L2- HLTENN041_Practise within scope of professional nursing practice_V3_2023.pdf

RMIT Classification: Trusted HLTENN041 Apply legal and ethical parameters to nursing practice NURS5420C/NURS5421C Lesson 2 Enrolled nurse scope of professional practice RMIT Classification: Trusted LEARNING OUTCOMES By the end of this session, learners will be able to Identify the various organizati...

RMIT Classification: Trusted HLTENN041 Apply legal and ethical parameters to nursing practice NURS5420C/NURS5421C Lesson 2 Enrolled nurse scope of professional practice RMIT Classification: Trusted LEARNING OUTCOMES By the end of this session, learners will be able to Identify the various organizations associated with nursing profession in Australia Identify the important NMBA codes, standards, guidelines and frameworks for nursing profession in Australia. Recognize the role of NSQHS standards in healthcare School of Vocational Engineering, Health & Sciences RMIT Classification: Trusted What do we know about law and ethics? Sources of Law : Constitution, Statute /Parliament Law (Federal/ State), Common Law (Doctrine of precedent) Types of Law: Civil, Criminal (Indictable offences) Courts and Tribunals – High courts (highest), Magistrate court (lower in the hierarchy), Coroners court Office of Health Complaints Commissioner (OHCC) Victorian Civil and Administrative Tribunal (VCAT) Charter of Healthcare rights Declaration on rights of indigenous people Antidiscrimination laws Acts and legislations that impact on nursing practice ACTIVITY RMIT Classification: Trusted Find out the full forms of these words. What is their role? NMBA AHPRA ANMAC ANMF As student and future nurses you must familiarize yourself with these two websites NMBA https://www.nursingmidwiferyboard.gov.au/ AHPRA https://www.ahpra.gov.au/ RMIT Classification: Trusted AHPRA, ANMAC and ANMF What were your findings for these terms?? AHPRA – Australian Health Practitioner Regulation Agency ANMAC – Australian Nursing and Midwifery Accreditation Council ANMF – The Australian Nursing and Midwifery Federation RMIT Classification: Trusted AHPRA Australian Health Practitioner Regulation Agency (AHPRA) is the organisation responsible for implementation of the National Registration and Accreditation Scheme across Australia. Came into effect on 1 July 2010 Consistency – national standards Improved public protection – online registers Efficiency – streamlined administration Collaboration – between national boards Mobility - interstate RMIT Classification: Trusted ROLE OF AHPRA Professional standards – policy advise Registration – national register Notifications – manage complaints Compliance – monitor and audit Accreditation – work with authorities RMIT Classification: Trusted ANMAC ANMAC- Australian Nursing and Midwifery Accreditation Council Accreditation of Australian providers of Nursing & Midwifery courses Liaising with national and international professional bodies, regulators and educators on matters related to standards of education and practice Develops and reviews accreditation standards for nursing and midwifery professions in Australia Independent accrediting authority for Nursing & Midwifery education Skills assessing authority for Nurses & Midwives seeking to migrate Australia RMIT Classification: Trusted ANMF ANMF- The Australian Nursing and Midwifery Federation National union for Nurses & Midwives Professional Indemnity Insurance Offers members several scholarships, research grants and conference sponsorships to promote nursing excellence Industrial, professional & legal representation of Nurses & Midwives Continuous Professional Development Improved member wages & working conditions for better patient care RMIT Classification: Trusted Nursing And Midwifery Board of Australia (NMBA) Protect the public by: developing national standards, codes and guidelines for the nursing and midwifery profession determining requirements and maintain the register (with AHPRA) registering nursing and midwifery practitioners and students handling notifications, complaints, investigations and disciplinary hearings assessing overseas professional qualifications who wish to practice as ENs and RNs in Australia (with AHPRA) approving accreditation standards and accredited courses of study (with ANMAC) RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Professional codes and guidelines These define practice and behaviour of nurses and midwives and include: Codes of conduct - Effective 1 March 2018 EN Standards for practice - Effective 1 January 2016 Code of ethics – Revised 2021 ALWAYS REFER TO CURRENT VERSIONS https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards.aspx RMIT Classification: Trusted CODE OF CONDUCT FOR NURSES Effective 1 March 2018 Set out legal requirements Outline a set of minimum national standards of conduct members of the nursing profession are expected to uphold Inform the community of the standards of professional conduct it can expect nurses in Australia to uphold Provide consumer, regulatory, employing and professional bodies with a basis for evaluating the professional conduct of nurses. 