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    2.9. Critical Care Nursing

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    June Dumdumaya
    This document outlines standards of care for acute and critical care nursing. It defines critical care nursing as attending to patients at high risk for life-threatening health problems and providing around-the-clock care. It then describes 6 standards of care for assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It also outlines 8 standards of professional practice related to quality of care, individual practice evaluation, education, collegiality, ethics, collaboration, research, and resource utilization. Each standard includes detailed measurement criteria.

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    2.9. Critical Care Nursing

    Uploaded by

    June Dumdumaya
    142 views88 pages
    This document outlines standards of care for acute and critical care nursing. It defines critical care nursing as attending to patients at high risk for life-threatening health problems and providing around-the-clock care. It then describes 6 standards of care for assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It also outlines 8 standards of professional practice related to quality of care, individual practice evaluation, education, collegiality, ethics, collaboration, research, and resource utilization. Each standard includes detailed measurement criteria.

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    This document outlines standards of care for acute and critical care nursing. It defines critical care nursing as attending to patients at high risk for life-threatening health problems and providing around-the-clock care. It then describes 6 standards of care for assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It also outlines 8 standards of professional practice related to quality of care, individual practice evaluation, education, collegiality, ethics, collaboration, research, and resource utilization. Each standard includes detailed measurement criteria.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    142 views88 pages

    2.9. Critical Care Nursing

    Uploaded by

    June Dumdumaya
    This document outlines standards of care for acute and critical care nursing. It defines critical care nursing as attending to patients at high risk for life-threatening health problems and providing around-the-clock care. It then describes 6 standards of care for assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It also outlines 8 standards of professional practice related to quality of care, individual practice evaluation, education, collegiality, ethics, collaboration, research, and resource utilization. Each standard includes detailed measurement criteria.

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    The key takeaways are the 5 standards of care for acute and critical care nursing: assessment, diagnosis, outcome identification, implementation, and evaluation.

    The standards of care for acute and critical care nursing involve collecting comprehensive data on the patient, making accurate diagnoses, identifying appropriate outcomes, developing and implementing a plan of care, and evaluating the effectiveness of the care provided.

    Critical care nursing involves attending to patients at high risk for life-threatening health problems and providing vigilant, around-the-clock care to these patients.

    HASHIM N. ALAWI JR.

    ,RN,MAN

    Standards of Care for Acute & Critical Care Nursing


    1. 2. 3. 4. 5. Assessment Diagnosis Outcome Identification Implementation Evaluation

    Definition:
    Critical:
    Being in; or verging on a state of crisis or emergency Urgently needed Absolutely necessary

    Definition:
    Critical Care Nursing:
    Attending to patients at high risk for life-threatening health problems.
    Providing vigilant, around-the-clock care.

    Assessment
    Standard of Care I:

    Assessment
    Standard of Care I:
    Measurement Criteria 1. Data collection involves the: Patient Family Other health care providers Purpose: Develop a Holistic picture of the patients needs

    Assessment
    Standard of Care I:
    Measurement Criteria 2. The priority of data collection activities depends on: patients immediate condition and/or anticipated needs

    Assessment
    Standard of Care I:
    Measurement Criteria

    3.
    4. 5.

    Data are collected using appropriate assessment techniques and instruments Documents are retrievable Collection process is: systematic ongoing

    Diagnosis
    Standard of Care II:

    Diagnosis
    Standard of Care II:
    Measurement Criteria 1. Diagnoses are derived from the assessment data. 2. Validated throughout the nursing interactions with the team consisting of the: Patient Family Other healthcare providers

    Diagnosis
    Standard of Care II:
    Measurement Criteria 3. Prioritized and documented : To facilitate determining expected outcomes To develop a plan of care Documented in a retrievable form

    4.

    Outcome Identification
    Standard of Care III:

    Outcome Identification
    Standard of Care III:
    Measurement Criteria

    1. Outcomes are derived from actual and potential diagnoses 2. Mutually formulated with: Patient Family Other health care providers

    Outcome Identification
    Standard of Care III:
    Measurement Criteria

    3. Individualized Culturally appropriate Realistic In relation to patients age Present and potential capabilities

    Outcome Identification
    Standard of Care III:
    Measurement Criteria
    4. Attainable in relation to resources available to the patient 5. Measurable, and should include a time estimate for attainment

    Outcome Identification
    Standard of Care III:
    Measurement Criteria
    6. Provide direction for continuity of care; Nurses competencies are matched with the patients needs 7. Documented in a retrievable form

    Planning
    Standard of Care IV:

