Analysis of Registered Nurse Standards and Mandatory Notifications

This report delves into the Registered Nurse (RN) standards of practice and mandatory notifications within the Australian healthcare context. It analyzes the importance of comprehensive patient assessments, emphasizing the collection and documentation of vital signs as outlined in Standard 4. The report explores Standard 7, focusing on the evaluation of patient outcomes to inform nursing practice, including the crucial step of notifying colleagues when patient conditions change. Furthermore, it examines Standard 2, highlighting the significance of therapeutic and professional relationships between nurses and patients, fostering trust and quality care. The report also discusses Standard 5, which addresses the development of nursing care plans and the collaborative efforts required to improve patient outcomes, particularly within intensive care settings. Part B of the report focuses on mandatory notifications, as required by the Health Practitioner Regulation National Law, outlining the responsibilities of healthcare professionals in reporting concerns such as impairment or intoxication of colleagues. It emphasizes the importance of these notifications in protecting patient safety and upholding ethical standards. The report uses case studies to illustrate the application of these standards and guidelines, reinforcing the RN's role in ensuring safe and effective healthcare practices.

Registered Nurse standards of Practice and Mandatory notifications
University
Assessment
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Date

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Part A
1. Standard 4: Comprehensively conducts assessments
Registered nurses play crucial roles in conducting comprehensive and systematic assessments of
patients. They undertake analysis of information and data in a manner that communicates care
outcomes based on the practices. Nurses are engaged in conducting holistic assessments, by applying
various strategies and engaging in partnership with other health care workers in promoting wellbeing
and health of the patients. In the case, assessment of vital signs of patient and correct documentation is
essential in the care practice. This care practice falls under this category due to comprehensive
assessments aspects entailing the patient's vital signs and documentation processes involved in this care
process. Nurses are engaged in the assessment as initial steps in the caring process. Critical thinking
skills are crucial in this process through a decision making framework which is crucial in developing and
planning patient care and entrenching evidence-based practice. According to Toney-Butler & Unison-
Pace (2019), gathering information on psychological, spiritual and psychological aspects of the patients
is critical. Both subjective and objective data are essential in this process. Key elements of this care
process entail the collection of vital data such as temperature; respiratory, blood pressure and pain
level are essential aspects taking place in this avenue. According to Dunham & MacInnes (2019),
assessments are essential in determining the needs of the patents through the formation of the patient
diagnosis process. This allows for review of normal and abnormal values regarding the patent state.
Thus this standard us an essential element in the care process towards aiming at achieving positive
patient outcomes.
2. Standard 7: Evaluates outcomes to inform nursing practice
In evaluating outcomes, registered nurses act based on agreed priorities, goals, plans and
outcome of the patients. Further, revision of the practice can be undertaken under this approach. In this
scenario, notification of the nurse colleague is an essential step in evaluating the outcomes of the
patient vital state assessment. Evaluation of the level of the patient in terms of outcomes is essential in
monitoring progress and offers an avenue for improvement of care towards goal attainment and
improving patient state. According to Jones (2016), nurses have a social role of evaluation of the nursing
practice effect on the outcomes of the patients in avenues of health promotion, injury and preventing
illness and reducing overall suffering. The underlying evaluation of outcomes in the patient care process
entails the interpretation of results and outcomes of the applied intervention. The measures of
assessment can entail psychosocial, physiologic or functional improvement. In this case, it entails the
functional improvement of the patent state. Thus nurses play a fundamental role in evaluating applied
nursing practice on the outcomes of the patients; this is geared towards the improvement of the patient
state (Dubois et al., 2013). Implementing this standard allow for positive patient outcomes and

