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Self-Assessment Running head: Standards of Practice

Self-Assessment of Nursing Standards of Practice Tracy Giraud Ferris State University

Self-Assessment A!stract The Society of Pediatric Nurses has ado"ted the standards of "ractice set forth !y the American Nurses Association #ANA$% These nursing standards serve to maintain care that is consistent in "ractice and research that is evaluated on an ongoing !asis% After careful consideration of my nursing "ractice and career& ' have found that ' have had e("erience )ith almost all of the standards% *o)ever& there is al)ays room for im"rovement and "rofessional gro)th )hich ' have addressed in a "lan )hile evaluating the effectiveness of my "erformance )ith each standard% To maintain a level of "rofessionalism in the s"ecialty of Pediatric Nursing& ' )ill maintain a mem!ershi" in the Society of Pediatric Nurses& "ractice according to the standards of that organi+ation& ,ee" current )ith -.U/s& continue to see, out ne) o""ortunities for advancement and strive to remain a "ositive mentor to those )ho are ne) to "ediatric nursing%

Self-Assessment Self-Assessment of Nursing Standards of Practice To maintain "rofessional nursing standards of "ractice& nurses must consistently evaluate their "erformance and effectiveness in their area of "ractice% The dedicated nurse )ill maintain com"etency in the area they )or, and )ill strive to gro) in the areas of )hich they may lac, e("erience or ,no)ledge% This self-assessment "a"er )ill address my nursing e("erience& analy+ing my accom"lishments in nursing and my goals for further education and gro)th in "ediatric nursing% ANA Standards of Nursing Practice Standards of Practice Assessment: This is )here the nurse collects com"rehensive data "ertinent to the "atient/s health in a systematic "rocess considering "hysical& functional& emotional& cognitive& environmental& s"iritual and economic uni1ueness of the individual% This assessment elicits the

"atient/s values& involves family and other health care "roviders& identifies !arriers& assesses family dynamics& "rioriti+es data collection !ased on the "atient/s immediate condition and uses a""ro"riate evidence !ased assessment techni1ues%#ANA& 212$% This is a standard that ' met )hile )or,ing in the res"iratory unit of a children/s hos"ital% Family& caregivers and "revious health care "roviders )ere e(tremely useful )hen gathering data and "iecing together the current issue )ith each child% 3y !est assessment e(am"le is )hen ' )as )or,ing )ith an asthmatic toddler in the res"iratory unit% The "hysicians had 4ust com"leted rounds and cleared my "atient as sta!le% 5hen ' have a severe asthmatic as a "atient& ' do more than hourly rounding% 5hen ' reassessed my "atient ' found her )ith la!ored !reathing and "ale% *er !reath sounds )ere diminished on one side% The "hysicians came as soon as they )ere called and the "atient )as "laced on continuous


treatments% 3y assessments are constantly !ased on the individual "atient in front of me and their "resent condition% Diagnosis: The nurse analy+es the assessment data to determine the diagnosis or the issues& validates the diagnosis )hen "ossi!le and a""ro"riate& identifies actual or "otential ris,s to the "atient/s health& uses standardi+ed classification systems to identify diagnosis and documents diagnosis or issues in a manner that facilitates the determination of the e("ected outcomes and "lan%#ANA& 212$% This standard is one that ' met )ithin my first year of nursing as ' moved from the children/s hos"ital to the "ediatric .-% 7iagnosis is im"erative in the timing of treatment for "atients in the emergency room% .(am"les are high fevers& "ost-sei+ure states& changes in consciousness8cognitive function& air)ay distur!ances& etc% Res"onse time can mean life or death% Outcomes Identification: The nurse identifies e("ected outcomes for a "lan individuali+ed to the "atient and8or their situation% They derive culturally a""ro"riate e("ected outcomes )hen "ossi!le and a""ro"riate% -onsider associated ris,s8!enefits )hen formulating e("ected outcomes& include a time estimate for the attainment of e("ected outcomes& develo"s e("ected outcomes that facilitate continuity of care& modifies e("ected outcomes according to changes in the status of the "atient and documents e("ected outcomes as measura!le goals%#ANA& 212$% This is also a standard that ' have met% *ourly rounding is a common "ractice in "ediatrics and ' address "atient and family goals )ith each interaction to assure "atient comfort and satisfaction% Planning: The nurse develo"s a "lan that "rescri!es strategies and alternatives to attain e("ected outcomes% They develo" an individuali+ed "lan in "artnershi" )ith the "atient& family and others considering the "erson/s characteristics or situation% They esta!lish the "lan "riorities )ith the "atient and others as a""ro"riate& include strategies in the "lan that address each of the identified diagnosis #"romotion of health& "revention of illness& alleviation of suffering& su""ortive care for those )ho are dying$& "rovides for continuity in the "lan& incor"orates im"lementation of

