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Standards & Guidance

standards and guidance

Glossary of nursing and midwifery terms

Various terms are used by The Nursing and Midwifery Board of Ireland (NMBI) in standards, requirements and guidelines published on this website and in documents we produce.  This glossary briefly explains these terms.

Use this A-Z list to go to a word or term:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y 

A

Accountability

Being answerable for one’s judgements, actions, and omissions as they relate to professional practice, incorporating maintaining competency, and upholding the values of the profession.

Action plan

An action plan is a plan drawn up by the Preceptor, the undergraduate / postgraduate student and the Verifier to facilitate and monitor the achievement of competence. It is initiated if necessary at the intermediate meeting if problem areas are identified.

Advance health care directive

Sometimes called a 'living will', an advance health care directive is a written statement of a person's wishes and preferences regarding their future health care. If a person has concerns that they might lose their ability to make decisions due to a loss of capacity, they make a written statement at a time when they are still capable of doing so.

Advanced practice

Advanced practice relates to registered nurses and registered midwives who engage in continuing professional development and clinical supervision; and who practice at an advanced level as independent, autonomous, and expert practitioners. These registered nurses and midwives work within an agreed scope of practice and must meet the Board’s established criteria to register as an Advanced Nurse Practitioner (RANP) or Advanced Midwife Practitioner (RAMP). 

Advocacy

A means of empowering people by supporting them to assert their views and claim their entitlements and, where necessary, representing and negotiating on their behalf.

Appropriate

Matching the circumstances, meeting the needs of the individual, groups or situation.

Assessment

Patient assessment guides safe practice, and encompasses physical, mental, cultural, environmental and spiritual assessment. Physical examination skills are essential to inform critical thinking, clinical decision-making, planning of therapeutic interventions, and identifying achievable person-centred outcomes. Assessment and patient responses to planned interventions requires constant reassessment and monitoring for evidence of deterioration or failure to meet the planned outcome.

Assessment (student)

Determining the extent to which an individual reaches the desired level of competence in skill, knowledge, understanding or attitudes in relation to a specified goal. Assessment measures the integration and application of theory to patient care learned throughout the programme, and requires the undergraduate / postgraduate nurse or midwife to demonstrate proficiency within practice through the achievement of learning outcomes.

Autonomy

Involves self-determination and is a person’s ability to make choices on the basis of his / her own preferences, beliefs and values.

B


C 
 

Capacity

The ability to understand, deliberate and communicate a choice in relation to a particular health care decision at a particular time.

Caseload       

The number of persons / clients / patients managed by a health professional at a particular time.

Clinical audit

A quality improvement process that seeks to improve services, care delivery and ultimately patients' outcomes through systematic review of care measured against explicit published criteria.

Clinical governance

The system of authority through which health care teams are accountable for the safety, quality and satisfaction of persons in the care they deliver. Clinical governance systems incorporate continuous improvements in the quality of clinical practice, maintaining high standards of care, and creating environments where excellence in care can flourish.

Clinical Indemnity

An insurance-based scheme for health care organisations or practitioners to indemnify their practice against claims of malpractice and to provide compensation for a loss suffered by a patient.

Clinical placement co-ordinator (CPC)    

A Clinical Placement Co-ordinator (CPC) is an experienced Registered nurse or Registered midwife who supports the facilitation of learning, and assessment of competence, among nursing / midwifery undergraduate students in the practice setting.

Clinical supervision

Is the facilitation of learning through the formal reviewing of clinical experiences with a professional colleague(s) who shares useful and insightful feedback. Clinical supervision involves reflection and is an opportunity for the professionals involved to explore alternative perspectives with a commitment to enhancing clinical outcomes.  Clinical supervision is central to the development and maintenance of high standards of professional performance and competence. 

Collaborative practice

Collaborative practice occurs when health workers from different professional backgrounds work together with persons of all ages, families, groups and communities in the achievement of shared effective health care outcomes.

Competence

The attainment and application of knowledge, intellectual capacities, practice skills, integrity and professional and ethical values required for safe, accountable, compassionate and effective practice as a Registered nurse or Registered midwife.

Competences

The knowledge, understanding, practical skill and ability levels specified in the learning outcomes that are directly related to academic award level.

Competency framework

A discrete collection of competencies and their indicators specifying the expected standards of effective performance.

Conduct

A person’s moral practices, actions, beliefs and standards of behaviour.

Confidentiality

An entrusted relationship whereby private or restricted information between the health professional and a person receiving health care is not shared with another without the consent of the person.

Conscientious objection

Where a nurse or midwife has a strong objection - based on religious or moral grounds - to providing or participating in the provision of a medical / clinical particular service.

