The ANA provides a publication on the scope and standards of gerontological nursing practice.

These standards are developed by gerontological nurses and used by them to evaluate and guide
practice. The standards for clinical gerontological nursing include assessment, diagnosis, outcome
identification, planning, implementation, and evaluation (ANA, 2001). The standards of professional
gerontological nursing performance include quality of care, performance appraisals, education,
collegiality, ethics, collaboration, research, and research utilization. Students will note that these are the
basic standards for professional nursing, but here they are applied in the care of the older adult. The
core competencies discussed in the next section provide more specific guidelines for gerontological
nursing care.

The years 1960 to 1970 were characterized by many “firsts,” as the specialty devoted to the care of
older adults began its exciting development (Table 1-1). Journals, textbooks, workshops and seminars,
formal education programs, professional certification, and research with a focus on gerontologic nursing
have since evolved. However, the singular event that truly legitimized the specialty occurred in 1969,
when a committee appointed by the ANA Division of Geriatric Nursing Practice completed the first
Standards of Practice for Geriatric Nursing (ANA, 1991). These standards were widely circulated during
the next several years; in 1976, they were revised, and the title was changed to Standards of
Gerontological Nursing Practice. In 1981, A Statement on the Scope of Gerontological Nursing Practice
was published. The revised Scope and Standards of Gerontological Nursing Practice were published in
1987, 1995, and 2010 (ANA, 2010). The changes to this document reflect the comprehensive concepts
and dimensions of practice for the nurse working with older adults. In 2010, the revised Scope and
Standards of Gerontological Nursing Practice not only reflected the nature and scope of current
gerontologic nursing practice but also incorporated the concepts of health promotion, health
maintenance, disease prevention, and self-care. The scope and standards of practice were combined
into a set of three books titled Nursing: Scope & Standards of Practice (ANA, 2010a), Nursing’s Social
Policy Statement: The Essence of the Profession (ANA, 2010b), and Guide to the Code of Ethics for
Nurses: Interpretation and Application (ANA, 2010c).

This merging of the standards of practice of all the specialties was an effort to outline the expectations
of the professional role within which all registered nurses (RNs) must practice nursing.

Another hallmark in the continued growth of the gerontologic nursing specialty occurred in 1973, when
the first gerontologic nurses were certified through the ANA. Certification is an additional credential
granted by the ANA, providing a means for recognizing excellence in a clinical or functional area (ANA,
1995).

Certification is usually voluntary, enabling the nurse to demonstrate to peers and others that a distinct
degree of knowledge and expertise has been achieved. In some cases, certification may mean eligibility
for third-party reimbursement for nursing services rendered. From the initial certification offering as a
generalist in gerontologic nursing, to the first Gerontologic Nurse Practitioner (GNP) examination
offering in 1979, to the most recent Gerontologic Clinical Nurse Specialist (GCNS) examination (first
administered in 1989), this specialty has continued to grow and attract a high level of interest. Changes
were being made as this edition was being written. The first combined certification for either acute care
Adult-Gerontologic Nurse Specialist (AGCNS) or primary care AGCNS examination will take place
beginning in 2014. Additionally, an AGCNS examination will take the place of the earlier GCNS. Eligibility
criteria for the application process to take any one of the four certification examinations can be found in
Box 1-1. Since changes are fluid, contact the ANA’s credentialing center for upto-date requirements

The standards of gerontological nursing practice are authoritative statements that identify the
responsibilities for which gerontological nurses are accountable, reflect the values and priorities of
gerontological nursing, are written in measurable terms, and provide a framework for the evaluation of
gerontological nursing practice. The standards remain stable over time as they reflect the philosophical
values of the nursing profession and specialty.

The standards are divided into two sections: the Standards of Practice and the Standards of Professional
Performance. The Standards of Practice describe the application of the steps of the nursing process
within practice:

Assessment

Diagnosis

Outcomes identification

Planning

Implementation

Evaluation

The development and maintenance of a therapeutic, holistic, nurseolder adult and family relationship
are essential throughout the nursing process. The nursing process forms the foundation of clinical
decision-making and encompasses all significant actions taken by the gerontological nurse in providing
care for older adults, their families, and significant others. The gerontological nurse is adept at:

Gerontological nursing is practiced in accordance with standards developed by the profession of nursing.
In 2010, the ANA Division of Gerontological Nursing Practice published the third edition of the Scope and
Standards of Gerontological Nursing Practice, in collaboration with the NGNA, the National Association
Directors of Nursing Administors in Long-Term Care, and the National Conference of Gerontoloigcak
Nurse Practitioners. These standards are divided into clinical care and the role of the professional nurse,
both at the generalist and advanced practice nurse level of practice. There are six standards, which
include assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The
eight standard of professional gerontoligcal nursing performance include quality of care, performance
appraisals, education, collegiality, ethics, collaboration, research, resource utilication, and transition of
care. Students should note that these are competencies.