Self-Assessment a timeline in the "lan& considers economic im"act& integrates current scientific evidence and research& utili+es the "lan to "rovide direction to other mem!ers of the healthcare team& modifies "lan according to ongoing assessment and documents the "lan in a manner that uses standardi+ed language or recogni+ed terminology%#ANA& 212$% This standard has !een met as )ell% Follo)ing the "atient/s "rogress through charting& documentation and re"ort allo)s me to alter any treatment "lan or goal according to the "atient/s dynamic condition and res"onses to treatment%

Implementation: The nurse im"lements the identified "lan& coordinates the delivery of care decided u"on !y the "atient and the nurse and em"loys strategies to "romote health and a safe environment to carry out the "lan%#ANA& 212$% This is a standard that ' also learned in the .-% Patients enter in an emergent state& and then receive a diagnosis and treatment "lan !y the "hysician% For e(am"le& )e had a child come in )ith an altered mental state% The child dran, a !ottle of :enadryl% 'mmediately ' chec,ed the A:-/s& chec,ed vital signs& "erformed a neurological assessment& and assessed the "atient/s !reathing and all 4ust !efore the "hysician rushed into the room% 5e called "oison control& administered charcoal and monitored the mental status of the "atient as ordered !y the "hysician% Evaluation: The nurse evaluates "rogress to)ard attainment of outcomes !y conducting a systematic& ongoing& criterion-!ased evaluation of the outcomes& evaluating effectiveness of strategies to o!tain outcome& disseminate results )ith "atient& family and su""ort system in accordance )ith federal and state regulations& "artici"ates in assessing and assuring the res"onsi!le and a""ro"riate use of interventions in order to minimi+e un)arranted or un)anted treatment and "atient suffering and documents the results of the evaluation%#ANA& 212$% ' have met this standard& !ut ' do !elieve that there is al)ays room to learn and enhance nursing s,ills in this area of care% 'n the a!ove situation& )ith the child that overdosed on the :enadryl& )e could

Self-Assessment evaluate our "rogress )ith the "atient !y "erforming neurological assessments% As the "atient/s mental status im"roved& )e decreased the fre1uency of neurological tests "erformed and documented accordingly% Standards of Professional Performance Ethics: The nurse "ractices ethically !y follo)ing the -ode of .thics for Nurses& delivers care in a manner that "reserves and "rotects the "atient& recogni+es the centrality of the "atient and family as core mem!ers of the healthcare team& u"holds "atient confidentiality )ithin legal and regulatory "arameters& assists "atients )ith informed decision-ma,ing& maintains thera"eutic nurse-"atient relationshi"& contri!utes to resolving ethical issues involving the "atient and the

healthcare team and advocates for the "atient%#ANA& 212$% This standard is one ' have also met% For e(am"le& )e had a "ediatric "atient that )as the child of a )ell-,no)n family% Peo"le from all over the hos"ital )ere trying to gain access to the chart% 3y manager even called to see )hat information ' had regarding the "atient/s condition% 3edia re"resentatives )ere calling and sho)ing u" at the front of the hos"ital& sending "eo"le u" to the unit as friends of the family% ' s"o,e to no one and reminded each of them of the confidentiality that e(ists !et)een "atients and the healthcare team and the fact that the "atient has a right to "rivacy% #3y manager )as not very ha""y$% Education: The nurse attains ,no)ledge and com"etence that reflects current nursing "ractice !y "artici"ating in ongoing educational activities related to a""ro"riate ,no)ledge !ases and "rofessional issues& demonstrating a lifelong commitment to learning& see,ing e("erience that reflect current "ractice to maintain ,no)ledge& s,ills& a!ilities& and 4udgment in clinical "ractice or role "erformance& see,ing formal and inde"endent learning e("eriences to develo" and maintain clinical and "rofessional s,ills and ,no)ledge& shares educational findings& e("eriences& and ideas )ith "eers& contri!utes to a )or, environment conducive to the education of healthcare

