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https://canvas.uts.edu.au/courses/37338/gradebook

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Promoting a culture of safety

Building confidence to reinforce the legal and ethical responsibilities of an RN.

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All our services are available online: Ahpra staff are here to help. We recommend you make an online enquiry. Alternatively, you can contact us by phone. You'll also find lots of helpful resources on our website, including on the COVID-19 updates page.

Download a PDF copy of the Registered nurse standards for practice (177 KB)

Registered nurse (RN) practice is person-centred and evidence-based with preventative, curative, formative, supportive, restorative and palliative elements. RNs work in therapeutic and professional relationships with individuals, as well as with families, groups and communities. These people may be healthy and with a range of abilities, or have health issues related to physical or mental illness and/or health challenges. These challenges may be posed by physical, psychiatric, developmental and/or intellectual disabilities.

The Australian community has a rich mixture of cultural and linguistic diversity, and the Registered nurse standards for practice are to be read in this context. RNs recognise the importance of history and culture to health and wellbeing. This practice reflects particular understanding of the impact of colonisation on the cultural, social and spiritual lives of Aboriginal and Torres Strait Islander peoples, which has contributed to significant health inequity in Australia.

As regulated health professionals, RNs are responsible and accountable to the Nursing and Midwifery Board of Australia (NMBA). These are the national Registered nurse standards for practice for all RNs. Together with NMBA standards, codes and guidelines, these Registered nurse standards for practice should be evident in current practice, and inform the development of the scopes of practice and aspirations of RNs.

RN practice, as a professional endeavour, requires continuous thinking and analysis in the context of thoughtful development and maintenance of constructive relationships. To engage in this work, RNs need to continue to develop professionally and maintain their capability for professional practice. RNs determine, coordinate and provide safe, quality nursing. This practice includes comprehensive assessment, development of a plan, implementation and evaluation of outcomes. As part of practice, RNs are responsible and accountable for supervision and the delegation of nursing activity to enrolled nurses (ENs) and others.

Practice is not restricted to the provision of direct clinical care. Nursing practice extends to any paid or unpaid role where the nurse uses their nursing skills and knowledge. This practice includes working in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory, policy development roles or other roles that impact on safe, effective delivery of services in the profession and/or use of the nurse's professional skills. RNs are responsible for autonomous practice within dynamic systems, and in relationships with other health care professionals.

The Registered nurse standards for practice consist of the following seven standards:

1. Thinks critically and analyses nursing practice.

2. Engages in therapeutic and professional relationships.

3. Maintains the capability for practice.

4. Comprehensively conducts assessments.

5. Develops a plan for nursing practice.

6. Provides safe, appropriate and responsive quality nursing practice.

7. Evaluates outcomes to inform nursing practice.

The above standards are all interconnected (see Figure 1). Standards one, two and three relate to each other, as well as to each dimension of practice in standards four, five, six and seven.

Figure 1: Registered nurse standards

Each standard has criteria that specify how that standard is demonstrated. The criteria are to be interpreted in the context of each RN's practice. For example, all RNs will, at various times, work in partnerships and delegate responsibilities, however not every RN will delegate clinical practice to enrolled nurses. The criteria are not exhaustive and enable rather than limit the development of individual registered nurse scopes of practice.

The Registered nurse standards for practice are for all RNs across all areas of practice. They are to be read in conjunction with the applicable NMBA standards, codes and guidelines, including the Code of conduct for nurses, National framework for the development of decision-making tools for nursing and midwifery practice, Supervision guidelines for nursing and midwifery, and Guidelines for mandatory notifications. The glossary is also important for understanding how key terms are used in these standards.

Registered nurse standards

RNs accurately conduct comprehensive and systematic assessments. They analyse information and data and communicate outcomes as the basis for practice.

The registered nurse:

4.1

conducts assessments that are holistic as well as culturally appropriate

4.2

uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice

4.3

works in partnership to determine factors that affect, or potentially affect, the health and wellbeing of people and populations to determine priorities for action and/ or for referral, and

4.4

assesses the resources available to inform planning.

RNs take responsibility for the evaluation of practice based on agreed priorities, goals, plans and outcomes and revises practice accordingly.

The registered nurse:

7.1

evaluates and monitors progress towards the expected goals and outcomes

7.2

revises the plan based on the evaluation, and

7.3

determines, documents and communicates further priorities, goals and outcomes with the relevant persons.

These definitions relate to the use of terms in the Registered nurse standards for practice.

Accountability means that nurses answer to the people in their care, the nursing regulatory authority, their employers and the public. Nurses are accountable for their decisions, actions, behaviours and the responsibilities that are inherent in their nursing roles including documentation. Accountability cannot be delegated. The registered nurse who delegates activities to be undertaken by another person remains accountable for the decision to delegate, for monitoring the level of performance by the other person, and for evaluating the outcomes of what has been delegated (Nursing and Midwifery Board of Australia 2013). See below for the related definition of 'Delegation'.

Criteria in this document means the actions and behaviours of the RN that demonstrate these standards for practice.

