Competency Standards for Psychiatric/Mental Health Nurses

Context of practice of competency standards

A Registered Psychiatric Nurse (RPN) provides psychiatric/mental health nursing care to individuals, families, and groups to enable them to function at an optimal level of psychological wellness through more effective adaptive behaviours and increased resilience to stress. The RPN must be able to provide safe, basic physical care, have a wide understanding of psychological and developmental problems and their treatment, and have a highly developed level of communication skills (verbal, nonverbal, and written). Registered Psychiatric Nurses work with children, adolescents, adults and elderly with dysfunctional behaviour patterns, and/or developmental handicaps. RPNs work as team members or independently, using appropriate consultation and small group decision-making. RPNs work in various kinds of inpatient facilities, community settings and, with suitable academic preparation and/or experience, in Independent practice, education, research or management. Competency standards are necessary to assure a safe, accountable and ethical level of psychiatric nursing practice.

The competency standards are developed to

1. Describe the expectation from the psychiatric/mental health nurse
2. Promote and maintain an enlightened and progressive standard of psychiatric/ mental health nursing education and practice
3. Help the professional development of psychiatric/mental health nurse
4. Ensure standards of practice and code of ethics
5. Guides in allocation of resources in psychiatric/mental health nursing
6. Provide consultation and support to members on personal matters and nursing issues.
7. Promote activities which contribute to mental health.

These competency standards are; in extension of, but complementary to, the basic competencies (laid down by Indian Nursing Council) which all registered nurses are required to meet. The standards must be used in conjunction with the code of ethics and professional conduct for nurse in India. These standards will be reviewed and updated periodically.

These are the 12 competency standards for practice as they apply to psychiatric/ mental health nursing. Competency standards for psychiatric nurses are classified under the following four practice area:

1.      Nursing process/practice: Standards 1 to 4 (assessment, planning, implementation, and evaluation).
 

2.      Professional development: Standards 5 to 8 (legal, ethical, collaborative, and growth).

3.      Administrative/management: Standards 9 and 10

4.      Nursing research and nursing education: Standards 11 and 12

For each practice area, there is:

1. Standard: This is an active statement of what the psychiatric/mental health nurse does.

2. Rational: Each standard is followed by rational which is designed to clarify the meaning through the provision of more details.

3. Element: with in each standard, are a number of elements of competency. These are active statements about how the psychiatric/mental health nurses demonstrate that unit of competency.
   
4. Performance criteria: Following each statement, there are number of performance criteria. These are statements of outcome of the Psychiatric/mental health nurses behavior.

Standards of psychiatric/mental health nursing practice

1. The Registered Psychiatric Nurse systematically collects, analyses, and synthesizes data about a client’s health status,
2. The Registered Psychiatric Nurse develops a specific psychiatric nursing care plan based on the nursing diagnosis.
3. The Registered Psychiatric Nurse carries out the planned interventions in assisting the client achieve optimal health.
4. The Registered Psychiatric Nurse observes and evaluates client’s health status in accordance with the plan of care designed to assist the client achieve optimal health.
5. The Registered Psychiatric Nurse practices within the limitations established by law.
6. The Registered Psychiatric Nurse practices within the boundaries established by the INC Code of Ethics.
7. The Registered Psychiatric Nurse functions effectively with other members of the health care team.
8. The Registered Psychiatric Nurse demonstrates responsibility for professional growth and contributes to the professional growth of others.
9. The Registered Psychiatric Nurse in Independent Practice/ Community Mental Health is an advanced level RPN using counseling, psychotherapy or case management interventions to assist clients in improving or regaining their optimal health.
10. The Registered Psychiatric Nurse in management is an advanced level nurse qualified by education and experience.
11. The Registered Psychiatric Nurse engages in activities to improve nursing practice.
12. The Registered Psychiatric Nurse acts to enhance the professional development of self.

STANDARD 1 (ASSESSMENT)

The Registered Psychiatric Nurse systematically collects, analyses, and synthesizes data about a client’s health status.

