Week 13 Communication & Teaching with Children & Families PDF

**FINALS- PEDIATRIC RESOURCE UNIT LECTURE** **WEEK 13- COMMUNICATION and TEACHING with CHILDREN and FAMILIES** **Learning Objectives:** After lecture/ discussion, the learners will be able to: 1. Describe principles of effective communication as well as teaching and learning as they relate...

**FINALS- PEDIATRIC RESOURCE UNIT LECTURE** **WEEK 13- COMMUNICATION and TEACHING with CHILDREN and FAMILIES** **Learning Objectives:** After lecture/ discussion, the learners will be able to: 1. Describe principles of effective communication as well as teaching and learning as they relate to health teaching with children. 2. Assess children for their ability to communicate and their readiness to learn. 3. Formulate nursing diagnosis related to communication and health teaching with children. 4. Identify expected outcomes for a specific child based on the child's age, developmental maturity, emotional needs, and communication or learning style. 5. Implement health teaching. 6. Evaluate expected outcomes for achievement and effectiveness of care. Communication- the interchange of information between 2 or more people; the exchange of ideas and thoughts. Any means of exchanging information or feelings between 2 or more people, the basic of human relationships. Modes of Communication 1. Verbal Communication - Uses spoken or written words. 2. Non-Verbal Communication- is sometimes called "body language". Often tells others more about a person is feeling than what is said. EX. Touch, eye contact, e-mail/ mail Communication is important in the care of children because it can make or break an effective relationship. 2 Major Categories of Communication as a Process: 1. Non-Therapeutic Techniques of Communication/ Communication Roadblocks -- is identified by its lack of structure or planning: it lacks deliberate purpose other than socializing. Ex. Dinner conversation. 2. Therapeutic communication- is a face-to-face process of interaction focusing on advancing the physical and emotional well-being of patients. It is an interaction between two people that is planned, has structure, and is helpful. Components of Good Communication 1\. The Encoder / Sender -- a person who desires to share a thought or feeling with someone else and so originates the message or a person or group who wishes to convey a message to another. Can be considered a source-encoder which suggests that the person or group sending the message must have an idea or reason for communicating (source) and must put the idea or feeling into a form that can be transmitted. 2\. Code/ Message -- message conveyed and includes the medium or system used to convey it or what is actually said or written, the body language that accompanies the words, and how the message is transmitted. - The medium used to convey the message is the channel, and it can target any of the receiver's senses. 3.The Decoder/ Receiver -- is the person who not only receives the message but also interprets or decodes its meaning or the listener, who must listen, observe, and attend. 4\. Response or Feedback -- the message or reply to the decoder or receiver returns to the sender to acknowledge the message has been received and interpreted. It is also called feedback. This can be either verbal or non-verbal, or both. It can be a nod, smile, hand gesture, return e-mail. The development of Language It involves not only physical being able to form and voice words but also the comprehension of what they mean and how they are used. BOX 35.2 page 966. The first cry of infant at birth important because it both signals that infant is breathing well and announces to parents the birth is real thus stimulate parent-child bonding. By 2 years of age, mastered language well enough to put two-word sentences (noun & verb) together. By preschool age, not only a vocabulary of 900 words but can code them into simple jokes or stories. School-age children enlarge their ability to communicate from oral exchanges to use of the telephone and various electronic devices. Write poetry and show adult sense of humor by jokes. Adolescents progress to a new phase in which they originate new words for objects or feelings (cool or and whatever as responses). Helps them separate their world from adults and keep their adolescent culture separate. Levels of Communication 1. The First Level: Cliché' conversation- is a pleasant chatting or comments such as "Have a nice day" between people who do not intend for their relationship to extend beyond a superficial level. When meeting a child for the first time that you introduce yourself not only your name but also your position and function (I am student nurse who is going to take care of you). This will move the conversation from a cliché level to a more meaningful one. 2. The Second Level: Fact Reporting- is simply stating facts about oneself (a child says, "I'm in sixth grade"), necessary for you to understand children, can only go to higher level when they feel they can trust you. 3. The Third Level: Shared Personal Ideas and Judgments -- when they know you well, they are able to share ideas such as" I always wanted to be an astronaut" and judgments as " This is too hard for me". This exposes them to a loss of self-esteem if their views are not respected. The beginning of therapeutic interactions. 