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NURSING PRACTICE
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DEFINITION Nursing
practice is defined as “Nursing as the diagnosis & treatment of human responses to actual & potential health problems.” A.N.A. Nursing practice is defined as “
Nursing as the diagnosis & treatment of human responses to actual or potential health problems.” A.N.A.
DEFINITION
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Advanced nursing practice is an umbrella term describing an advanced level of clinical nursing practice that maximizes the use of graduate educational preparation ,in depth nursing knowledge &expertise in meeting the health needs of individuals, families, groups, communities & populations. C.N.A.
DEFINITION
Advanced nursing practice is an umbrella term describing an advanced level of clinical nursing practice that maximizes the use of graduate educational preparation ,in depth nursing knowledge &expertise in meeting the health needs of individuals, families, groups, communities & populations. C.N.A.
DEFINITIONw
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DEFINITIONIt involves: Analyzing synthesizing
knowledge. Understanding, interpreting &
applying nursing theory & research.
Developing & advancing nursing knowledge & the profession as a whole.
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CHARACTERISTICS
In advanced nsg. Practice nurses build on their expertise in a specialty area, integrating & consistently displaying the following features & characteristics. 1] Provision of effective & efficient care delivered with high degree of autonomy to an identified population. 2] Demonstration of leadership & initiation of change to improve client organization & system outcomes.
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CHARACTERISTICS3] Deliberate, purposeful &
integrated use of in depth nursing knowledge .
4] Depth &breadth of knowledge that draws on a wide range of strategies to meet the needs of clients & to improve quality of care. 5] Ability to explain & apply the theoretical, empirical, ethical & experimental foundations of nursing.
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FRAME WORK OF NURSING PRACTICE
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THE ART OF NURSINGNurses demonstrate ethical,
insightful, caring practice by focusing on the health & wellbeing of individuals, families,& communities in health &during episode of illness.
Professional nursing practice is grounded in the art of nursing, described as taking a holistic, client centered, being caring & ethical in interactions.
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COMPETENCE Nurses competence is grounded
upon nursing theory, scientific knowledge & experience.
It is reflected in every day practice.
Professional practice demands competence is relation to knowledge & technical skills.
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ATTRIBUTES OF PRACTICEAutonomous professional practice
in nsg. Requires taking personal responsibility for excellence in practice & effective collaboration with multidisciplinary team members in meeting the health needs of the population.
Professional practice reflects a particular approach to one’s work with collaboration by far the most salient characteristic.
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PERSONAL COMMITMENT Nurses demonstrate commitment to
the profession by valuing nurses & nsg. Contributing to the advancement of the profession & continually striving for excellence in patient care.
This element of professional practice, respondents referred to the importance of having confidence in action& sound understanding of the boundaries & limitations of nsg. Practice.
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VALUES & PROFESSIONAL PRACTICE
The frame work is congruent with the values of the nurse as like Honesty, integrity, dignity, trust, respect, responsiveness, creativity learning.
The framework reinforces the prerequisites for the promotion of safe, competent & ethical nursing practice that are inherent in the standards of practice & code of conduct of the registered nurse.
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VISION & MISSION Vision for nursing is excellent
health care through professional nursing practice.
Nurses are committed to professional nursing practice that promotes quality, family centered care & efficient &effective delivery of integrated services provided in collaboration with community partners &members of the multidisciplinary health care team.
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SCOPEProviding comprehensive nursing
assessment of the health status of the client.
Collaborating with a health care team to develop an integrated client centered health care plan.
Developing plan of nsg. Strategies to integrated client centered health care plan.
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SCOPEDelegating & assigning nsg.
Interventions to implement the plan of care.
Providing for the maintenance of safe & effective nsg. Care rendered directly or indirectly. Promoting a safe & therapeutic environment.
Providing health teaching &counseling to promote attention &maintain optimum level of health.
Advocate to client.
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SCOPEEvaluating responses to
interventions & the effectiveness of the plan of care.
Communicating &collaborating with other health care professionals.
Acquiring & applying critical new knowledge & technologies of practice.
Teaching the theory &practice of nsg.
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SCOPEParticipating in the development
of policies.Allowing for the advancement of
nursing &midwifery practice.Allowing education providers to
incorporate the guiding principals to expand the scope of practice.
Integrating the development of nsg. Policy.
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SCOPEIn three tier health care delivery
system, health is concern of all. It is not only for sick & disabled,
but for healthy beings as well.People seek health care not only
in crisis, but for anticipated potential risks also.
In primary health care concept, nurse performs in expanded role-disease protection, prevention, rehabilitation, community health, referral services etc.
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FUTURE TRENDS IN NURSINGExpansion of employment
opportunitiesNursing’s public perceptionNursing’s impact on polities &
health policy. Characteristic of population
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EXPANSION OF EMPLOYMENT OPPORTUNITIES
Nursing practice trends includes a growing variety of employment setting in which nurses have greater independence, autonomy & respect as a member of health care team.
