Introduction
Registered nurse (RN) practice Is person-centred and evidence-based with preventative, curative, formative, supportive, restorative and palliative elements. RNs work in therapeutic and professional relationships with IndlAduels, as well as with families, groups and communities. These people may be healthy and with a range of abilities, or have heath Issues related to physical or mental illness and/or health challenges. These challenges may be posed by physical, psychiatric, developmental and/or Intellectual disabilities.
The Australian community has a rich mixture of cultural and linguistic diversity, and the Registered nurse standards for practice are to be read in this context. RNs recognise the importance of history and culture to health and wellbeing. This practice reflects particular understanding of the Impact of colonisation on the cultural, social and spiritual lives of Aboriginal and Torres Strait Islander peoples, which has contributed to significant health inequity in Australia. As regulated health professionals, RNs are responsible and accountable torthe Nursing and Midwifery Board of Australia (NMBA). These are the national Registered nurse stand rds for practice for all RNs. Together with NMBA standards, codes and guidelines, these Registered nurse standards for practice should be evident in current practice, and inform the development of the scopes of practice and aspirations of RNs.
RN practice, as a professional endeavour, requires continuous thinking and analysis in the context of thoughtful development and maintenance of constructive relationships. To engage in this work RNs need to continue to develop professionally and maintain their capability for professional practir determine, coordinate and provide safe, quality nursing. This practice includes compreher.._ assessment, development of a plan, implementation and evaluation of outcomes. As part of erect., RNs am responsible and accountable for supervision and the delegation of nursing activity to enrolled nurses (ENs) and others.
Practice is not restricted to the provision of direct clinical care. Nursing practice extends to any paid or unpaid role where the nurse uses their nursing skills and knowledge. This ornctice includes working in a direct non-clinical relationship with clients, working in management, admk Jon, education, research, advisory, regulatory, policy development roles or other roles that impact on safe, effective delivery of services in the profession and/or use of the nurse’s professional skills. RNs are responsible for autonomous practice within dynamic systems. and in relationships with other health care professionals.
Now to use these standards The Registered nurse standards for practice consist of the following seven standards:
1. Thinks critically and analyses nursing practice.
2. Engages in therapeutic and professional relationships.
3. Maintains the capability for practice.
4. Comprehensively conducts assessments.
5. Develops a plan for nursing practice.
- Provides safe, appropriate and responsive quality nursing practice. 7. Evaluates outcomes to inform nursing practice. The above standards are all interconnected (see Figure 1). Standards one, two and three relate to each other, as well as to each dimension of practice in standards four, five, six and seven. Figure 1: Registered nurse standards
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Each standard has criteria that specify how that standard is demonstrated. The criteria are to be interpreted in the context of each RN’s practice. For example. all RNs will, at various times, work in partnerships and delegate responsibilities, however not every RN will delegate clinical practice to enrolled nurses. The criteria are not exhaustive and enable rather than limit the development of individual registered nurse scopes of practice.
The Registered nurse standards for practice are for all RNs across all areas of practice They are to be read in conjunction with the applicable NMBA standards, codes and guidelines, including the Code of conduct for nurses, National framework for the development of decision-making tools for nursing and midwifery practice. Supervision guidelines for nursing and midwifery and Guidelines for mandatory notifications. The glossary is also important for understanding how key terms are used in these standards.
6.Provides safe, appropriate and responsive quality nursing practice.
7. Evaluates outcomes to inform nursing practice.
The above standards are all interconnected (see Figure 1). Standards one, two and three relate to each other, as well as to each dimension of practice in standards four, five, six and seven. Figure 1: Registered nurse standards
Each standard has criteria that specify how that standard is demonstrated. The criteria are to be interpreted in the context of each RN’s practice. For example. all RNs will, at various times, work in partnerships and delegate responsibilities, however not every RN will delegate clinical practice to enrolled nurses. The criteria are not exhaustive and enable rather than limit the development of individual registered nurse scopes of practice.
The Registered nurse standards for practice are for all RNs across all areas of practice They are to be read in conjunction with the applicable NMBA standards, codes and guidelines, including the Code of conduct for nurses, National framework for the development of decision-making tools for nursing and midwifery practice. Supervision guidelines for nursing and midwifery and Guidelines for mandatory notifications. The glossary is also important for understanding how key terms are used in these standards.
Registered nurse standards for practice
Standard 1: Thinks critically and analyses nursing practice RNs use a variety of thinking strategies and the best available evidence in making decisions and providing safe, quality nursing practice within person-centred and evidence-based frameworks.
