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DifferentiatedEssential Competencies (Decs)

Safetyis a core element that must be observed by each and everyprofessional when performing their duties and this applies to ADNnurses and transport tech. There are rules and regulations that arelaid down for ADN nurses and transport tech to follow in theDifferentiated Essential Competencies (DECs). The DECs wereformulated to make sure that those who graduate as nurses have all ittakes to guarantee the safety of those that they are attending to atthe moment.

Whenperforming a wheelchair transfer, either from a wheelchair or to awheelchair, it is of great importance for the ADN nurses andtransport tech to make sure that they understand the procedure. Also,they should make it their business to understand both the conditionand needs of the patient.

Thepaper below discusses the safety of a patient in a wheelchair and theprocedures that should be taken just in case the patient falls andincur some damages. The articles have been divided into parts to makeit easier for understanding. Some of these parts include thebackground and the purpose of DECs, legal and ethical application ofDECs in real life situation and the conclusion of the topic.

Backgroundand Description of the DECs and Its Purpose

DECsis one of the generations of the full Texas Board of Nursing thatoutlines the extent that each and every nurse should not exceed abouttheir level of education. The nursing level of education is groupedinto three categories in the DECs. Differentiated Entry LevelCompetencies and Essential Competencies which are documents of DECswere approved in 2002 and 1993 respectively (TexasBoard of Nursing, 2011).Based on these two documents revisions have been carried on DECs byvarious professionals that are directly involved in the field ofnursing.

Themain purpose of the DECs was to drill the idea of safety into nursinggraduates so as to perform their duties safely while showing somesense of competency and compassionate care towards their patients.The clinical behaviors, the extent of knowledge and the judgment thatshould be exhibited by each nurse graduate are clearly indicated inthe DECs.

Applicationsof DECs

TheADN nurse on the scene should do vital signs and check for anyvisible injuries like swellings, cuts or any bleeding. The ADN nurseshould also check for hematomas that may begin to swell or any otherdeformity to the limbs and note if there is any discoloration to theskin. Neuro checks are recommended and a quick head to toe to see ifthere are any other painful areas. The BSN nurse will also follow thesame steps as the ADN nurse to help the fallen patient both nursescan give an “all clear” and proceed to update the doc in chargeand call the person/family in charge of the patient.

Asa nurse, one is expected to follow and implement measures that leadto a safe and quality environment for patients, self, and others inthe hospital. The nurse should also use evidence-based data toformulate goals and outcomes to reduce any patients’ risks or anyother accidents (Winland-Brownet al, 2015).

ABSN nurse will not use evidence-based data, but also theoreticalanalysis of available data to reduce patient and community risks.Thenurse will write a report about the fall, and come up withinterventions to avoid any other similar incident and lastly send outa memo about the fall.

Legaland Ethical Application of the DECs

Boththe ethical and legal responsibilities of nurses in a scenario thatinvolves transferring a patient from a wheelchair to a hospital bedrun side by side. First, the nurse was supposed to put into mind theneeds of the patient. Some of the needs might include knowing themethod of transfer that the patient is preferred and the ability ofthe patient. Also, the nurses were legally obligated to announce eachand every step being taken during the transfer of the patient(Winland-Brown et al, 2015).

Preparationof the place where the patient is transferring to is also an ethicaland legal issue that the nurses should observe when performing awheelchair transfer. For example, in such a situation, it would havebeen proper for the nurse and the transport tech to make sure thatthe wheel lock of the bed was set and the wheelchair was stable.

Again,both the nurse and the transport tech were legally and ethicallyobliged to follow the two person transfer, which they clearly did notfollow the required steps. It was their duty to support the patientfrom the wheelchair, which in the scenario they clearly fail to doso.


Itis a good practice for nursing professionals to make sure that theyfollow the rules and regulations stipulated in the DECs to guaranteethe safety of their patients. If both the nurse and the transporttech in the scenario had followed the right procedure that has beenlaid down, the patient would not have fallen down.


TexasBoard of Nursing (2011). Differentiatedessential competencies of graduates of Texas nursing programsevidenced by knowledge, clinical judgments, and behaviors: Vocational, diploma/associate degree, baccalaureate degree.

Winland-Brown,J., Lachman, V. D., &amp Swanson, E. O. (January 01, 2015). The New`Code of Ethics for Nurses With Interpretive Statements` (2015):Practical Clinical Application, Part I.&nbspMedsurgNursing: Official Journal of the Academy of Medical-Surgical Nurses,&nbsp24,&nbsp4.)

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