Standards for Practice in Nursing: A Case Study of Rehabilitation Unit

NURS3002 2018
Assignment 3 Template
Standards for Practice
Student Name: Student ID: Date: Submission Due Date
Date Submitted: Topic Availability: Class no:
Standard 1: Thinks critically and analyses nursing practice
Family members recently transferred a patient named Monica Williams of 75 years old to
our rehabilitation unit who was of Aboriginal decent. She had faced stroke two months back and was
treated in the emergency ward for about a week. The stroke had paralysed most of the parts of her
body and she was not even instructed for rehabilitation by the previous healthcare organization. This
had resulted her to lead a very poor quality life. Her mobility is entirely affected. She had developed
bedsores, lost her independence in activities of daily life, speech had been affected and many more.
Therefore, when the situation went out of control from the hands of the family members due to her
excess pain from bedsores, the patient was admitted to the ward for development of her mobility,
speech activities, gaining independence, reduction of bedsores and others. Therefore, it was the
duty of the healthcare team to allocate important experts as well as nursing professionals to meet
each of her requirements and needs accordingly.
According to the standard one of the standards of practice provided by the NMBA, every
nursing professionals need to utilize varieties of thinking strategies that would be aligning with the
best available evidences in making decisions (Standard of practice, Nursing and midwifery board of
Australia 2016). This would help in providing safety as well as quality nursing practice that would be
strictly following the person-centred as well as evidence-based frameworks (Standard of practice,
Nursing and midwifery board of Australia 2016). The nursing professionals would ensure that they
are utilising evidence-based information after thoroughly analysing the research studies and their
credibility (Mallah, Nassar and Badr 2015, pp 110). This might include the research findings that
would help in providing safe as well as quality practice (Beeckman 2015, pp 1). Therefore, the
professionals used some of the most trusted database that are used in the nursing professionals like
Cinhal, Medplus, Pubmed and others and came up with some important evidence based
information. One of the articles has stated that pressure relief is one of the most important actions
that professionals should undertake (Mallah, Nassar and Badr, 2015, pp 110). It is very much
important to relieve pressure from the affected area that can be identified as the purplish or reddish
and warm skin. Therefore, according to the suggestions of the study, pillow and foam pads were
used for relieving pressure from the patient from the area where purplish coloration of the skin was
observed (Beeckman 2015, pp 1). This was mainly done, as the patient was not been able to be
moved into a position that would not put any weight on the sore (Mallah, Nassar and Badr 2015, pp
110). Moreover, the professional also followed another paper which advised him to cover the sore
with gauze or the moist bandage and thereby prevented the sores from getting irritated by rubbing
on clothing or bedding (Lozano et al. 2016, pp 50). Moreover, the patient was suffering from
immense pain from the pressure sores and therefore needed to make her relieve from the pain.
Evidences suggested that acetaminophen as well as ibuprofen can result in relieving some of the
discomfort that patients experience from bed sores and therefore such medications were also
provided to Monica (Lozano et al. 2016, pp 50). Moreover, evidence based articles also helped him
to know that tropical antibiotic creams are also useful that can help the wound to keep moist when
professionals apply bandage or dressing. This helped in reduction of the risk of infection and so, the
professional also applied this intervention (Avsar et al. 2018, pg 55). He also learnt that soaking the
affected areas in warm water result in smoothening of the painful beds sores and temporarily relieve
from stinging as well as burning sensation and therefore this was also applied me. Another

NURS3002 2018
Assignment 3 Template
Standards for Practice
important arena is nutrition. Researchers are of the opinion that a diet with adequate amounts of
protein, minerals as well as vitamins are important for the healing and prevention of the sores from
getting more infected or worse (Avsar et al. 2018, pg 56). The professional made sure that the
patient would be provided with the diet that was comprised of vitamin C as well as zinc supplements
along with the nutritious diet. In order to prevent any new occurrences of pressure sores, it would
be important for reducing moisture on the skin, as this increase would help in decreasing the risk for
pressure injury development (Clay et al. 2018, pp 14). This was done by applying barrier cream,
keeping skin clan and dry and thereby investigating as well as managing incontinence. Following the
evidences, the professional also used to reposition Monica at every two hours. I followed side lying,
right side lying, left side lying, seated on a chair or a bed. He did not massage any bony prominences
that could have proved harmful for the patient as per the evidences (Avsar et al. 2018, pg 57). This
standard advises nursing professionals to practice through reflection. I have therefore often
conducted reflection on his experiences as well as his knowledge actions, feelings and beliefs, this
not only has helped me to shape his practices but also has helped me in becoming self confident and
perform smart jobs (Standard of practice, Nursing and midwifery board of Australia 2016). The
professional was able to identify the skills that he was lacking and the clinical knowledge that he
needed to develop. In a way, the professional has become more competent through the reflective
practices. He have used the ethical framework of beneficence that dictates the professionals to
provide safe service that are evidence based and are safest for the patient (Clay et al. 2018, pp 14).
Non-maleficence is also followed which was based on the principle that the patient should gave no
suffering or that the professionals should ensure that none of the intervention taken should harm
the patient in any ways (Gunningberg et al. 2017, pp 56). Moreover,he also followed justice where
he provided care to the best quality of the patient irrespective of culture and background of the
patient. Documentation is one of the most important arenas where nursing professionals need to
input the details of the interventions taken, results of the tests, everyday actions taken for the
patient, medication list, progress update of the patient condition and others (Clay et al. 2018, pp 14).
Therefore, he kept all the information of the patient by documenting it in a proper format.
Documentation also helped the other members of the team to know about what each other is
performing and what their views are about the patients (Butcher et al. 2018, pp 225). All these
ensured collaborative work of the professionals. He followed all the legislations and policies and the
other professionals like Human rights acts, Data privacy rules and others. In this way,he maintained
the standard.
Standard 2: Engages in therapeutic and professional relationship[s
This standard mainly enables the professional to engage in effective therapeutic as well as
professional relationships. This would mainly include maintaining a number of principles that would
be based on the mutual trust as well as respect in the professional relationship (Standard of practice,
Nursing and midwifery board of Australia 2016). This standard advice the professionals to maintain
relationship with the patient which is entirely based within the professional boundaries and does not
include any form of personal relationships (Standard of practice, Nursing and midwifery board of
Australia 2016). He totally followed this principle while treating the patient. The patient and his
family members were highly satisfied by his service and therefore as a matter of gratitude, they had