Critical elements

These are defined as the set of single, discrete, observable behaviours that are mandatory for the designated skill at the targeted level of practice. They represent principles that are essential to ascribe competent performance. They enable the learning outcomes both from a clinical and curriculum perspective to be achieved.

Cultural competence

The attainment and demonstration of integrity and respect among health professionals who work with people from diverse ethnic origins in the achievement of effective care outcomes.

D

Delegation

Is the transfer of authority by a registered nurse or registered midwife (the delegator), to another person to perform a particular role or activity that is normally within the scope of practice of the delegator.

Domain

An organised cluster of competencies in broad categories that represent the functions of the registered nurse / registered midwife in contemporary practice.

Duty of care

An obligation to perform to a certain standard of conduct for the protection of another against an unreasonable risk of harm.

E

Ethics

The principles, values and virtues that enable people to live a morally good life. Applied to nursing and midwifery, the moral principles presented in the Code of Professional Conduct and Ethics for Registered nurses and Registered Midwives underpin professional practice.

Evidence-based practice

The conscious consideration and application of the best available evidence together with the nurse or midwife's expertise and a person's values and preferences in making health care decisions.

Expanded practice

An authorised / agreed change in the role of an individual registered nurse or registered midwife to include areas of practice that have not previously been within her / his scope of practice, but are within the overall scope of practice of the nursing and midwifery professions.

F

Family-centred care

A philosophy of care based on a collaborative relationship between the child, family and health care provider in decision-making about health care interventions.

G

Guideline

Defined as a principle or criterion that guides or directs action. Guideline development emphasizes using clear evidence from the existing literature, rather than expert opinion alone, as the basis for advisor materials.

H

Hand written prescription

A written prescription is handwritten on a single pre-printed form usually taken from a prescription pad. All handwritten prescriptions must be written in ink.

Harm

Any deliberate or accidental physical, emotional, psychological, social or reputational injury or damage to the health of a person or to any other party or parties to whom a duty of care is owed.

Health care record

All information collected, processed and held in either manual and / or electronic formats pertaining to a person under the care of a registered midwife or nurse or health care team, including personal care plans, clinical data, images, unique identification, investigation, samples, correspondence and communications relating to the person and his / her care.

Health assessment and structured physical examination

See assessement.

Health and wellbeing

A state of complete physical, social and mental wellbeing, and not merely the absence of disease or infirmity. Within the context of health promotion, health has been considered less as an abstract state and more as a means to an end. It is a positive concept emphasising personal resources as well as physical capabilities.

I

Inaction

Failure to act in a situation where an action is required and has been prescribed.

Incident

An event or circumstance which could have, or did lead to unintended and unnecessary harm to a person, or a complaint, loss, or damage.

Indicators

Statements describing the type of behaviours that would be observed when effective performance of a competence is demonstrated.

Integrity

Upholding the values of the profession and applying accepted standards of practice. Acting with integrity is to behave honestly and to adhere to the principles of the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives.

J
K

Knowledge

The cognitive representation of ideas, events or happenings. May be derived from practical or professional experience as well as from formal instruction or study, articulated in terms of description, memory, understanding, thinking, analysis, synthesis, debate and research.

L

Learning

Learning is the lifelong process of transforming information, ideas and experience through imitation, practice and reflection into relatively permanent new knowledge, skills, know-how, behaviour, and attitudes.

Learning contract

A learning contract is a means of reconciling the learning needs of the Return to Practice Nurse with the requirements for successful completion of the period of clinical practice and assessment. This is achieved through negotiation of learning needs and objectives. The focus is on the development of competence through achievement of the learning outcomes.

Learning log 

The learning log represents documented evidence of learning recorded by the undergraduate / postgraduate student in the form of a diary / journal. It facilitates assessment in the specified Domains of Competence as outlined by NMBI.

Learning outcomes

Learning outcomes for programmes of study specify the acquisition of knowledge, understanding, ability and skills that a learner should have attained through the process of learning which is demonstrated in terms of level of competency by a defined end point.

Lifelong learning

All learning activities undertaken throughout life, with the aim of improving knowledge, skills and competences within a personal, civic, social and / or employment-related perspective.

M

Maternity care

Care for women from when they access care or services during pregnancy, labour and birth through to the care of women and their baby in the postnatal period.

Maximum

Greatest possible quantity or value attainable.

Must

Commands the action a nurse or midwife is obliged to take from which no deviation whatsoever is allowed.

N

National clinical guidelines            

Systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions about appropriate health care for specific clinical circumstances across the entire clinical system.