    Planning
    Standard of Care IV:
    Measurement Criteria
    1. Individualized to reflect the patients characteristics and needs 2. Developed collaboratively with the team, consisting of: Patient Family Other health care providers promote each members contribution toward achieving expected outcomes

    Planning
    Standard of Care IV:
    Measurement Criteria
    3. Reflects current acute and critical care nursing practice 4. Provides for continuity of care 5. Prioritized 6. Documented to promote continuity of care

    Implementation
    Standard of Care V:

    Implementation
    Standard of Care V:
    Measurement Criteria
    1. Delivered in a manner that minimizes complications and life-threatening situations

    Implementation
    Standard of Care V:
    Measurement Criteria
    2. The patient and family participate in implementing plan of care based upon their : Ability to participate Decision making regarding care 3. Documented in a retrievable manner

    Evaluation
    Standard of Care VI:

    Evaluation
    Standard of Care VI:
    Measurement Criteria 1. Systematic, ongoing, and Criterion - based 2. Consisting of : Patient Family Healthcare providers

    Evaluation
    Standard of Care VI:
    Measurement Criteria
    3. Occurs within appropriate time frame after interventions are initiated 4. Ongoing assessment data are used to - revise diagnoses, - Outcomes - Plan of care as needed

    Evaluation
    Standard of Care VI:
    Measurement Criteria
    4. Document revisions in diagnoses, outcomes, and plan of care 5. Evaluate effectiveness of interventions in relation to outcomes 6. Document patients response to interventions

    Standards of Professional Practice


    1. Quality of care 2. Individual practice evaluation 3. Education 4. Collegiality 5. Ethics 6. Collaboration 7. Resource utilization

    Standard of Professional Practice I


    I. Quality of Care

    Standard of Professional Practice I


    I. Quality of Care Measurement Criteria 1. Participate in quality of care activities 2. Use the results to initiate changes to improve practices and healthcare delivery system 3. Incorporate the patients and familys perspective as appropriate

    Standard of Professional Practice II


    II. Individual Practice Evaluation

    Standard of Professional Practice II


    II. Individual Practice Evaluation Measurement Criteria 1. Evaluate the nursing practice vs. the professional practice standards

    Standard of Professional Practice II


    II. Individual Practice Evaluation Measurement Criteria 2. Engage in self-assessment &/or a formal performance appraisal identifying: Areas of strength Areas where professional development would be of benefit

    Standard of Professional Practice II


    II. Individual Practice Evaluation Measurement Criteria 3. Seek and reflect constructive feedback from the team consisting of: The patient Family Healthcare providers

    Standard of Professional Practice II


    II. Individual Practice Evaluation Measurement Criteria

    4. Take action to achieve performance goals

    Standard of Professional Practice III


    III. Education

    Standard of Professional Practice III


    III. Education Measurement Criteria 1. Participate in ongoing educational activities to acquire knowledge and skills

    Standard of Professional Practice III


    III. Education Measurement Criteria 2. Seek experiences that reflect current clinical practice

    Standard of Professional Practice III


    III. Education Measurement Criteria 3. Participate in ongoing educational activities related to professional issues.

    Standard of Professional Practice IV


    IV. Collegiality

    Standard of Professional Practice IV


    IV. Collegiality Measurement Criteria 1. Share knowledge, Skills, and experiences with colleagues

    Standard of Professional Practice IV


    IV. Collegiality Measurement Criteria 2. Provide peers & other healthcare providers with constructive feedback regarding their practice, as appropriate to their level of expertise

    Standard of Professional Practice IV


    IV. Collegiality Measurement Criteria 3. Interact with colleagues to enhance own professional nursing practice

    Standard of Professional Practice IV


    IV. Collegiality Measurement Criteria 4. Contribute to the learning environment that is conducive to healthcare education

    Standard of Professional Practice IV


    IV. Collegiality Measurement Criteria 5. Contribute to an effective team environment by working with others in a way that promotes & encourages each persons contribution.

