Showing posts with label 11 Core Competency. Show all posts
Showing posts with label 11 Core Competency. Show all posts

Sunday, July 29, 2012

Patient's Bill of Right

Title 111: Declaration of Rights
Sec. 4. The Rights of Patients. - The following rights of the patient shall berespected by all those involved in his care:
(1) Right to Appropriate Medical Care and Humane Treatment. - Every person has a right to health and medical care corresponding to his state of health,without any discrimination and within the limits of the resources, manpower and competence available for health and medical care at the relevant time.The patient has the right to appropriate health and medical care of good quality.In the course of such care, his human dignity, convictions, integrity, individual needs and culture shall be respected.If any person cannot immediately be given treatment that is medically necessary he shall, depending on his state of health, either be directed to wait for care, or be referred or sent for treatment elsewhere, where the appropriate care can be provided. If the patient has to wait for care, he shall be informed of the reason for the delay.Patients in emergency shall be extended immediate medical care and treatment without any deposit, pledge, mortgage or any form of advance payment for treatment.
(2) Right to Informed Consent. - The patient has a right to a clear, truthful and substantial explanation, in a manner and language understandable to the patient, of all proposed procedures, whether diagnostic, preventive, curative, rehabilitative or therapeutic, wherein the person who will perform the said procedure shall provide his name and credentials to the patient, possibilities of any risk of mortality or serious side effects, problems related to recuperation, and probability of success and reasonable risks involved: Provided, That, the patient will not be subjected to any procedure without his written informed consent, except in the following cases:
a. in emergency cases, when the patient is at imminent risk of physical injury,decline or death if treatment is withheld or postponed. In such cases, the physician can perform any diagnostic or treatment procedure as good practice of medicine dictates without such consent;
b. when the health of the population is dependent on the adoption of a mass health program to control epidemic;
c. when the law makes it compulsory for everyone to submit to a procedure;
d. when the patient is either a minor, or legally incompetent, in which case, a third party consent is required;
e. when disclosure of material information to patient will jeopardize the success of treatment, in which case, third party disclosure and consent shall be in order;
f. when the patient waives his right in writing.
Informed consent shall be obtained from a patient concerned if he is of legal age and of sound mind. In case the patient is incapable of giving consent and a third party consent is required, the following persons, in the order of priority stated here under, may give consent:
i.spouse;
ii.son or daughter of legal age;
iii.either parent;
iv.brother or sister of legal age,
or v.guardian