4. The Fourth Level: Shared Feelings- Difficult to share feelings until you truly trust another person because feelings are fragile concepts, easily destroyed and crushed by inept or uncaring comments. Ex. "I hate always being sick," represents trust in you. 5. The Fifth Level: Peak Communication: - is a sense of oneness or being able to know what the other person is experiencing without any words being voiced out. Occurs spontaneously in high -intensity situations but generally arises out of long-term relationships. NON-VERBAL COMMUNICATION Wrinkling the nose can be especially important in areas such as ICU when a child may be unable to speak because of ET tube or ventilators. Factors to consider: 1\. General Appearance- children with high self-esteem tend to maintain good body hygiene and care about appearance, those who feel depressed may not feel the effort involved in grooming. 2\. Body Posture and Gait- children who feel good about themselves usually assume an upright body posture and walk rapidly, those depressed or insecure tend to slouch and move mor timidly., those threatened tend to draw back or act aggressively. 3\. Humor- some people have a natural knack for finding humor in any natural situation, others do not. Be careful of the use of humor with children. 4\. Drawings- useful non- verbal technique to learn how children feel about frightening experiences is to ask them to draw a picture of what happened of themselves. 5\. Music- type of music children listen conveys their mood. Feel good- lively music, sad- quitter or more comforting type. Techniques to encourage Therapeutic Communication 1. Distance - Personal Space*-* the distance people prefer in interaction with others. It involves paying attention to the total message both verbal and non-verbal, and noting whether these communications are congruent. - Proxemics is the study of distance between people interactions. - Intimate: touching to 1 ½ feet, characterized by body contact, heightened sensations of body heat & smell, vocalization is low. - Personal: 1 ½ to 4 feet, less overwhelming. Voice tones are moderate, & body heat & smell are noticed less. - Social: 4-12 feet, characterized by clear visual perception of the whole person. Body & heat are imperceptible, eye contact is increased & vocalizations are loud enough to be heard. - Public: 12-15 feet, requires loud, clear vocalizations with careful enunciation. 2. Genuineness and Truthfulness -- is a quality of projecting sincerity or being yourself. 3. Warmth- is an innate quality some people manifest more spontaneously than others. Ways: direct eye contact, use of gentle tone of voice, listening attentively, approaching a child within a comfortable space of 1 to 4 ft and use of touch. 4. Empathy- is the ability to put yourself in another person's place and understand and be sensitive to the feelings of another. 5. Gestures- children vary a great deal in gestures they use to accompany their spoken words. 6. Facial expressions- important accompanying gestures to words. 7. Touch- most intimate and meaningful of non-verbal techniques. 8. Attentive listening- Nodding, maintaining eye contact and stopping all other activities are strong indicators you are attuned to what is being said. 9. Reflecting- is restating the last word or phrase a child has said. Ex. "I am worried' and the stops. "Worried"? 10. Clarifying repeating statements others have made so you can be certain you understood them especially when a child describes a set of symptoms. 11. Paraphrasing-restating what the child has said not only to assure the child you have heard correctly but also to help explain a thought. 12. Perception checking- documents a feeling or emotion reported to you. A step deeper than paraphrasing- In paraphrasing you document a statement or fact, in perception checking you document emotion or feeling. 13. Focusing- it is done by repeating something they had said. Helps children to center on a subject you suspect is causing them anxiety because they comment about it indirectly or completely avoid it. 14. Supportive Statements- let children know you accept their behavior or at least appreciate they have dealt well with unfortunate circumstances. 15. Silence- effective therapeutic technique Process Recording- is a method to examine how effective you are at therapeutic communication. Factors that Can Interfere with Effective Communication 1. Age and Developmental level- levels- influence vocabulary and reading ability. 2. Intellectual or Behavioral Level -- affects vocabulary and ability to encode and decode messages. 