7 principles across 4 domains https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professionalstandards.aspx RMIT Classification: Trusted ENROLLED NURSES STANDARDS FOR PRACTICE Effective 1 January 2016 Core practice standards – Framework for assessing enrolled nurse (EN) practice – (Set the expectations of practice ) (inform education standards, regulation and determination of capability/ fitness for practice) Guide consumers, employers and other stakeholders on what to reasonably expect from practitioner regardless of the area of nursing practice or years or experience 10 standards https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards/enrolled-nurse-standards-for-practice.aspx RMIT University©2017 School of Vocational Engineering, Health & Sciences RMIT Classification: Trusted ENROLLED NURSES STANDARDS FOR PRACTICE Effective 1 January 2016 Total 10 standards focusing on 3 major domains: Professional and collaborative practice (Standards 1,2,3) Provision of care (Standards 4,5,6,7) Reflective and analytical practice (Standards 8,9,10) https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards/enrolled-nurse-standards-for-practice.aspx RMIT University©2017 School of Vocational Engineering, Health & Sciences RMIT Classification: Trusted CODES OF ETHICS Revised 2021 Has four principal elements that provide a framework for ethical conduct: nurses and patients or other people requiring care or services, nurses and practice, nurses and the profession, and nurses and global health. 1. 2. 3. 4. Nurses and patients or other people requiring care or services Nurses and practice Nurses and the professional Nurses and global health https://www.icn.ch/system/files/2021-10/ICN_Code-ofEthics_EN_Web_0.pdf RMIT Classification: Trusted CORE REGISTRATION STANDARDS What does the Nursing and Midwifery Board require in order for you to be a Nurse in Australia? Standards – set by NMBA, Mandatory , Audited Registration standard: Continuing professional development Registration standard: Recency of practice Criminal history registration standard English language skills registration standard Registration standard: Professional indemnity insurance arrangements https://www.nursingmidwiferyboard.gov.au/Registration-Standards.aspx RMIT University©2017 School of Vocational Engineering, Health & Sciences RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Standards: CPD Registration Standard Complete 20 hours of CPD each year CPD must be relevant to the nurse/midwife role CPD should be documented in an evidence record Records may include: - Tertiary, vocational and other courses/ post graduate studies - Conferences, forums, seminars and symposia - Short courses, workshops, seminars and discussion groups - Mandatory learning activities (area of practice) / in-services - Author a book chapter or have an article published in a peer-reviewed journal - Self directed learning - Any other structured learning activities RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Standards: Recency of practice To maintain registration [3 months equivalent of full-time work as a nurse/ midwife over a 5-year period (450hrs)] Refresher course to re-register at the end of the 5-year period Standards: Criminal history To ensure only nurses/ midwives who are suitable and safe to practise are granted registration Relevance of criminal history to the practice of their profession e.g. nature and gravity of offence Mandatory to declare any criminal history (alleged or convicted) to AHPRA RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Standards: English Language skills: 2019 Demonstrate English language proficiency in accordance with Board approved English language tests e.g., IELTS or OET or equivalent , no more than 2 years old , attained in one test sitting OR 5 years full time equivalent of education taught and assessed in any of the countries listed in the Registered Standard (Australia, Canada, New Zealand, UK, South Africa, Republic of Ireland, USA) RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Standards: Professional Indemnity Insurance Arrangements (PII) Must not practice their professions unless covered by appropriate PII arrangements that secure for their professional practice, insurance against civil