If a patient is a minor, consent shall be obtained from his parents or legal guardian. If next of kin, parents or legal guardians refuse to give consent to a medical or surgical procedure necessary to save the life or 1imb of a minor or a patientincapable of giving consent, courts, upon the petition of the physician or any person interested in the welfare of the patient, in a summary proceeding, mayissue an order giving consent.
(3) Right To Privacy and Confidentiality. - The privacy of the patients must be assured at all stages of his treatment. The patient has the right to be free from unwarranted public exposure, except in the following cases:
a) when his mental or physical condition is in controversy and the appropriate court, in its discretion, orders him to submit to a physical or mental examination by a physician;
b) when the public health and safety so demand;
and c) when the patient waives this right.
The patient has the right to demand that all information, communication and records pertaining to his care be treated as confidential. Any health care provider or practitioner involved in the treatment of a patient and all those who have legitimate access to the patient's record is not authorized to divulge any information to a third party who has no concern with the care and welfare of the patient without his consent, except:
a) when such disclosure will benefit public health and safety;
b) when it is in the interest of justice and upon the order of a competent court;
and c) when the patients waives in writing the confidential nature of such information;
d) when it is needed for continued medical treatment or advancement of medical science subject to de-identification of patient and shared medical confidentiality for those who have access to the information.Informing the spouse or the family to the first degree of the patient’s medical condition may be allowed; Provided, That the patient of legal age shall have the right to choose on whom to inform. In case the patient is not of legal age or is mentally incapacitated, such information shall be given to the parents, legal guardian or his next of kin.
4) Right to Information. - In the course of his/her treatment and hospital care,the patient or his/her legal guardian has a right to be informed of the result of the evaluation of the nature and extent of his/her disease, any other additional or further contemplated medical treatment on surgical procedure or procedures,including any other additional medicines to be administered and their generic counterpart including the possible complications and other pertinent facts,statistics or studies, regarding his/her illness, any change in the plan of care before the change is made, the person’s participation in the plan of care and necessary changes before its implementation, the extent to which payment may be expected from Philhealth or any pay or and any charges for which the patient maybe liable, the disciplines of health care practitioners who will furnish the care and the frequency of services that are proposed to be furnished.The patient or his legal guardian has the right to examine and be given an itemized bill of the hospital and medical services rendered in the facility or by his/her physician and other health care providers, regardless of the manner and source of payment. He is entitled to a thorough explanation of such bill.The patient or his/her legal guardian has the right to be informed by the physician or his/her delegate of his/her continuing health care requirements following discharge, including instructions about home medications, diet, physical activity  and all other pertinent information to promote health and well-being. At the end of his/her confinement, the patient is entitled to a brief, written summary of the course of his/her illness which shall include at least the history, physical examination, diagnosis, medications, surgical procedure, ancillary and laboratory procedures, and the plan of further treatment, and which shall be provided by the attending physician. He/she is likewise entitled to the explanation of, and to view, the contents of the medical record of his/her confinement but with the presence of his/her attending physician or in the absence of the attending physician, the hospital’s representative. Notwithstanding that he/she may not be able to settle his accounts by reason of financial incapacity, he/she is entitled to reproduction, at his/her expense, the pertinent part or parts of the medical record the purpose or purposes of which he shall indicate in his/her written request for reproduction. The patient shall likewise be entitled to medical certificate, free of charge, with respect to his/her previous confinement.The patient has likewise the right not to be informed, at his/her explicit request.
(5) The Right To Choose Health Care Provider and Facility. - The patient is free to choose the health care provider to serve him as well as the facility except when he is under the care of a service facility or when public health and safety so demands or when the patient expressly or impliedly waives this right. The patient has the right to discuss his condition with a consultant specialist, atthe patient’s request and expense. He also has the right to seek for a secondopinion and subsequent opinions, if appropriate, from another health care provider/practitioner.
(6) Right to Self-Determination. - The patient has the right to avail himself/herself of any recommended diagnostic and treatment procedures. Any person of legal age and of sound mind may make an advance written directive for physicians to administer terminal care when he/she suffers from the terminal phase of a terminal illness: Provided, That a) he is informed of the medical consequences of his choice; b) he releases those involved in his care from any obligation relative to the consequences of his decision; c) his decision will not prejudice public health and safety.
(7) Right to Religious Belief. - The patient has the right to refuse medical treatment or procedures which may be contrary to his religious beliefs, subject to the limitations described in the preceding subsection: Provided, That such a right shall not be imposed by parents upon their children who have not reached the legal age in a life threatening situation as determined by the attending physician or the medical director of the facility.
(8) Right to Medical Records. - The patient is entitled to a summary of his medical history and condition, He has the right to view the contents of his medical records, except psychiatric notes and other incriminatory information obtained about third parties, with the attending physician explaining contents thereof. At his expense and upon discharge of the patient, he may obtain from the health care institution a reproduction of the same record whether or not he has fully settled his financial obligation with the physician or institution concerned.The health care institution shall safeguard the confidentiality of the medical records and to likewise ensure the integrity and authenticity of the medical records and shall keep the same within a reasonable time as may be determined by the Department of Health.The health care institution shall issue a medical certificate to the patient upon request. Any other document that the patient may require for insurance claims shall also be made available to him within a reasonable period of time.
(9 ) Right to Leave . - The patient has the right to leave a hospital or any other health care institution regardless of his physical condition:
Provided, That
a) he/she is informed of the medical consequences of his/her decision;
b) he/she releases those involved in his/her care from any obligation relative to the consequences of his decision;
c) his/her decision will not prejudice public health and safety

