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    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition
    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition
    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition
    Ebook361 pages4 hours

    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition

    By American Nurses Association and Rheumatology Nurses Society

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    About this ebook

    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition covers the full extent of rheumatology nursing practice needs in any setting or role and at any level of influence and authority. This specialty’s core accountabilities illustrate that depth and breadth of practice:

    Safety, quality, and risk management
    Patient and population health advocacy
    Clinical care delivery and optimal patient outcomes
    Healthy work environments
    Strategic, financial, and human resource management
    Legal and regulatory compliance
    Networking, partnering, and collaborating
    Accountability/advocacy for their employees
    The publication also addresses 17 updated national standards, which offer a framework for evaluating practice outcomes and goals, as well as for what is expected of all rheumatology nurses, and its scope of practice specifies the who, what, where, when, why, and how of their practice. This new book is a must-have for the aspiring or practicing rheumatology nurse, or any registered nurse.
    LanguageEnglish
    PublisherNursesbooks
    Release dateJun 6, 2019
    ISBN9781947800335
    Rheumatology Nursing: Scope and Standards of Practice, 2nd Edition
    Author

    American Nurses Association

    The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA is at the forefront of improving the quality of health care for all. Founded in 1896, and with members in all 50 states and U.S. territories, ANA is the strongest voice for the profession

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      Book preview

      Rheumatology Nursing - American Nurses Association

      This ANA publication, Rheumatology Nursing: Scope and Standards of Practice, Second Edition, reflects the thinking of the rheumatology specialty nurses on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of rheumatology nursing, while Rheumatology Nursing: Scope and Standards of Practice, Second Edition, guides nurses in the application of their professional knowledge, skills, and abilities.

      American Nurses Association

      8515 Georgia Avenue, Suite 400

      Silver Spring, MD 20910-3492

      1-800-274-4ANA

      http://www.Nursingworld.org

      Published by Nursesbooks.org

      The Publishing Program of ANA

      Rheumatology Nurses Society

      8437 Tuttle Avenue – Suite 404

      Sarasota, FL 34243

      https://rnsnurse.org/

      Cataloging-in-Publication Data on file at Library of Congress.

      Copyright ©2019 American Nurses Association and Rheumatology Nurses Society. All rights reserved. Reproduction or transmission in any form is not permitted without written permission of the American Nurses Association (ANA). This publication may not be translated without written permission of ANA. For inquiries, or to report unauthorized use, email copyright@ana.org.

      ISBN- Print: 978-1-947800-31-1

      ePDF: 978-1-947800-32-8

      EPUB: 978-1-947800-33-5

      Kindle: 978-1-947800-34-2

      SAN: 851-3481

      First published: 05-2019

      Contributors

      Overview of the Content

      Essential Documents of Professional Nursing

      Essential Documents of Professional Rheumatology Nursing

      Audience for This Publication

      Scope of Rheumatology Nursing Practice

      Introduction

      Rheumatic Diseases

      Historical View

      Today’s View

      History and Evolution of Rheumatology Nursing Practice

      Education and Facilitation of Learning for Rheumatology Nurses

      Adopted Tenets for Rheumatology Nursing Practice

      Populations Served by Rheumatology Registered Nurses

      Pediatric Population

      Special Population—Transition of Care of Teen to Adult

      Adult Population

      Special Population—Child-Bearing Adults

      Advanced Age Population (Gerontologic Population)

      Practice Settings for Rheumatology Nursing Practice

      Acute Care Settings

      Outpatient Settings

      Research Facility Settings

      Infusion Suites/Facility Settings

      Special Settings

      Camp

      Rehabilitation or Long-Term Care Facility, Home Health, Hospice, and/or Palliative Care

      Community/Religious

      Pharmaceutical Companies

      Role and Responsibilities of the Rheumatology Registered Nurse

      Basic Practice Responsibilities of the Rheumatology Registered Nurse

      Basic Practice Responsibilities of the Rheumatology NursePractitioner or Clinical Nurse Specialist

