Critcal Thinking #1



GEORGIA BAPTIST COLLEGE OF NURSING OF MERCER UNIVERSITY

NUR 420

Guidelines for Writing in the Critical Thinking Paper #1

DESCRIPTION:

This critical thinking paper #1 is one of the essential links between class and seminar content and the application of theory, concepts, and research in clinical practice. The paper requires that you reflect on your professional insights and personal beliefs and that you react critically to what you have read and heard, rather than merely accepting the ideas of others.

OBJECTIVES OF THE PAPER ASSIGNMENT:

1. To facilitate the consciousness integration of course content with clinical experiences.

2. To facilitate exploration of leadership roles in nursing practice.

3. To facilitate critical and reflective thinking and independent judgment. (Program Objective 8)

4. To enhance professional writing skills. (Program Objective 5)

5. To explore concepts that enables the student to further refine a personal philosophy of nursing. (Program Objective 1)

6. To synthesize knowledge from across the curriculum as a basis for professional practice. (Program Objective 3)

7. To foster professional growth. (Program Objective 10)

GUIDELINES:

Papers will reflect the following components:

1. Application of theory, concepts, and research to practice

A. Synthesis of content and connections between readings

B. Application of leadership and management theories and research in nursing practice and in clinical settings

C. Identification of the multiple roles of the professional nurse

D. Articulation of personal beliefs and values regarding the topic

2. Appropriate writing form

A. Correct grammar, sentence and paragraph structure, and spelling

B. Professional writing style

C. Clarity and logical flow of ideas

D. Accurate APA referencing with current references (published within 5 years), utilizing the 5th edition of the APA manual. See GBCN APA requirements.

E. Adherence to standards of academic integrity

Two critical thinking papers are assigned for the semester (see criteria for Critical Thinking Paper #2). Critical Thinking Paper #1 must be limited to 3-4 pages (double-spaced and typed). Papers will be evaluated by clinical faculty and comprise 30% of the course grade. Papers are due at 9:00 a.m. on the dates assigned.

TOPICS FOR CRITICAL THINKING PAPERS:

Paper 1: Delegation Due: September 13, 2005

Paper 2: Nursing Theory Due: November 8, 2005

Revised 11/99/SKR & EL

Revised 11/03/BR

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Board Policy Statements and Decision Trees

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[pic]Policy Statements

• Assignment to Unlicensed Assistive Personnel

• Medication Administration

• Patient Abandonment

[pic]Decision Trees 

• RN Assignment Tree

• Scope of Practice (available in Adobe Acrobat .pdf format)

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Assignment to Unlicensed Assistive Personnel Policy Statement

There has been a substantial increase in the use of unlicensed assistive personnel (UAP) to provide direct patient care services in the changing health care industry. UAP’s are found performing nursing activities in almost all health care settings. Because there is a potential that the improper utilization of unlicensed individuals may result in a risk to public safety, the Georgia Board of Nursing has promulgated rules regarding the criteria under which a registered nurse may assign certain tasks to unlicensed assistive personnel.

Other states have promulgated rules to define the parameters within which a licensed nurse may allow an unlicensed individual to provide direct care to patients. Some states chose to define task lists for UAP’s, often because the state directly regulates these care providers. However, by creating task lists for UAP’s, an unofficial scope of practice is created. Also, there is no guarantee that a licensed health care professional is involved in the assessment of the patient to determine if the task can be safely provided by a UAP. Therefore, the Georgia Board of Nursing has determined that development of lists of activities that may unequivocally be performed by unlicensed individuals does not result in the best protection for the public.

Many states have language in their Nurse Practice Act that specifically provides for “delegation” to unlicensed individuals. OCGA 43-26-1 Georgia Nurse Practice Act does not provide for delegation of licensed activities to unlicensed individuals. Based upon well-established administrative case law, RNs may not delegate activities which require professional nursing licensure to unlicensed individuals unless they have specific statutory authority to do so. If the care and activities under the specific circumstances do require the knowledge and skills of a registered nurse, and if a registered nurse permits an unlicensed individual to engage in these activities, it is inappropriate delegation of licensed activities. This inappropriate delegation has regulatory consequences. However, Registered professional nurses may delegate professional nursing activities to other licensed individuals where there is statutory authority within their practice act to perform such acts. (i.e. Licensed Practical Nurses who are under the “direction and supervision” of a Registered Professional Nurse).