No patient shall be detained against his/her will in any health care institution on the sole basis of his failure to fully settle is financial obligations. However, he/she shall only be allowed to leave the hospital provided appropriate arrangements have been made to settle the unpaid bills: Provided, farther, that unpaid bills of patients shall be considered as lost income by the hospital and health care provider/practitioner and shall be deducted from gross income as income loss for that particular year.
(10) Right to Refuse Participation in Medical Research. - The patient has the right to be advised if the health care provider plans to involve him in medical research, including but not limited to human experimentation which may be performed only with the written informed consent of the patient. Provided, further, That, an institutional review board or ethical review board in accordance with the guidelines set in the Declaration of Helsinki be established for research involving human experimentation: Provided, finally, That the Department of Health shall safeguard the continuing training and education of future health care provider/practitioner to ensure the development of the health care delivery in the country.
 (11) Right to Correspondence and to Receive Visitors - The patient has the rightto communicate with relatives and other persons and to receive visitors subject toreasonable limits prescribed by the rules and regulations of the health careinstitution.
(12) Right to Express Grievances. - The patient has the right to express complaints and grievances about the care and services received without fear of discrimination or reprisal and to know about the disposition of such complaints.The Secretary of Health, in consultation with health care providers, consumer groups and other concerned agencies shall establish a grievance system wherein patients may seek redress of their grievances. Such a system shall afford all parties concerned with the opportunity to settle amicably all grievances.
(13) Right to be Informed of His Rights and Obligations as a Patient. – Every person has the right to be informed of his rights and obligations as a patient. The Department of Health, in coordination with health care providers, professional and civic groups, the media, health insurance corporations, people’s organizations, local government organizations, shall launch and sustain a nationwide information and education campaign to make known to people their rights as patients, as declared in this Act. Such rights &d obligations of patients shall be posted in a bulletin board conspicuously placed in a health care institution.It shall be the duty of health care institutions to inform patients of their rights as well as the institution's rules and regulations that apply to the conduct of the patient while in the care of such institution.

Monday, October 3, 2011

Nursing leadership and management

Effective management leadership in nursing is not a career that is suitable for everyone or for every nurse. Leadership positions not only require additional sacrifices on your behalf but it also requires someone who is a critical thinker, in other words, somebody who can work effectively under pressure and who is able to resolve problems within the workplace quickly and efficiently and without conflict. Nurses who assume leadership and management roles also need to be creative thinkers. Not only is their work demanding of them, but they too have to oversee that everyone else is fulfilling their duties and that patient care is of the best. Within a position of leadership, one should be a role model and a positive influence on the nurses within the hospital as well as on the image of the hospital as a whole. Therefore, effective management leadership in nursing does not mean just barely surviving the job, it actually means taking it full force and making it flourish!

A nurse leader may be a nurse manager, responsible for one nursing unit, or a nurse executive, responsible for all in-patient nursing units. Rather than choosing just one leadership style, an outstanding nurse leader typically uses multiple styles depending on the situations she's facing.

Sunday, September 13, 2009

SAFE AND QUALITY NURSING CARE

I. SAFE AND QUALITY NURSING CARE


CORE COMPETENCY 1:
Demonstrate knowledge based on health/illness status of individual/ groups

Indicators :
○ Identifies health needs of patients/groups
○ Explains patient/group status

CORE COMPETENCY 2:
Provides sound decision making in care of individual/groups considering their beliefs, values

Indicators :
○ Problem identification
○ Data gathering related to problem
○ Data analysis
○ Selection appropriate action
○ Monitor progress of action taken

CORE COMPETENCY 3:
Promotes patient safety and comfort

Indicators :
○ Performs age-specific safety measures and comfort measure in all aspects of patient care

