Professional Practice Models
NUR532 Professional practice
Module 1 Introduction
By the end of this module you will be able to critique and review the application of professional practice models in different practice and professional contexts in relation to their contribution to effective quality care. The module will also develop your understanding of the scope and
credentialing of nursing practice through the exploration of nurses’ independent and collaborative practice.
NUR532 Professional practice Assignment-Australia.
Learning Outcomes:
- Determine how a professional practice model provides the foundations for quality nursing practice
- Critically analyze the development process for a professional practice model
- Discuss the roles and responsibility of the RN
- Discuss what a multidisciplinary team looks like in nursing
- Define the peak regulatory bodies that govern nursing practice
- Articulate and define the Australian Registered Nurse Standards for Practice and Codes of Conduct for the Registered Nurse
- Discuss the legal and ethical responsibilities of the nurse in diverse healthcare settings including mental health, aged care, remote health and medication Management
Roles and responsibility:
Modern Nursing is thought to have been founded by Florence Nightingale in the 1800s. One of her many roles was being responsible for the nursing care of wounded soldiers injured in the Crimean war. Florence went on to author books and open Nursing schools and till her death was advocated for the development of nursing.
Click here to see how some of Florence Nightingale’s principles are still relevant today.
The role of the nurse has developed since Florence Nightingale’s time and currently, The International Council of Nurses defines nursing as;
“Autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles”
This definition of nursing highlights the key roles that nurses are expected to assume in a health care context, in a variety of settings across the lifespan and across the health/illness continuum. Within this definition it is possible to identify major roles and fundamental functions that are generic to professional nursing practice regardless of the context in which nursing care takes place.
NUR532 Professional practice Assignment-Australia.
Nurses have many different roles and responsibilities, some of which include
The nurse as the care giver
The nurse as the educator
The nurse as the advocate
The nurse as leaders/managers
The nurse as researcher
1.Read chapter 7 of The Road to Nursing by
2.Read the journal article below and reflect on how the role of “caring” has changed with the introduction of things such as higher workloads, technology and machinery. Have these things helped or hindered the art of “caring”.
3.Suggested video: Click here (or view it below) to watch the TED x talk “In the age of machines, bedside manner matters more than ever”
Multidisciplinary teams
An important part of professionalism is working in partnerships. You might think this is limited to your nursing colleagues, but increasingly in health care and as a health professional, you are expected to develop the skills of interacting as part of a multidisciplinary team. As health care professionals, nurses provide 24-hour care; however, all members contribute to health care. Partnerships and teamwork are expectations of professionalism and therefore of health care professionals.
Good teamwork requires the same ground rules that apply to group work. These include:
- setting agreed goals and standards, agreeing on roles and responsibilities
- encouraging positive interpersonal behaviour, e.g., being friendly, being responsive, being receptive to input from others
- interpreting or clarifying ideas or suggestions, being willing to look at alternatives.
- being involved in problem solving through creative and/or helpful suggestions
- being willing to compromise and explore differences where these arise
- being willing to disagree in a constructive manner; seeking justification
- reflecting on progress, clarifying objectives.
Members of a multidisciplinary teams can include a range of people from the same or different organizations member can include but are not limited to general practitioners, RN and enrolled nurses, community health nurses, allied health professionals such as physiotherapists, occupational therapists, dietitians, psychologists, social workers, podiatrists and Aboriginal health practitioners, health educators – such as diabetes educators – providing promotion and prevention clinics and other activities.
1.Read Chapter 12 Integrated care and multidisciplinary teamwork by
2.Reflect on the chapter above and think about who benefits from multidisciplinary care and what are some of the attributes required for successful partnerships. From Elizabeth’s journey can you list 5 different disciplines or roles that made up her team or care givers?