      Pain Management and Self-Image

      Ethics in Rheumatology Nursing Practice

      Rheumatology Registered Nurse Role and Responsibilities in Nursing Research

      Interprofessional Teams, Including the Health Care Consumer

      Complementary and Alternative Medicine in Rheumatology

      Trends and Issues Facing Rheumatology Registered Nurses

      Collaboration, Entrepreneurship, and Nurse-Led Practice Models

      Advances in Genetics and Related Therapies

      Increased Knowledge with New Medications/Biosimilars

      Immuno-Oncology

      Communication and Growth

      Summary

      Standards of Professional Rheumatology Nursing Practice

      Significance of Standards

      Standards of Rheumatology Practice

      Standard 1. Assessment

      Standard 2. Diagnosis

      Standard 3. Outcome Identification

      Standard 4. Planning

      Standard 5. Implementation

      Standard 5A. Coordination of Care

      Standard 5B. Health Teaching and Health Promotion

      Standard 6. Evaluation

      Standards of Professional Performance

      Standard 7. Ethics

      Standard 8. Culturally Congruent Practice

      Standard 9. Communication

      Standard 10. Collaboration

      Standard 11. Leadership

      Standard 12. Education

      Standard 13. Evidence-Based Practice and Research

      Standard 14. Quality of Practice

      Standard 15. Professional Practice Evaluation

      Standard 16. Resource Utilization

      Standard 17. Environmental Health

      Glossary

      References and Bibliography

      Appendix A: Rheumatology Nursing: Scope and Standards of Practice (2013)

      Index

      Rheumatology Nursing: Scope and Standards of Practice, Second Edition, is the product of extensive thought work by many registered nurses and a three-step review process. This document originated from the decisions garnered during a significant number of telephone conference calls and electronic mail communications of the diverse workgroup members. The first review process, a 30-day public comment period, followed. All workgroup members reviewed every comment, resulting in further workgroup refinements of the draft document. The official American Nurses Association (ANA) review process included evaluation by the Committee on Nursing Practice Standards and final review and approval by the ANA Board of Directors in September 2018.

      Rheumatology Nursing: Scope and Standards Workgroup, 2017–2018

      Sheree C. Carter, PhD, RN, CNS, RN-BC—Chair, Scope and Standards

      Susan Williams-Judge, RN, MN, CNS, ARNP

      Carrie Beach, MSN, RN-BC—BOD Liaison/Committee

      Tara Valcarcel, RN, MSN, CPNP

      Barbara Kienzle, RN, BSN

      Alexandra Andrews, RN, BSN

      Nancy Delnay, CNP, MSN, RN

      Gwendolyn Robinson, RN, AD

      Ceceilia Gee, RN, ADN, CRNI

      Victoria Ruffing, RN, RN-BC, CCRP—Council Leader Liaison

      ANA Staff

      Carol J. Bickford, PhD, RN-BC, CPHIMS, FHIMSS, FAAN—Content Editor

      Joi Morris, BS, CAP-OM – Project coordinator

      Lisa M. Myers, Esq. – Legal counsel

      Liz Stokes, JD, RN – Ethics consultant

      Erin E. Walpole, BA, PMP—Project editor

      ANA Committee on Nursing Practice Standards

      Danette Culver, MSN, APRN, ACNS-BC, CCRN

      Patricia Bowe, DNP, MS, RN, Co-Chair

      Renee Gecsedi, MS, RN

      Kirk Koyama, MSN, RN, CNS, PHN, Co-Chair

      Tonette McAndrew, MPA, BSN, RN

      Mona Pearl Treyball, PhD, RN, CNS, CCRN-K, FAAN

      Verna Sitzer, PhD, RN, CNS

      Stacy McCall, MSN, RN, IBCLC

      Ruth Odochi Ifediora, MSN-ED, RN, Alternate

      Jordan Wilson, BSN, RN, Alternate

      About the Rheumatology Nurses Society

      The Rheumatology Nurses Society (RNS) is a professional organization committed to the development and education of nurses to benefit its members and the health care consumers within their care, families, and their communities. The RNS vision is to lead nurses to excellence in the treatment of health care consumers with rheumatologic diseases through preparation in the scientific basis of nursing, meeting prescribed standards of education and clinical competence, and serving as integral members of the health care team as health care consumer counselors, educators, and advocates.

      About the American Nurses Association

      The American Nurses Association (ANA) is the premier organization representing the interests of the nation’s 4 million registered nurses. ANA advances the profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of health care for all.

      About Nursesbooks.org, The Publishing Program of ANA

      Nursesbooks.org publishes books on ANA core issues and programs, including ethics, leadership, quality, specialty practice, advanced practice, and the profession’s enduring legacy. Best known for the essential documents of the profession on nursing ethics, scope and standards of practice, and social policy, Nursesbooks.org is the publisher for the professional, career-oriented nurse, reaching and serving nurse educators, administrators, managers, and researchers as well as staff nurses in the course of their professional development.