CORE COMPETENCY 4:
Priority setting in nursing care based on patients’ needs

Indicators :
○ Identifies priority needs of patients
○ Analysis of patients’ needs
○ Determine appropriate nursing care to be provided

CORE COMPETENCY 5:
Ensures continuity of care

Indicators :
○ Refers identified problems to appropriate individuals/ agencies
○ Establish means of providing continuous patient care

CORE COMPETENCY 6:
Administers medications and other health therapeutics

Indicators :
○ Conforms to the 10 golden rules in medication administration and health therapeutics

CORE COMPETENCY 7:
Utilizes nursing process as framework for nursing. Performs comprehensive, systematic nursing assessment

Indicators :
○ Obtains consent
○ Complete appropriate assessment forms
○ Performs effective assessment techniques
○ Obtains comprehensive client information
○ Maintains privacy and confidentiality
○ Identifies health needs

CORE COMPETENCY 8:
Formulates care plan in collaboration with patients, other health team members

Indicators :
○ Includes patients, family in care planning
○ States expected outcomes in nursing interventions
○ Develops comprehensive patient care plan
○ Accomplishes patient centered discharge plan

CORE COMPETENCY 9:
Implements NCP to achieve identified outcomes

Indicators :
○ Explain interventions to patient, family before carrying them out
○ Implement safe, comfortable nursing interventions
○ Acts according to client’s health conditions, needs
○ Performs nursing interventions effectively and in timely manner

CORE COMPETENCY 10:
Implements NCP progress toward expected outcomes

Indicators :
○ Monitors effectiveness of nursing interventions
○ Revises care plan PRN

CORE COMPETENCY 11:
Responds to urgency of patient’s condition

Indicators :
○ Identifies sudden changes in patient’s health conditions
○ Implements immediate, appropriate interventions

MANAGEMENT OF RESOURCES AND ENVIRONMENT

II. MANAGEMENT OF RESOURCES AND ENVIRONMENT


CORE COMPETENCY 1:
Organizes workload to facilitate patient care

Indicators:
○ Identifies task or activities that need to be accomplished
○ Plans the performance of task or activities based on priority
○ Finishes work assignment on time

CORE COMPETENCY 2:
Utilizes resources to support patient care

Indicators:
○ Determines the resources needed to deliver patient care
○ Control the use of equipment

CORE COMPETENCY 3:
Ensures the functioning of resources

Indicators:
○ Check proper functioning of the equipment
○ Refers Malfunctioning equipment to appropriate unit

CORE COMPETENCY 4:
Check the Proper functioning of the Equipment

Indicators:
○ Determines the task and procedures that can be safely assigned to the other members of the team
○ Verifies the competence of the staff prior to delegating tasks

CORE COMPETENCY 5:
Maintains safe Environment

Indicators:
○ Observe proper disposal of waste
○ Adheres to policies, procedures and protocols on prevention and control of infection
○ Defines steps to follow incase of fire , earthquake and other emergency situation

HEALTH EDUCATION

III. HEALTH EDUCATION


CORE COMPETENCY 1:
Assesses the learning needs of the patient and the family

Indicators:
○ Obtains learning information through interview, observation and validation
○ Defines relevant information
○ Completes assessment records appropriately
○ Identify priority needs

CORE COMPETENCY 2:
Develops Health Education plan based on assessed and anticipated needs.

Indicators:
○ Considers nature of the learner in relation to social, cultural, political, economic, educational, and religious factor

CORE COMPETENCY 3:
Develops learning material for health education

Indicators:
○ Involves the patient, family and significant others and other resources
○ Formulates a comprehensive health educational plan with the following components , objectives, content and time allotment
○ Teaching-learning resources and evaluation parameters
○ Provides for feedback to finalize plan

CORE COMPETENCY 4:
Implements the health Education Plan

Indicators:
○ Provides for conducive learning situation in terms of timer and place
○ Considers client and family preparedness○ Utilize appropriate strategies
○ Provides reassuring presence through active listening, touch and facial expression and gestures
○ Monitors client and family’s responses to health education

CORE COMPETENCY 5:
Evaluates the outcome of health Education

Indicators:
○ Utilizes evaluation parameters
○ Documents outcome of care
○ Revises health education plan when necessary

ETHICO-MORAL RESPONSIBILITY

IV. ETHICO-MORAL RESPONSIBILITY


CORE COMPETENCY 1:
Respects the rights of individual/ groups

Indicator:
○ Renders nursing care consistent with the patient’s bill of rights (ie. confidentiality of information, privacy, etc.)