Nursing roles to continue to expand & develop broadening the focus of nsg. Care & providing a more holistic & all encompassing domain.
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TRENDSNursing therapies are not only
drawing from traditional nursing & medicine ,spiritual & emotional realms but also expanding in to alternative therapies such as healing touch, massage therapy & use of natural herbs & vitamins.
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NURSING’S PUBLIC PERCEPTIONS Any member of society who
has been ill, hospitalized or visited an emergency department has experienced nursing care.
Nursing is a pivotal health care profession as front line health care provider’s nurses practice in all health care settings & constitute the largest number of professionals.
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TRENDSNurses are essential to provide skilled specialized, knowledgeable care, to improve the health status of the public & to ensure safe, effective quality care.
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NURSING’S IMPACT ON POLITICS & HEALTH POLICY
Nurses involvement in politics is receiving greater emphasis in nursing curricula, professional organizations & health care settings.
Political activism & commitment are a part of professionalism however & politics are an important aspect of the delivery of health care.
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TRENDS
The plan for reform focuses on primary health care services & the promotion ,restoration & maintenance of health
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CHARACTERISTIC OF POPULATION
Patterns of nursing care should change in positive way to meet the new trends & new situations as they arise.
Birth rate, mortality &morbidity rate are in descending trend while life span & longevity show opposite trend. This is demographic transition.
Geriatric problem is serious. Industrial & occupational health problems are in front step.
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CHARACTERISTIC OF POPULATIONNeeds of population are also
changing its dimentions.This is epidemiological transition.
So nursing practices are also searching ways to take responsibilities of these new &different health problems.
Much more wider role of nurses are in pipeline with the changing outlook of society.
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ALTERNATIVE MODALITIES OF CAREReflexologyReikiRolfingAlexander techniqueAroma therapyBioenergeticsPolarity therapyHydrotherapy
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ALTERNATIVE SYSTEMS OF HEALTH CARE
AYURVEDASIDDHAUNANIHOMEOPATHYNATUROPATHY&YOGAACCUPRESSURE
&ACCUPUNCTURETELE MEDICINE(MODERN
METHOD)
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AYURVEDA
The origin &Nature: Ayurveda is an ancient system of medicine practiced in India.
The word (Ayur+veda) implies the science of life. The origin of Ayurveda is linked with the origin of universe & it is developed from the hymns from Atharvaveda describing philosophies about the world of life, diseases & medicine.
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AYURVEDAAround 1000BC,the comprehensive
documentation of the knowledge of Ayurveda was done by Charak in charaka samihita & by sushruta in sushruta samihita.Charaka samhita is the treatise on medicine & sushruta samhita is the treatise on surgery.
Theoretical basis:-The practice of Ayurveda is based on the theory of punch mahabhutas.
Diagnosis & treatment:-Diagnosis in Ayurveda system is done on the basis of history taking & examination of pulse, urine, faces, tongue, eyes etc.
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AYURVEDATreatment includes preventive &
curative measures.Specialties:-Ayurveda developed
eight branches of specialties during charak & sushruta period.
Education & research workPractice & Drugs standards.
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SIDDHA
ORIGIN & NATURE Siddha is one of the oldest systems of
medicine in India. The term siddha implies achievement.
It was practiced by “Siddharas” who aimed to maintain perfect health in order to achieve siddhi or heavenly bliss.
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SIDDHASiddha is largely practiced in
Tamil speaking areas of India & abroad. Siddha literature is in Tamil.
Basic philosophyDiagnosis & treatment methodEducation & research work
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UNANI
ORIGIN & NATURE The Unani system of medicine
has its origin in Greece before Christ under the patronage of Hippocrates & Galen.
It was introduced in India around the eleventh century by the Arabs & Persians.
Theoretical basis Diagnosis & Treatment Education &research
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HOMEOPATHY SYSTEM
ORIGIN & NATURE Homeopathy has been in practice
for 170 years by thousands of practitioners & there are over 100 homeopathy journals world-wide.
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HOMEOPATHY SYSTEMHomeopathy is based on the
theory of “Similia Similibus Curentis” or let like be treated by like which means that any substance capable of producing artificial symptoms on healthy individuals can cure the same symptoms in a natural disease.
Basic Laws, Diagnosis & treatment method
Education & research work
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NATUROPATHY
Naturopathy system is not only therapeutic but also it is a way of life.
It is based mainly on application of simple laws of nature.
Naturopathy is holistic system & it helps promote physical, mental, emotional, social &spiritual health by self regulation of life activities on a normal & natural basis.
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NATUROPATHYThe advocates of naturopathy pay
particular attention to regulation of eating & living habits, adoption of purificatory measures, use of hydrotherapy, cold packs, mud packs, baths, massage & a variety of methods/measures based on various innovations depending upon the disease & its root causations.
