Priorities in Nursing Practice and Nursing Standards of Care

 Establishing Nursing Priorities

1. Prioritizing - decisions of which needs or problems require immediate attention or action and which ones could be delayed until a later time since they are not urgent.
2. Needs that are life-threatening or could result in harm to the client if left untreated are high priorities.
3. Actual problems or needs have higher priority than potential problems or needs.
4. Problems or needs identified by the client are of a higher priority.
5. Principles of Maslow's Hierarchy of Needs or the ABCs may guide decisions.
6. Mutual decision-making for priorities may be made with the client based on the client's needs, desires and safety.

NURSE PRACTICE ACTS

• Definition: passed by each state legislature to regulate the practice of nursing in that state
• Nurse Practice Acts define:
• Scope of Practice
• Education
• Licensure
• Professional Misconduct:
• Negligence
• The 'Impaired Nurse'
• The nurse who violates boundaries
• Administered by the Board of Nursing in each state:
• The nurse must know how their state defines professional misconduct
• For Professional Misconduct, the State Board of Nursing imposes penalties (in order of severity):
• On Probation
• Censured
• Reprimanded
• License Suspended
• License Revoked

STANDARDS OF NURSING PRACTICE AND STANDARD OF CARE

Nursing Charting and Documentation

 EFFECTIVE DOCUMENTATION

• Legal Guidelines for Charting
1. Record the facts legibly, in ink
2. Never erase, scratch out or apply correction fluid. Cross through an error once, date and initial the change.
3. Do not leave black spaces in your nursing notes.
4. Never chart for another person
5. Avoid interpreting patient statements. Record exactly what the patient said in quotation marks.
6. Correct all errors in a timely manner.
7. Chart in a timely manner.
• Computerized Charting
1. Never lend access your ID to another person.
2. Maintain confidentiality of documented information printed from the computer.

TYPES OF DOCUMENTATION