPECTS OF
CARE AND TREATMENT, INCLUDING WHEN
ALL MISTAKES OR HARM HAVE TAKEN
PLACE.
14. ALWAYS OFFER HELP IN CASE OF AN
EMERGENCY IN YOUR WORK PLACE OR
ANYWHERE ELSE.
15.ACT WITHOUT DELAY IF YOU
BELIEVE THAT THERE IS A RISK
TO PATIENTS SAFETY OR
PUBLIC PROTECTION.
PROMOTE
PROFESSIONALISM AND
TRUST.
16.UPHOLD THE REPUTATION OF YOUR
PROFESSION AT ALL TIMES
• Keep the standards set by the code in all times.
• Act with honesty and integrity all times
• Treat people in way that will not take an
advantage on their vulnerability.
• Stay objective and have a clear professional
boundary with the patient and their family
members.
• Do not impose your personal or religious belief
on your patient.
Contd….• Act as a role model to nursing students and
newly qualified nurses to aspire to
• Maintain the level of health you need to carry out your professional role .
• Use all forms of spoken , written and digital communication including social media platforms responsibly respecting the privacy of the patients.
17.UPHOLD THE POSITION OF RN
AND RM • Refuse all gifts , hospitality or favors from
the patient .
• Never ask for or accept loans from anyone in your care or anyone close to them.
• Act with honesty and integrity in any financial dealing you have with everyone you have professional relationship with
• Cooperate with media only when it is appropriate .
18. COOPERATE WITH
INVESTIGATIONS AND AUDITS
19. RESPOND TO ANY COMPLAINTE
MADE AGAINST YOU PROFESSIONALLY
• Never allow someone's complaint to affect the
care that is provided to them.
• Use all complaints as a form of feedback and an
opportunity for reflection and learning to
improve practice.
20. PROVIDE LEADERSHIP TO MAKE SURE
PEOPLES WELLBEING IS PROTECTED.
• Identify the priorities manages time, staff and
resources effectively.
• Support any staffs that you may be responsible to
follow the code .
QUICK
BRAINSTORMING
SECTION
Q no 1 :- A nurse is not trained to do the procedure
of IV cannulation , still she tries to do the
procedure . You are the colleague of this nurse.
What will be your action?
• A – You should tell that nurse to not to do this
again
• B – You should report the incident to someone in
authority
• C – You must threaten the nurse, that you will
report this to the authority
• D – You should ignore her act
Q no. 2 A mentally capable client in a critical
condition is supposed to receive blood transfusion.
But client strongly refuses the blood product to be
transfused. What would be the best response of the
nurse?
• Accept the client’s decision and give information
on the consequences of his actions.
• Let the family decide
• Administer the blood product against the patients
decision
• The doctor will decide
Q No 3. A police officer approached the nurses’
station asking for information on a specific client.
The nurse knows that the she can give the
necessary information if:
• The police shows his identification
• The police officer has the right to such
information
• There is a clear risk of safety and potential harm
to the public
• The hospital manager authorized to give the
information
STANDARDS OF
PROFESSIONAL NURSING
PRACTICE
NURSING STANDARDS• Nursing standards reflect a desired and achievable
level of performance against which actual
performance can be compared. Their main
purpose is to promote, guide and direct
professional nursing practice.
(Registered Nurses Association of BC (2003) & the
College of Nurses of Ontario (2002)
WHY STANDARDS ARE IMPORTANT • Outlines what the profession expects of its
members.
• Promotes guides and directs professional nursing practice – important for self-assessment and evaluation of practice by employers, clients and other stakeholders.
• Provides nurses with a framework for developing competencies
• Aids in developing a better understanding & respect for the various & complimentary roles that nurses have.
STANDARDS OF NURSING
STANDARDS OF PRACTICE
STANDARDS OF PROFESSIONAL PERFORMANCE
HEALTHY WORK ENVIRONMENT FOR
NURSING PRACTICE
SKILLED COMMUNICATION
TRUE COLLABORATION
EFFECTIVE DECISSION MAKING
EFFECTIVE STAFFING
MEANINGFUL RECOGNISATION
AUTHENTIC LEADERSHIP
MODEL OF PROFESSIONAL NURSING
PRACTICE REGULATION- ANA 2006
ANA STANDARDS OF PRACTICE
ANA STANDARDS OF PROFESSION
ETHICS
EDUCATION
EBP
QUALITY OF PRACTICE
COMMUNICATION
LEADERSHIP
COLLABORATION
PRACTICE EVALUATION
RESOURCE ULTILISATION
ENVIRONMENTAL HEALTH
PATIENT SATISFACTION MODEL FOR
NURSE MANAGERS
Patient flow
Customer service and patient satisfaction
Hiring pratices Safety
Financial goals
Medical staff performance
Work environment
Plans to boost performance
1. PATIENT FLOW • Was the patient spoken with respect when calling in for
an appointment?
• Was the patient greeted by the receptionist with courtesy and respect?
• How long did the patient wait to see the doctor?
• Did the nurse and doctor explain the details of the services provided to the patient?
• Did the nurse and doctor answer all the patient's questions?
CONTD…• Did the patient receive excellent customer service?
• Was the exam room clean, comfortable and prepared?
• Was the waiting area safe, clean and spacious?
2. CUSTOMER SERVICE AND PATIENT
SATISFACTION.
• Develop and distribute Patient Satisfaction Surveys.
• Sit in the waiting area and observe what goes on
from that point of view.
• Put yourself through the entire process.
• Talk to your staff and find out what problems they
may be aware of.
3. HIRING PRACTICES
• CRIMINAL BACKGROUND CHECK
• REFERENCE CHECK
• HEALTH CHECK UP
• VERIFICATION OF CREDENTIALS.
4.. SAFETY
• OCCUPATION AND ENVIRONMENT
SAFETY
• PATIENT SAFETY
5. FINANCIAL GOALS
• RISING OPERATING COSTS
• MAXIMISING INSURANCE
REIMBURSEMENTS
6. MEDICAL STAFF
PERFORMANCE
• COMPLIANCE
• COMMUNICATION
• MOTIVATION
• DEVELOPMENT
7.WORK ENVIRONMENT
8. PLANS TO BOOST
PERFORMANCES
TIPS TO IMPROVE PATIENT SATISFACTION
– NURSES PERSPECTIVE
Scripting
Supplies
Uniform
Hourly Rounding
Sitting Down
Patient Education
Bed Side Report
Nurse Led Initiatives
Nurse Empowerment
Demonstrate Caring
THANK YOU !!!!