Tuesday, October 6, 2015

Standards of Care for Ambulatory Care including ambulatory surgery, written by Gloria Poole,Registered Nurse of Missouri and Georgia

Standards of Care for Ambulatory Care including ambulatory surgery, written by Gloria Poole,Registered Nurse of Missouri and Georgia:

Standards are written policies and protocols developed by professional and or governmental /regulatory agencies by which the practice of medical services, research or education can be judged. The AACN developed the Ambulatory Care Nursing Administration and Practice Standards in 1987 and updated them in 2004. They also developed and published the Telehealth Nursing Practice Administration and Practice Standards in 1997 and revised them in 2004 and again I think more recently. The American Nurses Association published the principles on Telehealth in 1998. As far as I can tell the so-called ObamaCare downgraded all actual standards of care for any hospital or ambulatory center, in an effort to make abortuaries and euthanasia acceptable. But these are the standards that were and should be again.

The standards included are:

structure and organization of ambulatory care nursing



ambulatory nursing practice

continuity of care


patients' rights



and performance improvement

For any ambulatory care center to function, it must be in compliance with it's State Dept of Health rules and regulations, and must also operate in compliance with OSHA {Occupational Safety and Health Administration] standards. Evidence-based practice guidelines are available from The Agency for Healthcare Research and Quality for many common health problems. They are available at http://ahrq.gov. Professional nursing organizations such as American Nurses Association and the Oncology Nurse's Society also have specific standards.

Competence is defined as the "demonstrated knowledge, skills and ability to carry out the requirements of a given role" according to textbook Medical-Surgical Nursing ,Eight Edition Vol I, written by Joyce M. Black and Jane Hokanson Hawks. Each specialty in nursing has it set of competencies. For example operating room nurses have a specific set of competencies that correspond with the many duties of working in the operating room of an Ambulatory Surgery Center. Those duties include admission interview, assessment, patient teaching, identifying the correct patient and applying tag and the correct part of the anatomy to be operated on and bringing patient to the surgical suite, setting up sterile equipment and trays, operating electrical equipment safely which involves getting the right equipment, and making sure any part that comes into contact with the patient was correctly sterilized, assisting the surgeon and assistant into their sterile gowns and gloves, opening trays as the unsterile Circulator, handing instruments from an unsterile field to a sterile field in way not to contaminate the sterile supplies, documenting all events that happen in the operating room during any case, recording on patients medical record all actions, reactions, responses, questions of patient, results, doctor's visits, doctor's actions to/on patients, status of patient, patient teaching, patient discharge instructions,and any untoward events, medicine adverse reactions; recovering patient in the recovery room, critical care emergency responses. For each duty there is a competency test administered by the person assigned that role in most hospitals and Ambulatory Care centers.

Certification is a statement, declaration by the regulatory agency that a certain nurse has achieved the number of hours and the level of competency that was predetermined by the regulatory group, as the amount of time and knowledge required to be labeled as "certified" in that area. To obtain certification, nurses must take and pass an examination that was developed by a panel of experts and administered by a recognized certification agency. The Ambulatory Care Nursing Conceptual Framework and the American Nurses' Credentialing Center developed a certification examination for the first time in 1999. AACN has led the development of a core curriculum for for ambulatory care nursing and certification, and it's website is http://inurse.com.

Ambulatory care centers including ambulatory surgery in doctor's offices or clinics must be licensed in the state in which they are located. The national association of The Joint Commission evaluates ambulatory care centers and accredits them [with the exception of abortuaries which seem not be required to meet any sort of standard in most states as an effort to appease RADICAL political groups]. The three major accreditation agencies publish their standards, and provide the public an external method of evaluating ambulatory care. Those 3 agencies are: The Joint Commission, The National Committee for Quality Assurance and the Accreditation Association for Ambulatory Health Care which serves free-standing centers including medical group practices, student health centers, and office-based surgeons' practices.

The safety goals for ambulatory care centers are:

accuracy of patient identification

accuracy of communication between health care staff

safe administration of the correct medicines

prevent nosocomial infections

prevent spread of infection from patient admitted with infection

prevent fires in the operating room caused by electrical equipment and flammable substances

accurate accounting for Class III, and all drugs regulated by DEA

accuracy of medical records

protection of patient confidentiality

accurate and timely patient teaching that is well-documented to prevent infections at home, or post-op complications

preventing injury to unconscious patient during surgery

preventing injury to patient while in facility

This is not a comprehensive list of information by any means on the operation of ambulatory care centers or clinics, but it is the basics .

You can follow me on twitter at : @ProlifeNurse; @personhood1; @gloriapoole; @gloria_poole; @tweetie0817; and at @Tartan_Bliss, which are my twitter accounts that are written entirely by me Gloria.

My profile for this blog is :https://profiles.google.com/106271267621391694994/about

You can read more on the prolife and personhood causes on these blogs of mine:









http://gloriapoole.livejournal.com [scroll to the list of medical references]

http://gloriapoole-UK.livejournal.com [scroll to articles]





https://sites.google.com/site/gloriapooleRN/optimumhealthisachievable or at:

https://sites.google.com/site/optimumhealthisachievable/ ; or at :




I referred to the textbook Medical-Surgical Nursing ,Eight Edition Vol I, written by Joyce M. Black and Jane Hokanson Hawks. chapter five, pages 69 and 70, but I am also a Registered Nurse who has had my license for years, and I worked in a hospital operating room and an ambulatory surgery center, and I wrote the Infection Policy Manual for the Ambulatory Surgery Center I worked in [it had to be approved by board of medical doctors and it was], and I worked on med-surg and trauma units and Emergency departments in my career. I have a Registered Nurse license in the state of Missouri.