RATIONALE:

Systematic collection of data is the first part of the nursing process and is a prerequisite for realistic assessment of a client’s, family’s, or community’s needs for the formulation of the entire care plan.

ELEMENT 1.1

Systematically collects data about the client from all available sources.

PERFORMANCE CRITERIA:

1.1.1 Collects and documents pertinent client data. The data may include but is not limited to:

• Ability to remain safe and not be a danger to self or others –client’s presenting concerns, and symptoms -mental health examination, physical health examination -history of family and significant others

• Physical, mental, developmental, cognitive and emotional health status

• Daily activities, addictions, functional health status, health habits, social roles

• Interpersonal relationships, communication skills, and coping patterns spiritual or philosophical beliefs and values -strengths and competencies that can promote wellness

• Other contributing factors that promote health such as: living situation and ability to manage the environment

ELEMENT 1.2

Organizes and analyses the data using a nursing model.

PERFORMANCE CRITERIA:

1. 2.1 Describes the nursing model being used.

1. 2.2 Collects information that is consistent with the model described.

1. 2.3 Interprets the data in accordance with the described conceptual model.

1. 2.4 Interprets the data taking into consideration the interdisciplinary plan of care.

1. 2.5 Validates the data collection with the client and, whenever possible, with the family.

ELEMENT 1.3

Formulates and organizes by prioritizing actual and potential nursing diagnoses.

PERFORMANCE CRITERIA:

1. 3.1 States nursing diagnoses those are consistent with the model being used.

1. 3.2 States the criteria used to establish priorities.

1. 3.3 Documents the nursing diagnoses in order of priority.

1. 3.4 Modifies the diagnoses or the priorities based on the changing needs of the client or family.

1. 3.5 Includes the client and, whenever possible, the family in developing the diagnoses, arranging priorities, and modifying care.

1. 3.6 Identifies priority of needs in collaboration with the client and other relevant persons.

ELEMENT 1.4

Identifies health strengths.

PERFORMANCE CRITERIA:

1. 4.1 Documents the health strengths of the client or family.

1. 4.2 Incorporates the health strengths into the formulation and development of diagnoses. 

1. 4.3 Diagnoses conform to accepted classification system -for example: North American Nursing Diagnosis Association (NANDA), The Diagnostic and Statistical Manual (DSM IV, 1994).

STANDARD 2 (PLANNING)

The Registered Psychiatric Nurse develops a specific psychiatric nursing care plan for a client based on the nursing diagnosis.

RATIONALE:

Planning is the second of four steps in the nursing process. A definite plan of care, based on thorough and ongoing assessment, is needed to develop the goals and the interventions required to meet the client’s needs and to provide a specific outline for continuity of care.

ELEMENT 2.1:

Acknowledges the client’s right to participate in decisions affecting care.

PERFORMANCE CRITERIA:

2.1.1 Assesses the client’s abilities and resources to participate in care planning.

2.1.2 Explains the rationale for participation to the client.

2.1.3 Provides the client with relevant information about health problems.

2.1.4 Consults with the client prior to making decisions affecting care.

2.1.5 Verifies the identification of diagnoses, goals, and the methods of achieving, evaluating, and revising them.

2.1.6 Verifies the appropriateness of the plan before proceeding.

2.1.7 In consultation with the client, identifies client’s responsibilities.

2.1.8 Supports the client’s independence.

2.1.9 Discusses progress in attaining stated goals.

2.1.10 Discusses alternatives that may be selected to deal with health problems.

2.1.11 Documents the client’s involvement in care planning.

ELEMENT 2.2:

Whenever possible, incorporates observations and reports by the client and the family in developing and modifying the psychiatric nursing care plan.

PERFORMANCE CRITERIA:

2.2.1 Assesses the family’s and community’s abilities and resources for participation in care planning.

2.2.2 Explains the rationale for participation to the family.

2.2.3 Provides the family with relevant information.

2.2.4 Consults with the family prior to making decisions as appropriate.

2.2.5 Verifies the identification of diagnoses, goals, and the methods of achieving, evaluating, and revising them with the family.