3. Physical factors- speech impairment, hearing or vision, challenges interfere with the transmission of messages. 4. Technical Terminology- use of medical words 5. Showing Disapproval- criticize them. 6. Not showing Approval When warranted- no reward given. 7. Growing defensive -- do not enjoy being criticized. 8. Cliché' Advice- too general 9. Topping Up Communication Situations that Require Unique Skills 1. The shy child 2. The Angry child 3. The Demanding child 4. The Bullying or Sexually Aggressive Adolescent 5. The Child who is not Proficient in English 6. The Unconscious child 7. The Child with Hearing Impairment- difficulty enunciating words. 8. The child with Vision Impairment- never touch. Health Teaching in a Changing Healthcare Environment 1. Cognitive learning- change in the individual's level of understanding or knowledge 2. Psychomotor learning- requires a change in a person's ability to perform a skill. 3. Affective learning- change in a person's attitude, most difficult area. Influence of Age and Stage on Ability to Learn: - The Infant- learn by exploring with senses. - The Toddler- sense of autonomy - The Preschooler- sense of initiative - The school age- sense of industry - The adolescent- use scientific reasoning. Developing and Implementing Teaching Plan - Teaching plan- is a design of the content to be taught, the teaching/learning techniques to be used, and the evaluation method and tools to be used. Determining Teaching Strategies 1. Lecture (directly explain information)-most efficient and time saving method. 2. Demonstration -- actually performing a procedure. 3. Redemonstration- exact imitation of the procedure 4. Discussion- shared learning experience 5. Role Modelling- demonstrating certain attitude or behavior. Behavioral Therapy- called behavioral modification. Used for a system aimed at erasing some form of behavior that interferes with healthy functioning. -- help people cognitively challenged erase unacceptable behavior. Learning occurs best with positive reinforcement by praising the child. Selecting Teaching Tools 1. Visual Aids- is realistic-helpful in explaining anatomy. 2. Pamphlets - or information sheets helpful teaching aids with school age, adolescents, and parents. - Contain brief, easy to read, and easily understood information illustrated with cartoon characters to make them enjoyable. 3\. Learning Games- use of flash cards with questions for health teaching 4\. Videos -- used as part of the health education program. 5\. Puppets & dolls- able to open up to an uncritical puppet or doll. 6. Mass Media- ex. Television or radio- used to teach children about self- help or self-care. 7. Computers & internet- answer questions about illness, learn to solve problems for preschool age- you- tube videos. Preparing Teaching supplies- put in one basket all the information and equipment needed for the procedure. Implementing the Plan- health teaching begins immediately after contact with a child. Using designated teachers- have specific people who are available for teaching. Parent Education- can perform the required skill. Evaluating the Effectiveness of Teaching - Evaluation or assessing whether teaching has been effective is the final step in teaching. Health Teaching for a Surgical Experience - psychological preparation of both the child and the parents is aimed at reducing a child's fears about the procedure. Teaching to prepare a child for surgery. - Psychological preparation of both child & parent - Assessing current level of knowledge - Emotional preparation **Patient's Bill of Rights and Obligations** 1\. Medical Care. The right to quality care and treatment consistent with available resources and generally accepted standards. The patient has the right to refuse treatment to the extent permitted by law and government regulations, and to be informed of the consequences of his/her refusal. 2\. Respectful Treatment. The right to considerate and respectful care, including effective pain management, with recognition of his/her personal dignity. 3\. Privacy and Confidentiality. The right, within the law and military regulations, to privacy and confidentiality concerning medical care. 4. Identity. The right to know, at all times, the identity, professional status, and professional credentials of health care personnel, as well as the name of the health care personnel, and the name of the health care provider primarily responsible for his/her care. 5\. Explanation of Care. The right to an explanation concerning his/her diagnosis, treatment, procedures, and prognosis of illness in terms the patient can be expected to understand. When it is not medically advisable to give such information to the patient, the information should be provided to appropriate family members. 6\. Informed Consent. The right to be advised in non-clinical terms of information is needed to make knowledgeable decisions on consent or refusal for treatment. Such information should include significant complications, risks, benefits, and alternative treatments available. 