Delegation is the relationship that exists when a RN delegates aspects of their nursing practice to another person such as an enrolled nurse, a student nurse or a person who is not a nurse. Delegations are made to meet peoples' needs and to enable access to health care services, that is, the right person is available at the right time to provide the right service. The RN who is delegating retains accountability for the decision to delegate. They are also accountable for monitoring of the communication of the delegation to the relevant persons and for the practice outcomes. Both parties share the responsibility of making the delegation decision, which includes assessment of the risks and capabilities. In some instances delegation may be preceded by teaching and competence assessment. For further details see the NMBA's National framework for the development of decision-making tools for nursing and midwifery practice (2013).

Enrolled nurse is a person who provides nursing care under the direct or indirect supervision of a registered nurse. They have completed the prescribed education preparation, and demonstrate competence to practise under the Health Practitioner Regulation National Law as an enrolled nurse in Australia. Enrolled nurses are accountable for their own practice and remain responsible to a registered nurse for the delegated care.

Evidence-based practice is accessing and making judgements to translate the best available evidence, which includes the most current, valid, and available research findings into practice.

Person or people is used in these standards to refer to those individuals who have entered into a therapeutic and/or professional relationship with a registered nurse. These individuals will sometimes be health care consumers, at other times they may be colleagues or students, this will vary depending on who is the focus of practice at the time. Therefore, the words person or people include all the patients, clients, consumers, families, carers, groups and/or communities that are within the registered nurse scope and context of practice. The registered nurse has professional relationships in health care related teams.

Person-centred practice is collaborative and respectful partnership built on mutual trust and understanding through good communication. Each person is treated as an individual with the aim of respecting people's ownership of their health information, rights and preferences while protecting their dignity and empowering choice. Person-centred practice recognises the role of family and community with respect to cultural and religious diversity.

Registered nurse is a person who has completed the prescribed education preparation, demonstrates competence to practise and is registered under the Health Practitioner Regulation National Law as a registered nurse in Australia.

Scope of practice is that in which nurses are educated, competent to perform and permitted by law. The actual scope of practice is influenced by the context in which the nurse practises, the health needs of people, the level of competence and confidence of the nurse and the policy requirements of the service provider.

Standards for practice in this document are the expectations of registered nurse practice. They inform the education standards for registered nurses, the regulation of nurses and determination of the nurse's capability for practice, and guide consumers, employers and other stakeholders on what to reasonably expect from a registered nurse regardless of the area of nursing practice or years of nursing experience. They replace the previous National competency standards for the registered nurse (2010).

Supervision includes managerial supervision, professional supervision and clinically focused supervision. For further details see the NMBA's, Supervision guidelines for nursing and midwifery.

Therapeutic relationships are different to personal relationships. In a therapeutic relationship the nurse is sensitive to a person's situation and purposefully engages with them using knowledge and skills in respect, compassion and kindness. In the relationship the person's rights and dignity are recognised and respected. The professional nature of the relationship involves recognition of professional boundaries and issues of unequal power. For further details see the NMBA's Code of conduct for nurses.

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australian health practitioner regulation agency

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Skip to content All our services are available online: Ahpra staff are here to help. We recommend you make an online enquiry. Alternatively, you can contact us by phone. You'll also find lots of helpful resources on our website, including on the COVID-19 updates page.

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Step 2: Scarf Model Discussion and Slides

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Step 2: Scarf Model Discussion and Slides

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David Rock, author of Your Brain at Work and Co-Founder & Chief Executive Officer of NeuroLeadership Institute

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Starting Acute Care Shift: S4/S8 med and emergency trolley checks

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Starting Acute Care Shift: S4/S8 med and emergency trolley checks

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RN responsibilities of S4/S8 medication checks and emergency equipment readiness with the resuscitation trolley

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GI Colorectal Ward:

Pre/post operative care, pain management, time management, drain, stoma and wound care

The objectives of this session include:
1. Remember key RN responsibilities of S4/S8 medication checks and emergency equipment readiness with the resuscitation trolley.
2. Understand the SCARF model and it’s relevance to communication and clinical interactions.
3. Apply communication and teamwork strategies in simulated clinical and peer scenarios.
4. Analyse factors that influence practice including team dynamics and checking procedures.
5. Evaluate their own communication style and decision making during clinical tasks.
6. Create action plans for participating in group assessments and managing complex conversations (SLO1-5)

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What surprised you about the checking process today?
• How confident did you feel?
• In clinical practice whose responsibility is it to make sure these checks happen?
Reflection: Why are these checks
important to patient safety.

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SCARF Model Information Sheet: Support your transition to practice

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SCARF Model Information Sheet: Support your transition to practice

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The SCARF Model Supporting You in Transition to Practice (1)

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The SCARF® Model assesses the differences in people’s social motivation. Some people are more sensitive to status threats and rewards, while others are more sensitive to certainty and relatedness.

Knowing your strongest SCARF® drivers can help you:

Understand how your role and work environment impact your current engagement

Better regulate your emotions

Better communicate your needs to others

Make choices more suited to your own preferences

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https://neuroleadership.com/research/tools/nli-scarf-assessment/

Understanding the SCARF model helps RNs improve
communication, teamwork, and leadership by recognising how social and emotional factors impact behaviour.

