Framework, Scope and

Trends of Nursing Practice

 FRAMEWORK
Health care faces many challenges, including rising costs,
shortage of professionals, un ageing population.
The introduction of new technologies and difficulties with
access to care is also a challenge.
• In particular advance nursing plays a key role in meeting
the Health needs , by building the nursing knowledge,
advancing the nursing profession and effective healthcare
system.
DEFINITION OF ADVANCE NURSING
PRACTICE
• Advance nursing practice is an umbrella term describing an
advance level of clinical practice that maximizes the use of
graduate educational preparation, it depth nursing knowledge
and expertise in meeting the health needs of the individual,
families, group, communities and population. It involves ,
• Analyzing and synthesizing knowledge.
• Understanding, interpreting and applying nursing theory and
research
CHARACTERSTICS OF ADVANCED
NURSING PRACTICE :
Provision of effective and efficient care, delivered with a high
degree of autonomy.
• Demonstrate of leadership and initiation of change to
improve client organization and system outcomes.
• Deliberate, purposeful and integrated use of in-depth nursing
knowledge, research and clinical expertise.
• Depth and breadth of knowledge that draws on a wide range
of strategies to meet the needs of client and to improve access
to and quality of care.
Ability to participate in planning coordinating implementing
evaluating programs to meet client needs and support nursing
practice.
• Demonstration of advance judgment and decision making
skills.
 SCOPE OF NURSING PRACTICE
The scope of nursing practice is the range of roles, functions,
responsibilities and activities which a registered nurse is
educed competent and has the authority to perform.
• Nursing is both an art and science It requires the
understanding and applications of specific knowledge and
skills and its draws on knowledge and techniques drive from
the humanities and the physical, social medical and
biological science
• Nursing profession is accountable for ensuring that its
member act in the public interest and provide the unique
service that has been designated to them by society. This
process is called professional regulation.
• The profession of nursing regulates itself through defining
practice, establishing and developing the public standard of
practice and a code of ethics.
• In tum, the state through statues, attests to the public that
registered nurses meet minimal standards for practice and
prohibits unlicensed individual from practicing as registered
nurse.
 Principles
The primary motivation for expansion of practice must be the
best interest of patient/clients and the promotion and
maintenance for the best quality health services for the
population.
• Expansion of practice must only be made with due
consideration to legislation National policy, local policy and
guidelines.
In determining of his or her scope of practice the
nurse/midwife must make a judgment as to whether he/she is
competent to carry out the role function.
• The nurse/midwife must take measures to develop and
maintain the competence communications and evaluations.
• Expansion of the practice must be based on appropriate
assessment, planning, communication and evaluation.
The nurse who is delegating a particular role/function is
accountable for the decision to delegate.
• The individual nurse is accountable for his/her practice.
NURSING PRACTICE IN DIFFERENT
SETTING
Individual RNs Responsibility
The Nurse Manager and Nurse Executive
Mobile Nursing Practice
Mobile Nursing Services
Military Nursing Services
Tele Nursing
Nursing in Occupational Health
• School Health Nursing
 Individual RNs Responsibility
• The registered nurse is responsible and accountable,
profetional and legally for determining his/her professional
scope of nursing practice.
• Since the role and consequently the scope of nursing
practice, is ever changing and increasing in complexity. It is
important that the nurse makes decision regarding his her
own scope of practice.
The Nurse Manager and Nurse Executive
The nurse manager makes decision regarding the roles and
responsibilities for nurses within the institution in order to
provide care.
The nurse executive is knowledgeable regarding changes in
rules and regulation , standards of care and practice.
• The nurse executes and/or the nurse manager facilitates
changes us assure quality patient care outcomes and develop
mechanism that will promise the same.
 Mobile Nursing Practice
In 1984 a need was seem to offer more extensive home health
care for local residents who preferred to receive needed care in
own homes.
• This enabled many to reduce costs and remain in their homes,
at least for a longer period of time.
• It is the largest and oldest home health care system in the
area, except or public organization.
 Mobile Nursing Services
• These services provide home teaching and care for patient
with varied needs and health problem .
• Patient discharge curly from hospital.
• Patient suffering from chronic and ante medical problems.