2.2.6 Verifies with the family the appropriateness of the plan before proceeding.

2.2.7 In consultation with the family, identifies family responsibilities.

2.2.8 Supports family in carrying out care.

2.2.9 Discusses with the family progress toward goals.

2.2.10 Discusses with the family alternative strategies for care.

2.2.11 Documents the family’s involvement in care planning.

ELEMENT 2.3:

Incorporates observations and reports of other members of the health care team in developing and modifying the psychiatric nursing care plan.

PERFORMANCE CRITERIA:

2.3.1 Involves other members of the nursing team in formulating the plan of care.

2.3.2 Delegates aspects of data collection and implementation to allied nursing personnel in line with their job descriptions.

2.3.3 Communicates relevant information to allied nursing personnel.

2.3.4 Obtains feedback from allied nursing personnel.

2.3.5 Communicates with appropriate members of the health care team about the management of the client.

2.3.6 Formulates expected outcomes congruent with those of other members of the health team.

2.3.7 Participates in the formulation of overall team goals and plans.

2.3.8 Verifies the client’s achievement of actual outcomes with other members of the health team.

2.3.9 Identifies psychiatric nursing knowledge, skills, and activities, and articulates information so that it is coordinated with other health team members.

2.3.10 Provides psychiatric nursing consultation to other team members.

2.3.11 Incorporates observations and reports of others in developing and modifying the psychiatric nursing care plan.

2.3.12 Uses small group decision-making process to facilitate team activities.

2.3.13 Provides for appropriate community follow up to insure continuity of care.

ELEMENT 2.4:

Goals are client-oriented, therapeutically sound, measurable, and achievable behavioural outcomes.

PERFORMANCE CRITERIA:

2.4.1 Records goals, which include expected outcomes stated in measurable terms.

2.4.2 Records goals with specified time for accomplishment.

2.4.3 Records long term goals.

2.4.4 Records short term goals.

2.4.5 Communicates nursing goals to other members of the health care team,

ELEMENT 2.5:

Formulates nursing orders in relation to identified goals.

PERFORMANCE CRITERIA:

2.5.1 Formulates a plan of care which reflects the Registered Psychiatric Nurse’s identification of health problems.

2.5.2 Identifies a variety of interventions designed to achieve goals.

2.5.3 Selects interventions that reinforce the strengths of the client,

2.5.4 Uses scientific principles in selecting the interventions.

2.5.5 Includes interventions which are the responsibility of the client.

2.5.6 Includes interventions to achieve expected physiological outcomes.

2.5.7 Includes interventions to achieve expected psychological outcomes.

2.5.8 Determines the method of measuring effectiveness of interventions.

2.5.9 Determines time frame for interventions,

2.5.10 Records client based nursing interventions.

2.5.11 Modifies interventions according to changes in health status.

STANDARD 3 (Implementation)

The Registered Psychiatric Nurse carries out the planned interventions in assisting the client achieve optimal health.

RATIONALE:

Psychiatric/mental health nurses use a wide variety of interventions to prevent mental and physical illness and to promote, maintain and retain health. The Registered Psychiatric Nurse selects interventions according to their level of practice. The basic level nurse may select counseling, case management, self-care activities, group therapy, health teachings, and a variety of other approaches to meet the mental health needs of clients. The advanced level nurse may engage in psychotherapy, and act as a consultant in addition to the basic level interventions.

ELEMENT 3.1:

Initiates or supervises the initiation of the psychiatric nursing care plan.

PERFORMANCE CRITERIA:

3.1.1 Initiates or supervises the initiation of client focused, goal-directed interventions.

3.1.2 Uses the care plan to guide interventions.

3.1.3 Records the care plan.

ELEMENT 3.2:

Implements nursing orders until they are no longer required, are observed to be ineffective, or need revision.

