Nursing Clinical Roles Ethical, legal, and Regulatory Responsibilities

 Nursing Clinical Roles

Nursing Clinical Roles. Nurses have ethical and legal responsibilities in the provision of care to

patients. Evidence-based practice is beneficial to nursing practice in several ways. The care for

hypertensive patients in geriatrics care is different from the care of adult patients diagnosed with

hypertension. Specific research-based approaches to the prevention of falls among the elderly in

the home setting and hospital setting have been developed (Johnstone, 2015). The following essay discusses several aspects of nursing care for the elderly.

Nursing Clinical Roles Ethical, legal, and Regulatory Responsibilities

Billing and documentation of information give access to the patient’s data. The Health Insurance Portability and Accountability Act (HIPAA) guidelines require that clinicians maintain the privacy of the patient’s data. In my own opinion, maintaining the privacy of the patient’s data requires extra measures by the nurses and other clinicians. HIPAA highlights the general responsibilities of healthcare professionals in maintaining the confidentiality of patient information. According to HIPAA, systems containing patients’ information should only be accessed through passwords accessible only by authorized persons. As a nurse, there is a need for extra measures to avoid access to the patient’s information by unauthorized persons (Haydel, 2018). Clinicians should not type the passwords into systems containing patients’ information in situations where unauthorized persons can view. Besides, clinicians documenting or accessing patients’ information should ensure that no unauthorized persons can view the display screens of computers containing the patients’ information. According to the principle of confidentiality, patients’ information should not be discussed in public. Nurses should take extra measures and ensure discussions about patients’ information are only done in enclosed places (Goodman, 2016).

Nursing practice in the clinical setting requires extra integrity and professional honesty regarding coding and billing. Billing involves the provision of patients’ information a completely and accurately. The information should be complete since the patients’ data is used in determining the amount and the process of reimbursements to the healthcare provider. Nurses are social human beings who are members of various social groups. In coding for healthcare services offered to a patient, the nurse can inaccurately enter information and affect the amount of reimbursement to the healthcare provider. Economic status of an individual affects the accessibility to healthcare services. Social relationships, economic implications of healthcare accessibility should not affect the integrity in coding while billing (Grace, 2017).


 Nursing Clinical Roles
 Nursing Clinical Roles


Nursing Clinical Roles

The Importance of Evidence-Based Research

Evidence-based research offers the practical and reliable basis for clinical practice. Evidence-based clinical practice relies on the results of scientific research studies. The results of research are used to modify existing clinical practice. Nursing care aims to optimize the health outcomes of patients while maintaining patients’ safety through patient-centered care. In order to optimize patient healthcare outcomes, data is required to assess and determine the effectiveness of existing management approaches. Alternatively, the findings of research studies form the basis for making comparisons of the effectiveness of several treatment approaches. Evidence-based practice is a way of evaluating the existing practice approaches. Some research studies, for instance, meta-analysis studies, evaluate the effectiveness of previously applied nursing practice. Evidence-based practice establishes the relationship between several aspects and disciplines in healthcare. For instance, socio-economic factors affect health-seeking behaviors and general health status of individuals. Research offers data that supports and explains the interrelationship between health care outcomes and other aspects such as culture (Haydel, 2018). Research guides policy-makers in formulating new policies or modifying existing policies. For example, data, which indicates a high prevalence of health care condition, may require the enactment of a policy that directs all the individuals to undergo screening for the same medical condition. In my clinical role, the problems experienced in clinical practice are translated into research questions. The clinical problems pertain the patients’ satisfaction with nursing care services, the patient’s safety and the economic impact of specific nursing service. The relevant literature is conducted, and the gap in evidence on the same topic of study is identified. The study is conducted in order to provide data to provide answers to the gaps in practice and literature. The results of the study are converted into clinical practice guidelines (Johnstone, 2015).

The Importance of Health Maintenance Specific To Geriatric Falls

The article by Avanecean, Calliste, Contreras, Lim, & Fitzpatrick, (2017) discusses various measures for the prevention of falls among the elderly. Physical exercises are approaches towards the prevention of falls among the elderly. One of the risk factors towards falls among the elderly is the lack of body balance and incompetent gait. The elderly are at risk of sustaining falls because of impairment in sensory functioning. Body balance is achieved through the perception of the body’s position through the vestibulo-chochlear nerve. Aging reduces the sensory functioning of the nerve. iAlso, according to the article, physical exercises compensate for the loss of sensory functioning of the vesstibulo-chochlear nerve. Physical exercises increase the strength of skeletal muscles.