NURS3002 2018
Assignment 3 Template
Standards for Practice
invited him to their house for a dinner (Fisher 2017, pp 4). This was against standard 2 as he needed
to maintain proper boundaries between professional and personal aspects of the relationship he
shared with the patient (Fisher 2017, pp 4). The family members gave him gifts that were very
auspicious to their culture but it was against the standard to accept such gifts therefore. He
communicated with them politely and made them understand the main reason for his not being able
to accept any gifts from them. They understood his explanation and were satisfied by his approach.
This standard also states the importance of effective communication along with respecting the
dignity, culture, beliefs and values of the person (Endacott et al. 2018, pp 915).He had realized that
person centred care is the most important approach that brings out positive outcome on the patient.
The aboriginal people were neglected over many generations in different ways in the nation and
therefore they had lost all hopes from the western healthcare system (Wilson et al. 2018, pp 25).
They never expect culturally competent care from the present healthcare professional (Wilson et al.
2018, pp 25). It was important for our team to change the ideas of the Aboriginal people (Fisher
2017, pp 4) . He along with his team members provided a culturally competent care that aligned
with their cultural perceptions, inhibitions, beliefs and values. The patient felt that her dignity was
respected. He had provided total freedom and autonohis to the patient allowing her to make her
own decisions. According to her preferences, the interventions were provided only after her
approval. Informed consent was taken and all the pros and cons of the interventions were discussed
to her and her family members in details (Endacott et al. 2018, pp 915). Her autonohis was
respected. Moreover, the standard also advises the professionals to provide support and direct
patients as well as the family members to different important resources for optimizing different
health related decisions. Following this, I sat into a discussion with the family members of the
patient and accordingly made a list of the resources to the family members in order to find the
proper services in the community and get in contact with experts who provide homecare services.
This would help the patient and the family members to get in touch with the services and get
support from them when they will go back home (Nagle et al. 2017, pp 10). This would help in
reducing the anxiety and fear of managing the conditions of the patient. The standard expects the
professionals to use delegation, supervision, coordination as well as consultation and referrals in
professional relationships that would help in the achievements of the improved health outcomes
(Ossenberg. Henderson and Dalton 2015, pp 13). Therefore, when his shift ended per day, he made
sure that he delegated the task of handling the patient successfully to the other members of the
nursing team. He documented the instructions properly so that they could follow them and
accordingly plan their care in that shift (Ossenberg. Henderson and Dalton 2015, pp 13). He also
used to verbally communicate the important instruction of handling the pressure sores of the
nursing professionals who handled the patient’s next shift. He also took up the responsibility of
supervisor one day when his senior nurse was absent and he completed the action successfully
(Jacob, Duffiled and Jacob 2018, pp 58). Another of the most important aspect of the care is the
collaborative practice done by the team of the healthcare members. It was seen that different
experts like the speech therapist, occupational therapists, physiotherapist, dieticians, nursing
professionals, physicians and many others act in coordination with each other so that all the
requirements of the patient was met (Jacob, Duffiled and Jacob 2018, pp 58). Just as the standard
dictates that, the nursing professionals should foster a culture of safety and learning that include
engaging with the professional relationships with others so that there is effective sharing of
knowledge and the practices that support the person centred care (Ossenberg. Henderson and
Dalton 2015, pp 13).The members of the healthcare teams were often seen to conduct meetings
twice a week where the members used to share their knowledge, views and ideas about the
treatment procedures of the patient and how different types of initiatives should be taken so that
the patient is benefitted. Such discussion often helped in enlightening each other’s and regular
constructive feedbacks from each other’s that helped in developing our expertise as well (Birks et al.
2016, pp 540).