PERFORMANCE CRITERIA:

3.2.1 Follows through with the plan of care in an organized fashion.

3.2.2 Attends to all elements of care within a time period realistic to the situation.

3.2.3 Continually updates the plan of care.

ELEMENT 3.3:

Modifies priorities on an ongoing basis to meet the client’s needs.

PERFORMANCE CRITERIA:

3.3.1 Records the effects of the care plan.

3.3.2 Modifies priorities to meet the changing needs of the client.

ELEMENT 3.4:

Provides consistent support and reassurance to the client and whenever possible, to the family while implementing the care plan.

PERFORMANCE CRITERIA:

3.4.1 Selects interventions based on the highest probability of acceptability and effectiveness to the client and/or family.

3.4.2 Encourages participation by the client and/or family in implementing the plan.

3.4.3 Provides positive feedback to the client and/or family.

ELEMENT 3.5:

Encourages the client to maintain active involvement in the ongoing therapeutic program.

PERFORMANCE CRITERIA:

3.5.1 Encourages the client toward independence and self-direction.

3.5.2 Assists the client to identify, test out, and evaluate constructive patterns of living.

3.5.3 Reinforces positive behaviour.

ELEMENT 3.6:

Whenever possible encourages the family to discuss, question, and explore feelings and concerns about past, present, and projected therapies.

PERFORMANCE CRITERIA:

3.6.1 Employs principles of communication.

3.6.2 Employs principles of problem solving and critical thinking.

3.6.3 Encourages the family to discuss, question, and explore their feelings about the client’s problem.

3.6.4 Encourages the family to discuss, question, and explore their feelings about the client’s treatment.

3.6.5 Encourages the family to discuss, question, and explore their feelings about the client’s and their own coping strategies.

ELEMENT 3.7:

Promotes the realization of optimal health In individuals through the use of psychotherapeutic interventions,

PERFORMANCE CRITERIA:

3.7.1 Identifies the learning needs of the client.

3.7.2 Uses appropriate teaching techniques to meet the client’s learning needs.

3.7.3 Evaluates the teaching carried out.

3.7.4 Records the teaching plan.

ELEMENT 3.8:

Promotes the realization of optimal health in clients through health teaching.

PERFORMANCE CRITERIA:

3.8.1 Incorporates multiculturalism concepts to maintain a therapeutic milieu.

3.8.2 Employs a variety of psychotherapeutic interventions (group therapy, out patient counseling) to assist clients to achieve and maintain their optimal health.

3.8.3 Documents interventions.

ELEMENT 3.9:

Provides information regarding referral to available community resources that may assist the client and/or the family to meet identified goals.

PERFORMANCE CRITERIA:

3.9.1 Involves the client, family, the health team, and appropriate community resources.

3.9.2 Is aware of and refers clients and families to appropriate community resources.

ELEMENT 3.10:

Performs psychiatric nursing procedures as defined by the employing agency.

PERFORMANCE CRITERIA:

3.10.1 Demonstrates competent psychomotor skills.

3.10.2 Promotes physical health.

3.10.3 Performs procedures as defined,

3.10.4 Records procedures and their effect on the client.

STANDARD 4 (Evaluation)

The Registered Psychiatric Nurse observes and evaluates the client’s health status in accordance with the plan of care which is designed to assist the client achieve optimal health.

RATIONALE:

Evaluation is the fourth part of the nursing process. The Registered Psychiatric

Nurse observes and evaluates the effectiveness of Interventions so appropriate changes can be made in the treatment and nursing plans of care, incorporating the contributions of the client, family, and other members of the health care team.

ELEMENT 4.1

Observes, evaluates, reports, and records the effects of therapies and nursing interventions on an ongoing basis.

PERFORMANCE CRITERIA:

4.1.1 Selects criterion standards that guide observation.

4.1.2 Relates the criterion standards to the diagnosis and goal.

4.1.3 Collects information on the effectiveness of all portions of the care plan.

4.1.4 Assesses the care plan in relation to identified diagnoses, goals and interventions.

4.1.5 Adapts the care plan to meet the changing needs of the individual.

ELEMENT 4.2

Whenever possible, discusses with the client and the family the client’s progress toward goals.