ANA Standards of Gerontological Nursing Practice

• Standard I. Assessment

• Standard II. Diagnosis

• Standard III. Outcome Identification

• Standard IV. Planning

• Standard V. Implementation

• Standard VI. Evaluation

Standards of Professional Gerontological Nursing Performance

• Standard I. Quality of Care

• Standard II. Performance Appraisal

• Standard III. Education

• Standard IV. Collegiality

• Standard V. Ethics

• Standard VI. Collaboration

• Standard VII. Research

• Standard VIII. Resource Utilization

Standard I

Data collected about the health status of the older adult are

systematically and continuously. The data are accessible, communicated and recorded.

Standard II

Nursing diagnoses are derived from the identified normal responses

of the individual to ageing and the data collected about the health

status of the older adult.

Standard III

A plan of nursing care is developed in conjunction with the older

adult and/or significant others, that includes goals derived from the

nursing diagnosis.

Standard IV
The plan of nursing care includes priorities and prescribed nursing

approaches, and measures to achieve the goals derived from the

nursing diagnosis.

• American Nurses' Association. 1976. Standards of Gerontological

Nursing Practice. Kansas City, MO: American Nurses' Association.

165

Standard V

The plan of care is implemented, using appropriate nursing actions.

Standard VI

The older adult and/or significant other(s) participate in determining the process attained in the
achievement of established goals.

Standard Vll

The older adult and/or significant others participate in the ongoing

process of assessment, the setting of new goals, the reordering of

priorities, the revision of plans for nursing care, and the initiation of

new nursing actions.

https://link.springer.com/content/pdf/bbm:978-1-349-12879-2/1.pdf

Standards of Professional Nursing Practice

The Standards of Professional Nursing Practice content consists of the

Standards of Practice and the Standards of Professional Performance.

Standards of Practice

The Standards of Practice describe a competent level of nursing care as demonstrated by the critical
thinking model known as the nursing process. The

nursing process includes the components of assessment, diagnosis, outcomes

identification, planning, implementation, and evaluation. Accordingly, the

nursing process encompasses significant actions taken by registered nurses

and forms the foundation of the nurse’s decision-making.

standard 1. assessment
The registered nurse collects comprehensive data pertinent to the healthcare

consumer’s health and/or the situation.

standard 2. diagnosis

The registered nurse analyzes the assessment data to determine the diagnoses

or the issues.

standard 3. outcomes identification

The registered nurse identifies expected outcomes for a plan individualized to

the healthcare consumer or the situation.

standard 4. planning

The registered nurse develops a plan that prescribes strategies and alternatives

to attain expected outcomes.

standard 5. implementation

The registered nurse implements the identified plan.

standard 5a. coordination of care

The registered nurse coordinates care delivery.

standard 5b. health teaching and health promotion

The registered nurse employs strategies to promote health and a safe

environment.

standard 5c. consultation

The graduate-level prepared specialty nurse or advanced practice registered

nurse provides consultation to influence the identified plan, enhance the

abilities of others, and effect change.

standard 5d. prescriptiVe authority and treatment

The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments,
and therapies in accordance with state and

federal laws and regulations.

standard 6. eValuation

The registered nurse evaluates progress toward attainment of outcomes.

Standards of Professional Performance

The Standards of Professional Performance describe a competent level of

behavior in the professional role, including activities related to ethics, education, evidence-based
practice and research, quality of practice, communication, leadership, collaboration, professional
practice evaluation, resource

utilization, and environmental health. All registered nurses are expected to

engage in professional role activities, including leadership, appropriate to

their education and position. Registered nurses are accountable for their

professional actions to themselves, their healthcare consumers, their peers,

and ultimately to society.

standard 7. ethics

The registered nurse practices ethically.

standard 8. education

The registered nurse attains knowledge and competence that reflects current

nursing practice.

standard 9. eVidence-based practice and research

The registered nurse integrates evidence and research findings into practice.

standard 10. Quality of practice

The registered nurse contributes to quality nursing practice.

standard 11. communication

The registered nurse communicates effectively in all areas of practice.

standard 12. leadership

The registered nurse demonstrates leadership in the professional practice setting and the profession.

standard 13. collaboration

The registered nurse collaborates with healthcare consumer, family, and others

in the conduct of nursing practice.

standard 14. professional practice eValuation

The registered nurse evaluates her or his own nursing practice in relation to

professional practice standards and guidelines, relevant statutes, rules, and

regulations.

standard 15. resource utilization

The registered nurse utilizes appropriate resources to plan and provide nursing

services that are safe, effective, and financially responsible.

standard 16. enVironmental health

The registered nurse practices in an environmentally safe and healthy manner.

https://www.bethelu.edu/uploads/general/Nursing-Program-ApplicationProcess_Scope-and-
Standards.pdf

http://www.ohnurses.org/wp-content/uploads/2014/09/ANA-Standards-of-Nursing-Practice.pdf