Nurse practitioner standards for practice 代写

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    Nurse practitioner standards for practice
    Orientating statements
    Nurse practitioners have the capability to provide high levels
    of clinically focused nursing care in a variety of contexts
    in Australia. Nurse practitioners care for people and
    communities with problems of varying complexity.
    The nurse practitioner (NP) scope of practice is built on the
    platform of the registered nurse (RN) scope of practice, and
    must meet the regulatory and professional requirements
    for Australia including the National competency standards for
    the registered nurse, Code of ethics and Code of professional
    The nurse practitioner standards (Standards) build on,
    and expand upon, those required of a registered nurse.
    When assuming the title and scope of practice of a nurse
    practitioner, the NP understands the changes in the scope
    of practice from that of a registered nurse, and the ways that
    these changes affect responsibilities and accountabilities.
    Fundamentally, a nurse practitioner provides nursing care
    within their regulated scope.
    The core Standards in this document are the minimum
    Standards that are applicable across diverse practice
    settings and patient/client populations for both beginning
    and experienced NPs.
    Nurse practitioner attributes are consciously cultivated
    through formal learning that includes a work based
    component. The educational requirement for endorsement
    of NPs in Australia is a Masters degree. This formal learning
    builds on demonstrable advanced practice within the RN
    The nurse practitioner has a high degree of systems literacy
    and can manage care across a variety of health systems to
    maximize outcomes; NPs engage in complex and critical
    thinking; integrate information and/or evidence; judiciously
    use clinical investigations; and skilfully and empathetically
    communicate with all involved in the care episode, including
    the person receiving care and their family and community,
    and health professional colleagues.
    NP attributes are clinically focused, and NPs are capable
    in research, education and leadership as applied to clinical
    care (Refer Figure 1). Research includes processes to
    support reflective practice, evidence-based care and quality
    management. The NP has the capability to educate others
    related to the focus of, and available options, of care. Nurse
    practitioners are leaders and have an ability to lead care
    and care teams. Nurse practitioners engage in reflective
    practice and support others in this process through clinical
    supervision or mentoring.
    Nurse practitioners are capable of managing episodes of
    care, including wellness focused care. Nurse practitioners
    may be the primary provider of care or part of a care team.
    They collaborate and consult with health consumers, their
    families and community, other professionals, including
    health personnel, to plan, implement and evaluate integrated
    care that optimises outcomes for recipients and the systems
    of care.
    As part of providing care, NPs can order and interpret
    investigations to facilitate diagnosis and care planning. Care
    may include nursing interventions that involve initiation,
    titration or cessation of medications. Nurse practitioners
    take responsibility for following-up on any components of
    care initiated. They are accountable for care provided and
    self-monitor their work.
    How to use these Standards
    The Standards have been written so as to be easily accessible
    to a variety of groups, including nurse practitioners,
    governments, regulatory agencies, health care professionals
    and the community. It should be noted that the Cues (refer
    to Glossary) written below the Statements are indicative of
    nurse practitioner behaviours, they are not intended to be
    exhaustive. Rather, the cues are examples of activities that
    demonstrate the Statement for that standard.
    Read the Standards in conjunction with other relevant
    documentation, including: the National competency standards
    for the registered nurse, the Code of professional conduct for
    nurses in Australia, the Code of ethics for nurses in Australia,
    and a companion document, A nurse’s guide to professional
    boundaries. They should also be read in conjunction with the
    attached Glossary, which clearly stipulates the way in which
    key terms are used in the Standards.
    In Figure 1, the Nurse practitioners standards framework is
    illustrated. There are four domains, namely:
    Nurse practitioner standards for practice
    •  clinical
    •  education
    •  research, and
    •  leadership.
    The education, research and leadership domains are couched
    within the clinically focused standards. The knowledge and
    skills contained within the three domains of education,
    research and leadership, are integrated in their expression in
    the clinical role or work.
    Collectively, these attributes expressed in nurse practitioners’
    knowledge, skills and affect, are applied in the education
    domain through educating those receiving care, peers and
    colleagues. The use of knowledge in the research domain
    is evidenced through the judicious application of research
    evidence in formulating practice decisions, self- regulation
    and the development of new systems of care. The domain
    of leadership, initially evident in clinical work, increases in
    capacity to include community and political engagement.
    Figure 1: Representation of how the education,
    research and leadership domains are couched
    within the clinically focused standards
    Nurse Practitioner Standards Framework
    Standard 1
    Standard 2
    Standard 3
    Standard 4
    Assesses using diagnostic capability
    Clinical Domain
    Plans care and engages others
    Prescribes and implements therapeutic
    Monitors outcomes to evaluate and
    improve practice
    Nurse practitioner standards
    Standard 1: Assesses using diagnostic capability
    Statement 1.1: Conducts comprehensive, relevant and holistic
    health assessment
    •  Demonstrates extensive knowledge of human sciences
    and health assessment
    •  Demonstrates comprehensive and systematic skill in
    obtaining relevant, appropriate and accurate data that
    inform differential diagnoses
    •  Assesses the complex and/or unstable health care needs
    of the person receiving care through synthesis and
    prioritisation of historical and available data
    •  Assesses the impact of comorbidities, including the effects
    of co-existing, multiple pathologies and prior treatments in
    the assessment of the person receiving care
    •  Demonstrates comprehensive skill in clinical examination
    including physical, mental health, social, ethnic and
    cultural dimensions
    •  Consistently and accurately synthesises and interprets
    assessment information specifically history, including prior
    treatment outcomes, physical findings and diagnostic data
    to identify normal, at risk and abnormal states of health
    •  Critically evaluates the impact of social determinants on
    the person and population.