PERFORMANCE CRITERIA:

4.2.1 Involves client and family in assessment of nursing care in perception of their health needs.

4.2.2 Involves the individual and family in revising the plan of care.

ELEMENT 4.3

Recommends changes in the treatment plan to other members of the health care team.

PERFORMANCE CRITERIA:

4.3.1 Incorporates observations and reports of other health care professionals in developing and modifying the care plan.

4.3.2 Recommends changes in the treatment plan to other members of the health care team.

ELEMENT 4.4

Modifies the plan of care based on the attainment of goals, the effectiveness of the treatment plan, and whether or not a positive change has occurred.

PERFORMANCE CRITERIA:

4.4.1 Modifies the care plan as required on the basis of evaluation.

4.4.2 Implements the revised nursing interventions.

4.4.3 Records the effects of therapies and Interventions on an ongoing basis.

4.4.4 Continues the nursing process in a cyclical fashion until the relationship is terminated.

STANDARD 5 (Legal)

Registered Psychiatric Nurse practices within the limitations established by law.

RATIONALE:

Knowledge of the legal boundaries governing psychiatric nursing practice is necessary to protect the public, the client, and the Registered Psychiatric Nurse.

ELEMENT 5.1:

Knows relevant legislation and regulations governing psychiatric nursing.

PERFORMANCE CRITERIA:

5.1.1 Describes specific legislation affecting RPN practice in employment setting.

5.1.2 Describes regulations affecting RPN practice in employment setting.

5.1.3 Discusses relationship of legislation to RPN practice with other team members.

ELEMENT 5.2:

Knows relevant legislation governing rights of clients.

PERFORMANCE CRITERIA:

5.2.1 Describes legislation that governs client rights.

5.2.2 Explains legislated rights to clients and others.

5.2.3 Monitors own practice in relation to client’s rights legislation.

ELEMENT 5.3:

Takes appropriate action to ensure that own and others. Practice conforms to acceptable standards.

PERFORMANCE CRITERIA:

5.3.1 Follows accepted procedures in identifying breaches of care standards,

5.3.2 Follows accepted procedures in acting on Identified breaches of care standards.

5.3.3 Recognizes own limitations and refers the client to appropriate resources whenever necessary.

5.3.4 Uses professional judgment in carrying out dependent care.

ELEMENT 5.4:

Maintains membership in good standing in the professional regulatory body.

STANDARD 6 (Ethical)

The Registered Psychiatric Nurse practices within the boundaries established by the INC Code of Ethics.

RATIONALE:

A guide to ethical behaviour is required to insure safety to the public. The psychiatric/ mental health nurse engages in therapeutic interactions and relationships that promote and support health. Boundaries must be established to safeguard the client’s well-being and to prevent the development of intimate or sexual relationships.

ELEMENT 6.1:

Provides care within the boundaries established by the Code of Ethics.

PERFORMANCE CRITERIA:

6.1.1 Identifies the parts of the Code of Ethics related to client care.

6.1.2 Identifies the relationship between the content of the Code of Ethics and own RPN practice,

ELEMENT 6.2:

Conducts all professional relationships in accordance with the Code of Ethics.

PERFORMANCE CRITERIA:

6.2.1 Identifies those parts of the Code of Ethics relating to professional relationships.

6.2.2 Identifies ethical dilemmas and seeks available resource to help resolve dilemmas.

ELEMENT 6.3:

Interprets the Code of Ethics to others.

PERFORMANCE CRITERIA:

6.3.1 Discusses the Code of Ethics with colleagues and others.

6.3.2 Describes the relationship of the Code of Ethics to RPN practice.

6.3.3 Reports abuse of client’s rights, unethical, incompetent and illegal practices.

ELEMENT 6.4:

Maintains a therapeutic and professional relationship at all times.