liability incurred by or loss arising for a claim of negligent act, error, or omission in the conduct of the nurse/ midwife. Applies to independent practice and employee practice RMIT Classification: Trusted NMBA – Nursing And Midwifery Board of Australia Standards: Professional Indemnity Insurance Arrangements (PII) May be through: A membership of a professional body, trade union or defence organisation A contract of insurance Through private or public sector employer Vicarious liability: Employers may provide some PII vicariously to their employees, but it is up to individual nurses/midwives to ensure they are covered appropriately. RMIT Classification: Trusted SUPERVISION Supervision will be DIRECT or INDIRECT As an EN you will work under supervision of an RN. Supervision guidelines for nursing and midwifery https://www.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/Supervisedpractice.aspx Fact sheet: Enrolled nurse standards for practice https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Enrolled-nursestandards-for-practice.aspx RMIT Classification: Trusted DELEGATION IN NURSING One member of the health care team delegates aspects of consumer care to another member of the health care team from a different discipline, or to a less experienced member of the same discipline. Delegation vs allocation Delegation by registered Nurses- as per NMBA ANMF guideline “Delegation by registered nurses” http://anmf.org.au/documents/policies/G_Delegation_RNs.pdf RMIT Classification: Trusted ALWAYS ✓ Work within your scope ✓ Report to RN- patient management, clinical deterioration WHAT IS SCOPE OF PRACTICE? RMIT Classification: Trusted WHAT IS SCOPE OF PRACTICE? The scope of practice in nursing is what the nurse is allowed to do in their course of employment basing on their education, competence and law requirements. Influenced by Setting of their practice Health needs of the consumer Level of competence of the nurse Service provider’s policy requirements RMIT Classification: Trusted An Enrolled Nurse tries to interpret a scribbled medication order by the attending physician. The nurse thinks it says to give 50mg of the drug. The nurse administers 50 mg of the medication to the patient, and then discovers that the dose was incorrectly interpreted and should have been 5.0 mg. Who is ultimately responsible for the error? This Photo by Unknown Author is licensed under CC BY RMIT Classification: Trusted SOCIAL MEDIA GUIDELINES ACTIVITY Navigate this link https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/CodesGuidelines/Social-media-guidance.aspx WHY ARE THESE IMPORTANT? WHAT IS THE PURPOSE? SHARE YOUR THOUGHTS WITH THE CLASS. RMIT Classification: Trusted IMPLICATIONS OF NMBA SOCIAL MEDIA GUIDELINES Professionalism Complying with confidentiality and privacy obligations. Take care when using apps and sites to ensure you do not inadvertently post or communicate publicly, while thinking you are communicating privately. Make sure you know and understand the relevant security and privacy settings. Complying with your professional obligations as defined in your Board’s Code of conduct Maintaining professional boundaries RMIT Classification: Trusted IMPLICATIONS OF NMBA SOCIAL MEDIA GUIDELINES Nursing Communicating professionally and respectfully with or about patients, colleagues and employers Take care when sharing information, including comments or photos, that you do not inadvertently disclose patient information. Ethics Not presenting information that is false, misleading or deceptive, including advertising only claims that are supported by acceptable evidence. Comments in social media that reflect or promote personal views about social and clinical issues might impact on someone’s sense of cultural safety or could lead to a patient/client feeling judged, intimidated or embarrassed. RMIT Classification: Trusted SOME ACTS THAT NURSES “MUST NOT DO” WITH REGARDS TO SOCIAL MEDIA ▪ Friend/follow clients or their friends or family ▪ Make assumptions that privacy or security settings or status of other devices you may use, including workplace computers, will protect them in any way. ▪ Post unauthorised photographs of patients on Facebook or any other social media site This Photo by Unknown Author is licensed under CC BY-SA RMIT Classification: Trusted SOME ACTS THAT NURSES “MUST DO” WITH REGARDS TO SOCIAL MEDIA Use personal electronic devices as per workplace policy Consider the actions and the content of any post (or re-post) to social media before posting Comply with confidentiality and privacy obligations Take care when sharing information, including comments or photos, that you do not inadvertently disclose patient information. This