CORE COMPETENCY 2
Accepts responsibility & accountability for own decisions and actions

Indicators:
○ Meets nursing accountability requirements as embodied in the job description
○ Justifies basis for nursing actions and judgment
○ Protects a positive image of the profession

CORE COMPETENCY 3
Adheres to the national and international code of ethics for nurses

Indicators:
○ Adheres to the Code of Ethics for Nurses and abides by its provisions
○ Reports unethical and immoral incidents to proper authorities

LEGAL RESPONSIBILITY

V. LEGAL RESPONSIBILITY


CORE COMPETENCY 1:
Adheres to practices in accordance with the nursing law and other relevant legislation including contract and informed consent.

Indicators:
○ Fulfill legal requirements in Nursing Practice
○ Holds current professional license
○ Acts in accordance with the terms of contract of employment and other rules and regulation
○ Complies with the required CPE
○ Confirms information given by the doctor for informed consent
○ Secures waiver of responsibility for refusal to undergo treatment or procedures
○ Check the completeness of informed consent and other legal forms

CORE COMPETENCY 2:
Adheres to organizational policies and procedures, local and national

Indicators:
○ Articulates the vision and mission of the institution where one belongs
○ Acts in accordance with the established norms and conduct of the institution/ organization

CORE COMPETENCY 3:
Document care rendered to patients.

Indicators:
○ Utilizes appropriate patient care records and reports
○ Accomplish accurate documentation in all matters concerning patient care in accordance with the standard of nursing practice.

PERSONAL & PROFESSIONAL DEVELOPMENT

VI. PERSONAL & PROFESSIONAL DEVELOPMENT


CORE COMPETENCY 1
Identifies own learning needs

Indicators:
○ Verbalizes strengths, weaknesses, limitations.
○ Determines personal and professional goals and aspirations.

CORE COMPETENCY 2
Pursues continuing education

Indicators:
○ Participates in formal and non-formal education.
○ Applies learned information for the improvement of care.

CORE COMPETENCY 3
Gets involved in professional organizations and civic activities

Indicators:
○ Participates actively in professional, social, civic and religious activities
○ Maintain membership to professional organizations
○ Support activities related to nursing and health issues

CORE COMPETENCY 4
Projects a professional image of nurse

Indicators:
○ Demonstrate good manners and right conduct at all times.
○ Dresses appropriately.
○ Demonstrates congruence of words and actions.
○ Behaves appropriately at all times.

CORE COMPETENCY 5
Possesses positive attitude towards change and criticism
Indicators:
○ Listens to suggestions and recommendations.
○ Tries new strategies or approaches.
○ Adapts to changes willingly.

CORE COMPETENCY 6
Performs function according to professional standards

Indicators:
○ Assesses own performance against standards of practice.
○ Sets attainable objectives to enhance nursing knowledge and skills.
○ Explains current nursing practices, when situations call for it.