    Standard of Professional Practice V

    V. Ethics

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 1. The nurses practice is guided by the : PRC-BON Code for Nurses Critical Care Nurses Association of the Philippines Ethics of Care and Ethical Principles

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 2. Maintain patient confidentiality within legal and regulatory parameters

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 3. Act as a patient advocate and assist others in developing skills so they can advocate for themselves

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 4. Deliver care in a: Non judgmental Non discriminatory manner that is sensitive to patient diversity

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 5. Deliver care in a manner that: meets the diverse needs and strengths of the patient and preserves patients autonomy, dignity, and rights

    Standard of Professional Practice V


    V. Ethics Measurement Criteria 6. Use available resources in formulating ethical decisions

    Standard of Professional Practice VI


    VI. Collaboration

    Standard of Professional Practice VI


    VI. Collaboration Measurement Criteria 1. Communicate with the team regarding: Patient care Nurses role in providing care

    Standard of Professional Practice VI


    VI. Collaboration Measurement Criteria 2. Work with the team to: formulate the plan of care and to make decisions related to the care and delivery of services

    Standard of Professional Practice VI


    VI. Collaboration Measurement Criteria 3. Consult with other healthcare providers and initiates referrals as appropriate to promote continuity of care

    Standard of Professional Practice VII


    VII. Research

    Standard of Professional Practice V


    VII. Research Measurement Criteria 1. Continually question and evaluate practice Use best available evidence or research findings to develop appropriate plans of care

    Standard of Professional Practice V


    VII. Research Measurement Criteria 2. Participate in activities to support clinical inquiry appropriate to the nurses level of expertise

    Standard of Professional Practice VIII


    VIII. Resource Utilization

    Standard of Professional Practice VIII


    VIII. Resource Utilization Measurement Criteria 1. Evaluate factors related to: Safety Effectiveness & Cost when choosing between two (2) or more practice options that would result in the same expected outcome

    Standard of Professional Practice VIII


    VIII. Resource Utilization Measurement Criteria 2. Assist the patient & family in: Identifying & Securing appropriate & available services to address health-related needs

    Standard of Professional Practice VIII


    VIII. Resource Utilization
    Measurement Criteria 3. Assign or delegate aspects of care as defined by the nurse practice acts

    Standard of Professional Practice VIII


    VIII. Resource Utilization
    Measurement Criteria

    4. Assist the patient & family in becoming informed consumers about: Costs Risks & Benefits of treatment & care

    Critical Thinking in Critical Care Nursing


    Critical Thinking :

    A multidimensional skill
    A cognitive or mental process Set of procedures

    Critical Thinking in Critical Care Nursing


    Critical Thinking : involves;

    Reasoning Purposeful Systematic Reflective Rational Outcome directed thinking

    Critical Thinking in Critical Care Nursing


    Critical Thinking : involves;

    Outcome directed thinking based on: A body of knowledge Examination Analysis of all available information and ideas

    Components of Critical Thinking


    1. Ask questions: To determine the reason why certain developments have occurred 2. Gather as much relevant information presented 3. Analyze the information 4. Draw on past clinical experience and knowledge

    Components of Critical Thinking

    5. Maintain flexible attitude 6. Consider available options 7. Formulate decisions that reflect: Creativity Independent decision making

    Critical Thinking In Nursing Practice


    Predominant Thinking Strategies Used by Nurses; Regardless of their area of Clinical Practice

    Thinking Strategies
    1. 2. 3. 4. 5. 6. Recognize a pattern Set priorities Search for information Generate hypotheses Make predictions Form relationships

    Thinking Strategies
    7. State the proposition (if then) 8. Make choices (alternative actions) 9. Judge the value 10. Draw conclusions 11. Provide explanations

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:

    1. What relevant assessment information do I need,


    How do I interpret this information? What does this information tell me?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:

    2. To what problems does this information point? Have I identified the most important one? Does the information point to any other problems that I should consider?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions: 3. Have I gathered all the information I need?

    Signs / symptoms Laboratory values Emotional factors Mental status Is anything missing?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:
    4. Is there anything that needs to be reported immediately? Do I need to seek additional assistance?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:

    5. Does this patient have any special risk factors?


    Which ones are most significant? What must I do to minimize these risks?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:
    6. What are the possible complications?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions: 7. What are the desired outcomes for this patient? Which have the highest priority? Does the patient agree with me on these points?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:
    8. What will be my first intervention in this situation? 9. How can I construct a Plan of Care to achieve the goals?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions: 10. Are there any age related factors involved?

    Will they require special approach? Will I need to make some changes in the plan of care to make them effective?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions:

    11. How do the family dynamics affect this situation? Will this affect my plan of care?
    12. Are there cultural factors that I must address and consider?

    The Inquiring Mind: Critical thinking in Action


    Some guide questions: 13. Am I dealing with an ethical problem here? If yes, how am I going to resolve it? 14. Has any nursing research been conducted on this subject?

    1. Standards of care 2. Standards of professional practice 3. Critical thinking defined 4. Thinking strategies

    Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.

    Leo Buscaglia

    AJ ALAWI

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