7\. Research Projects. The right to be advised if the facility proposes to engage in or perform research associated with his/her care or treatment. The patient has the right to refuse to participate in any research projects. 8\. Safe Environment. The right to care and treatment in a safe environment. 9\. Medical Treatment Facility (MTF). The right to be informed of the facilities' rules and regulations that relate to patient or visitor conduct. The patient should be informed about smoking rules and should expect compliance with those rules from other individuals. Patients are entitled to information about the mechanisms for the initiation, review, and resolution of patient complaints. 10\. Pediatric Considerations. Pediatric patients will be provided the same rights to medical care, respectful treatment, confidentiality, and a safe environment and privacy. - Parents/legal guardians will be afforded the right to be informed of the identity of health care personnel, an explanation of care, including diagnosis, treatment and prognosis, and the right to refuse treatment for the patient to the extent permitted by law. **Responsibilities** 1. Providing Information. The responsibility to provide, to the best of his/her knowledge, accurate and complete information about past illness, hospitalizations, medications, and other matters relating to his/her health. - A patient has the responsibility to let his/her primary health care provider know whether he/she understands the treatment and what is expected of him/her. 2. Respect and Consideration. The responsibility for being considerate of the rights of other patients and health care personnel and for assisting in the control of noise, smoking, and the number of visitors. The patient is responsible for being respectful of the property of other people and of the facility. 3. Compliance with Medical Care. The responsibility for complying with the medical and nursing treatment plan, including follow-up care, recommended by health care providers. This includes keeping appointments on time and notifying the facility when appointments cannot be kept. 4. Medical Records. The responsibility for ensuring that medical records are promptly returned to the medical facility for appropriate filing and maintenance when records are transported by the patients for the purpose of medical appointment or consultation, etc. All medical records documenting care provided by any MTF are the property of the hospital. 5. Rules and Regulations. Patients must follow general medical facility rules and policies affecting patient and visitor conduct. 6. Reporting of Patient Complaints. The responsibility for helping the MTF Commander provide the best possible care to all beneficiaries. Patient's recommendations, questions, or complaints should be reported to the Patient Contact Representative/ Customer service. 7. Pediatric Considerations. Parents/legal guardians have the same responsibility to provide medical information concerning the patient's illness, to be respectful and considerate of other patients and health care personnel, and to assist in reinforcing compliance by children with the treatment plan recommended by health care personnel. Parents/legal guardians and children are expected to abide by MTF rules and regulations, and to promptly bring concerns or observations about changes in the patient's condition to the attention of medical or nursing staff. Parents/legal guardians are expected to visit their children on a regular basis to provide emotional support. 1. The patient has the right to considerate & respectful care, irrespective of socio-economic status. 2. The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis in terms the patient can reasonably be expected to understand. When it is not medically advisable to give such information to the patient. The information should be made available to an appropriate person on his behalf. He has the right to know by name or in person, the medical team responsible for coordinating his care. 3. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and or treatment. Except in emergencies, such information for informed consent should include but not necessarily limited to the specific procedure and or treatment, the medically significant risks involved, and the probable duration of incapacitation. Where medically significant alternatives for care or treatment exist, or when the patient requests information concerning medical alternatives, the patient has the right for such information. The patient also has the right to know the name of the person responsible for the procedure and/or treatment. 4. The patient has the right to refuse treatment / life-giving measures, to the extent permitted by law and to be informed of the medical consequence of his action. 