Standards of Parish Nursing

  1. Here is an interesting article:

    http://humancare.lcms.org/HM/spikes.htm

    Standards of Parish Nurse Practice
    A Presentation at the 5th Annual National Parish Nurse Conference
    St. Louis, Missouri
    by
    Janice M. Spikes, R.N., Ph.D.



    A professional association has an obligation to assist its membership to practice the profession at a prescribed standard of care. Standards of care are dynamic and evolve to reflect current issues and trends within the profession and of those with whom the membership practices in the interdisciplinary health care setting.

    In 1973, the American Nurses' Association (ANA) developed and published its first set of standards of practice. In 1991, the ANA revised the original set of standards and developed the Standards of Clinical Nursing Practice and further expanded into the Standards of Professional Performance. The standards formalized the steps of assessment, planning, implementation and evaluation to become known as the nursing process. Additional standards of practice have been developed by recognized and specialty groups such as the American Association of Critical Care Nurses and the Association of Women's Health, Obstetric and Neonatal Nurses. Other groups to have developed Standards of Practice for Parish Nurses include denominational church bodies, i.e. The Lutheran Church--Missouri Synod and the Health Ministries Association, an interdenominational organization dedicated to health and healing ministries.

    Guidelines for Standards of Care are found in Guido (1988) and are listed below.

    Guidelines for Standards of Care
    Recognize that all professions have standards of care. Standards are the minimal level of expertise that may be delivered to the patient; they are a starting point for greater expectations.
    Standards of care may be externally or internally set. The nurse is responsible for both categories of standards; those set by forces outside of nursing and those set by the role of nursing.
    Standards of care can be found in the following:
    The state nurse practice act
    Published standards of professional organizations and specialty practice groups, such as the American Association of Critical Care Nurses or the Association of Operating Room Nurses
    Federal Agency guidelines and regulations
    Hospital policy and procedure manuals
    The nurse's job descriptions
    The nurse is accountable for all standards of care as they pertain to his/her profession. To remain competent and skillful, the nurse is encouraged to read professional journals and to attend pertinent continuing education and inservice programs.
    Standards of care are determined for the judicial system by expert witnesses. Such people testify to the prevailing standards in the community--a standard that all nurses are accountable for matching and exceeding--thus insuring that patients receive quality, competent nursing care.

    Guido, G.W. (1988). Legal issues in nursing: A sourcebook for practice. Norwalk, CT: Appleton and Lange, p.93.

    The American Nurses' Association Standards of Care and Standards of Professional Performance have been abstracted and are listed below.

    Standards of Care*
    for Registered Nurses
    Standard I. ASSESSMENT
    Collects relevant client health data using appropriate tools and sources.
    Standard II. DIAGNOSIS
    Analyzes assessment data in determining diagnoses which are validated through others when appropriate.
    Standard III. OUTCOME IDENTIFICATION
    Identifies mutually formulated and realistic outcomes individualized to the client.
    Standard IV. PLANNING
    Develops, with appropriate others, a plan of care that reflects current nursing practice for the client to achieve expected outcomes.
    Standard V IMPLEMENTATION
    Implements the plan of care with appropriate interventions.
    Standard VI. EVALUATION
    Evaluates, at appropriate intervals, the client's progress toward achievement of outcomes and revises the plan of care accordingly.
    * American Nurses' Association, 1991, Standards of Clinical Nursing Practice, pp. 9-11. (Measurement criteria have not been included in this brief outline.)
    Standards of Professional Performance*
    for Registered Nurses
    Standard I. QUALITY OF CARE
    Systematically participates in quality of care processes, uses the results of quality of care monitoring and initiates changes when necessary.
    Standard II. PERFORMANCE APPRAISAL
    Evaluates own nursing practice in relation to professional practice standards and relevant statutes and regulations through self evaluation and performance appraisal.
    Standard III. EDUCATION
    Participates in educational endeavors to acquire and maintain current knowledge of professional nursing practice.
    Standard IV. COLLEGIALITY
    Shares knowledge and skills with peers and colleagues and fosters learning in others.
    Standard V. ETHICS
    Bases decisions and actions related to clients on an ethical frameКwork.
    Standard VI. COLLABORATION
    Communicates/consults with the client, significant others, and health care providers to deliver quality client care.
    Standard VII. RESEARCH
    Participates in clinical research activities and uses research findings for quality client care.
    Standard VIII. RESOURCE UTILIZATION
    Considers factors such as safety, effectiveness, and comparative cost for quality client care
    *American Nurses' Association, 1991, Standards of Clinical Nursing Practice, pp. 13-17. (Measurement criteria have not been included in this brief outline.)
    Standards of Practice for Parish Nursing, as outlined by The Lutheran Church--Missouri Synod (LCMS), were developed to guide the practice of parish nurses in LCMS churches. Many of the nurses had various preparation experiences for the role of parish nurse, and the Standards were an attempt to help the different nurses practice the role in a more systematic way.

