Week 9 Student (1) PDF

Scopes and Standards NURS 72050 AGENDA Nursing Legislation Regulatory Bodies Enforcement/Complaints Discipline Interprofessional Group Assignment Canadian Nursing Legislation Legislative Process The nursing profession is self-regulating Legislation and regulation across Nursing...

Scopes and Standards NURS 72050 AGENDA Nursing Legislation Regulatory Bodies Enforcement/Complaints Discipline Interprofessional Group Assignment Canadian Nursing Legislation Legislative Process The nursing profession is self-regulating Legislation and regulation across Nursing Regulatory Bodies have provinces and territories govern the profession. The law authorizes the use of a Duty to protect the public interest the title nurse and Oversight over the establishment and defines nursing and the various regulation of nursing categories categories of nurses, education, clarifies scopes of practice and entry into the profession holds regulatory bodies accountable scope of practice for nursing standards of behaviour, standards of practice practice, education, etc. complaint and reporting processes disciplinary processes  Travel Across Canada You have decided to travel across Canada for the next few years and your goal is to work coast to coast. o As a small group choose at least 4 provinces or territories your plan to work in. o Using the table provided in e-Conestoga determine the legislation that guides nursing practice in your chosen province and the regulatory body you will need to register with. Using the Nursing title Use of Titles RN All provinces and territories restrict the practice of nursing, and use of titles, to members in good standing A member who has retired, is under suspension or whose certificate has been revoked may not use the title of nurse or practice nursing Continuing to practice while under suspension constitutes professional misconduct  Scope of Practice Scope of Practice provides a framework to determine what constitutes the practice of nursing draws a distinction between nursing and other health professionals aids the courts in interpreting the accountabilities of provides a framework for findings of professional misconduct defines controlled acts  Controlled Acts In most provinces and Exemptions exist to allow territories, the law defines specific medical actions Nonregulated persons to and procedures may be perform acts to assist a performed person with routine who may perform and activities of daily living delegate them acts done to treat a person by spiritual means Delegating Controlled Acts: Key Considerations Controlled Acts: These are specific nursing activities that require specialized education, training, and judgment. In Ontario, they include activities such as administering certain medications, performing invasive procedures, and providing certain health assessments. Delegation: The transfer of responsibility for performing a task from one health professional to another. CNO Standard: The CNO outlines specific requirements for delegating controlled acts to ensure patient safety and maintain public trust.  Essential Requirements for Delegating Controlled Acts Competence: The nurse must ensure that the delegate has the necessary knowledge, skills, and judgment to perform the controlled act safely and effectively. Supervision: The nurse must provide appropriate supervision and guidance to the delegate, ensuring they understand the risks and responsibilities associated with the task. Communication: The nurse must clearly communicate the specific instructions for performing the controlled act, including dosage, route, and potential side effects. Documentation: The nurse must document the delegation in the patient's chart, including the date, time, controlled act, and delegate's name.  Critical Thinking A registered nurse (RN) at a busy hospital is assigned to a patient who requires multiple medications, including several controlled substances that need to be administered into a cental line. Due to the high patient-to-nurse ratio, the RN feels overwhelmed and decides to delegate the administration of all the medications to a brand new registered practical nurse (RPN). Using the requirements for delegation on the previous slide, explain how the RN has met or not met the essential requirements for delegating controlled acts. Mandate of Regulatory Bodies  Regulatory Bodies… oversee who enters the profession establish mechanisms to ensure candidates have the knowledge and competencies to provide safe and effective care Entry To inform curriculum and approve education programs Practice establish standards for registration including successful completion of the Canadian entry to practice exam undertake criminal background checks  Groups 1-4 Review the following link and outline how the CNO is supporting changes in nursing practice with the addition of RN Prescribing. News | RN prescribing: Collaborating for succe ss (cno.org) Practice Groups 5-8 Review the following link and outline how the CNO is supporting changes in nursing practice with the addition of the new Support Practice Standard: Discontinuing or Declining Care News | CNO releases new standard for disconti nuing or declining care Read the Article from The Standard and click on the link within the article to learn more about the guidance being provided from the CNO for nursing practice. Be prepared to share with the large group.  Practice standards are established by all regulatory bodies across Canada Reflect the philosophy and ethical codes of nursing Relevant to malpractice and negligence PRACTICE issues Provide directly relevant evidence of the STANDARDS standard of care Provide criteria by which a nurse’s conduct will be judged in legal or disciplinary proceedings  Continued Competence Nursing regulatory bodies Examples across Canada ensure the ongoing include: competence of nurses reflective practice models which involve self or peer reviews of practice (or both) quality assurance programs minimum practice hours and personal practice reviews learning and ongoing improvement plans random testing Enforcement Disciplinary proceedings against nurses are: governed by the nursing regulatory body designed to ensure nurses’ professional conduct conforms to ethical codes and regulations Disciplinary proceedings are not criminal proceedings  Enforcement: Addressing Complaints The procedures are generally as