• Surgical patient.
• Patient requiring IV. Therapy
• The elderly.
• Respiratory patients.
The seriously ill.
Patient in need of medication management.
Hospice concept Ventilator dependent.
Assistance with bathing, dressing, meals, transportation, light
housekeeping.
• Service may be covered by Medicare, medical private
insurance, private Payment.
 Military Nursing Services
The military naming services has its origin from the Army
Naming Service formed in 1881part of Royal army. The Army
Nurses served in Flanders. The Medittarean the Balkans, the Middle
East and Onboard hospital ships. After the war on October 1926 the
mug services was granted permanent status in Indian Army.
Rank structure: the various task of the Military Nursing services in
lined below in descending orders:
•Commissioned officers Major-General
•Brigadiers •major •captain
 Tele Nursing
• Refers to the use of telecommunication and information
technology for providing nursing services in health care
whenever a large physical distance exists between patient and
nurse, or between any numbers of nurses.
 Nursing in Occupational Health
• Occupational health nurses (OHIN)
OHN are registere the nurse who independently observe the
ate the worker’s health status with respect to Job tasks and
hazards, using their specialized experience and education,
these registered nurse recognize and prevent health effects
from hazardous exposure and treat worker’s injuries illness.
• Scope:
• OHN bring their nursing expertise to all industries such as
meat packing, manufacturing, Construction as well as the
health care industry, OHIN have,
• special knowledge of work place hazarders and the
relationship to the employee health status.
• Understand industry’s hygiene principles of engineering
controls, administrative controls, and personal protective
equipment.
• Have knowledge of toxicology and epidemiology as related
to the employee and the work site.
 School Health Nursing
School nurses are primary care nurses for school children.
They work with individual children young people and families,
schools and communities to raising educational standards.
• A school nurse is qualified, experienced professional and the
only trained nurse working across health and education
boundaries, they also provide the link between school, home
and the community.
Responsibilities of School Health Nurse
Promoting healthy lifestyle and school.
Child and adolescent mental health.
Chronic and complex health care net in children and young
people.
• Vulnerable children and young people.
 Activities of school health Nurse
Health Assessments for children at entrance to the school when
required. Individual health interviews offered to young people
aged 13-14 years
Immunization programme.
Child protection
• Health education.
 TRENDS IN NURSING PRACTICE
• Trends in nursing care closely tied to what is happening to
health care in general. Trends are fascinating phenomena, but
they do not exist in vacuums.
• The focus of nursing has broadened from the care of the ill
person to the care of the people in illness and from care of
only the patient to care of the clients, the family, und in some
instance the community.
• In the past, nursing like medicine was oriented towards
disease and illness.
Indication of Increasing Technology:
The proliferation of the technologies equipment used in case of
client in hospitals and homes.
The increasing Home and self-care equipment.
• Use of computers in many areas of health care.
 CHANGING TRENDS IN NURSING
• Nursing has originated from the word “nurturing” which
means nourishing, helping in growth and development of a
human being, in the past nursing was family based work .
• Modern nursing began in the 19tury under the leadership of
Florence Nightingale.
• The aim of nursing was only to promote the poverty of
patients.
• The present day nurse provides care for the people is health
services and illness.
• Nursing process includes doing, thinking and interaction
component. It is mainly and Basically a problem solving
approach of nursing cares. The sing process consists :
• Assessment.
• Nursing Diagnosis.
• Planning.
• Implementation.
• Evaluation.
• Each step of a nursing process leads to the next one, which
makes it a Continue cyclic process.
MORDEN TRENDS IN NURSING
PRACTICE :
The public perception of alternative, complimentary treatment
Method has been changing over the past few decades.
A few therapies investigated by the OAM-1995
Biofeedback to control pain.
Acupuncture to relieve depression.
Imagery to control Asthma.
Ayurvedic medicine to treatment to treat Parkinson’s disease.
• Music therapy to treat brain injured client.
Summary
 Conclusion
• Clinical competencies consist of advanced skills, which type an
expanding role that offers new possibilities for holistic patient care
practice.’ Scope of practice is characterized by responsibility and
competence in making autonomous judgments based on expanded
clinical competence.
Bibliography
Thank you