    Statement 1.2: Demonstrates timely and considered use of
    diagnostic investigations to inform clinical decision making
    •  Makes decisions about the use of person-focused
    diagnostic investigations that are informed by clinical
    findings and research evidence
    •  Demonstrates accountability in considering access, cost,
    clinical efficacy and the informed decision of the person
    receiving care when ordering diagnostic investigations
    •  Orders and/or performs selected screening and diagnostic
    •  Is responsible and accountable for the interpretation of
    results and for following-up the appropriate course of
    •  Uses effective communication strategies to inform the
    person receiving care and relevant health professionals of
    the health assessment findings and diagnoses.
    Nurse practitioner standards for practice
    Statement 1.3: Applies diagnostic reasoning to formulate
    •  Synthesises knowledge of developmental and life stages,
    epidemiology, pathophysiology, behavioural sciences,
    psychopathology, environmental risks, demographics and
    societal processes when making a diagnosis
    •  Considers the person’s expectations of assessment,
    diagnosis and cost of health care
    •  Acts to prevent and/or diagnose urgent and emergent and
    life threatening situations
    •  Determines clinical significance in the formulation of an
    accurate diagnosis from an informed set of differential
    diagnoses through the integration of the person’s history
    and best available evidence.
    Standard 2: Plans care and engages others
    Statement 2.1: Translates and integrates evidence into
    planning care
    •  Takes personal responsibility to critically evaluate and
    integrate relevant research findings into decision making
    about health care management and interventions
    •  Ethically explores therapeutic options considering
    implications for care through the integration of
    assessment information, the person’s informed decision
    and best available evidence
    •  Is proactive and analytical in acquiring new knowledge
    related to nurse practitioner practice.
    Statement 2.2: Educates and supports others to enable their
    active participation in care
    •  Respects the rights of the person to make informed
    decisions throughout their health/illness experience
    or episode, whilst ensuring access to accurate and
    appropriately interpreted information
    •  Uses appropriate teaching/learning strategies to provide
    diagnostic information that is relevant, theory-based and
    •  Communicates about health assessment findings and/or
    diagnoses, including outcomes and prognosis
    •  Works to meet identified needs for educating others
    regarding clinical and ongoing care.
    Statement 2.3: Considers quality use of medicines and
    therapeutic interventions in planning care
    •  Develops an individual plan of care and communicates
    this to appropriate members of the healthcare team and
    relevant agencies
    •  Exhibits a comprehensive knowledge of pharmacology and
    pharmacokinetics related to nurse practitioner scope of
    •  Works in partnership with the person receiving care to
    determine therapeutic goals and options
    •  Verifies the suitability of evidence-based treatment
    options including medicines, in regard to commencing,
    maintaining/titrating or ceasing interventions
    •  Demonstrates accountability in considering access, cost
    and clinical efficacy when planning treatment.
    Statement 2.4: Refers and consults for care decisions to obtain
    optimal outcomes for the person receiving care
    •  Collaborates with other health professionals to make and
    accept referrals as appropriate
    •  Consults with and/or refers to other health services,
    disability services, aged-care providers and community
    agencies at any point in the care continuum.
    Standard 3: Prescribes and implements
    therapeutic interventions
    Statement 3.1: Prescribes indicated non-pharmacological and
    pharmacological interventions
    •  Contributes to health literacy by sharing knowledge with
    the person receiving care to achieve evidence-informed
    management plan
    •  Safely prescribes therapeutic interventions based on
    accurate knowledge of the characteristics and concurrent
    therapies of the person receiving care
    •  Demonstrates professional integrity and ethical conduct
    in relation to therapeutic product manufacturers and
    pharmaceutical organisations
    •  Safely and effectively performs evidence-informed
    invasive/non-invasive interventions for the clinical
    management and/or prevention of illness, disease,
    injuries, disorders or conditions
    •  Interprets and follows-up the findings of screening and
    diagnostic investigations in an appropriate time frame
    during the implementation of care.
    Nurse practitioner standards for practice
    Statement 3.2: Maintains relationships with people at the
    centre of care
    •  Supports, educates, coaches and counsels the person
    receiving care regarding diagnoses, prognoses and
    self-management, including their personal responses to
    illness, injuries, risk factors and therapeutic interventions
    •  Advises the person receiving care on therapeutic
    interventions including benefits, potential side effects,
    unexpected effects, interactions, importance of compliance
    and recommended follow-up
    •  Shares information with others in consultation with the
    person receiving care
    •  Coordinates care with other health, disability and aged-
    care providers, agencies and community resources
    •  Discloses the facts of adverse events to the person
    receiving care and other health professionals; mitigates
    harm, and reports adverse events to appropriate
    authorities in keeping with relevant legislation and
    organisational policy
    •  Advocates for improved access to health care, the health
    care system and policy decisions that affect health and
    quality of life.