The registered nurse:
1.1 accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice
1.2 develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice
1.3 respects at cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures
1.4 complies with legislation, regulations, policies, guidelines and other stgndards or requirements relevant to the context of practice when making decisions
1.5 uses ethical frameworks when making decisions
1.6 maintains accurate, comprehensive and timely documentation of assessments, planning, decision-making, actions and evaluations, and
1.7 contributes to quality improvement and relevant research. Standard
2: Engages in therapeutic and professional relationships RN practice is based on purposefully engaging in effective therapeutic and professional relationships. This includes collegial generosity in the context of mutual trust and respect in professional relationships. The registered nurse:
2.1 establishes, sustains and concludes relationships in a way that differentiates the boundaries between professional and personal relationships
2.2 communicates effectively, and is respectful of a person’s dignity, culture, values, beliefs and rights
2.3 recognises that people are the experts in the experience of their life
2.4 provides support and directs people to resources to optimise health-related decisions
2.5 advocates on behalf of people in a manner that respects the person’s autonomy and legal capacity
2.6 uses delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes
2.7 actively fosters a culture of safety and learning that includes engaging with health professionals and others, to share knowledge and practice that supports person-centred care
2.8 participates in and/or leads collaborative practice. and
2.9 reports notifiable conduct of health professionals, health workers and others.
Standard 3: Maintains the capability for practice
RNs, as regulated health professionals, are responsible and accountable for ensuring they are safe, and have the capability for practice. This includes ongoing self-management and responding when there is concern about other health professionals’ capability for practice. RNs are responsible for their professional development and contribute to the development of others. They are also responsible for providing information and education to enable people to make decisions and take action in relation to their health.
The registered nurse:
3.1 considers and responds in a timely manner to the health and wellbeing of self and others in relation to the capability for practice
3.2 provides the information and education required to enhance people’s control over health
3.3 uses a lifelong leaming approach for continuing professional development of self and others
3.4 accepts accountability for decisions, actions, behaviours and responsibilities inherent in their role, and for the actions of others to whom they have delegated responsibilities
3.5 seeks and responds to practice review and feedback
3.6 actively engages with the profession. and
3.7 identities and promotes the integral role of nursing practice and the profession in influencing better health outcomes for people.
Standard 4: Comprehensively conducts assessments
RNs accurately conduct comprehensive and systematic assessments. They analyse information and data and communicate outcomes as the basis for practice.
The registered nurse’
4.1 conducts assessments that are holistic as well as culturally appropriate
4.2 uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice
4.3 works in partnership to determine factors that affect, or potentially affect, the health and wellbeing of people and populations to determine pnonties for action and/ or for referral.
Standard 5: Develops a plan for nursing practice
RNs are responsible for the planning and communication of nursing practice. Agreed plans are developed in partnership. They are based on the RNs appraisal of comprehensive, relevant information, and evidence that is documented and commurticated.
The registered nurse: 5.1 uses assessment data and best available evidence to develop a plan 5.2 collaboratively constructs nursing practice plans until contingencies, options priorities, goals, actions, outcomes and timeframes are agreed with the relevant persons 5.3 documents, evaluates and modifies plans accordingly to facilitate the agreed outcomes 5.4 plans and negotiates how practice will be evaluated and the time frame of engagement, and 5.5 coordinates resources effectively and efficiently for planned actions. Standard 6: Provides safe, appropriate and responsive quality nursing practice RNs provide and may delegate, quality and ethical goal-directed actions. Tpese are based on comprehensive and systematic assessment, and the best available evidenle to achieve planned and agreed outcomes. The registered nurse: 6.1 provides comprehensive safe, quality practice to achieve agreed goals , Jtcomes that are responsive to the nursing needs of people Registered nurse standards for practice
6.2 practises within their scope of practice
6.3 appropriately delegates aspects of practice to enrolled nurses and others, according to enrolled nurse’s scope of practice or others’ clinical or non-clinical roles
6.4 provides effective timely direction and supervision to ensure that delegated practice is safe and correct
6.5 practises in accordance with relevant policies. guidelines, standards, regulations and legislation, and 6.6 uses the appropriate processes to identify and report potential and actual risk related system issues and where practice may be below the expected standards. Standard 7: Evaluates outcomes to inform nursing practice RNs take responsibility for the evaluation of practice based on agreed priorities, goals, plans and
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