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improvement of patients state. The case scenario demonstrates an aspect of outcomes evaluation
indicating the deteriorating state of the patient vital assessment on blood pressure which necessitates
action to manage the deteriorating state of the patient.
3. Standard 2: Engages in therapeutic and professional relationships
Registered nurses have the essential role of engaging in the therapeutic relationship and enabling
professional relationships with patients and other staffs. These are geared towards the comprehensive
and systematic assessment of the patient's needs. Registered nurses are tasked with assuring the
patient's safety, quality practices and offering outcomes which are geared towards meeting the needs of
those they are caring for. In this case scenario, the patient is assured of a safe and responsive quality of
care offered by the nurse, thus meeting his needs at the time of the care process. Registered nurses are
tasked with communicating effectively and respecting the patient values, beliefs and cultures thus
earning patient trust as envisaged in substandard 2.2 of this standard. Based on substandard 2.5, nurses
are essential in advocating for patients in the manner in which they respect their autonomy and legal
capacity. Fostering a culture of safety is essential to earn trust as illustrated in the case scenario further
being in line with substandard 2.7. Therapeutic process in the nursing practice is geared at the en-
calculating mutual trust, respect and nurturing hope and ability to have self sensitivity aspects. This is
crucial in the nursing practice which ensures that the healing process and recovery phase is enhanced in
a therapeutic manner facilitating faster and improved patient outcomes. According to Pullen & Mathias,
(2010) therapeutic relationship in nursing practice is essential in developing caring relation when the
patient and the nurse engaged together leading to a harmonious relationship. Moreover, it facilitates an
avenue of developing positive clinical patient experience which has the role of improving and enriching
the experiences of the patients at large (Kornhaber, Walsh, Duff & Walker, 2016).
4. Standard 5: Develops a plan for nursing practice
Registered nurses are engaged in developing nursing care plans in their practice through
adequate planning and communication. Patient reviews are undertaken and agreed in partnership with
other health care teams. These are formulated based on appraisals and reviews of relevant information.
According to substandard 5.1, nurses have the role of conducting assessment and applying it to develop
a plan of care. In the case study scenario, patient assessment demonstrated that declined patient state,
necessitating intensive care plan. This is essential in improving the patient state. Beyond this plan,
development of collaborative contingencies of care, priorities and goals of outcome are evaluated on
the patient with the key goal of improving the outcome of care. Enhancing and deliberating on
intensive care for the patient is geared at improving the overall care process for the patient and prevent
deterioration of his health state (Clark & Bernhard, 2017). This aspect of care calls for coordination and
collaboration among the health care nurses with the key aim of offering care and improving patient

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state while at the intensive care unit. Thus engaging other nurses and health care professional is an
essential avenue for prioritizing care and formulating care plan for the patient. The goal of care is to
improve the patient intensive care state to normal recovery. Hence NMBA standards offered a critical
avenue on demonstrating and improving the outcome of the patients though rigorous care plan which is
patient-centred. (Lyons & Bliss, 2018).

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Part B: Mandatory notifications
Introduction
According to the Health Professional Councils Authority, Australia ((AHPRA, online) registered
health care practitioners have a professional and ethical bound to promote and protect health care
practices. Health professional practitioners, employers and education providers have crucial
responsibilities of providing mandatory responsibilities of the report based on the Health Practitioner
Regulation National Law. There is a need to file a notification to the Australian Health Practitioner
Regulation Agency-AHPRA all forms of reasonable belief on the conduct of practitioners in a manner
which allows a notifiable conduct making. According to AHPRA, any consumer can make voluntary
reporting or raise any concern, however under the National Law, registered health practitioners,
employees and allied staffs have to make this mandatory notification. There are key fundamental issues
which often trigger mandatory notifications; these entail impairment, intoxication while practising, a
departure from normal professional standards and sexual misconduct. Despite this, there are various
thresholds which allow mandatory notification process (AHPRA, online).
Importance of mandatory notifications
Health care professionals are at key strategic points in identifying colleagues who pose danger
and are great risks to patients however they have been reluctant in the past to identify those at risks
(MLC et al., 2014). In the past few years laws have been passed across Australians states which require
the health care practitioners to report and make all notifiable conduct which attracts the attention of
Australian Health Practitioner Regulation Agency (AHPRA online). The relevance of mandatory
notification in the health care practice is to enhance and ensure patient safety progresses. Mandatory
notifications are essential in ensuring that health care professionals' adhere to the set standards of
practice and conduct themselves effectively in health care practice. APHPRA in collaboration with
National Boards play a fundamental role of setting standards and policies for practices, this offers an
avenue for assessing the conduct and performance in the care practice ensuring that optimal safety and
care practices are facilitated to the patients and the general public (AHPRA, online).
Action plan
As the crucial role of protecting the patient from risks of harm the need for making a mandatory
notification in this scenario is paramount. The National Law guideline offers an avenue on who should
make notifications, how to make them and the protection for notifiers. This guideline offers an avenue
for making the mandatory notification and the various levels at which there are risks necessitating
notification. Under the Law, key underlying concerns which trigger notifications entail impairment,
intoxication while practising, a departure from the accepted norms of practices and sexual misconduct.
In this case, the registered nurse is working and performing nursing duties while under intoxication