It supports patient centred care, enhances self-awareness, and promotes psychological safety in clinical and learning environments.

SCARF connects emotional intelligence to professional communication

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Discover which domains of social threat and reward affect you the most. Take 5 minutes to complete the SCARF Assessment today.

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Schedule 4 Appendix D and Schedule 8 medications must be stored separate to all other medications pending supply to the patient

An exception is for discharge medications supplied in a sealed, tamper evident container labelled with the contents and patient details which may be stored in the Schedule 4 Appendix D medication cabinet or Schedule 8 medication safe or cabinet.

Schedule 8 medications kept in the patient care area must be recorded in the drug register with a witness.

https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2022_032.pdf

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Records in the Schedule 8 drug register The registered nurse/midwife in charge of the patient care area is responsible for ensuring that a record is kept of all transactions in a drug register relating the Schedule 8 medications stored in the Schedule 8 medication drug safe/cabinet. Unless otherwise approved in electronic form under NSW Health Framework for Use of an Electronic Drug Register Requiring Dual Signatures, the drug register must be the State Forms bound book with consecutively numbered pages (unless otherwise approved under facility procedures). A separate page must be used for each form and each strength of the Schedule 8 medication active ingredient. Where brands of the same strength and form need to be differentiated (for example, methadone liquid formulations) they may be on separate pages under facility procedures.

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The authorised person making an entry in a patient care area drug register:

must not make any false or misleading entry 

must not make any alterations, obliterations or cancellations.

No lines may be drawn through entries, no entries scribbled out or crossed out in any way, nor numerals altered.

If a mistake is made, the entry must be left as it is, marked with an asterisk, rewritten as corrected on the next line (and countersigned by the second person) with a marginal note or footnote explaining the error (signed and dated by both staff members), also marked with an asterisk.

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Witness to Schedule 8 medication transactions - p. 82

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Witness to Schedule 8 medication transactions - p. 82

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The witness to a Schedule 8 medication transaction must be a person who is fully familiar with Schedule 8 medication handling and recording procedures.

This may include a registered nurse or registered midwife, an authorised prescriber, a pharmacist, and any other person authorised by the registered nurse/midwife in charge of the patient care area to complete this task, such as an enrolled nurse or anaesthetic technician.

The witness must be present during the entire procedure

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Balance checks in the Schedule 8 drug register 

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Balance checks in the Schedule 8 drug register 

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The registered nurse/midwife in charge of the patient care area must ensure that the balance of Schedule 8 medications recorded in the drug register is checked against the physical balance in the Schedule 8 medication storage unit(s) at least once every 24 hours

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In addition to balance checks, regular audits of patient care area Schedule 8 drug registers at intervals approved by the Drug and Therapeutics Committee must be conducted to confirm records are meeting legislative and policy requirements and also to detect any possible misappropriation.

Where an area of non-compliance or concern is revealed, appropriate steps must be instituted to rectify the issue.

Audits must be performed by two staff members

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Discus Team Communication and Collaboration Expectations

Handout group assignment/info

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93219 93232 TPP Assessment 1 Allocation Form-1 (1)

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UTS acknowledges the Gadigal
People of the Eora Nation upon
whose ancestral lands our university
stands. We also pay respect to the
Elders both past, present and
emerging, acknowledging them as
the traditional custodians of
knowledge for these lands.

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Check uniforms and must have student IDs

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Check uniforms and must have student IDs

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Groups of 4: each group to rotate every 15-20 mins to each patient scenario and complete the workbook

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Groups of 4: each group to rotate every 15-20 mins to each patient scenario and complete the workbook

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All patient charts are in CANVAS

Use your laptop to access the info

Some skills are repeated across more than one patient

Keep workbooks for Week 2

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A: Airway (airway obstruction)

B: Breathing (resp, SPO2, chest rise/fall)

C: Circulation (BP/Pulse, cap refill/skin colour, devices)

D: Disability (AVPU/GCS, falls risk/mobility)

E: Exposure (bleeding, skin integrity)

F: Fluids (FBC, VIP score, hydration, urine output/UA)

G: Glucose (BGL, s/sx hypo/hyper)

H: Holistic (ADLs, psychosocial needs, patient education)

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Performing an A-G patient assessment: a step-by-step guide

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Abstract The A-G method is a systematic and structured approach of assessing patients, useful both in routine and emergency situations. It is based on the

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Have you seen these domains challenged in clinical settings?

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Bed 1: Douglas: 66 yrs old: Day 2 post Right Hemicolectomy secondary to diverticulitis

Bed 2: Fatmia Kan: 72 yrs old: Day 1 post Emergency Laparotomy, penetrating knife wound - came from ICU

Bed 3: Leon Tan: 58 yrs old: Preop laparoscopic hernia repair (new admission)

Bed 4: Dalia Singh: 71 yrs old: Day 2 postop Bowel Resection for colorectal cancer (stoma)

Bed 5: Paul Romero: 58 yrs old: Day 1 post Low Anterior Resection for colorectal cancer (has CADD pump)

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UTS log in required

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University of Technology Sydney - Sign In