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1. One of the important components associated with the nursing practice is the assessment of healthcare user’s family centred care planning provisions. The national competency standard in context to registered nurses The Nursing and Midwifery Board of Australia (NMBA) states that to subject a wide-ranging and organized nursing assessment, planning of nursing care in discussion with persons or groups, considerable others and interdisciplinary team of healthcare responds efficiently to unforeseen or rapidly altering situations. It is required to review the healthcare user’s physical state considering an overall emotional behavioural state. The healthcare user’s hospital stay needs monitoring from the time of admission.
As the “baseline observations” are recorded in the form of admission assessment as well as documented as vital signs on the healthcare user’s observatory “flow-sheet”. The situation at present scenario falls under the Standard category of evaluating the contextual outcomes associated with nursing practices. An assessment of ongoing vital signs is completed for healthcare users. Reviewing the “VICTOR graph” is mandatory and is done to observe the vital signs every two hours to support the clinical process of decision making (Cashin et al. 2017).
Tympanic temperatures for “6 months+” children and use a digital thermometer as per “Axilla” for the Less than 6 month’s ones.
Respiratory Rate: to assess any respiratory distress a full minute count for child’s breaths is necessary.
Heart Rate: For accuracy, a full minute pulse count for reading the “Palpate brachial pulse or femoral pulse” in infant and “radial pulse” in children of older ages.
Blood Pressure: “Baseline measurement” obtained from every healthcare users by selecting “the cuff size” is important. The right kind of guide to ensure appropriate “cuff size fits 2/3 of upper-arms width”. For neonates, blood pressures on all the four limbs are required.
Oxygen Saturation: oxygen requirement and delivery mode as clinically Monitored and Noted.
2. Thinking of critical analysis nursing practices fall under “standard 1 category”. The right kind of available evidence associated with the process of decision-making along with the practising of safe nursing inside the frameworks of person and evidence creates a variety of thinking strategies used by RN’s. This standard practice falls under the current situation in context to the registered nurse. They include research findings for a safe, assessment of quality practices, by analyzing and using available evidence. They address ways to develop and shape these practices through reflection based on the requisite experience, knowledge-base, and actions associated with the beliefs and feelings.
Cultural experiences of all forms are respected, including response to community and family roles helped in underpinning the health conditions related to the “Aboriginal and Torres Strait Islander peoples”. Legislator regulations that are in context to the related health care policies, and other guidelines standards for requirement’s compilation those are relevant in relation to those of the health care practice while decision making. It encourages the use of the ethical framework and helps to maintain accuracy, through a comprehensive and on-time assessment of documentation, based on planning the actions through apt evaluations, while decision making. In this way, all the mentioned factors are contributing highly toward the improvement of quality aspect in context to the relevant research (Wilson et al. 2019).
3. This type of situation tends to fall under standard 2 associated with the Nursing Practices of NMBA. The reason behind this fact is that the contextual RN practice is wholesomely based on the aspect of purposeful engagement of the nurses in efficient therapeutic along with specialized relationships. Collegial generosity in this context is included toward mutual trust along with respect toward professional relationships. In the mentioned topic all the registered nurses tend to establish, sustain as well as conclude the relationships in a particular way that are instrumental in differentiating the boundaries associated with both the professional along with the development of personal relationships.
Going further it tends to communicate effectively, by being respectful toward a person or a healthcare users’ dignity, cultural values, considering their respective beliefs and rights (Thompson et al.2017). They need to recognize those people that are considered as the experts in the field of their individual life experiences. Alongside it is instrumental in providing some support alongside direct the people toward some resources that are needed to optimize the decisions related to health. It also advocates in support of those people in a definite manner which in turn respect’s the autonomy of an individual’s legal capacity.
It is instrumental in using professional relationships based on delegation, supervision, coordination through consultation, along with referrals. All of the mentioned ones are true needs to achieve an improved form of health outcomes. It actively promotes a culture of protection and learning where health professionals and others participate and exchange knowledge about practices that support “person-centred” care. They participate and conduct collaborative exercises and reports important behaviours for “health professionals, health workers, and others”.