RESEARCH

VII. RESEARCH


CORE COMPETENCY 1:
Gathers data using different methodologies

Indicators:
Identifies researchable problems regarding patient care and community health
Identifies appropriate methods of research for a particular patient/community problem
Combines quantitative and qualitative nursing design thru simple explanation on the phenomena observed
Analyzes data gathered

CORE COMPETENCY 2:
Recommends actions for implementation

Indicator:
Based on the analysis of data gathered, recommends practical solutions appropriate for the problem

CORE COMPETENCY 3:
Disseminates results of research findings

Indicators:
Communicates results of findings to colleagues/patients/family and to others
Endeavors to publish research
Submits research findings to own agencies and others as appropriate

CORE COMPETENCY 4:
Applies research findings in nursing practice

Indicators:
Utilizes and findings in research in the provision of nursing care to individuals/groups/communities
Makes use of evidence-based nursing to ameliorate nursing practice

RECORDS MANAGEMENT

VIII. RECORDS MANAGEMENT


CORE COMPETENCY 1:
Maintains accurate and updated documentation of patient care

Indicator:
Completes updated documentation of patient care

CORE COMPETENCY 2:
Records outcome of patient care

Indicator:
Utilizes a record system

CORE COMPETENCY 3:
Observes legal imperatives in recording keeping

Indicators:
Observes confidentially and privacy of patient’s records
Maintains an organized system of filing and keeping patient’s records in a designated area
Refrains from releasing records and other information without proper authority

COMMUNICATION

IX. COMMUNICATION


CORE COMPETENCY 1:
Establishes rapport with patients, significant others and members of the health team.

Indicators:
○ Creates trust and confidence
○ Listens attentively to client’s queries and requests
○ Spends time with the client to facilitate conversation that allows client to express concern.

CORE COMPETENCY 2:
Identifies verbal and non-verbal cues

Indicator:
○ Interprets and validates client’s body language and facial expression

CORE COMPETENCY 3:
Utilizes formal and informal channels

Indicator:
○ Makes use of available visual aids

CORE COMPETENCY 4:
Responds to needs of individuals, family, group and community

Indicator:
○ Provides re- assurance through therapeutic, touch, warmth and comforting words of encouragement
○ Readily smiles

CORE COMPETENCY 5:
Uses appropriate information technology to facilitate communication

Indicator:
○ Utilizes telephone, mobile phone, email and internet, and informatics
○ Identifies a significant other so that follow up care can be obtained
○ Provides “holding” or emergency numbers of services

COLLABORATION and TEAMWORK

X. COLLABORATION and TEAMWORK

CORE COMPETENCY 1:
Establishes collaborative relationship with colleagues and other members of the health team

Indicators:
○ Contributes to decision making regarding patients” needs and concerns
○ Participates actively in patients care management including audit
○ Recommends appropriate intervention to improve patient care
○ Respects the role of the other members of the health team
○ Maintains good interpersonal relationships with patients, colleagues and other members of the health team

CORE COMPETENCY 2:
Collaborates plan of care with other members of the health team

Indicator:
○ Refers patients to allied health team partners
○ Acts liaison / advocate of the patients
○ Prepares accurate documentation of efficient communication of services

QUALITY IMPROVEMENT

XI. QUALITY IMPROVEMENT


CORE COMPETENCY 1:
Gathers data for quality improvement

Indicators:
Demonstrates knowledge of method appropriate for the clinical problems identified
Detects variation in the vital signs of the patient from day to day
Reports necessary elements at the bedside to improve patient stay at hospital
Solicits feedback from patient and significant others regarding care rendered

CORE COMPETENCY 2:
Participates in nursing audits and rounds

Indicators:
Contributes relevant information about patient condition as well as unit condition and patient current reactions
Shares with the team current information regarding particular patients condition
Encourages the patient to speak about what is relevant to his condition
Documents and records all nursing care and actions
Performs daily check of patient records/condition
Completes patients records
Actively contributes relevant information of patients during rounds thru readings and sharing with others

CORE COMPETENCY 3:
Identifies and reports variances

Indicators:
Documents observed variance regarding patient care and submits to appropriate group within 24 hours
Identifies actual and potential variance to patient care
Reports actual and potential variance to patient care
Submits report to appropriate groups within 24 hours

CORE COMPETENCY 4:
Recommends solutions to identified problems

Indicators:
Gives appropriate suggestions on corrective and preventive measures
Communicates and discusses with appropriate groups
Gives and objective and accurate reporton what was observed rather than an interpretation of the event.