    Lutheran Church Missouri Synod
    Standards of Practice for Parish Nursing
    The Standards of Practice set forth in this document are taken from the Parish Nurse Distance Learning Program of Concordia University Wisconsin and Ministerial Health/Health and Healing Ministries.

    Standards of Practice
    While standards of practice set forth the for each of the four roles of the PN in the PN/DL Program and Spirituality is certainly a component of each, the area of spirituality calls for a separate set of standards, Professional Development will also be listed as a separate category.

    a. Spirituality

    The Parish Nurse:

    recognizes God as giver of life, and healing as part of the restorative mission of Jesus;
    demonstrates an active participation in congregational and personal worship, Bible study, and devotions;
    identifies her level of spiritual maturity and gifts (caring, wisdom, faith, healing presence, service, encouragement mercy, leadership, etc.) and uses his/her gifts in service to the Lord;
    acquires specific knowledge of disturbances in his/her spiritual life;
    integrates the teaching about the Holy Spirit into the health and healing ministry as a means and goal of wholistic health;
    conceptualizes the interrelationship of disturbances in the emotional, physical and psycho social life of a member with disturbances in the spiritual life;
    assess the spiritual needs of the congregation and collects data that is comprehensive and accurate;
    analyzes data collected about the congregation to determine diagnoses;
    develops plans that specify nursing actions unique to congregational needs;
    applies scriptural concepts as a basis for spiritual intervention;
    incorporates the principles and skills of spiritual intervention into his/her Parish Nursing practice;
    evaluates the effects of ministry on spiritual dimension in terms of structure, process, and outcome; and
    recognizes and commits to the complementary nature of pastor and Parish Nurse.
    b. Health Educator

    The Parish Nurse:

    applies theoretical and scriptural concepts as a basis for decisions in the role of health educator;
    systematically collects data which are comprehensive and accurate in reference to the health needs of the congregation;
    analyzes data collected about the congregation to determine diagnoses;
    plans educational programs through any appropriate channel which touch the needs of any age group;
    guided by the plan, intervenes to promote, maintain, or restore health, to prevent illness, and to effect rehabilitation;
    documents and keeps necessary records, while protecting client's rights to confidentiality; and
    evaluates responses of the congregation to interventions in order to determine progress toward goal achievement and to revise the data base, diagnoses and plan.
    c. Health Counselor

    The Parish Nurse:

    applies theoretical and scriptural concepts as a basis for decisions in practice;
    systematically collects data which are comprehensive and accurate in reference to the health counseling needs of the congregation;
    analyzes data collected about the congregation to determine diagnoses;
    develops plans to meet health counseling needs of the congregation;
    guided by the plan,intervenes to promote, maintain, or restore health, to prevent illness, and to effect rehabilitation;
    respects confidentiality;
    documents and keeps necessary records;
    evaluates responses of the congregation to interventions in order to determine progress toward goal achievement and to revise the data base, diagnoses, and plan.
    d. Liaison to Community Resources

    The Parish Nurse:

    is a viable expression of the Christ-centered caring and sharing of the congregation within the surrounding community;
    develops plans that specify nursing actions unique to congregational needs;
    applies theoretical and spiritual concepts as a basis for decisions in practice;
    systematically collects data that are comprehensive and accurate in reference to community resources and congregational needs;
    analyzes data collected about the congregation and community resources to determine how to collect them;
    documents and keeps necessary records, while respecting the client's rights to confidentiality; and
    evaluates responses of the congregation and community resources to interventions in order to determine progress to goal achievement and to revise the database, diagnoses, and plan.
    e. Coordinator of Volunteers

    The Parish Nurse:

    applies theoretical and scriptural concepts as a basis for decisions in practice;
    systematically collects data that are comprehensive and accurate in reference to volunteer ministry within the congregation;
    analyzes data collected;
    plans for ways in which to expand the healing ministries of the church through the use of volunteers, recognizing that volunteers differ in gifts, resources of time, talents, and motivations, and delegates responsibilities and tasks on that basis;
    by utilizing volunteer caregivers, models of healthy interdependence and collaboration;
    enables volunteer caregivers to experience a service of meaning and purpose that fosters wellness, training and recognition when appropriate;
    documents and keeps necessary records to enable him/her to do the above effectively; and
    evaluates responses of the congregation in order to determine progress toward goal achievement and to revise the data base and plan.
    f. Professional Development

    The Parish Nurse:

    participates in peer review and other means of evaluation to assure quality of Parish Nurse practice, the nurse assumes responsibility for professional development and contributes to the professional growth of others;
    collaborates with other health care providers, professionals, and community representatives in assessing, planning implementing and evaluating programs for congregational and/or community health, when necessary; and
    stays informed through theory and practice of Parish Nursing via independent reading, conferences, and networking.
    Recently, additional standards for parish nursing have been developed and published by Health Ministries Association (HMA). These are not included here but are available through HMA.







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Standards of Parish Nursing