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which is a fundamental risk factor for the health care state of the patient. Thus my role while in this
aspect is to make notifications concerning the practitioners due to her admission of practising while
intoxicated, as it placed the patient at risk of deteriorating health care state.
Mandatory reporting and notifications
Mandatory notifications allow protection to the public on the risks of harm from registered health
care practitioners. The legal law sets out how must make, the mandatory notification, process and
protection. Mandatory notification under the National Law takes place in states where there is
impairment, intoxication while practising, a departure from the professional stands and sexual
misconduct among the practitioners in the care setting (Parker, 2011).
In making mandatory reporting, there is a need for an assessment on the type of concern raised
by an assessment on the level of harm to the public and whether to make a notification. Before
engaging in mandatory notification reporting, assessment based on reasonable belief is essential. In
applying this concept, there is a need for the application of knowledge of the incident which led to the
incident. The employers or persons responsible for making the notification, need to directly observe the
incident or behaviour, thus in this case, speculation, rumours or gossip do not form a concrete reason to
form a reasonable belief (AHPRA, online).
Protection role in public and health care services
Mandatory notifications in the health care practice are essential in protecting the patients and
consumers of health care practices from harm occasioned by professionals who engage in sexual
conduct with patients concerning their profession, practising while intoxicated or placed the public at
public risks of harm due to significant departure from professional practice. Further, the notifications
allow adherence to a health care professional ethics and standards which are geared towards achieving
patient outcomes and increasing quality of care. Mandatory notifications ensure that practitioners are
working safely and not putting patients at risks (Bismark et al., 2016). This aspect of practices is geared
at improving the level of care being provided at the health care practice.
Conclusion
Registered health care practitioners and professionals in care practices have a role to act and
work ethically by promoting public safety and offering safe health care practices. Essentially health care
practitioners, employers and education providers in Australia have a role to play in making mandatory
reporting and notifications responsibilities under the guidance of the National Law on health
practitioner’s regulation. Adherence to these guidelines allows for safe delivery of health care for the
consumers in health care practices. Thus adhering to these guidelines and notifications and reporting is
essential in the care practice.

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References
AHPRA (Online). Guidelines for mandatory notifications. https://www.medicalboard.gov.au/codes-
guidelines-policies/guidelines-for-mandatory-notifications.aspx. Viewed on 11/04/2020.
Bismark, M. M., Mathews, B., Morris, J. M., Thomas, L. A., & Studdert, D. M. (2016). Views on
mandatory reporting of impaired health practitioners by their treating practitioners: a qualitative
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Clark, C. S., & Bernhard, C. E. (2017). Scope and standards of practice for cannabis nurses.
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Pullen Jr, R. L., & Mathias, T. (2010). Fostering therapeutic nurse-patient relationships. doi:
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