5. The patient has the right to every consideration of his privacy concerning his own medical care program. Case discussion, consultation, examination & treatment are confidential and should be conducted discreetly. Those not directly involved in his care must have permission of the pt. to be present. 6. The patient has the right to expect that all communication and records pertaining to his care should be treated as confidential. 7. The patient has the right that within its capacity, a hospital must make reasonable response to the request of patient for services. The hospital must provide evaluation, service and or referral as indicated by the urgency of care. When medically permissible, a patient may be transferred to another facility only after he has received complete information concerning the needs and alternatives to such transfer. The institution to which the patient is to be transferred must first have accepted the patient for transfer. 8. The patient has the right to obtain information as to any relationship of the hospital to other health care and to other health care and educational institutions in so far as his care is concerned. The patient has the right to obtain as to the existence of any professional relationship among individuals, by name who are treating him. 9. The patient has the right to be advised if the hospital proposes to engage on or perform human experimentation affecting his care or treatment. The patient has the right to refuse or participate in such research projects. 10. The patient has the right to expect reasonable continuity of care; he has the right to know in advance what appointment times the physicians are available and where. The patient has the right to expect that the hospital will provide a mechanism whereby he is informed by his physician or a delegate of the physician of the patient\'s continuing health care requirements following discharge. 11. The patient has the right to examine and receive an explanation of his bill. 12. The patient has the right to know what hospital rules and regulations apply to his conduct as a patient. **Week 14 - Maternal & Childcare Entrepreneurial Opportunities** Learning Objectives**:** After lecture/ discussion, the students will be able to: 1. Define related terms. 2. Compare birth center from a hospital setting. 3. Identify the scope and standards of maternal and childcare practices in the Philippines. **Week 14 - Maternal & Childcare Entrepreneurial Opportunities** Entrepreneurship - The act of running and starting your own business or wishing to work for yourself in your own venture. - About Innovations, about seeing problems as opportunities and about changing the world. - A birth center is a healthcare facility, staffed by nurse midwives, midwives and/or obstetricians, for mothers in labor. The midwives monitor the labor, and well-being of the mother and fetus during birth. Should additional medical assistance be required the mother can be transferred to a hospital. - A birthing center is a medical facility, homelike, specializing in childbirth, that is less restrictive, who desire a [natural childbirth experience](https://www.whattoexpect.com/pregnancy/natural-birth/). - Freestanding facilities, but sometimes they're adjacent to or inside a hospital. - In most birthing centers, [midwives](https://www.whattoexpect.com/pregnancy/doctor-type/) (and not OB-GYNs) are the primary care providers. - Besides offering a comfortable place to deliver your baby, services include: a. Woman's vaginal exams b. Preconception counseling c. Prenatal care d. Childbirth e. Breastfeeding classes f. f. Postpartum care and support g. Post-baby birth control. - At birth centers, care is typically led by midwives, though birth centers may work in collaboration with OB-GYNs, pediatricians, and other healthcare professionals --- meaning they consult them if the need arises. But giving birth at a birth center and giving birth at a hospital differ in several ways. While a labor room in a hospital looks like, well, a room in a hospital, birthing rooms at a birthing center are much more comfortable. And procedures that are standard or at least common in a hospital setting (such as [continuous fetal monitoring](https://www.whattoexpect.com/pregnancy/labor-and-delivery/procedures-and-interventions/electronic-fetal-monitoring.aspx), [routine IV's](https://www.whattoexpect.com/pregnancy/labor-and-delivery/procedures-and-interventions/routine-iv.aspx), and [induction of labor](https://www.whattoexpect.com/pregnancy/labor-induction/)) aren't routine at a birthing center. - Comfort. - Greater privacy. - More freedom. You can walk around and be as active as you like, wear what you want, and give birth in whatever position feels most comfortable. You even get to eat a light meal or snack and drink during and after labor (no food or drinks during the pushing phase though). At a hospital, on the other hand, all food, and fluids (except for ice chips) are usually a no-go, your movements will probably be limited (since there is usually continuous electronic