PERFORMANCE CRITERIA:

6.4.1 Functions as a client advocate.

6.4.2 Delivers care in a nonjudgmental and nondiscriminatory manner,

6.4.3 Discusses with client boundaries of the client-nurse relationship.

6.4.4 Does not promote or engage in intimate or sexual relationships with current clients.

6.4.5 Recognizes that to engage in intimate or sexual relationships with former clients is unusual to accepted practice.

STANDARD 7 (Collaborative)

The Registered Psychiatric Nurse functions effectively with other members of the health care team.

RATIONALE:

The delivery of effective health care requires a collaborative effort by all personnel.

ELEMENT 7.1:

Functions competently as a member of an interdisciplinary team.

PERFORMANCE CRITERIA:

7.1.1 Identifies own role and roles of other team members in the local community in which the RPN practices.

7.1.2 Uses appropriate communication channels.

7.1.3 Demonstrates respect for colleagues.

7.1.4 Participates in planning, implementing, and evaluating selected programs to meet the community’s mental health needs.

ELEMENT 7.2:

Identifies relationship of own role to the health care system.

PERFORMANCE CRITERIA:

7.2.1 Identifies components of health care system.

7.2.2 Identifies role of employing agency in the health care system.

7.2.3 Identifies own role in relation to employing agency.

ELEMENT 7.3:

Assumes required leadership roles.

PERFORMANCE CRITERIA:

7.3.1 Describes expectations of leadership roles in employing agency.

7.3.2 Identifies appropriate situations for assuming leadership role.

7.3.3 Demonstrates ability to supervise other staff as appropriate.

STANDARD 8: (Professional)

The Registered Psychiatric Nurse demonstrates responsibility for personal growth and contributes to the professional growth of others.

RATIONALE:

All Registered Psychiatric Nurses have a responsibility to contribute to the growth of self and of the profession.

ELEMENT 8.1:

Participates in activities of the professional regulatory body.

PERFORMANCE CRITERIA:

8.1.1 Attends meetings of the College at the local and provincial level.

8.1.2 Participates in committees of the College,

8.1.3 Participates in projects and other special activities of the College.

ELEMENT 8.2

Participates in continuing professional education activities.

PERFORMANCE CRITERIA:

8.2.1 Takes part in in-service education offered at place of employment.

8.2.2 Participates in non-credit continuing education activities.

8.2.3 Participates in post-basic credit practice-related educational opportunities.

8.2.4 Shares in identifying the educational needs of other members of the nursing team.

ELEMENT 8.3

Promotes and participates in activities designed to improve psychiatric nursing practice and care.

PERFORMANCE CRITERIA:

8.3.1 Applies and shares knowledge and skills to improve psychiatric nursing practice.

8.3.2 Accepts accountability for own psychiatric nursing practice.

8.3.3 Seeks peer review of care plan effectiveness.

ELEMENT 8.4

Participates, promotes, and utilizes research as an integral part of professional psychiatric nursing.

PERFORMANCE CRITERIA:

8.4.1 Utilizes nursing research findings to guide psychiatric/mental health nursing practice.

8.4.2 Participates in nursing research projects when opportunity arises.

8.4.3 Refines abilities to collect, organize, categorize and analyze research data.

8.4.4 Suggest research questions that need to be addressed to improve the practice of psychiatric/mental health nursing.

STANDARD 9: (Independent Practice/Community Mental Health)

The Registered Psychiatric Nurse in Independent Practice/Community Mental Health is an advanced level RPN using counseling, psychotherapy or case management interventions to assist clients in improving or regaining their optimal health.

RATIONALE:

A plan of care is used to guide therapeutic interventions in a systematic way to achieve expected client outcomes. Counseling or psychotherapy may be individual, group or family oriented. Child psychotherapy and other therapeutic treatments may be used by the qualified psychiatric/mental health nurse to assist clients to foster mental health, prevent mental Illness and disability, and improve or regain previous health status and functional abilities.