About me Gloria Poole, RN, artist, blogger, writer, author, photographer, tweeter:

This is my selfie of me Gloria Poole in spring 2014 sitting on my sofa in Missouri; but it is my most recent selfie. I am still putting my hair in a lop-sided pony tail however and look the same.

Symbols and photos that represent me Ms Gloria Poole, RN, artist of Missouri and Georgia:

This is one of my Christian crosses that I wear sometimes, and my hand as it looks this year. I am posting it here to remind all that I am a believer in THE LIVING LORD JESUS who is THE MESSIAH as foretold by the Old Testament. You can read more about JESUS and how to be born again on this blog of mine:


This is my personal logo that I made to add to blogs. I add it intermittently to blogs.

This is the seal of the Georgia Baptist College of Nursing where I graduated nursing school years ago. I am a Registered Nurse licensed in Missouri but before that in other states; but for most of my life, my license was in state of Georgia, where I was born and grew up and was educated.

I am also a graduate of the University of Georgia's Terry College of Business.

For the record, I never worked with or for my 2nd exhusband [with initials DBP in Colorado who is a massage man] in any capacity and he never worked with or for me in any capacity. It is necessary to write that because he has NO authority to sign my name to anything nor to hijack any account of mine, nor to represent himself as any sort of agent of mine. He injured me several times,and he tried to kill me four times and said he intended to annihilate me from life and the web. DBP by any name is not a business partner of mine and never was, nor is he a courier, nor associate, nor employee,nor assistant ,nor boss, nor supervisor,nor agent, nor "co-worker" of mine AND NEVER WAS. This documentation is necessary for law enforcement and the public to know that if/when male DBP tries to intercept messages, photos or phone calls to me he is stalking me and he is violating a mandatory protection order issued by a Magistrate to prevent DBP from coming near me or my dwelling or any place that he knows I would be such as my family of origin home etc. I removed the Pappas name from my name at the time of final divorce decree in Oct 2007 by order of Judge who signed final divorce decree from male DBP; and I resumed my born with name including my surname of Poole. I MOVED to Missouri on Oct 31, 2009 and into my own apt on Nov 3, 2009. I got reciprocity of my Registered Nurse license in Missouri from my state of origin Georgia.


This blog and all content, all words, all photos and all art on it, are owned by me and were created and posted by me Gloria Poole , RN, artist of Missouri and Georgia, signed by me, photographed by me and uploaded by me, and I own all rights to it collectively and individually.

Copyright notice :I Gloria Poole, own all rights to all content on this blog. Usually I sign the art I create as simply Gloria since that is my first name, that I was born with; but on pencil and or ink drawings I sometimes also sign my born with surname of Poole which is my legal name again because I resumed it by Court order after both divorces. I am also known on the web and in real life as Gloria; Gloria Poole; Gloria J Poole; Gloria Poole, RN, artist; and on the web as : gloriapoole; gloria-poole; gloria.poole; Ms Gloria Poole; gloriapoole.RN; gloriapoole_RN; gloriapooleRN at yahoo; gloria0817; gpoole817; artist-gloriapoole; gloriapoole-paintings; artist-gloria; Poole,Gloria; gloriapoole1749; and other variations of my real, born with, and legal name of Gloria Poole. For the record, I am a white, single-again, twice divorced, Southern Baptist, born again, Christian, woman and the mother of only two children who are grown daughters who are named Jennifer and Leigh. I am also a prolife activist, blogger, artist in all mediums; photographer for my own purposes, Registered Nurse with a license in Missouri but before that for most of my life in the state of Georgia, U.S. citizen born in the state of Georgia; University of Georgia alum, Georgia Baptist College of Nursing alum, writer, illustrator, author, personhood promoter. This blog may not be downloaded, nor copied individually or collectively as a whole; nor have domains forwarded to it that do not belong to me, nor may the photos or art on it be reproduced or saved to disk by anyone . Repeat for emphasis: I create all content on this blog and I, Gloria Poole, own all rights to this blog collectively and individually as single posts. All telephones listed on this account and any account of mine on the web belong to me personally and are in my apartment in Missouri or in my possession at all times. Some of my numbers are wired, landline telephones and some are mobile phones. This blog and all blogs that I create and that contain my words I wrote and or art I made and signed and or photos that I photographed belong exclusively to me Gloria Poole, of Missouri and Georgia. Copyright. Gloria Poole / Gloria / gloriapoole /gloria-poole /gloria.poole/ Ms Gloria Poole/ Poole Gloria / G-L-O-R-I-A / gloriapoole1749 /gloria0817 /gpoole817 / gloriapooleRN at yahoo / gloriapoole.RN / artist-gloriapoole /Gloria Poole,RN,artist /cartooning-by-gloriapoole / photo-by-gloriapoole, and other variations of my real name with or without my professional status as Registered Nurse and with or without numbers after my name, at my own private apt in Missouri which is not shared with anyone and neither is my equipment nor phones shared with anyone, and neither is my isp account shared with anyone which means no one is authorized to log into any account of mine anywhere but me. /signed/ Gloria Poole, RN, artist; at my apt in Missouri on 6th Oct 2015 at 3:35pm. Gloria Poole / Gloria / gloriapoole / [Ms ] Gloria Poole,RN,artist of / in Missouri, USA .