Which category of standards includes hospital policy manuals, job descriptions, and employment contracts?

• A. External Standards of Care
• B. Internal Standards of Care
• C. Nursing Practice Act
• D. State Nurse Practice Acts

Answer: (B)

Standards of care come from different sources. Internal standards are established within the employing organization to guide day-to-day practice, define roles, and shape employment expectations. Hospital policy manuals, job descriptions, and employment contracts are examples of these internal rules because they originate from the hospital itself and apply to staff within that setting. External standards come from outside bodies such as licensing boards and professional associations, providing the broader legal and professional framework. A Nursing Practice Act or State Nurse Practice Act is an external statute that defines the scope of practice and licensure requirements, not a document created by a specific employer. Therefore, the category that includes hospital policy manuals, job descriptions, and employment contracts is internal standards of care.