follows: Submission of complaint interim investigation investigation disciplinary committee hearing  Complaints Complaints of professional misconduct must be in writing, and be signed and dated name the health professional alleged to have acted unprofessionally outline the facts of the alleged misconduct may be filed by nursing or other colleagues, patients, family members, or employers  Managing Complaints As a small group review the CNO process for making a complaint: 42017_resolvingcomplaints.pdf (cno.org)  Investigations Members who are the subject of an investigation must be notified of the complaint immediately are entitled to submit documents or information for consideration have a legal duty to cooperate with the investigation should consult a lawyer without delay  INVESTIGATIONS Complaints are investigated, and if warranted, referred to appropriate committees for further investigation and or hearing If allegations relate to patient safety or security, the committee may suspend the nurse’s right to practice immediately  Disciplinary Committee The committee, after hearing the evidence, may find that the nurse is innocent of any wrongdoing potentially incapacitated related to a health issue incompetent, unskilled, or lacking in essential knowledge guilty of professional misconduct habitually impaired by alcohol or drugs, and therefore unable to perform his or her duties and obligations Penalties and Appeals Penalties may include A nurse found guilty of professional censure or reprimand, orally or in misconduct may appeal the decision, the writing penalty, or both conditions placed on the nurse’s right Depending on the province, further to practice, such as education, regular appeals can be made to a provincial monitoring or treatment court, or a professional review board suspension In some provinces and territories, judicial permanent revocation of license to review may occur in certain practice circumstances DISCIPLINE As a small group using the link provided review some of the summarized decisions and discuss Summarized Decisions (c how the member did not no.org) adhere to the Code of Conduct and their professional practice standards.  Groups 1,3,5,7 will be the decision- making committee What Standards Class Tribunal have been violated? What parts of the Code of Conduct have not been followed?  A registered nurse (RN) named Sarah is working on a medical-surgical unit. One evening, she administers a medication to a patient, John, who has a known allergy to the medication. Despite the patient's allergy being clearly documented in the patient's chart, Sarah fails to verify the medication before Case 1 administering it. John experiences a severe allergic reaction to the medication, resulting in anaphylactic shock and requiring immediate emergency treatment. The patient is successfully resuscitated but suffers long- term consequences from the allergic reaction.  Groups 2,4,6,8 will be the decision- making committee CLASS What Standards have been violated? TRIBUNAL What parts of the Code of Conduct have not been followed?  A registered nurse (RN) named Sarah is caring for a patient named John who is recovering from a stroke. During one of their interactions, Sarah discloses personal details about her own life, including her struggles with depression and anxiety. She also expresses admiration for John's resilience and tells him that she wishes she could be more like him. Case 2 John feels a deep gratitude for the nursing care Sarah provided him and he asks to continue his friendship with Sarah. John would like to repay the favour by offering Sarah support with her mental health. Sarah accepts the offer and she on John meet for coffee on a regular basis.  Break  Interprofessional Practice Nurses must understand the role of professional nursing in collaboration with the client and the interprofessional team. Interprofessional collaborative practice must be client- centred. A partnership between a team of health care providers and a client A participatory, collaborative, and coordinated approach to share decision-making Canadian Interprofessional Health Collaborative Framework Interprofessional Communication Four aspects Affinity- Valuing of a team members contributions to the team. Immediacy- How well team members pay attention to the content of a message. Respect- An individuals need to be valued as a competent member of the team. Control-Persuasive power some members may exert over others. This can be decisional and communicative. Interprofessional Collaboration Role clarification Generic role Focal role Functional role Interprofessional Collaboration Team functioning Norms Interdependencies Shared responsibilities Shared goals Interprofessional Collaboration Collaborative leadership Understanding that each member of the team including clients/family can accept the capacity to lead the group. Work together to achieve shared judgement related to the clinical situation. Interprofessional Collaboration Interprofessional team conflict resolution Three types of team conflict: relational task process Participants in conflict respond to on the basis of their perceptions of a particular situation.  Collaboration Expectations Reminder: Review the collaborator sections What are the professional responsibilities of of the CNO Entry to Practice Competencies a nurse when engaging in an to understand the professional interprofessional relationship? expectations. https://www.cno.org/globalassets/docs/reg/4 1037-entry-to-practice-competencies-2020. pdf Interprofessional team Case Analysis Review the case health history provided in e-Conestoga As a group determine which health care providers should be involved in the care Consider what each health care professionals priorities might be for this case List the opportunities for collaboration between nursing and the other members of the health care team.  Group Assignment Assignment Review For the remainder of the class time students can work on the group assignment. If possible, students should select a real-world nursing case involving a legal or ethical dilemma faced by a nurse (e.g., patient confidentiality breach, medication error, conflict of interest). The case can be from your own experience or from a reputable Canadian media source. Ensure you review the case with your faculty for approval. Plan for next week ETHICAL CONSIDERATIONS GROUP ASSIGNMENT