3.Watch this short video: What are multidisciplinary teams? (Integrated care) by clicking here or you can watch it below
Regulatory bodies:
To start with let’s look at some of the nursing regulatory bodies that will guide your career as a nurse. Two of the names and acronyms you will hear a lot of talk around is the Nursing and Midwifery Board of Australia (NMBA) and the Australian Health Practitioner Regulation Agency (AHPRA).
Nursing regulatory bodies are accountable for public protection by ensuring registered nurses are safe, competent and ethical practitioners. Regulatory bodies achieve this mandate through a variety of regulatory activities such as registration and licensing, setting standards governing nursing practice and education, describing the scope of registered nursing practice, and identifying competencies required for entry‐level registered nurse practice.
Nursing has its own code of conduct, ethics, competency standards and its own philosophic views. It stands alone within the health care team by working under their own license. That means that each nurse is completely responsible for their own work.
We will start by looking at the role and functions of the NMBA. The Board ensures that nurses and midwives are responsive to people’s health needs through:
- registering nursing and midwifery practitioners and students
- developing standards, codes and guidelines for the nursing and midwifery profession
- handling notifications, complaints, investigations and disciplinary hearings
- assessing overseas trained practitioners who wish to practice in Australia
- approving accreditation standards and accrediting courses of study.
The NBMA has established State and Territory Boards to support the work of the National Board and its functions are supported by AHPRA.
To see more on the role of the Board and to read the NMBA news letters
click here and explore the page, locate the May 2020 newsletter produced by the board by clicking on the hyperlink “newsletters” on the web page. Read the news article titled Former nurse who filmed patients disqualified for eight years. Keep some notes about what the tribunal found that she demonstrated
AHPRA is the national organisation responsible for implementing the National Registration and Accreditation Scheme across Australia. AHPRA works together with 15 health professional boards (including NMBA) to help protect the public by regulating Australia’s registered health practitioners and set standards and policies that all registered health practitioners must meet.
Each Board (like the NMBA) has a health profession agreement with AHPRA that sets out fees, budget and the services provided by AHPRA.
Standards of Practice
As an RN your practice is governed by standards of practice that make you accountable to the NMBA. Working as an RN requires continuous thinking and analysis in the context of thoughtful development and maintenance of constructive relationships. To engage in this work, RNs need to continue to develop professionally and maintain their capability for professional practice. RNs determine, coordinate and provide safe, quality nursing. This practice includes comprehensive assessment, development of a plan, implementation and evaluation of outcomes. As a part of their
practice, RNs are responsible and accountable for supervision and the delegation of nursing activity to enrolled nurses (ENs) and others.
Practice is not restricted to only providing clinical care, practice includes anytime your nursing skills and knowledge are used so includes areas such as education, research, advisory roles along with many more.
NUR532 Professional practice Assignment-Australia.
The most recent RN standards of practice released in June 2016 consists of 7 interconnected standards, those standards are
1.Thinks critically and analyses nursing practice.
2.Engages in therapeutic and professional relationships.
3.Maintains the capability for practice.
4.Comprehensively conducts assessments.
5.Develops a plan for nursing practice.
6.Provides safe, appropriate and responsive quality nursing practice.
7.Evaluates outcomes to inform nursing practice.
The image below shows how each standard is connected
Each of the 7 standards is broken down to contain criteria of how the standards is demonstrated, they are for all practicing nurses, regardless of area of practice, to uphold.
to take you to the Registered nurses standards of practice page of the NMBA website. You will then need to click to download a copy of the Registered nurse standards for practice document.
Nursing and Midwifery Board Standard
Read the RN standards of Practice and reflect on the news article from the previous Activity
1.Can you locate and list 3 standards and sub points that the nurse breached? To start you off look at Standard 2 sub point 2.2. What are your thoughts, did the nurse uphold this standard?
Code of conduct
The Code of Conduct for nurses (and midwives) is a supporting document that sets out the legal requirements, professional behaviour and conduct expectations for all nurses. The Code is an essential document that governs behaviour and expectations for all nurses in all practice settings. Nurses are one of the most highly trusted professions in the community and this
documentation ensures that daily practice meets this trust. The Code of Conduct also informs the public about the standards of conduct and behaviour they should expect from nurses and midwives.