ELEMENT 9.1:

Interventions are based on the needs of the client and accepted nursing practice.

PERFORMANCE CRITERIA:

9.1.1 Counseling interventions may include but not limited to: communication and interviewing techniques, problem-solving skills, crisis intervention, stress management, relaxation techniques, assertiveness training, conflict resolution, and behaviour modification. These shall be documented.

9.1.2 Healthy behaviour and interaction patterns are reinforced helping the client to modify or discontinue unhealthy behaviour patterns.

9.1.3 Counseling promotes client social and personal integration.

ELEMENT 9.2:

Interventions are selected according to the psychiatric/mental health nurse.s level of practice, education and qualifications.

PERFORMANCE CRITERIA:

9.2.1 The therapeutic contract is structured to include but not limited to:

• Purpose, goals, and expected outcomes

• Time, location, and frequency of therapy

• Fees and payment schedule

• Confidentiality

• Members involved in therapy

• Availability and way to contact psychiatric/mental health nurse

• Responsibilities and expectations of client and psychiatric/mental health nurse

9.2.2 Knowledge of growth and development, psychology, personality theory, psychopathology, social systems, small-group and family dynamics, stress and adaptation and theories related to selected therapies based on the client’s needs.

9.2.3 Utilizes therapeutic principles and research to understand and interpret the client’s emotions, thoughts, and behaviors.

9.2.4 To reinforce healthy client behaviors and interactions, increasing responsibility and independence are fostered.

9.2.5 In the absence of the psychiatric/mental health nurse, continuity of care is provided.

9.2.6 When it has been determined that care provided by the psychiatric/mental health nurse would impair the client/nurse relationship, the client is referred to another qualified provider of client care.

ELEMENT 9.3

Interventions are performed in a safe, ethical, and appropriate manner.

PERFORMANCE CRITERIA:

9.3.1 Case management services are based on a comprehensive approach to the client’s physical, mental, emotional, spiritual, and social health concerns.

9.3.2 As the client advocate, health-related services and more specialized services are negotiated as required.

9.3.3 Agencies and providers are maintained throughout the client’s use of the health care service to ensure continuity of care.

9.3.4 Decisions affecting the care plan will be made in collaboration with the client.

ELEMENT 9.4

Interventions are implemented within an established nursing care plan.

ELEMENT 9.5

Interventions are documented and evaluated.

STANDARD 10: (MANAGEMENT)

The Registered Psychiatric Nurse in management is an advanced level nurse qualified by education and experience. The nurse executive or nurse manager uses communication, motivation, leadership, management, problem solving and decision making skills and functions to promote, develop, and maintain an organizational climate conducive to quality nursing practice and effective management of the nursing resource.

RATIONALE:

The delivery of effective health care requires management of the health care team and resources to ensure quality of client care and promotion of psychiatric nursing practice.

ELEMENT 10.1:

Maintains proficiency in clinical practice as well as able to implement on the unit the operations and goals of the institution.

PERFORMANCE CRITERIA:

10.1.1 Acts as a clinical resource, rendering expert service to client care.

10.1.2 Serves as the official supervisor of an assigned division and functions to plan, direct, coordinate, implement, control, evaluate, and improve the quality of client care delivered.

ELEMENT 10.2

Interacts with clients both directly and indirectly.

PERFORMANCE CRITERIA:

10.2.1 Interaction with clients may include but is not limited to:

• answers questions and requests for multidisciplinary team, staff, clients, and families

• Direct client care

• Observes client in rounds

• Receives reports on client status

• Reviews client records.

ELEMENT 10.3

Contributes to client and staff well-being by ensuring that quality care is given by staff

PERFORMANCE CRITERIA:

10.3.1 Establishes and maintains division standards, goals, objectives, priorities, and facilitates change based on the needs of clients and their families, allied health staff, and on the results and recommendations of audits.

10.3.2 Ensures competent, well-trained nursing personnel by identification of skill needs and recommendation of formal education and developmental activities or personally instructing subordinates.