Further, physical exercises increase the strength of bones. The overall effect is the improvement to the gait and balance among the elderly. Vitamin D supplementation is another healthcare maintained that reduces the risk of falls among the elderly. Vitamin D is useful in the absorption of calcium from digestive systems. Calcium forms the mineral contents that make up the supportive framework of the bones. Assessment for the risk of falls is another strategy that the authors of the article document as preventive measures against the patient fall among the elderly. The assessment for the risk of falls involves the history of falls, the history of current medication and medical conditions and cognitive functioning. The article proposes home-based strategies to prevent falls among the elderly such as assistance with ambulation and provision with assistive aids such as hearing aids. The articles describe that modification of home environment is necessary for preventing falls. Effective strategies, according to the particles include modification of staircases and removal of objects from the reach of the elderly (White, Brown, & Terhaar).

I agree with the health maintenance as a preventive masseur against falls among the elderly. The existing practice protocols on prevention of falls among the elderly include; the practice of updated physical exercise of protocols for the elderly patients, vitamin D nutritional supplementation and assessing the level of risks associated with future falls and the patients’ level of education concerning falls.

Nursing Clinical Roles
Treatment of Hypertension among Geriatric Patients

The treatment of hypertension among the elderly is different from treatment of hypertension among other age groups. Age is associated with loss of elasticity of the blood vessels. Age reduces the level of elastic tissues found on the walls of blood vessels. The elasticity of blood vessels offers a homeostatic response to the increase in blood pressure. Therefore, vasodilators are not commonly used as pharmacological agents in treating hypertension among the elderly since the blood vessels do not dilate in response to the physiological effects of vasodilators.

On the other hand, adult patients diagnosed with hypertension should be evaluated for contributing hormones in hypertension. The baseline levels of aldosterone are measured before the beginning of the pharmacological treatment. Aldosterone controls the amount and rate of reabsorption of sodium in the kidney. The serum levels of aldosterone are measured. The patient is assessed for history or risks of adrenal gland tumors that increase the amount of aldosterone secreted (Supiano, 2015).

Unlike elderly patients, adult patients diagnosed with hypertension are evaluated for stroke when the history of the con-constant cardiovascular disease is positive. Co-occurring conditions in hypertension include heart failure, chronic kidney disease, and diabetes (Wright, Hong, & Burt, 2015).

Nursing Clinical Roles
My learning progress and Benner’s Novice to Expert theory

My learning experience in my field of practice has occurred within the steps described by Benner’s Novice to Expert theory. During the beginning of my academic learning, I had no prior experience and lacked confidence in the care of the elderly. I relied on continuation great guidance from my instructors at the practice areas. However, over time, I developed some skills of care for the geriatric patients (Thomas & Kellgren, 2017). During this time, I relied on minimal instructions from my supervisors. After approximately two years of clinical experience with the care of the elderly, I developed competence in my skills. I required minimal cues inform of instructions. My efficiency improved, according to the assessments done by my instructors. I had also developed confidence in the care of the elderly. I can now implement complex interventions of care. My plans for intervention are based on abstract and conscious thinking and analyses. Currently, I am an expert in the care of the elderly. Based on my instructors’ assessment comments, I can perceive patient presenting problems form a holistic point of view (Thomas, Sievers, Kellgren, Manning, Rojas, & Gamblian, 2015).

In conclusion, nurses providing care to the elderly require maximal professional integrity in order to execute the ethical and legal responsibilities. The care for elderly parties against falls includes environmental modification, nutritional adjustments, and assistance with activities of daily living and physical exercise and risk assessment. The care for elderly patients diagnosed with hypertension is different from the care for adult patients diagnosed with hypertension. I have undergone the novice stage of professional development all through to the competent stage of professionalism, in line with Benner’s Novice to Expert theory.

Nursing Clinical Roles

Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. (2017). Effectiveness of patient-centered interventions on falls in the acute care setting: a quantitative systematic review protocol. JBI database of systematic reviews and implementation reports, 15(1), 55-65.

Goodman, K. W. (2016). Ethical and legal issues in decision support. In Clinical decision support systems (pp. 131-146). Springer, Cham.

Grace, P. J., & DRN, P. (Eds.). (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Haydel, M. J. (2018). Health Insurance Portability and Accountability Act (HIPAA). In StatPearls [Internet]. StatPearls Publishing.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.

Supiano, M. A. (2015). Hypertension in the geriatric population: a patient-centered approach. Medical Clinics, 99(2), 379-389.

Thomas, C. M., & Kellgren, M. (2017). Benner’s Novice to Expert Model: An Application for Simulation Facilitators. Nursing science quarterly, 30(3), 227-234.

Thomas, C. M., Sievers, L. D., Kellgren, M., Manning, S. J., Rojas, D. E., & Gamblian, V. C. (2015). Developing a theory-based simulation educator resource. Nursing education perspectives, 36(5), 340-342.

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence into nursing and health care. Springer Publishing Company.

Wright, J. D., Hong, Y., & Burt, V. (2015). Trends in blood pressure among adults with hypertension: United States, 2003 to 2012. Hypertension, 65(1), 54-61.

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