The Code of Conduct consists of 4 domains and 7 principles, each principle has sub points, domains and principles listed below.
1.Read the Code of conduct for nurses that can be found by clicking here. On this page you will need to locate and download the Code of conduct for nurses document.
2.On that same page locate the document Case studies: applying the codes of conduct in practice. Read his document and you can see how you can apply the code of conduct in certain practice situations
NUR532 Professional practice Assignment-Australia.
Basically, law is considered to be a system of rules and principles developed and recorded formally over time. The law seeks to govern or moderate specific areas of human activity (Kerridge, Lowe and Stewart 2013).
Categories of law in the Australian Legal system are:
Statute law: this is enacted by legislation and includes criminal law. Statutes, also known as Acts, can be passed by federal Parliament, or by the states (remember, should these conflict, federal law will override state law to the extent of the inconsistency between the two laws).
Common law: which is based on custom and precedence (what has happened in similar cases in law previously)
Civil law: where disputes between people are resolved.
The Role of the Coroner’s Court
The Coroner’s Court holds public hearings into reportable deaths (inquests) and is presided over by a magistrate referred to as the coroner in a coroner’s court. These are public hearings when a person dies in unusual, unexpected, violent or unnatural circumstances that make it necessary to
inquire into the cause and manner of a death. Examples of circumstances in which referral to the coroner will arise include:
- where the circumstances of death are unclear and/or may have occurred in suspicious circumstances (see above)where the deceased person’s identity is unknown;
- where there is no signed death certificate;
- where death occurs as a result of an anaesthetic;
- where a person had not been attended by a GP in last 3 months;
- where a death occurs in custody;
- where death occurs in a psychiatric institution, or in state care;
You can see from this list that a number of these circumstances relate to health care and/or health care facilities. Note that the coroner does not conduct trials, but can determine if there is a criminal case to answer, in which case the person or persons will then stand trial in a higher court.
In a health setting, the investigation is usually one of whether there was any impropriety or negligent action. Health staff may be requested to give evidence at an inquest and can be subpoenaed (compelled to attend). If the coroner is critical of the conduct of a health professional, then the findings will be sent to the appropriate regulatory board. Good documentation is essential in all patient care events. What was done (or not done and why) and what happened must be documented. Memory is a faulty thing, particularly over time.
NUR532 Professional practice Assignment-Australia.
Where relevant health care actions have not been documented, then in law, they are considered not to have taken place. Any record and information, however recorded, can be required to be presented in a court of law if it is relevant to an issue that is before the courts. Privileged information is very limited in scope, and failure to comply with a legitimate request from the
courts may hold serious consequences for the institution or health care professional who fails to comply with the request.
- What is Law?
- Nursing Code of Ethics
- What is Ethics?
- Ethics is a branch of philosophy. It has been described as ‘the study of what we ought to do’ (Kerridge et al. 2013, p. 3). The specific field of ethics that focuses on health is called bioethics. Bioethics concerns the moral, political and social issues raised by the clinical practice of medicine and health care in general, biomedical research and life sciences research.
Ethical theories have evolved from the thinking of great moral philosophers over centuries!! It is well beyond the role of this topic to explore theoretical underpinning of ethics in any great depth (this is more post-graduate work!). However this is a VERY brief overview.
o Deontology is one of the major schools of moral philosophy. Its major position is that things are essentially right or wrong, regardless of the consequences or circumstances. This means that a wrong action is always wrong, even where the outcome is positive.
o Consequentialist theories are based on a rational process of moral reasoning and these theories probably arose due to difficulties with rule based (deontological) morality. The basic tenet (belief) here is that the rightness or wrongness of an action is based solely on the consequences or outcomes of undertaking the action.
o Virtue theory considers that it is not the characteristic of the action itself, nor the consequences of the action that make it right or wrong, but the intentions or the motives of the person carrying out the action.
