RCN Principles of Nursing Practice

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A

Nurses and nursing staff treat everyone in their care with dignity and humanity – they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally

Example measures
• person-centred care – patients/people who felt privacy and dignity was maintained
• safe and effective care – patients/people with nutritional assessment and management plans
• context of care – patients/people who reported nurses talked in front of them as if they were not there.

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B

Nurses and nursing staff take responsibility for the care they provide and answer for their own judgments and actions – they carry out these actions in a way that is agreed with their patients, and the families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law.

Example measures
• person-centred care – incidence of written complaints/compliments
• safe and effective care – patients whose recorded vital signs triggered an appropriate response
• context of care – teams with a shared governance system5 in place for decision-making and evaluation.

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C

Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care.

Example measures
• person-centred care – patients/people who perceive adequate nurse staffing levels
• safe and effective care – patient falls in which injury occurs
• context of care – teams who have assessed safety climate/culture.

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D

Nurses and nursing staff provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.

Example measures
• person-centred care – patients/people who perceive they are provided the opportunity to be involved in decision-making about care
• safe and effective care – patients/people confident in nurses skills and knowledge
• context of care – teams where staff perceive culture as patient-centric.

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E

Nurses and nursing staff are at the heart of the communication process: they assess, record and report on treatment and care, handle information sensitively and confidentially, deal with complaints effectively, and are conscientious in reporting the things they are concerned about.

Example measures
•person-centred care – patients/people who report they were provided information about the outcome of their treatment/operation
• safe and effective care – handovers that comply with best practice standards
• context of care – teams who have documentation audits, for example, record keeping standards.

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F

Nurses and nursing staff have up-to-date knowledge and skills, and use these with intelligence, insight and understanding in line with the needs of each individual in their care.

Example measures
• person-centred care – patients/people who felt involved in decision-making about care
• safe and effective care – patients/people discharged following discussion with the community nursing team
• context of care – staff who receive mandatory training to ensure patient safety.

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G

Nurses and nursing staff work closely with their own team and with other professionals, making sure patients’ care and treatment is co-ordinated, is of a high standard and has the best possible outcome.

Example measures
• person-centred care – patients/people who felt their care as seamless and uninterrupted
• safe and effective care – patients/people who felt health professionals in the team worked well together
• context of care – patients/people who can name their key worker/nurse responsible for their care

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H

Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.

Example measures
• person-centred care – patients/people provided with an opportunity to provide feedback about the care they have received
• safe and effective care – patients/people who feel they have received continuity of care
• context of care – staff participating in appraisals annually

RCN Key Nursing Principles Examples in end of life care
Dignity, equality, diversity and humanity Individualised holistic assessment of need including culture and reasonable adjustments made. Also consider the needs of the carer
Ethical integrity, legal integrity, accountability, responsibility Potential conflict within the family regarding management of nutritional needs when there is a decline in ability to swallow leading to choking
Safety of patients, visitors and staff, management of risk, clinical safety Risk assessment in caring for a person who is in hospital and wants to go home to die and lives alone
Advocacy, empowerment, patient-centred care, patient involvement Supporting a person with learning disabilities to die in their preferred place of care. Advanced care planning.
Communication, handling feedback, record keeping, reporting, monitoring Responding to a complaint about poor end of life care
Evidence-based, practice, technical skills, education, clinical reasoning The possible introduction of tele-health care in a rural setting
Multi-disciplinary and multi-agency working, co-ordination, and continuity of care Co-ordination of care in the community setting with a person with highly complex needs
Leadership, contributing to an open and responsive culture Nurses and nursing staff lead by example ensuring end of life care is given in a manner that is responsive to individual needs
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