O

Omission

Failure to do something, especially something that a person has a moral or legal obligation to do.

P

Patient

A person who uses health and social care services. In some instances, the terms 'client', 'individual', 'person', 'people', 'resident', 'service user', 'mother', 'woman' or 'baby' are used in place of the term patient, depending on the health or social care setting.

Patient assessment

See assessment

Performance Criteria

These are statements of selected actions or behaviours that identify how achievement of competence is demonstrated.

Period of Adaptation

A period of adaptation is a period of supervised practice possibly being accompanied by further education and training. The supervised practice is under the responsibility of a registered midwife. This period of supervised practice shall be the subject of assessment. 

Person

A person means an individual who uses health and social care services. In some instances, the terms 'client', 'individual', 'patient', 'people', 'resident', 'service user', 'mother', or 'baby', ’child’, ‘young person’ are used in place of the term person depending on the health or social care setting.

Person-centred nursing and midwifery

Respecting a person’s values and beliefs by involving her / him centrally in decision-making, providing for the person’s needs within an empathetic approach to affect mutually agreed effective outcomes. 

Practice         

Any role, whether remunerated or not, in which the individual uses his / her skills and knowledge as a nurse or midwife, incorporating, direct and indirect patient care.

Practice placement

A clinical site, approved by NMBI, to provide appropriate learning experiences for undergraduate or postgraduate nursing or midwifery students.

Practice standards for midwives

Authoritative statements developed, monitored and enforced by the Nursing and Midwifery Board of Ireland to describe the responsibilities and conduct expected of registered midwives. The standards are based on the principles and values that underpin professional midwifery practice.

Preceptor

A preceptor is a registered nurse or registered midwife who has undertaken preparation for the role and who supports undergraduate nursing or midwifery students in their learning in the practice setting and assumes the role of supervisor and assessor of the students’ achievement of clinical learning outcomes and competence.

Policy

A written statement that indicates clearly the position and values of the organisation on a given subject.

Primary care

Primary care is an approach to care that includes a range of services designed to keep people well, from promotion of health and screening for disease to assessment, diagnosis, treatment and rehabilitation as well as personal social services. The services provide first-level contact that is fully accessible by self-referral and have a strong emphasis on working with communities and individuals to improve their health and social well-being.

Primary carer

Nominated family member(s), or another, as agreed with the patient, with whom the health professional collaborates in the development of evidence based plans of care.

Protected disclosure

A nurse or midwife, in good faith, can report:

  • Safety concerns which may place the person or public at risk.
  • Legal obligations that are not being met.
  • Where public funds are being wasted.

By reporting their concerns in line with the relevant legislation, the nurse or midwife is protected from their employer taking action against them.
 

Public health

Public health deals with the structures, processes and competencies required to monitor, protect and promote the health of defined populations. Whereas public health used to rely heavily on legislation and concentrate on programmes for disease control, the new health for all based public health is more strategic. It draws on the contribution of many sectors, disciplines and actors; it operates in policy-making spheres as well as at technical levels; it encourages community participation; and it places strong emphasis on the social, economic and environmental determinants of health (EUR/RC48/13 1998).
 
The following key elements of public health have been identified:

  • Assessing the health needs of a population.
  • Planning and implementing programmes that promote and protect health, i.e. immunisation and screening programmes, health promotion. campaigns and planning and delivering integrated services across agencies.
  • Working with other agencies to address the wider threat to health e.g. housing, transport, social exclusion.
  • Identifying health inequalities and taking action to address these.

Q

Quality care

Care that is person-centred, safe, effective and results in better health and well-being.
 

R

Referral

An act of referring someone for consultation, review, or further action if the required intervention is outside the scope of practice of the nurse or midwife’s competence to provide safe, quality care.
 

Reflection

Reflection is both a theoretical and practical concept that involves reviewing one’s practice, pondering alternatives, thinking critically and creatively, and analysing other evidence with a view to learning from experiences. Reflective practice involves a conscious review of an event, situation, information or emotion encountered with the aim of analysing and evaluating the experience to apply insights to future practice. Reflection enables individuals and teams to engage in a structured intellectual activity that critically evaluates experiences and practices, promotes change and results in self-awareness, deeper understandings, learning that is meaningful and memorable, and enhanced clinical outcomes.   
 

Registered midwife

A midwife whose name is entered in the Midwives Division of the Register of Nurses and Midwives maintained by NMBI.
 

Registered nurse

A nurse whose name is entered in the Nurses’ Division of the Register of the Nurses and Midwives maintained by NMBI.
 

