Orthopaedic Nursing Standards

Standards of Orthopaedic Nursing Practice have been developed within the four domains of nursing. They are built upon the broad standards of nursing practice formulated by the Canadian Nurses Association and the standards of practice of the provincial and territorial regulatory bodies. These standards are meant to reflect current knowledge and understanding of the specialty of orthopaedic nursing.

Practice

The goal of Orthopaedic Nursing is to support the promotion and restoration of the health of individuals who have the potential for or who are experiencing neuromuscular and skeletal challenges.

Orthopaedic nurses intervene to prevent and support correction of deformities of the musculo-skeletal system, to assist in reducing fractures and dislocations of bones and joints, and to support restoration of function to those with bone and joint injury and disease. Orthopaedic nurses work with the client to maximize and regain health through rehabilitative efforts. If recovery is not possible, the orthopaedic nurse provides supportive end of life care.

The orthopaedic nurse engages in the nursing process and:

• analyses, prioritizes, plans, implements and evaluates care in partnership and collaboration with the client and the interdisciplinary healthcare team;
• conducts a holistic assessment of the client;
• develops an individualized nursing plan of care for orthopaedic clients with emphasis on the following areas:
1. pain
2. limb & joint alignment
3. mobility
4. skin integrity
5. neurovascular integrity
6. nutrition
7. self-care
8. risk management
9. social systems
10. learning needs
11. coping
• strives to apply evidenced-based nursing interventions to the care of the client in an efficient and effective manner;
• evaluates the client's response to the plan of care and thoroughly documents client outcomes;
• plans interventions related to client learning and evaluates the client's response;
• demonstrates collaborative, interdisciplinary approaches to decision-making;
• facilitates activities of the interdisciplinary team;
• implements plans developed by the interdisciplinary team;
• ensures meaningful, relevant, and accurate communication (written and verbal);
• demonstrates effective interpersonal skills;
• includes and supports the client in decision-making;
• facilitates the continuity of care across settings;
• participates in the reflective practice process;
• promotes recreational and vocational practices to prevent injury to the musculo-skeletal system.

Education

The education of the orthopaedic nurse consists of specialized knowledge enhanced by clinical skills gained in practice. These clinical skills of evidence-based nursing practice are acquired by caring for clients with neuromuscular and skeletal challenges, and are advanced through specialty educational programs and continuing education programs.

Through the use of the reflective process, the orthopaedic nurse provides comprehensive care consistent with changing knowledge, technology, research, and practice.

The orthopaedic nurse:

• performs a learning needs assessment in collaboration with the client and plans, implements, and evaluates strategies to meet those learning needs;
• provides information and support to assist clients to implement agreed changes in lifestyle and self-care;
• demonstrates current knowledge through the use of appropriate nursing interventions;
• participates in the development of educational tools and programs to assist clients with neuromuscular and skeletal challenges through their healthcare experience;
• participates in the ongoing discovery, acquisition, critical application, and evaluation of knowledge and skills for orthopaedic nursing;
• acts as a role model/preceptor for nursing students and the beginning practitioner in orthopaedic nursing;
• participates actively in the planning and teaching of orthopaedic nursing both formally and informally;
• shares knowledge with colleagues through consultation, publication and/or presentations
• identifies and addresses personal learning needs;
• seeks professional recognition through Canadian Orthopaedic Certification;
• participates in activities of professional nursing organizations;
• attends conferences, workshops and professional meetings to enhance professional practice;
• identifies and/or creates resources to facilitate on-going learning;
• evaluates the impact of learning on outcomes.

Leadership

Leadership is the action of influencing the activities of an individual or group towards the attainment of a goal or goals. Leadership is viewed as a participatory, mutual process wherein a common sense of purpose is fostered within a climate of change, innovation, empowerment, and vision. Orthopaedic nurses may demonstrate and use their leadership skills in a leadership position or in the provision of client care.

The orthopaedic nurse:

• coaches and mentors others (colleagues, peers, staff, clients);
• delegates activities to others within the scope of their practice and capabilities;
• manages human, material, and organizational resources effectively;
• identifies limitations in the workplace or care setting that interfere with nurses' ability to perform with skill, safety, and compassion and takes appropriate action;
• shares freely all relevant knowledge that impacts on improved client health outcomes identifies, monitors, analyzes, and plans action in response to developing trends in orthopaedic care;
• facilitates interdisciplinary collaboration;
• demonstrates effective conflict resolution skills;
• articulates and promotes the role of orthopaedic nursing within a dynamic healthcare system;
• facilitates and promotes the peer review process;
• influences change in nursing practice by engaging in continuous quality improvement activities;
• demonstrates strategies to maintain and promote own health and the health of co-workers;
• influences health outcomes of orthopaedic clients through social and political action;
• creates environments that foster professional growth and improvements in nursing practice;
• participates in and provides leadership for committees and groups relating to care delivery, policy and procedure development, ethical issues, research, education, and professional development;
• demonstrates an effective range of communication skills and strategies in one-on-one and group situations.

Research

Research is an integral part of the evolving practice of orthopaedic nursing. Research informs and is informed by practice, the interaction of which is key to the provision of quality orthopaedic nursing and its ongoing development. Orthopaedic nurses strive to ground their practice in the developing body of knowledge relevant to issues pertaining to neuromuscular and skeletal challenges and the client's responses to them.

The orthopaedic nurse:

• demonstrates an understanding of and appreciation for the research process;
• reflects critically on practices to identify researchable questions pertaining to neuromuscular and skeletal health, for example: mobility, independence, self-care ability;
• reviews the literature for solutions to identified client problems / challenges;
• stimulates colleagues to read about and to apply research findings in their practice;
• networks with colleagues and explores available resources to seek solutions to identified problems;
• participates in nursing research initiatives, the degree of involvement being commensurate with preparation level and ability;
• supports ongoing research efforts in nursing and/or other disciplines and where appropriate participates in the process;
• shares research outcomes with colleagues at professional meetings and/or through publications;
• contributes to the activities of the research committees/groups in the practice setting;
• adheres to ethical practices in conducting research activities;
• advocates for client well-being in healthcare research;
• initiates and supports changes in practice based on research findings.