CNO PRACTICE STANDARDS FOR NURSES AND CLIENT CENTRED CARE
The following is a quick reference to sections in the College of Nurses of Ontario (CNO)
Compendium of Standards of Practice for Nurses in Ontario, Second Edition that relate to the
concept of Client Centered Care.
College of Nurses of Ontario Professional Standards (2004)
Accountability: Each nurse is accountable to the public for ensuring that her/his practice
and conduct meets legislative requirements and the standards of the profession.
A nurse demonstrates the standard by: providing, facilitating, advocating and
promoting the best possible care for clients.
Ethics: Each nurse understands, upholds and promotes the values and beliefs described
in the CNO standard entitled Ethics.
Ethical nursing care means promoting the values of client wellbeing, respecting
client choice.
Knowledge Application: Each nurse continually improves the application of
professional knowledge.
A nurse demonstrates the standard by: creating plans of care that address clients
needs, preferences, wishes and hopes.
Leadership: Each nurse demonstrates her/his leadership by providing, facilitating and
promoting the best possible care/services to the public:
A nurse demonstrates the standard by: collaborating with clients and the health
team to provide professional practice that respects the rights of clients.
Relationships: Each nurse establishes and maintains respectful, collaborative,
therapeutic and professional relationships.
A nurse demonstrates the standard by: Demonstrating respect, empathy and
interest for clients.Ensuring clients’ needs remain the focus of the nurse-client
relationship.
College of Nurses of Ontario Practice Standard: Ethics (2004)
Prepared by Gina De Souza, RNAO Best Practice Coordinator, Central South Ontario
Page
Client choice means self-determination and includes the right to the information
necessary to make choices and to consent to or refuse care. Clients know the context
in which they live and their own beliefs and values. As a result, when they have the
necessary information, they can decide what is best for them.
1
Client Choice:
Maintaining commitments to clients:
The commitment to clients also includes a commitment to respect family members
and/or significant other(s), some of whose needs may conflict with those of clients.
College of Nurses of Ontario Practice Standard: Restraints (2004)
Professional judgement is integral to decision making and includes organizing data,
giving them meaning and coming to a conclusion.
•
Nursing interventions promote well being and prevent harm.
Nurses respect the dignity of the individual and advocate for an environment
that promotes a client’s quality of life.
•
Nurses involve clients or substitute decision makers in the planning.
It is important for the nurse to develop a plan of care with the client and the
family. The health team, which includes the client, discusses the proposed
interventions to identify the client’s therapeutic needs and to facilitate the
client’s short and long term goals.
•
Clients will at times prefer to endure safety risks rather than be restrained.
College of Nurses of Ontario Practice Standard: Resuscitation (2004)
Nurses contribute to ongoing communication regarding resuscitation wishes and to
implementing of the client’s wishes by:
•
Reviewing the client’s resuscitation wishes on a regular basis and specifically
when the client’s condition changes.
•
Documenting the discussion and outcomes
•
Communicating any changes in wishes to the health care team.
Nurses contribute to client well-being and act in the best interest of clients by:
Providing an opportunity to discuss, identify and review the client’s
resuscitation wishes
•
Developing an advocacy plan
Page
2
•
Prepared by Gina De Souza, RNAO Best Practice Coordinator, Central South Ontario
College of Nurses of Ontario Practice Standard: Therapeutic Nurse-Client Relationship
(2004)
Respect for the dignity and worth of a client is fundamental to the relationship.
The nurse needs to respect the individual characteristics of the client, such as
cultural, social identity, appearance, sexual orientation and religious affiliation, and
to recognize the impact that these things have on the nurse-client relationship and
the health of the client.
Effective communication is an essential factor in creating and maintaining a successful
relationship.
1. Introducing her/himself to the client and addressing the client by the name
and/or the title that she/he prefers
2. Identifying the goals, wishes, hopes and dreams of clients and making them the
focus of the plan of care
3. Providing information to promote client choice and to enable the client to make
informed decisions
Page
3
4. Helping clients find the best possible solution for themselves given their personal
values, beliefs and different decision-making styles
Prepared by Gina De Souza, RNAO Best Practice Coordinator, Central South Ontario