Some more contemporary approaches to ethics include:
o feminist approaches—these reject the male-dominated development of ethics and philosophically, such approaches are quite diverse
o causitry, or case-based moral reasoning (often seen in bio-ethics)
o trans cultural ethics, which argues that ethics varies with culture
o postmodernism/pragmatism which grounds ethics in reality
o postmodernism rejects any one only approach to ethics and emphasises the contribution of social context and the interaction between facts and individual Values to ethical decision making.
If you feel confused and think that there is no absolute clear pathway to follow, you are right. Kerridge, Lowe and Stewart (2013) suggest that ethical theory is fraught with inconsistencies and divisions, and that using more than one moral theory is helpful to guide
ethical behaviour. For example, it is possible to believe that killing is morally wrong (deontology) yet abortion, assisted suicide and euthanasia may be justified in certain circumstances (utilitarianism)?
NUR532 Professional practice Assignment-Australia.
8.What is Ethics?
10.Relevant Legislation
In 2018 the NMBA endorsed the International Council of Nurses (ICN) Code of ethics for nurses as the guiding document for ethical decision making for nurses. This document was last revised in 2012 but is currently in the review stage and an updated document is due to be released in 2021.
The ICN Code of ethics for nurses is divided into four elements give a framework for the ethical standards of conduct, these four elements are:
- Nurses and people
- Nurses and practice
- Nurses and the profession
- Nurses and co-word
The ICN code of ethics can be found
Download a read copy of the ICN Code of ethics for nurses) from the above link. See if you can find linkages between this documents and other standards and codes you have studied along the way. I will give you an example:
ICN code of ethics standard 2 has a point about establishing systems for professional appraisal, continuing education and systematic renewal of a nurse’s licence to practice. This to me is related to the Registration standard of continuing professional development, and Standard 3.3 of the RN standards of practice, do you agree/disagree? Can you find other linkages?
9.Nursing Code of Ethics
- Mental Health – Law and Ethics
Patients suffering mental illness have sometimes been abused by health professionals, family,carers and other patients, abuse can come in forms of physical, sexual, psychological and exploitation.
There are certain legislation/Acts which are often state specific so individual research is required to find your specific state’s legislation.
To start you off you can find and have a look at the following:
o Anti-discrimination Act
o Equal opportunity Act
o Mental Health Act (discussed more in the E-book)
Aged Care – Law and Ethics
It is well researched that negative attitudes towards the elderly are held by health professionals. Elder abuse can be caused by health professionals, family, friends or anyone in a relationship with the client. It can take many forms including financial, psychological/emotional, social, physical, sexual abuse or neglect. It is imperative that nurses are aware of the legislation
applicable to aged care so that they can prevent or report elder abuse and protect the elderly person.
There is certain legislation/Acts which are often state specific so individual research is required to find your specific state’s legislation.
To start you off you can research:
o Aged Care Act – this is a Commonwealth Act
o Age Discrimination Act – this is a Commonwealth Act
NUR532 Professional practice Assignment-Australia.
Medication Management
RNs can administer medications according to relevant state or territory legislation and facility policies. This means that the role you play in medication management for your patients may change throughout your career. There are different requirements for enrolled nurses, RNs, nurse
practitioners, student nurses and regulations vary between each state and territory. You have a duty of care to be aware of the legislation pertaining to medication management for you patients.
Activity
Locate the federal legislation titled Therapeutic Goods Regulations 1990 (this link will help from here Part 1 section 3 will show you the breakdown of important state specific legislation.
Choose the legislation of any state or territory and identify information specific to your nursing practice.