Regulation

A rule or law designed to control or govern conduct.
 

Requirement

Something that is compulsory and a necessary condition for achievement or approval.
 

Respect

Having due regard for a person's feelings, wishes, and / or rights to receive appropriate care.
 

Responsibility

The obligation to perform duties, tasks or roles based on sound professional judgement and being answerable for one’s competent performance of those duties, tasks and roles.

S

Scope of practice     

The range of roles, functions, responsibilities and activities which a registered nurse or registered midwife is educated, competent and has authority to perform.  For more details, visit the Scope of Practice section.

Self-determination

A person taking control of his / her own life and making one’s own decisions.

Service needs analysis

This definition as it applies to advance practice means established service need based on audit findings using quantitative and data. These data illustrate the benefit of preparing the site for employment of Advanced Practice in terms of positive outcomes.  Service needs analysis may be used to justify employment costs in the organisation’s service plan / business case. It is the health care provider’s responsibility to determine the need for the development of advanced practice posts to meet their service needs. Principles underpinning support for the development of advanced practice posts include safety, equity, security, respect, partnership, reciprocity, and multi-disciplinary team work.
 

Should

Indicates a strong recommendation to perform a particular action from which deviation in particular circumstances must be justified.
 

Site preparation

As relates to advanced practice, this means  the development of a health service site by an organisation to support the employment of Advanced Nurse/Midwife Practitioner Candidates (ANPcs/AMPcs) and Registered Advanced Nurse/Midwife Practitioners (RANP/RAMP) in terms of preparing a comprehensive job description that clearly outlines the scope of practice of the post. Before a post is created the principles of necessity, effectiveness, role delineation, relevance and transparency must be considered.  Site preparation involves the development of evidence based policies, procedures, protocols and guidelines to support Advanced Nurse / Midwife Practitioner Candidates and Registered Advanced Nurse / Midwife Practitioners in their roles.  Site
preparation may also involve service level agreements and memoranda of understanding to enable the RANP/RAMP fulfil his/her role. 

Standards

Authoritative statements developed, monitored and enforced by NMBI to describe the responsibilities and conduct expected of registered nurses and registered midwives. The standards are based on the principles and values that underpin professional practice.
 

Sufficient knowledge

Having knowledge equal to the proposed end as specified in a learning outcome or practice based indicator as judged by the person evaluating the performance of the learner or peer.
 

Supernumerary status

Students undertaking the registration education programme are surplus to the staffing requirements for the health care setting during the supernumerary period of the programme. This excludes a final placement of 36 weeks internship, which consolidates the completed theoretical component of the programme. Students continue to need support and supervision during the internship period to enable them achieve clinical competence during the practice placement and in the interest of patient safety. 
 

Supervision

Provision of oversight, direction, guidance, or support by a nurse or midwife to students, or other regulated or unregulated health care workers. Supervision may be direct or indirect Students undertaking the undergraduate registration education programme do so under the supervision of a registered nurse/registered midwife who has been designated as his/her preceptor and under the wider supervision and direction of a team of registered nurses within each practice setting. During final year placements within the 36 weeks internship, students continue to need guidance, support, prompting, feedback and evaluation to enable them achieve the level of clinical competence expected within the practice setting.
 
Supervision may be direct, close, indirect or distant.

  • Direct supervision: the preceptor is actually present and works alongside the student.
  • Close supervision: the preceptor is present or nearby.
  • Indirect supervision: the preceptor does not directly observe the student, but is accessible.
  • Distant supervision: the student carries out their duties and is expected to recognise if they need help or advice from the preceptor. If they need help, they should look for it in a timely manner. 

T

Therapeutic relationship

The relationship established and maintained between a person requiring or receiving care and a nurse or midwife through the use of professional knowledge, skills and attitudes in order to provide nursing or midwifery care expected to contribute to the person’s health outcomes.

U

Unregulated health care worker 

A person who is not statutorily regulated and is employed within a health care, residential or community setting and whose role includes a component of direct patient care and the performance of delegated care activities, supported in organisational policy.

V

Validation of a programme

Validation is the process by which an awarding body shall satisfy itself that a learner may attain knowledge, skill or competence for the purpose of an award made by the awarding body.

Verifier

The Verifier is an independent person who ensures that the assessment is conducted fairly. If difficulties arise during the period of adaptation the Verifier is responsible for verifying the assessment process. The Verifier attends the intermediate and final meeting if requested to do so by a Return to Practice Nurse, undergraduate or postgraduate nursing or midwifery student, the Preceptor or both. A link academic, Clinical Placement Coordinator or Clinical Nurse Manager may serve as a verifier.

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