10.3.3 Directs or personally engages in client/family teaching for optimal recovery and health.

10.3.4 Maintains timely documentation and anecdotal records on staff to be used in the preparation of performance appraisals.

10.3.5 Contributes to creating a work climate that encourages positive staff morale, motivations, and commitment.

10.3.6 Supervises the allocation of resources, remaining accountable to an established budget.

10.3.7 Establishes an effective working relationship with the health care team.

10.3.8 Enforces agency and nursing service policy and procedure.

STANDARD 11: (RESEARCH)

The Registered Psychiatric Nurse engages in activities to improve nursing practice.

RATIONALE

The Registered Psychiatric Nurse uses reliable and meaningful knowledge as a basis for improving practice. The Registered Psychiatric Nurse adopts a creative and resourceful approach to the development of practice. The Registered Psychiatric Nurse uses a range of process to contribute to nursing knowledge.

ELEMENT 11.1

Uses relevent theroritical framework to inform nursing practice.

PERFORMANCE CRITERIA:

11.1.1 Practice is grounded in sound nursing theoretical framework.

11.1.2 A contribution is made to nursing knowledge through reflection on practice.

11.1.3 Theoretical framework form relevant disciplines are used.

ELEMENT 11.2

Uses research to inform nursing practice.

PERFORMANCE CRITERIA:

11.2.1 Research is used to validate current nursing practices.

11.2.2 Research is critically evaluated.

11.2.3 Research findings are incorporated in to nursing practice.

11.2.4 Research findings are disseminated to colleagues.

ELEMENT 11.3

Contribute to the process of nursing research

PERFORMANCE CRITERIA:

11.3.1 Problems in nursing practice are identified as the basis for research.

11.3.2 A contribution is made to the conduct of approval research.

11.3.3 Opportunities to participates in research are taken

11.3.4 Others are encouraged to undertake research.

ELEMENT 11.4

Engages in quality improvement processes.

PERFORMANCE CRITERIA:

11.4.1 Quality improvement processes within the workplace are supported.

11.4.2 Feedback on quality improvement processes is provided to colleagues.

11.4.3 A contribution is made to quality improvement processes.

11.4.4 Outcome from quality improvement processes are incorporated in to nursing practice.

11.4.5 Structured client feedback is used consistently for on-going quality improvement.

STANDARD 12: (EDUCATION)

The Registered Psychiatric Nurse acts to enhance the professional development of self.

RATIONALE

The Registered Psychiatric Nurse demonstrates a commitment to on-going professional development to maintain best practice.

ELEMENT 12.1

Regularly engages in the process of self-assessment

PERFORMANCE CRITERIA:

12.1.1 Practice is defined in accordance with the current role statement

12.1.2 An appropriate framework of standards is used as the bench mark.

12.1.3 Feedback is elicited from peers.

12.1.4 Formal clinical supervision is used.

ELEMENT 12.2

Analyses evidence gathered

PERFORMANCE CRITERIA:

12.2.1 Evidence is analyzed to identify trends in professional growth.

12.2.2 Analysis leads to recognition of the need for participation in professional activities to maintain and enhance practice.

ELEMENT 12.3

Initiates an ongoing professional development program

PERFORMANCE CRITERIA:

12.3.1 The need for on-going professional development is articulated.

12.3.2 Responsibility is taken for own learning strategies.

12.3.3 The developed plan is used as a basis for review.

12.3.4 A plan for professional development is formulated.

ELEMENT 12.4

Participates in activities related to the enhancement of context specific practice.

PERFORMANCE CRITERIA:

12.4.1 Appropriate professional journal are read.

12.4.2 Activities of relevant professional organization are engaged in

12.4.3 Other professional activities are undertaken.

ELEMENT 12.5

Review progress towards career goals

PERFORMANCE CRITERIA:

12.5.1Achievements are assessed.

12.5.2Changed circumstances are identified.

12.5.3The plan is modified as required.