Nursing Practice Regulations Overview

Nursing Practice Regulations

• Nurse Practice Acts: State laws governing nursing practice, overseen by state boards.
• Standards of Practice: Guidelines for providing safe, quality care.
• Code of Ethics: American Nurses Association (ANA) guidelines for acceptable nurse behavior.
• Nursing Process: Assessment, diagnosis, planning, implementation, evaluation.
• Clinical Judgement Model: Recognizing and analyzing cues, prioritizing hypotheses, generating solutions, acting, and evaluating outcomes for safer client care.
• Critical Thinking: Higher-level thinking leading to logical actions, vital for assessing client responses to interventions.
• Nursing Values & Behaviors: Autonomy, caring, use of the nursing process.
• Autonomy: Self-governance in choosing and acting on a choice.
• Advocacy: Supporting client decision-making or protecting clients unable to make decisions.
• RN Scope of Practice: Assessing clients, administering treatments/medications, educating, modifying care plans based on client responses.
• Interprofessional Healthcare Team: Includes physicians, NPs, PAs, LPNs, UAPs, pharmacists, therapists, technologists, dieticians/nutritionists, social workers, spiritual care providers, and alternative care providers. Each plays a specific role in patient care.

HIPAA

• Health Insurance Portability & Accountability Act (HIPAA): Ensures confidentiality & privacy of patient medical information in healthcare agencies and for employees.
• HIPAA Violations: Penalties include civil penalties ($50,000 per violation, up to $1.5 million per violation category per year) and criminal penalties (up to 1 year in prison).
• Limiting HIPAA Violations: Educate, supervise, enforce HIPAA regulations.

Prioritization and Delegation

• Prioritization: Assessing and responding to clients' needs based on urgency and severity of needs.
• ABCs: Airway, Breathing, Circulation (priority in triage).
• Maslow's Hierarchy of Needs: Physiological (water, food), Safety & Security, Social, Esteem, Self-Actualization.
• Five Rights of Delegation: Right task, right circumstance, right person, right direction/communication, right supervision/evaluation.
• UAP Tasks: Defined activities like bathing, grooming, vital signs, specimen collection, assisting with ADLs.
• Non-Delegable Tasks: Tasks requiring nursing judgment (e.g., assessment for fall risks, interpreting a client's response to treatment).

Therapeutic Communication

• Interpreter Use: Employ trained interpreters for clients with limited English proficiency.
• Environment: Quiet, distraction-free settings for client education.
• Open-Ended Questions: Questions requiring more than a "yes" or "no" answer (e.g., "Tell me about the pain you are experiencing?").
• Client Education: Assess existing knowledge, address client preferences, and clearly explain treatment plans.
• Therapeutic Communication Qualities: Empathy, respect, genuineness, concreteness, confrontation.
• Nonverbal Factors: Posture, gestures, and facial expressions influence communication.

Safety and Risk Reduction (Hospital)

• Two-Factor Authentication: Verifying patient identity using name and date of birth.
• Restraints: Used cautiously for self-harm or harm to others (wrist/ankle restraints).
• Needle Stick Protocol: Report injuries, wash with soap and water, and inform the charge nurse.
• Alert Bands: Unique patient identifiers to prevent errors with similar names.
• Seizure Precautions: Padded rails, suction, oxygen.
• Fall Risk Determination: Level of consciousness, history of falls, mobility.
• Fall Prevention (Home/Hospital): Assess potential hazards, use safety checklists and assessments, use non-slip socks, lower the bed, move near the nursing station, use 2 side rails.
• Modifiable Risk Factors: Smoking, weight, exercise, diet.
• Non-modifiable Risk Factors: Genetics, age, family history, sex.
• Fire Safety: Know the location and operation of fire extinguishers.

Levels of Prevention

• Primary Prevention: Actions directed at healthy individuals (e.g., vaccinations).
• Secondary Prevention: Early detection and diagnosis (e.g., screenings, mammograms).
• Tertiary Prevention: Maximizing recovery (e.g., rehabilitation, support groups).

Cultural Awareness

• Understanding Cultural Needs: Ask about patient values, beliefs, and preferences to understand needs appropriately.
• Cultural Competency: Providing care that respects patients' values, beliefs, needs, and preferences. Incorporate culture into patient care and empower decision making.
• Bias and Vulnerable Populations: Bias can affect care; vulnerable populations (e.g., low-income, certain ethnic groups) have increased risk.

Dosage Calculations & Abbreviations

• Dosage Calculation: (Requires specific questions to provide relevant instructions).
• Abbreviations: PO (by mouth), TID (three times a day,), BID (twice a day), ODT (orally disintegrating tablet), AC (before meals), c/o (complaint of), d/c (discharge or discontinue), PC (after meals), QH (every hour), QID (four times a day), etc.

Explore the essential components of Nursing Practice Regulations, including Nurse Practice Acts, Standards of Practice, and the Nursing Process. This quiz will assess your understanding of the legal and ethical guidelines that govern nursing, as well as critical thinking and clinical judgment in patient care. Test your knowledge on the foundational principles that ensure safe and effective nursing practices.