Standards and Conceptual Approach

The Open RN Nursing Health Alterations textbook is based on several external standards and uses a conceptual approach based on concepts introduced in Open RN Nursing Fundamentals,2e.

External Standards

American Nurses Association (ANA)

The ANA establishes Standards for Professional Nursing Practice and the Nursing Code of Ethics.^[1],[2]

• American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. https://www.nursingworld.org/ana/about-ana/standards/
• American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses

The National Council Licensure Examination for Registered Nurses: NCLEX-RN and NCLEX-PN Test Plans

The NCLEX-RN and NCLEX-PN test plans are updated every three years to reflect fair, comprehensive, current, and entry-level nursing competency.^[3]

• https://www.ncsbn.org/nclex.htm

The National League for Nursing (NLN): Competencies for Graduates of Nursing Programs

NLN competencies guide nursing curricula to position graduates in a dynamic health care arena with practice that is informed by a body of knowledge to help ensure the public receives safe, quality care.^[4]

• https://www.nln.org/education/nursing-education-competencies/competencies-for-graduates-of-nursing-programs

American Association of Colleges of Nursing (AACN): The Essentials: Core Competencies for Professional Nursing Education

The AACN provides a framework for preparing individuals as members of the discipline of nursing, reflecting expectations across the trajectory of nursing education and applied experience.^[5]

• https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

Quality and Safety Education for Nurses (QSEN) Institute: Prelicensure Competencies 

Quality and safety competencies include knowledge, skills, and attitudes to be developed in nursing prelicensure programs. QSEN competencies include client-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.^[6]

• https://qsen.org/competencies/

Wisconsin State Legislature, Administrative Code Chapter N6

The Wisconsin Administrative Code governs the Registered Nursing and Practical Nursing professions in Wisconsin.^[7]

• https://docs.legis.wisconsin.gov/code/admin_code/n/6

Healthy People 2030

Healthy People 2030 envisions a society in which all people can achieve their full potential for health and well-being across the life span. Healthy People provides objectives based on national data and includes social determinants of health.^[8]

• https://health.gov/healthypeople

Conceptual Approach

The Open RN Nursing Health Alterations textbook incorporates several concepts including, but not limited to, the following:

• Evidence-Based Practice. Evidence-based practices are referenced by footnotes throughout the textbook. To promote the development of digital literacy, links are provided to credible, free online resources that supplement content. The Open RN series of textbooks will be updated on a three-year cycle in alignment with the release of updated NCLEX test plans.
• Clinical Judgment. Learning activities include case studies written to reflect verbiage by the NCSBN Clinical Judgment Measurement Model used on the NCLEX-RN. Formative assessments encourage students to recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, and evaluate outcomes.^[9]
• Cultural Humility. Nurses have an ethical obligation to practice with cultural humility and provide culturally responsive care to the clients and communities they serve based on the ANA Code of Ethics^[10] and the ANA Scope and Standards of Practice.^[11]
• Safe, Quality, Client-Centered Care. Content reflects the priorities of safe, quality, client-centered care.
• Clear and Inclusive Language. Clear language is used based on preferences expressed by prelicensure nursing students to enhance understanding of complex concepts.^[12] “They” is used as a singular pronoun to refer to a person whose gender is unknown or irrelevant to the context of the usage, as endorsed by APA style. It is inclusive of all people and helps writers avoid making assumptions about gender.^[13] 
• Open-Source Images and Fair Use. Images are included to promote visual learning. Students and faculty can reuse open-source images by following the terms of their associated Creative Commons licensing. Some images are included based on Fair Use as described in the “Code of Best Practices in Fair Use for Open Educational Resources” presented at the OpenEd 2020 conference. Refer to the footnotes of images for source and licensing information throughout the text.
• Open Pedagogy. Students are encouraged to contribute to the Open RN project in meaningful ways by reviewing content for clarity and assisting in the creation of open-source images.^[14]

Supplementary Materials

Several supplementary resources are provided with this textbook:

• “Pretests” are provided at the beginning of each chapter.
• Supplementary “RN Recap” videos are included in each chapter to address the needs of auditory learners.
• Interactive and written learning activities encourage students to apply content to authentic client care scenarios.
• NCLEX Next Generation-style case studies and questions encourage the development of clinical judgment and provide immediate formative feedback with rationale for the correct answers.
• Free downloadable PDFs and other versions can be downloaded from the home page for offline use.