Photo by Unknown Author is licensed under CC BY-SA RMIT Classification: Trusted SOME ACTS THAT NURSES “MUST DO” WITH REGARDS TO SOCIAL MEDIA Make sure that any comments you make on social media are consistent with the codes, standards and guidelines of your profession and do not contradict or counter public health campaigns or messaging. Maintain professional boundaries Communicate professionally and respectfully with or about patients, colleagues and employers Do not present information that is false, misleading or deceptive, including advertising only claims that are supported by acceptable evidence. This Photo by Unknown Author is licensed under CC BY-SA RMIT Classification: Trusted DECISION-MAKING FRAMEWORK FOR NURSING Effective 3rd February 2020 Support nurses and midwives to make decisions in practice, particularly about scope of practice and delegation, which is consistent, safe, person-centred and evidence based. 1. 2. 3. 4. Identify need/benefit Reflect on scope of practice and nursing practice standards Consider context of practice, governance and identification of risk Select appropriate, competent person to perform activities https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Frameworks.aspx RMIT Classification: Trusted DECISIONMAKING FRAMEWORK FOR NURSING RMIT Classification: Trusted NURSING AND MIDWIFERY DIGITAL HEALTH CAPABILITY FRAMEWORK Guide nurses and midwives to determine their digital capability level and identify where they can enhance their skills. https://www.digitalhealth.gov.au/sites/default/files/202011/National_Nursing_and_Midwifery_Digital_Health_Capability _Framework_publication.pdf RMIT Classification: Trusted NATIONAL SAFETY AND QUALITY HEALTH SERVICE (NSQHS) STANDARDS 8 Standards Provide a nationally consistent statement about the level of care consumers can expect from health services. Developed by the Australian Commission on safety and quality in healthcare To protect the public from harm To improve the quality of health service provision. https://www.safetyandquality.gov.au/standards/nsqhs-standards RMIT University©2017 School of Vocational Engineering, Health & Sciences RMIT Classification: Trusted Enrolled Nurse practice RMIT Classification: Trusted Enrolled Nurse practice RMIT Classification: Trusted Enrolled Nurse practice RMIT Classification: Trusted Social media guidelines https://www.nursingmidwiferyboa rd.gov.au/Codes-GuidelinesStatements/CodesGuidelines/Social-mediaguidance.aspxhttps://www.nursing midwiferyboard.gov.au/CodesGuidelines-Statements/CodesGuidelines/Social-mediaguidance.aspx RMIT Classification: Trusted Case study Mary is an enrolled nurse working in residential aged care. Mary’s colleagues had noticed that the residents in Mary’s care were looking uncared for over several shifts and that wet sheets were unchanged and urine bottles not emptied. Mary was also spending a lot of time at the nurses’ station while her residents were left unattended. Mary’s manager raised the issues that both she and her colleagues had noticed with Mary. Identify the code of conduct principles that apply to this scenario. RMIT Classification: Trusted Enrolled Nurse practice Key bodies : NMBA, AHPRA, ANMAC, ANMF Guidelines: – – – – – Code of conduct ICN Code of Ethics EN Standards for practice Core registration standards – CPD, Recency of practice, English language requirements, Criminal history check, Professional indemnity arrangements Social media guidelines RMIT Classification: Trusted REFERENCES Nursing and Midwifery Board of Australia. (2018). Code of Conduct for Nurses in Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards.aspx Nursing and Midwifery Board of Australia. (2018) Code of ethics for Nurses March 2018 Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards.aspx Nursing and Midwifery Board of Australia. (2016). Standards of Practice for Enrolled Nurses. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards/enrolled-nurse-standards-for-practice.aspx RMIT Classification: Trusted REFERENCES RMIT University©2017 Koutoukidis, G., Stainton, K., & Hughson, J. (2017). Tabbner’s Nursing Care Theory and Practice. (7th ed.). Australia: Elsevier. Staunton, P. & Chiarella, M. (2020). Law for Nurses and Midwives. (9th ed.). Sydney: Elsevier. Walker, L. (2023). Law and Ethics (ANMF) - [PowerPoint slides]. Legislations www.legislation.vic.gov.au www.australia.gov.au http://supremecourt.vic.gov.au http://hcc.vic.gov.au https://www.safetyandquality.gov.au/consumers/working-yourhealthcare-provider/australian-charter-healthcare-rights/resourcesaustralian-charter-healthcare-rights https://www.aph.gov.au/constitution School of Vocational Engineering, Health & Sciences