    Statement 3.3: Practises in accordance with federal, state and
    territorial legislation and professional regulation governing
    nurse practitioner practice
    •  Defines duty of care in accordance with relevant legislation
    and regulation
    •  Remains informed of changes to legislation and
    professional regulations, and implements appropriate
    alterations to practice in response to such changes
    •  Contributes to the development of policy and procedures
    appropriate to context and specialty.
    Standard 4: Evaluates outcomes and improves
    Statement 4.1: Evaluates the outcomes of own practice
    •  Monitors, evaluates and documents treatments/
    interventions in accordance with person- determined goals
    and health care system outcomes
    •  Considers a plan for appropriately ceasing and/or
    modifying treatment in consultation with the person
    receiving care and other members of the health care team
    •  Applies the best available evidence to identify and select
    appropriate outcomes measures of practice
    •  Uses indicators to monitor and measure the effectiveness
    of strategies, services and interventions to promote safe
    •  Participates in clinical supervision and review
    •  Implements research-based innovations for improving
    •  Contributes to research that addresses identified gaps in
    the provision of care and/or services.
    Statement 4.2: Advocates for, participates in, or leads systems
    that support safe care, partnership and professional growth
    •  Advocates and provides evidence for expansion to nurse
    practitioner service where it is believed that such an
    expansion will improve access to quality and cost-effective
    health care for specific populations
    •  Demonstrates clinical leadership in the design and
    evaluation of services for health promotion, health
    protection or the prevention of injury and/or illness
    •  Articulates and promotes the nurse practitioner role in
    clinical, political and professional contexts
    •  Acts as an educator and/or mentor to nursing colleagues
    and others in the healthcare team
    •  Critiques health care policies for their implications on the
    nurse practitioner role and the populations for whom they
    •  Influences health, disability and aged-care policy and
    practice through leadership and active participation in
    workplace and professional organisations.
    Nurse practitioner standards for practice
    Advanced nursing practice (ANP): ANP is a continuum along
    which nurses develop their professional knowledge, clinical
    reasoning and judgement, skills and behaviours to higher
    levels of capability (that is recognisable). Nurses practising
    at an advanced level incorporate professional leadership,
    education and research into their clinically based practice.
    Their practice is effective and safe. They work within a
    generalist or specialist context and they are responsible and
    accountable in managing people who have complex health care
    Advanced nursing practice is a level of practice and not a
    role. It is acknowledged that advanced nursing practice
    is individually attributed within a regulated nursing scope
    (enrolled nurse, registered nurse or nurse practitioner).
    Advanced practice nursing (APN): APN in the Australian
    nursing context identifies the additional legislative functions
    of an endorsed nurse practitioner that are outside the
    contemporary registered nurse scope of practice.
    Advanced practice nursing as a nurse practitioner is a
    qualitatively different level of advanced nursing practice to
    that of the registered nurse due to the additional legislative
    functions and the regulatory requirements. The requirements
    include a prescribed educational level, a specified advanced
    nursing practice experience; and continuing professional
    Advanced practice nursing should not be confused with the
    term ‘practice nurse’ that is used colloquially to describe
    nurses working in the general practice setting.
    Attributes: Are characteristics that underpin competent
    performance. Refer to National competency standards for the
    registered nurse under Codes and guidelines on the Nursing and
    Midwifery Board of Australia website.
    Competence: The combination of skills, knowledge, attitudes,
    values and abilities that underpin effective and/or superior
    performance in a profession/occupational area. Refer to
    National competency standards for the registered nurse under
    Codes and guidelines on the Nursing and Midwifery Board of
    Australia website.
    Cues: Key generic examples of competent performance. They
    are neither comprehensive nor exhaustive. They assist the
    assessor when using their professional judgement in assessing
    nursing practice. They further assist curriculum development.
    Refer to National competency standards for the registered nurse
    under Codes and guidelines on the Nursing and Midwifery Board
    of Australia website.
    Nurse Practitioner: A nurse practitioner is an advanced
    practice nurse endorsed by the Nursing and Midwifery Board of
    Australia to practise within their scope under the legislatively
    protected title ‘nurse practitioner’.
    Person/ people: In these Standards, person/ people is used to
    refer to those individuals who have entered into a relationship
    with a nurse practitioner. Person/ people encompass patients,
    clients, consumers and families that fall within the NP scope
    and context of practice.
    Prescribing: is defined as the steps of information gathering,
    clinical decision making, communication and evaluation which
    results in the initiation, continuation or cessation of a medicine.
    Scope of practice: The scope of nursing practice is that
    in which nurses are educated, competent to perform and
    permitted by law. The actual scope of practice of individual
    practitioners is influenced by the settings in which they
    practise, the health needs of people, the level of competence
    and confidence of the nurse and the policy requirements of the
    service provider.