The Georgia Board of Nursing has determined that certain tasks can be individually assigned to unlicensed individuals and has generated rules to this end. The Rules have their statutory basis in O.C.G.A. 43-26-12(a)(3) and O.C.A. 43-26-12(a)(5). The exemptions for the requirement of licensure as a registered nurse are that:

(a) No provision in this article shall be construed to require licensure in Georgia as a registered professional nurse in:

(5) The performance of auxiliary services in the care of patients when such care and activities do not require the knowledge and skill required of a person practicing nursing as a registered professional nurse and when such care and activities are performed under orders or direction of a licensed physician, licensed dentist, licensed podiatrist, or person licensed to practice nursing as a registered professional nurse;

Registered nurses have always utilized unlicensed individuals to assist in the provision of nursing care. OCGA 43-26-1 et seq. acknowledged that practice by incorporating certain exemptions from the requirement of professional nursing licensure within the Nurse Practice Act. OCGA43-26-12 (5) provides an exemption to licensure for the performance of auxiliary services in the care of patients when such care and activities do not require the knowledge and skills required of a person practicing nursing as a registered professional nurse and when such care and activities are performed under orders or direction of a licensed physician, licensed dentist, licensed podiatrist, or person licensed to practice nursing as a registered professional nurse. Therefore if the care and activities meet all the above criteria for the exemption, it is an unlicensed activity and can be assigned.

The Georgia Board of Nursing has generated rules and a decision making tool to assist registered nurses and nurse employers to make appropriate decisions regarding whether to assign a task to an unlicensed person. The tool, “RN Assignment Decision Tree” will assist the registered nurse to evaluate patient care tasks on an individual patient basis. It guides the nurse to assign only those tasks that can be safely performed by trained unlicensed assistive personnel.

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RN Assignment Decision Tree

Assignment to Unlicensed Assistive Personnel (UAP)

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|NO |

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|Do NOT assign |

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|Is the care and activity to be performed based upon orders or directions of a licensed physician, licensed dentist, licensed |

|podiatrist, or person licensed to practice nursing as a registered professional nurse? |

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|Yes |

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|YES |

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|Do NOT assign |

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|Does performance of the task require licensure in another health care profession? |

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|No |

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|YES |

|( |

|Do NOT assign |

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|Does the task require the knowledge and skills of a person practicing nursing as a registered professional nurse? |

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|No |

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|((( (((((( |

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|Unsure |

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|YES |

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|Do NOT assign |

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|Does the client’s health status and situation involve complex observations or critical decisions that require the knowledge and |

|skills of a professional nurse? |

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|No |

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|NO |

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|Do NOT assign |

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|Can the task be safely performed according to exact, unchanging directions? |

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|Yes |

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|NO |

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|Do NOT assign |

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|Are the results of the task reasonably predictable? |

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|Yes |

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|NO |

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|Do NOT assign to that UAP |

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|Has the RN verified that the UAP has the knowledge and skills necessary to accept assignment? |

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|Yes |

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|May assign |

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GEORGIA BAPTIST COLLEGE OF NURSING

OF

MERCER UNIVERSITY

NUR 420 Critical Thinking Paper #1 Evaluation Form

Name: Paper # Date:

APPLICATION OF THEORY, CONCEPTS, AND RESEARCH TO PRACTICE:

A. Synthesis of content and connections between readings

B. Application of leadership and management theories and research in nursing practice and in clinical settings.

C. Articulation of personal beliefs and values regarding the topic

Comments: Score = of 20 points

APPROPRIATE WRITING FORM:

A. Correct grammar, spelling, sentence and paragraph structure

B. Professional writing style

C. Clarity and logical flow of ideas

D. Accurate referencing (utilizing 5th edition of APA Manual) with current references. See College Policy regarding minimum competency APA Requirements.

E. Adherence to standards of academic integrity

Comments: Score = of 10 points

Total score =

11/99/EL/SKR

10/03/BR

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