Saturday, 21 July 2012

NABH COP-5: The new standard on nursing care

NABH 3rd edition has brought with it a host of new requirements and probably gives a hint on what to expect in the years ahead for quality accreditation and Indian healthcare. There’s this new standard COP-5 on nursing care and I found one objective element, i.e. COP 5G, of particular interest. The statement of the objective elements is “Nurses are empowered to take nursing-related decisions to ensure timely care of patients”. The interpretation says “Self-explanatory”. And I always thought that nurses are required to only follow orders!!


This standard requires nurses to prepare their own ‘Nursing care plan’ for each patient. I wonder whether we have adequate teaching standards in our nursing schools and colleges where they can teach clinical discretion to the new generation of nurses because most nursing superintendents I meet always crib about the quality of new nursing workforce.

I guess this ‘nursing care plan’ requirement will increase the expectations and work load on the already overloaded nurses in our hospitals. And can anyone please explain to me, what is the scope of ‘nursing-related decisions’ in COP 5G, and if these decisions are anyways related to nursing, why do we need to empower them?

My personal knowledge is limited in this aspect of patient care and I have no idea about the nursing protocols. But whatever I have observed, I think nurses are supposed to follow the orders of the doctors as well as manage the care plan for the patient developed by the doctor (in his absence). When we speak of empowering nurses in nursing-related decision making, how can I make sense of it? Knowledgeable people on this topic, please guide me with your comments.

6 comments:

  1. Please let me know,how to implement this new chapter in manual.

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  2. the nurses job is not only to carry out the doctors order. it is only a part of the treatment. the real care provided to the patient is based upon the assessment, diagnosis, implementation and evaluation of the nursing process. when the nurse applies the nursing process in the practice, the COP 5 will be corrected. the same matter is teaching all the nursing students in their curriculum. to implement this the institute should have proper nurse patient ratio and taking away all jobs that is not in the scope or practice of nursing. there are hospitals which runs completely based on this nursing process and the patient satisfaction is very high.

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    1. Thanks Jeril, you are absolutely right. Hospitals should maintain a healthy nurse-patient ratio to ensure the nurses are able to focus adequately on all the aspects of care. When the ratio is skewed leading to more patients per nurse, definitely the risk gets magnified that the nurse may skip a few important tasks.

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    2. Hi frnds your thinking is right 1]nurse-patient ratio 2]job description should be categorize for ANM GNM BSC AND MSC nurses and 3]doctors and nurses are coworkers 4]Taking away all that is not in the scope or practice of nursing.nurses need to respect as nsg manager nsg officer nsg supervisor nsg in-charge scribe nurse nurse nursing aid.

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    3. Hi frnds your thinking is right 1]nurse-patient ratio 2]job description should be categorize for ANM GNM BSC AND MSC nurses and 3]doctors and nurses are coworkers 4]Taking away all that is not in the scope or practice of nursing.nurses need to respect as nsg manager nsg officer nsg supervisor nsg in-charge scribe nurse nurse nursing aid.

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  3. Hi
    I strongly agree with Jeril & Manu. Nurses are well trained and competitive enough to take up or to develop protocols based on comprehensive care required. The nurses are the Health care workers made to contribute extensively becoz non nursing members are not aware of nurses role in the health care. The strict standards on Ratio of nurses, liberty to practice the profession to be cleared defined in terms of standards. I would suggest you to look into the course outline and make sure that, what extent the nurse contribute based on that the protocols to be developed. The various categories, equal opportunity based on education these kind of guidelines to be set. the chapter proposed as nursing resource management , who would be doing this. Nurses are simply harassed due to lack of guidelines in terms of practice, service, benefits & employment.
    I congratulate you for venturing into it. Make sure the seven chapters guidelines and protocols address these issues adequately well.

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