Educational programmes
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YOGA
Yoga is a science which helps to co-ordinate body & mind more effectively.It promotes mental, physical, social & spiritual health.It also helps in prevention & cure of various psychosomatic disorders, psychic & physical disorders.Yoga is an ancient science. It has been described in Vedas.
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YOGAIt consists of eight components. these are Restraint in every sphere of life; Austerity in every sphere of life; Maintaining physical posture; Breathing exercises; Restraining of sense of organs; Contemplation; Mediation; Samadhi. These yogic practices have potential for improvement of personal & social behavior.
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ACCUPRESSURE
Acupressure is based on the principal that the body contains energy channels or meridians through which flows a vital life energy.It stimulating the energy points in the ,acupressure aims to remove energy blocks which produce health problems.It is non invasive technique that applies the pressure of the practitioner’s fingers to acupuncture sites to cure or ameliorate diseases.
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ACCUPRESSURE It applies on specific sites of the body to control symptoms such as pain or nausea. This therapy is also used to stop bleeding. It is derived from traditional Chinese medicine, which is a form of treatment for pain that involves pressure on particular points in the body known as “acupressure points.” A practitioner use this therapy to relive discomfort, prevent tension& promote good health. This treatment is gaining popularity in India & several private practitioners have a booming practice.
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ACCUPUNCTURE
A technique based on an ancient Chinese belief that the entire universe is composed of two types of energy; the positive yang, which contracts & stimulates & the negative yin which sedates & expands.
Heath is believed to exist when equilibrium between yang & yin in the vital life force moves along meridians as it flows through the human body. Disease is believed to result from an imbalance of yang & yin. Acupuncture is believed to restore balance.
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ACCUPUNCTURE Long, fine needles inserted through
the skin at specific acupuncture sites, along the meridians ,to cure disease associated with each site. In the past the needles were often twisted now they may be stimulated with a weak electrical current.
It is used for the treatment of chronic pain conditions such as arthritis, bursitis, headache, athletic injuries, post traumatic & post surgical pain, immune function, dysfunction such as psoriasis, allergies &asthma, alcoholism, addition smoking & eating disorders.
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TELE-MEDICINE
The concept of Telemedicine was introduced in 30yr’s ago.
Telemedicine generally refers to the use of communication & information technologies for the delivery of clinical care.
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TELE-MEDICINE It may be simple as two health
professionals discussing a case over the telephone or as complex as using satellite technology and Video- conferencing equipment to conduct a real time consultation between medical specialties in two different countries.
Telemedicine system consist of customized medical software integrated with computer hardware, along with medical diagnostic instruments connected to the commercial VAST.
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Impact of Telemedicine Improve the quality. Increase the efficiency. Expand the access of the health care delivery system
to the rural population & developing countries. Third generation wireless cellular systems will offer
video telephony that can facilitate the transfer. Tele-surgery helps to jump-start robotic.
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COMPLIMENTARY THERAPIESHerbalismOsteopathySpiritual healingHypnotherapyMusic therapyDance therapyArt therapyBiofeedbackRelaxation therapy
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EXPANDED AND EXTENDED ROLE OF NURSE
Promotive care - 1) Health education 2)Environmental modification 3)Nutritional interventions 4)Life style modification Preventive care - 1)Premordial prevention 2) Specific health protection 3)Protection against –
Occupational hazards
- Accidents
4)Use of specific nutrients for specific diseases
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Curative care-1) Primary care - Early detection &
routine care 2) Secondary care (Acute care) a) Emergency treatment b) Critical care (Intense &
elaborate diagnosis & treatment)
3)Tertiary care (Special care)a) Special care (Highly technical services for patients in a large
geographical area).
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ROLERestorative care —Intermediate
follow-up care (Surgical post operative routine care, routine medical care)
Rehabilitation Home careContinuing care--- Long term
care ----Chronic
care -----Hospice
care -----Personal
care
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BIBLIOGRAPHY Stanhope M, Lancaster J. community health nursing. Fifth
edition .Mosby;1996. Joan L Crfasfa, Barbara Parker. Conceptual Foundations
of professional nursing practice; copy right 1991 by mosbe year book.
Soreson, Luckmanns. Basic nursing. A psycho physiologic approach 3rd edition, Verobynrac bolande Page no.38-41.
JB Lippincot. Textbook of Basic nursing.6th edition. Caroline Bunkar Rosdahl.
Kozier,Erbblais, Wilkinson. Fundamentals of nursing.8th edition, Page no.284-94.
Potter Perry. Fundamentals of nursing.6th edition,Mosby2005.
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BIBLIOGRAPHY Kamlam,Community Health Nursing
Principles & Practices. Reprint 2004,page no.689-700.
Prospectus & syllabus of Educational Programmes;Naturopathy,2008-2009.
The Nursing Journal of India, Vol. XCIX No:12, Dec 2008.
www.google.com
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THE END
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