1.Nursing Shared Leadership Councils
Module 2 Introduction week 5 ,week 6
A key component of a Professional Practice Model (PPM) in nursing is nurses as leaders within an organisation and in the provision of clinical patient care (Slatyer et al., 2016). Specifically, leadership in nursing may present itself as nursing shared leadership councils, advocacy, community and organisational leadership, preceptor ship/mentoring and succession planning (Cordo & Hill- Rodriguez, 2017). This module will take you through an introductory look at each of these aspects of leadership in nursing.
Learning outcome
o Identify, understand and critically review the implementation of the components of nursing leadership in a given setting.1. Healing Environments
Module 3 Introduction week 7, week 8
According to Slater et al. (2016) nurses’ practice environments, in the context of nursing Professional Practice Models (PPM), are viewed in one of two ways. Firstly a nurse’s practice environment can be viewed as the healing environment where the nurse patient interaction takes place. Alternatively, the nursing practice environment can be viewed as
the workplace environment. In this module you will examine both facets of nurses’ practice environments.
Learning Outcomes
o Identify the elements essential to a healing environment
o Differentiate between positive and negative healing environments
o Compare a respectful work environment to an environment where the nurse feels disrespected and identify the possible impact on interdisciplinary collaboration as a basis for quality care
o Explore global, national, regional and/or local issues affecting professional nursing practice and identify environmental influences
NUR532 Professional practice Assignment-Australia.
Healing environment
A healthy work environment for nurses
Disaster nursing and emergency global health issue
Scholarship and Critical Thinking
Module 4 Nurse recognition and development week 9 and week 10
Introduction
A Professional Practice Model (PPM) should provide nurses with a framework to support their professional development. The two main components necessary to ensure informed, independent and collaborative practice and the retention of nurses are critical thinking and technical expertise and the advancement and recognition of nurses (Slatyer et al., 2016) This module will predominantly focus on critical thinking and reflection.
Learning outcomes
o Demonstrate developing skills in academic and information literacy that provide foundational skills for evidence-based nursing.
o Understand the nature of critical thinking
o Describe the significance of critical thinking to nursing practice
o Understand the benefits of using a framework to guide reflection
o Reflect on the role of continuing education and lifelong learning for effective professional practice
o Critical thinking and critical appraisal
o Clinical reasoning cycle
o Reflection
Module 5 Research and innovation week 11
Why research ?
Why nursing research ?
Module 6 Patient out come week 12
n this final module of NUR532 we bring all the components of professional practice models (PPM) in nursing together. If a model is successful in its implementation then the expected outcome is empowered nurses capable of achieving quality patient outcomes. With the five previous PPM
components successfully implemented nurses will be well placed to improve patient and family experiences and satisfaction (Slatyer et al., 2016).
Learning outcomes
- Establish connections between the components of professional practice models in nursing and effective, quality care
- Analyze what constitutes quality care
- Understand the role of the Australian Commission on Safety and Quality in Health Care in the provision of safe, effective, quality health care.
Module 6 Introduction
In Australia key improvements in safety and quality in healthcare are coordinated through the the Australian Commission on Safety and Quality in Health Care (the Commission).
The Commission was established in 2006 and is funded by Australian, state and Territory governments. The purpose of the Commission is to contribute to improved outcomes and experiences in the health system for patients and consumers. It does this by leading and coordinating national improvements in safety and quality care.
The Commission works in partnership with patients, carers, clinicians, the Australian, state and territory health systems, the private sector, managers and healthcare organisations to achieve a safe, high-quality and sustainable health system.
Key functions of the Commission include: developing national safety and quality standards, developing clinical care standards, coordinating work in specific areas to improve outcomes for patients, and providing information, publications and resources about safety and quality.
NUR532 Professional practice Assignment-Australia.
The commissions define safety and quality as
“prevention of error and adverse effects associated with health care; and quality as ‘the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge’.”
NUR532 Professional practice Assignment-Australia.
The final reading for this unit is a matched cohort study that compares hospitals that have made substantial versus limited investments in nursing and compares the cost of those investments with the outcomes for medical patients (Lasater et al., 2020). You can read the article by clicking
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