Self-Assessment "rofessionals and maintains "rofession records that "rovide evidence of com"etence and lifelong


learning%#ANA& 212$% This is the area )here ' need additional )or,% As an associate nurse& ' do feel that ' am effective in the care of my "atients% *o)ever& ' do feel that !y advancing my education ' )ill !e a!le to )or, alongside my fello) nurses to advance our "rofession% ' "lan to com"lete my :SN& and then move on to an 3SN% 't is my ho"e to !ecome a "ediatric nurse educator% After ' o!tain my :SN& ' )ill a""ly to teach "ediatric clinical grou"s in our "ediatric unit% ' )ill also 4oin the ANA and the Society of Pediatric Nurses and maintain the num!er of -.U/s e("ected of every RN% Evidence-Based Practice and Research: The nurse integrates evidence and research findings into "ractice !y utili+ing current evidence-!ased nursing ,no)ledge& incor"orating evidence )hen initiating changes in nursing "ractice& "artici"ating in the formulation of evidence!ased "ractice through research and sharing "ersonal or third-"arty research findings )ith colleagues and "eers%#ANA& 212$% This is a standard ' learned and met )hile )or,ing in the Pediatric 'ntensive -are Unit #P'-U$% There is .vidence-:ased Practice #.:P$ su""orting the inclusion of family during "atient care% 5e ,e"t family at the !edside and allo)ed them to assist in the "atient/s care )here and )henever "ossi!le% 5e found that it decreased the an(iety of the "arents !y ma,ing them feel as if they )ere actually hel"ing the "atient #and they )ere$ and it had a "ositive im"act on the "atient during healing% This is an area that ' "lan to continue to gro) !y attending "ediatric rounds& ,ee"ing current )ith -.U/s in matters concerning "ediatrics and !y attending formal and informal "resentations regarding current "ractices and treatments in "ediatrics% Qualit of Practice: Nurse demonstrates 1uality !y documenting the a""lication of the nursing "rocess in a res"onsi!le& accounta!le and ethical manner& uses creativity and innovation to enhance nursing care& and "artici"ates in 1uality im"rovement% #ANA& 212$% This is an area

Self-Assessment )here ' could use a !it of im"rovement% ' have yet to on any ty"e of leadershi" role in 1uality im"rovement% 5e have recently discussed 1uality im"rovement in our de"artment and the fact that more individuals need to ta,e an active role in this area% 't is my "lan to volunteer after the

holidays% ' have no "revious e("erience in this area& so ' )ould li,e to learn )hat it ta,es to create "ositive changes for the organi+ation and various units% !ommunication: The nurse communicates effectively in a variety of formats in all areas of "ractice !y assessing communication format "references of "atients& families& and colleagues& !y assessing his8her o)n communication s,ills in encounters )ith "atients& families and colleagues& !y see,ing continuous im"rovement of communication and conflict resolution s,ill& !y conveying information accurately& and 1uestioning the rationale su""orting care "rocesses and decisions )hen they do not a""ear to !e in the !est interest of the "atient% #ANA& 212$% This is one of my strongest areas% To !e an effective communicator& one must !e confident and ,no)ledgea!le in that )hich they are s"ea,ing% ' do not have any "ro!lems communicating )ith staff or "hysicians and ' )ill al)ays act as an advocate for my "atients% ' find that )hen the "hysician reali+es that ' have only the !est interest of his "atient in mind& he8she is much more a""reciative of our conversation% 5hen communicating )ith "atients& ' try to "ut myself in their "lace and act accordingly% They are all treated the same& regardless of their situation% ' ma,e it clear to each "atient that they are my "riority that day% "eadership: The nurse demonstrates leadershi" in the "rofessional "ractice setting and the "rofession !y overseeing the nursing care given !y others )hile retaining accounta!ility for the 1uality of care given to the "atient& mentoring colleagues for the advancement of nursing "ractice& the "rofession& and 1uality health care& treating colleagues )ith res"ect and dignity& develo"ing communication and conflict resolution s,ills& "artici"ating in "rofessional organi+ations& see,ing )ays to advance nursing autonomy and accounta!ility& and "artici"ating in efforts to influence