fetal monitoring), and you'll - Families stay together. With a hospital delivery, your baby will be taken to a different room for his or her first checkup, and a few times more for other procedures. At a birthing center, however, unless he needs emergency care, your baby won't be whisked off to another room after the birth (and family and friends won't be sent away either --- unless you want them to be). Everything --- from preventative care like the vitamin K shot to baby's first bath and checkup --- happens in the same room. - A shorter stay. Because fewer medications and medical interventions are involved, recovery time is shorter than at a hospital. Most families leave the center four to eight hours after birth, compared to 24 to 48 hours at a hospital. And a shorter stay means you'll spend less money.  - Reduced risk of a C-section. The rate of C-sections for women who chose a birth center to deliver is around 6% (compared to just under 26% for similar low-risk women in hospitals). - No epidural. Most birth centers don't give epidurals. Instead, they turn to [alternative pain relief](https://www.whattoexpect.com/pregnancy/labor-and-delivery/labor-pain/complementary-and-alternative-medicine-techniques.aspx) options, such as hydrotherapy, breathing exercises, massage and acupuncture. Some centers also offer nitrous oxide gas. - Lack of centers. The number of birth centers around the country is limited (and services may be in high demand) --- especially if you live in a small town. - Possible transfer to a hospital. If there is a problem or emergency, you'll be transferred to a hospital. Fortunately, fewer than 2 percent of transfers are due to emergencies (they're mostly due to mom having an extremely difficult labor and/or requests for an epidural.) However birthing centers do have IVs, oxygen and infant resuscitators on hand for use during the transfer process. - No insurance coverage. Some insurance companies don't cover births at a birthing center. Contact your insurance provider to discuss your coverage. - When you can't give birth at a birthing center. - Birthing centers handle only low-risk pregnancies. If you have hypertension, diabetes or gestational diabetes, your baby is in the breech position, you're pregnant with multiples, or you have other issues that may cause complications, a birthing center isn't the right option for you. Day Care A facility for kids aged four and below is classified as a day-care, while preschools serve children aged four-and-a-half to six. Technically, day-care centers are places where parents drop off. - Nursery rhymes, special toys and instruments for example should be available. - Day Care Centers are run by a team of staff with activities planned for entertainment and education. Preschool or day care centers are mainly established to help in the values formation and socialization of children aged 3 to 6 years old. The facility is intended for parents to prepare their children for grade school. As the population increases, the preschool education also steadily boomed and has become a profitable venture in the Philippines. RA. 6972 -- An Act Establishing a Day Care Center or Day Care Law. Day-care centers, also called day nursery, nursery school, institution that provides supervision and care of infants and young children during the daytime, particularly so that their parents can hold jobs. **Presidential Decree No. 1567 - Establishing a DAY CARE CENTER in every barangay and appropriating funds.** - There are three million Filipino children who are found to be suffering from malnutrition and lack of opportunities for their social development. - Pre-school children with ages ranging from 0-6 years are the most vulnerable to the ill-effects of malnutrition and lack of social and mental stimulation. - The government has exerted relentless effort to combat malnutrition by organizing day care centers and supplemental feeding units to promote the social and mental development of - The number of day care centers and feeding centers found throughout the Philippines are inadequate. - There is an urgent need to expand this program in order to reach more needy children, protect their interests and prevent the loss of these human potentials. - There is an urgent need to expand this program in order to reach more needy children, protect their interests and prevent the loss of these human potentials. - The expansion of this program can be achieved with the collective efforts of the public and private sector through the active involvement of non-governmental organizations. - Support for Day Care Centers may be drawn from the unexpended balance of local government or donations from private sector, as well as contribution from international organizations signed by Ferdinand E Marcos. - **Section 1.** Title and Scope of the Decree. This Decree shall be known as the Barangay Day Care Center Law of 1978. - **Sec. 2.