      Essential Documents of Professional Nursing

      Registered nurses practicing in the United States have three contemporary professional resources that inform their thinking and decision-making and guide their practice. First, the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2015) lists the nine succinct provisions and accompanying interpretive statements that establish the ethical framework for registered nurses’ practice across all roles, levels, and settings. Second, the 2015 Nursing: Scope and Standards of Practice, Third Edition, outlines the expectations of professional nursing practice. The scope of practice statement presents the framework and context of nursing practice and accompanies the standards of professional nursing practice and their associated competencies that identify the evidence of the standard of care. Last, the ANA Position Statement: Professional Role Competence (2014) reviews the public’s right to expect registered nurses to demonstrate competence throughout their careers, the registered nurse’s calling to remain individually responsible and accountable for their competence, and the shared responsibility of the profession and employer to provide an environment conducive to competent practice.

      Essential Documents of Professional Rheumatology Nursing

      For a better appreciation of the history, content, and context related to Rheumatology Nursing: Scope and Standards of Practice, Second Edition, readers will find the additional content of Appendix A useful: Appendix A. Rheumatology Nursing: Scope and Standards of Practice (2013).

      Audience for This Publication

      Rheumatology registered nurses in every clinical and functional role and setting constitute the primary audience of this professional resource. Students, interprofessional colleagues, agencies, and organizations also will find this an invaluable reference. Legislators, regulators, legal counsel, and the judiciary will also want to examine this content. In addition, the individuals, families, groups, communities, and populations interacting with rheumatology nurses and health care services can use this document to better understand what constitutes the specialty of rheumatology nursing and how registered nurses and advanced practice registered nurses lead within today’s health care environment.

      Introduction

      The Rheumatology Nurses Society (RNS) has demonstrated its commitment to serve health care consumers and their families by developing the Rheumatology Nursing: Scope and Standards of Practice. This second edition defines the scope of practice and educational requirements for nurses in the specialty of rheumatology nursing. The autonomy, accountability, and responsibilities of the rheumatology registered nurse are defined in this document. This revised version contains the various practice settings where the rheumatology nurse is found, the various roles a rheumatology nurse performs, and anticipated future trends in rheumatology nursing. In addition, the tenets for the role of the rheumatology nurse in the management of inflammatory arthritis are presented.

      Rheumatology nursing is the specialty practice devoted to the comprehensive care of children and adults across the lifespan with rheumatic diseases. Rheumatology registered nurses have a strong knowledge of the immune system and how it relates to rheumatic diseases. The rheumatology registered nurse has knowledge of autoimmune and inflammatory diseases, such as arthritis [juvenile idiopathic arthritis, rheumatoid arthritis (RA), and spondyloarthropathies], collagen/vascular disorders (systemic lupus, scleroderma), pain syndromes (fibromyalgia, complex regional pain), crystalline diseases (gout or crystalline pyrophosphate disease), vasculitides (giant cell arteritis and antineutrophil-associated cytoplasmic antibody), as well as mechanical diseases such as osteoarthritis, to name only a few. Over 100 diseases are identified within the rheumatology spectrum. Besides basic disease state information, rheumatology registered nurses need an intricate knowledge of anatomy, physiology, and understanding of classification criteria for the different diseases.

      The rheumatology registered nurse understands the complex medications and protocols used to treat autoimmune diseases such as disease-modifying antirheumatic drugs (DMARDs) including antimalarials, nonsteroidal anti-inflammatory drugs (NSAIDs), biologics and biosimilars, narcotic and nonnarcotic pain medications, and steroids. The rheumatology nurse is familiar with the use of multiple drug combinations and protocols to treat rheumatic diseases, the expected outcomes, various side-effect profiles, current monitoring measures, and the interactions with other prescribed medications and nutraceuticals. The rheumatology registered nurse educates the health care consumer about the safe use of these agents, the need for monitoring and observation, and the need for regimen modification (e.g., withholding medications while treating a concurrent infection, adjusting doses pre- and post-operatively, dealing with live virus vaccine concerns), as well as the health care consumer’s responsibility to inform all health care providers of all medications. Some of the medications used to treat rheumatic diseases are given in a health care setting. The administration of infusible medications requires the expertise of a rheumatology registered nurse with competencies in intravenous infusion technique, specific drug infusion criteria, and management of adverse and serious infusion reactions.

      The rheumatology registered nurse takes appropriate action regarding adverse events, as well as to identify insufficient therapeutic effects. The rheumatology registered nurse communicates these events to the prescribing provider.

      The diagnosis of rheumatic disease requires a comprehensive personal and family medical history using careful interview techniques to uncover sometimes-subtle symptomatology. In addition, laboratory, radiographic, and other studies may be necessary to complete the diagnosis. The rheumatology registered nurse coordinates those studies with other providers and assists and communicates with the health care consumer and family during the diagnostic process [American College of Rheumatology, n.d.; American Nurses Association (ANA), 2015].

      The Standards of

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