Standards of Nursing Practice
The American Nurses Association (ANA) developed general and specialty specific standards of nursing practice that provide guidelines for nursing practice. These standards are the rules of competent care, and RNs are required by law to carry out care in accordance with what other reasonably prudent nurses would do in the same or similar situations. The American Nurses Association standards consist of three components: (1) professional standards of care define diagnostic, intervention, and evaluation competencies; (2) professional standards identify role functions in direct care, consultation, and quality assurance; and (3) specialty practice guidelines are protocols for specific client populations. The ANA standards are comprised of standards of care and standards of professional practice. The standards of care are based on the nursing process and describe a competent level of nursing care. Standards of professional performance cover quality of care, performance appraisal, education, collegiality, ethics, collaboration, research, and resource utilization.
American Nurses Association standards of care for specialty-specific nursing practice include, but are not limited to: addictions nursing practice, cardiovascular nursing, corrections nursing, faith community nursing, genetics/genomic nursing, gerontological nursing, HIV/AIDS nursing, holistic nursing, home health nursing, hospice and palliative nursing, intellectual and developmental disabilities nursing, legal nurse consulting nursing, neonatal nursing, neuroscience nursing, nursing administration, nursing informatics, nursing professional development, pain management nursing, pediatric nursing, plastic surgery nursing, psychiatric nursing, public health nursing, radiology nursing, school nursing, and vascular nursing. The scope and standards of practice for forensic nursing is due out in 2009.
The ANA, along with its 54 constituent organizations, is the only full-service professional organization representing the nation's 2.9 million registered nurses, but it is not the only nursing organization, nor is it the only one to have standards of care and scope of practice for nurses. Several specialty nursing organizations also provide these guidelines for those nurses within their specialties. The National Association of Pediatric Nurse Practitioners and Associates (NAPNAP) and the Society of Pediatric Nurses (SPN) created unified standards and scope of practice for pediatric nurses; the American College of Nurse Midwives developed standards of care for nurse midwives; and the American Association of Nurse Anesthetists developed the scope and standards of care for nurse anesthetists. JCAHO, an organization that accredits healthcare facilities, sets standards for aspects of nursing care, such as documentation.
Nurses are also held accountable for employer standards of practice, which are frequently written as policies and procedures. For example, hospitals that allow nurses to start intravenous therapy will most likely have standards of practice for that intervention.