** That in every barangay with at least one hundred (100) family heads residing therein, there shall be established a Day Care Center. - **Sec. 3.** That said Day Care Center shall look after the nutritional needs and social and mental development of all children from ages 2 to 5 when their parents are unable to do so. - **Sec. 4.** That said Day Care Center should be staffed with at least one (1) female day care nursery worker of good physical health who is competent to provide substitute parental care and to provide services for their social and mental development. - **Sec. 5.** That said Barangay Day Care Centers shall be accredited by the Bureau of Family and Child Welfare of the DSSD. - **Sec. 6.** That funds for the establishment and maintenance of depressed Barangay Day Care Centers may be appropriated from the unexpended balance of local and national government or from public donations. **Scope & Standards of Maternal & Child Practices in the Philippines** Scope & Standards In line with the eight domains in the WHO quality of care framework, eight standards have been formulated to define the priorities for quality improvement: 1\. Evidence-based practices for routine care and management of complications. 2\. Actionable information systems. 3\. Functioning referral systems. 4\. Effective communication. 5\. Respect and preservation of dignity. 6\. Emotional support. 7\. Competent, motivated personnel; and 8\. Availability of essential physical resources. Standards of Maternal & Child Nursing Practice - In Maternal & Child health, standards were developed in 1980s by the Division of MCHN Practice of the American Nurses Association to provide important guidelines for planning care & devising outcome criteria for the evaluation of nursing care. Updated in connection with the society of Pediatrics Nurses. - ANA/ Society of Pediatric Standard of Care & Professional Performance Standards of Care - Comprehensive pediatric nursing care focuses on helping children & their families & communities achieve their optimum health potentials. Best achieved within the framework of family-centered care & the nursing process, including primary, secondary & tertiary care coordinated across health care & community settings - Standard I: Assessment - Standard II: Diagnosis - Standard III: Outcome Identification - Standard IV: Planning - Standard V: Implementation The pediatric nurse implements the interventions identified in the plan of care. - Standard VI: Evaluation The pediatric nurse evaluates the child's & family's progress toward attainment of outcomes. **Standards of Professional Performance** - Standard I: Quality Care The pediatric nurse systematically evaluates the quality & effectiveness of pediatric nursing practice. - Standard II: Performance Appraisal The pediatric nurse evaluates his or her own nursing practice in relation to professional practice standards & relevant statutes & regulations. - Standard III: Education The pediatric nurse acquires & maintains current knowledge in pediatric nursing practice. - Standard IV: Collegiality The pediatric nurse contributes to the professional development of peers, colleagues, & others. - Standard V: Ethics The pediatric nurse's decisions & actions on behalf of children \^ their families are determined in an ethical manner. - Standard VI: Collaboration: The professional nurse collaborates with the child, family, & health care provider in providing client care. - Standard VII: Research The pediatric nurse uses research findings in practice. - Standard VIII: Research Utilization The pediatric nurse considers factors related to safety, effectiveness, & cost in planning & delivering care. **Association of Women's Health, Obstetrics, & Neonatal Nurses Standards & Guidelines** Standards of Professional Performance - Standard I: Quality of Care - Standard II: Performance Appraisal - The nurse evaluates his/her own nursing practice in relation to professional practice standards & relevant statute & regulations. - Standard III: Education - The nurse acquires & maintains current knowledge in nursing practice. - Standard IV: Collegiality - The nurse contributes to the professional development of peers, colleagues & others. - Standard V: Ethics - The nurse's decisions & actions on behalf of patients are determined in an ethical manner. - Standard VI: Collaboration - The nurse collaborates with the patient, significant others, & health care providers in providing patient care. - Standard VII: Research - The nurse uses research findings in practice. - Standard VIII: Resource Utilization - The nurse considers factors related to safety, effectiveness, & cost in planning & delivering patient care. - Standard IX: Practice Environment - The nurse contributes to the environment of care delivery within the practice settings. - Standards X: Accountability - The nurse is professionally & legally accountable for his/her practice. The professional registered nurse may delegate to & supervise qualified personnel who provide patient care.