Basic Standards for Safe Nursing Practice

Critical Elements

Each patient for whom a nursing student provides care has the right to receive safe nursing care. It is understood that it is essential to avoid a break in asepsis or cause emotional jeopardy and/or physical jeopardy. It is also understood the nursing student will provide caring nurse-patient interactions. As a nursing student, it is expected that your performance will demonstrate a consistent integration of previously learned knowledge, skills, and attitudes.

The following behaviors are expected when students perform any nursing intervention in the clinical practice environment, as well as, in the Nursing Skills Laboratory. The Nursing faculty considers these behaviors essential to the practice of competent, caring, and safe quality patient care.

Practices/Principles of Asepsis

Asepsis is defined as prevention of the introduction and/or transfer of microorganisms. Special consideration should be given to hand washing/use of hand sanitizer before and after the administration of each area of health care as required by principles of asepsis.

It is essential to be mindful of the principles of asepsis.

Examples of clear violations include, but are not limited to, omitting one or more of the following:

  • Washing hands before implementing client care.
  • Protecting self or patient from contamination, including personal protective equipment (PPE) per CDC, healthcare agency, and SCCCD polices.
  • Disposing of contaminated material in designated containers.
  • Confining contaminated material to contaminated area.
  • Establishing and/or maintaining a sterile field when required.

Provides Physical Safety

Physical jeopardy is defined as any action, or inaction, on the part of the student, which threatens the client’s physical well-being.

The student is accountable for their assigned patient’s safety. Any time the patient’s safety is threatened through omission, such as not reporting a deterioration in the patient’s clinical condition, or by the student’s incorrect action, the instructor will document and report, describing the behavior of the student in clear terms.

Examples of clear violations include, but are not limited to, performing one or more of the following:

  • Not correctly identifying patient per facility policy prior to treatments or medication administration.
  • Medicating a patient with a central nervous system depressant and leaving the side rails down.
  • Leaving the patient’s side rails down.
  • Leaving a patient unattended in a potentially dangerous situation.
  • Disconnecting or interrupting a treatment (i.e., Intravenous therapy, nasogastric tube, etc.), or not reestablishing the treatment, as required.
  • Administering medication in an unsafe manner, and / or incorrectly.
  • Not using appropriate safety equipment to prevent patient falls.

Provides Psychological Safety

Emotional jeopardy is defined as any action, or inaction, on the part of the student which threatens the emotional well-being of the patient or significant others. The student’s behavior must not create emotional stress or create a non-therapeutic situation for the client.

Examples of clear violations include, but are not limited to, performing one or more of the following:

  • Using words or body language that constitute disapproval or disgust.
  • Lacking attention to patient-centered care.
  • Any violation of patient’s legal protection, such as maintenance of confidentiality as outlined in the Health Insurance Portability and Accountability Act (HIPAA).
  • Any violation of patient’s protection under the Patient’s Bill of Rights.
  • Any violation of patient’s dignity.

Demonstrates Caring

Caring is defined as a pattern of behavior that embodies the nurse-patient interaction. Essential characteristics are attentiveness to others’ experiences, establishing a trusting relationship with the patient and/or significant other, respecting the diversity of individuals and honoring the dignity of the patient.

Establishing communication with the patient is a fundamental skill of a nurse. This is accomplished by introducing self; explaining purpose of the interaction; and using touch with a patient who is unable to verbally communicate.

Examples of clear violations include, but are not limited to, performing one or more of the following:

  • Not encouraging the patient’s expression of needs.
  • Not responding to the patient’s verbal or nonverbal expressions.
  • Not facilitating goal-directed interactions by:
    • Explaining the nursing actions to be taken.
    • Asking questions to determine the patient’s response to nursing care.
    • Asking questions to determine the patient’s comfort level.
    • Focusing communication toward patient-oriented interest.
    • Using language consistent with the patient’s level of understanding.
    • Eliciting the patient’s choices/desires in the organization of care.
  • Using verbal and physical expressions that are overly familiar, patronizing, demeaning, abusive or otherwise unacceptable.
  • Not utilizing interpersonal communication skills that respect the values, dignity, and culture of the patient and/or family.

Demonstrates Accountability and Responsibility for Practice/Professional Behavior

The California Nursing Practice Act requires its practitioners to be fully accountable for their clinical decisions and actions. For the Fresno City College Nursing student, accountability means that the student will be, at all times, willing to learn and practice nursing with commitment and integrity. Additionally, this includes being attentive, responsive, and responsible to the needs of individual clients and colleagues. As the student acquires nursing knowledge, skills, and attitudes, the student will develop competencies, and assume professional responsibilities shaping an attitude of caring. Accountability and caring both develop as the student becomes knowledgeable and sensitive to the ethical and legal implications of nursing practice. A common goal in the practice of nursing is to provide the highest quality of care to all individuals entrusted to our care.