4. The contextual RNs provide also able to delegate, a well-defined quality alongside ethical goal-directed actions. This current situation falls under the practice of standard. Standard 6 is influential in providing a safe, at the same time appropriate as well as responsive quality nursing practices that are associated with comprehensive along with the systematic assessment, of the best evidence available to achieve planned along with the agreed outcomes. In this context, a registered nurse required to provide a completely safe renders the right kind of quality practice to achieve all the agreed goals along with the outcomes that respond toward the healthcare users nursing needs.
They tend to practice within a predefined practice scope that appropriately entrust the practice aspects associated with the enrolled nurses. It is directly in accordance with the practising scope of the enrolled nurses in favour of their other clinical or at times non-clinical roles. They also provide a timely yet effective direction as well as supervision toward ensuring the fact that these delegated practices are correctly practised within safety parameters. These practices are following all the relevant policies, the contextual guidelines, regulations along with the legislation standards. They use an appropriate process to identify and report all forms of potential or actual system-related risk factors as well as defines the place in which these contextual practices may be below the expected standards (Ryder et al. 2019).
Use of intoxicating drug is making it difficult for a buddy to carry out his duty. Mandatory notification to the concerned authority regarding the mentioned situation is required. Because it is considered to be essential in regards to the duty breach associated with the health care sector.
I will report the abovementioned situation because the situation is a victim of care violations. Responsibility for care is a legal obligation imposed on a person who needs to follow reasonable care standards when performing activities that may harm others. This is the first thing that should be taken care of. Ethical health study and isolation protection provides valuable profits to society. The research of Health is necessary to develop human health and health care. Subjecting healthcare users from the harm of any kind along with their rights is an essential part of ethical health care research. The primary reason to protect personal privacy is to protect the interests of individuals (Birks et al. 2019).
All registered healthcare practitioners have a specialized and ethical obligation to defend and encourage public health and safe health care. There are certain mandatory obligations under the Health care act to act sensibly while informing in regards to health practitioners, employers, and teachers providing health care education. "Mandatory reporting" is a word used to portray the legal requirements imposed on certain individuals in all states and territories of Australia to account suspected cases of child abuse, neglect, abuse in context to senior citizens, and "notifiable conduct" by any heath care practitioner. But the law as imposed by the Australian Government in context to the above-mentioned mandatory reporting is not the same in all jurisprudence.
The main point of confusion is associated with 'who should be reported and what kind of abuse and negligence should be reported'. There are also other differences, such as a state of mind that activates the obligation to report (e.g., anxiety, doubt, or belief for reasonable reasons) and the direction of the report. The National Law subjects’ practitioners who can be instrumental in advising AHPRA or a National Board of ‘notifiable conduct’ on issues that may lead to "uninformed behaviour" or treatment by other practitioners at risk of harm to the public. Indeed, the edge of compulsory reporting is even greater.
Registered health practitioners and employers report behaviours related to the practice of their profession in a way that creates an obligation for health practitioners to give legally binding notice of treatment. The term "reasonable belief" is commonly used in law, including criminal law, consumer law, and administrative law. Although it is not generally defined in national law, the term "reasonable belief" is the rational belief that is further based on a reasonable argument (Atkins et al.2020).
Conducts that are in need to be notified by registered health practitioners is well defined as in the below-mentioned points:
practising under the effect of alcohol or drugs intoxication
Misconduct while professional practices that are sexual
risking of substantial harm toward public health due to an impairment ( or physical issue),
Mandatory notifications were effective for all health professionals and were registered on July 1, 2010. All of the mentioned ones are planned to advance healthcare users and general safety by dropping community exposure to the risk of harm related to a health practitioner's behaviour or weakness. Below are four concerns that can be compelling depending on the type of concern. The risk of general loss must be assessed when deciding to issue a mandatory notification (Lewis 2018).
The four concerns are:
a significant amount of departure as of the accepted standards associated with health care professionals
staying intoxicated during practising
Misconduct with a healthcare user in sexual terms.
some levels of impairment
Different types of thresholds notification are issued depending on whether an individual send notices to different medical practitioners, non-medical practitioners, employers, or teachers. To understand the timing about making a “mandatory notification” about a medical practitioner, one must refer to the guidelines sections that are related with a treating practitioner, considering a non-treating practitioner, or an employer (McKenna et al.2019).
A practitioner is referred to as a treating practitioner who becomes aware of all types of concern that are instrumental in providing treatment to another practitioner. The threshold is higher as a treating practitioner for making a mandatory notification in comparison to other notified groups. The confidence to seek out for help without fearing the mandatory notification is given by the practitioners. When there is a substantial risk of harm to the public the threshold in favour of treating practitioners toward making a mandatory notification in regards to impairment, intoxication while practising.
Before giving mandatory notice, the investigator must understand that any accident or disturbing behaviour has already occurred and that it is a danger to the public. It is considered as a significant departure from accepted standards of professional practices. For example, an individual must have direct knowledge or a report of their experiences or observation from a reliable source. The mandatory notice should not be given based on rumours or gossip (Ruth Jacob et al. 2013).
Mandatory notifications are defining the obligations for registered health workers, employers, and teachers under national law. They protect the public using ensured as per the guidelines mentioned in their official websites that states, “Ahpra and the National Boards are told about practitioners who may be placing the public at serious risk of harm.”
At present, all the registered health practitioners, that includes the treating practitioners, along with the employers are in need to notify Ahpra if they believe on reasonable grounds that another registered health practitioner is behaving in a way mentioned in the guidelines of ‘notifiable conduct’.
Section 140 in National Law defines “Notifiable conduct” as a means that a practitioner has:
been practising health profession staying intoxicated under the effect of alcohol or intoxicating drugs (‘intoxication’)
While practising their profession they engage themselves in some sort of “sexual misconduct”
practice their profession with an impairment’ and places public at the risk of causing substantial harm
Practising their profession by significantly deviating from the accepted standards of health care profession that are risking public lives (“practice outside of professional standards”).
Health practitioners registered under national law are advised to notify their attorneys if they reasonably believe that any student registered under national law can cause significant harm to the public while undergoing clinical training (Kenny and Duckett 2005).
Atkins, K., De Lacey, S., Ripperger, B. and Ripperger, R., 2020. Ethics and law for Australian nurses. England: Cambridge University Press.
Birks, M., Davis, J., Smithson, J. and Lindsay, D., 2019. Enablers and Barriers to Registered Nurses Expanding Their Scope of Practice in Australia: A Cross-Sectional Study. Policy, Politics, & Nursing Practice, 20(3), pp.145-152.
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., Kerdo, E., Kelly, J., Thoms, D. and Fisher, M., 2017. Standards for practice for registered nurses in Australia. Collegian, 24(3), pp.255-266.
Kenny, A.J. and Duckett, S., 2005. An online study of Australian enrolled nurse conversion. Journal of Advanced Nursing, 49(4), pp.423-431.
Lewis, T. M. A., 2018. Becoming a climate-friendly hospital: Implications for nursing practice within the Australian healthcare context.
McKenna, L., Wood, P., Williams, A., O’Connor, M., Moss, C., Griffiths, D., Della, P., Endacott, R. and Cross, W., 2019. Scope of practice and workforce issues confronting Australian Enrolled Nurses: A qualitative analysis. Collegian, 26(1), pp.80-85.
Ruth Jacob, E., Barnett, A., Sellick, K. and McKenna, L., 2013. Scope of practice for Australian enrolled nurses: Evolution and practice issues. Contemporary Nurse, 45(2), pp.155-163.
Ryder, M., Jacob, E. and Hendricks, J., 2019. An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective. Journal of clinical nursing, 28(13-14), pp.2644-2658.
Thompson, M.J., Watt, M.E. and Ostaszkiewicz, J., 2017. Dr Bart O'Brien (Continence Nurse Adviser) with the help of flagrant from Australian Nurses for Continence.
Wilson, N.J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., Booley, R., Jaques, H. and Goddard, L., 2019. Reframing the role, identity and standards for practice for registered nurses working in the specialty area of intellectual and developmental disability in Australia: The NDIS and beyond. Collegian, 26(1), pp.132-139.
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