Self-Assessment healthcare "olicy involving healthcare consumers and the "rofession% #ANA& 212$% This is an area )here ' need to gro) and "lan to do that !y com"leting my education and !ecoming more involved in the committees at )or, and organi+ations outside of )or, that )or, to enhance


"ediatric nursing% ' have also never held a su"ervisory "osition in the hos"ital% ' )or,ed for a !rief time in a long term care facility as a nurse educator% 3y goal is to !ecome a charge nurse and move on to management after ' com"lete my degree% Until then& ' )ill continue to mentor ne) nurses and )or, as a team )ith my colleagues% !olla#oration: The nurse colla!orates )ith healthcare consumer& family& and others in the conduct of nursing "ractice !y "artnering )ith others to effect change and "roduce "ositive outcomes& communicating )ith the "atient& family and healthcare "roviders regarding "atient care& "romotes conflict management and engagement& a""lies grou" "rocess and negotiation techni1ues )ith "atients and colleagues& adheres to standards and a""lica!le codes of conduct that govern !ehavior among "eers and colleagues to create a )or, environment that "romotes coo"eration& res"ect& and trust% #ANA& 212$% This is a standard that ' met almost immediately% ' !elieve in team )or,& so ' am al)ays )illing to hel" others on the floor& )hether it/s a fello) nurse& a nurse assistant& etc% .veryone is im"ortant and there is not one "erson )ho can function )ithout the other% ' )ill co-sign for meds& hel" hang !lood& change "atients/ linens& )ash "atients u"& feed them& trans"ort them )hen there is no trans"orter availa!le& etc% Professional Practice Evaluation: The nurse evaluates his8her o)n nursing "ractice in relation to "rofessional "ractice standards and guidelines& relevant statutes& rules& and regulations% The nurse does this !y "roviding age-a""ro"riate and develo"mentally a""ro"riate care in culturally and ethnically sensitive manner& engaging in self-evaluation of "ractice on a regular !asis& o!taining informal feed!ac, regarding his8her o)n "ractice from "atients& "eers& "rofessional colleagues and others& "artici"ating in "eer revie) as a""ro"riate& and ta,ing action

Self-Assessment to achieve goals identified during the evaluation "rocess%#ANA& 212$% ' feel that this is an area that is so dynamic& '/m not sure anyone can com"letely achieve this% *ealthcare is al)ays changing% 5e must !e )illing to change as )ell& or )e )ill miss the o""ortunity to "romote ourselves to the ne(t level of care )ith our "atients% 5e do "eer evaluations and ' do loo, to those for areas of im"rovement% ' also strive to learn from the more seasoned colleagues in our unit% 5e also measure our "erformance against our unit "olicies and e("ected "erformance%


Resource $tili%ation: The nurse utili+es a""ro"riate resources to "lan and "rovide nursing services that are safe& effective& and financially res"onsi!le !y assessing the "atient/s care needs and resources availa!le to achieve desired outcomes& delegating elements of care to a""ro"riate healthcare )or,ers& advocate for resources that enhance nursing "ractice& and assisting "atients and families in identifying and securing a""ro"riate services to address needs across the healthcare continuum%#ANA& 212$% This is an area ' have achieved some success in% ' am very mindful of linens& su""lies& etc% *o)ever& ' am also a)are of local loan closets for )heelchairs& )al,ers& !edside commodes& etc% These are items that may not al)ays !e covered !y insurance and the hos"itals often do a cost transfer to cover them% There are also many times that a "atient does not have a ride home% There are community resources for that as )ell% This saves the unit from "aying for a ca!% Utili+ing community resources )ill also decrease the cost of individual units% :ecoming familiar )ith community resources and ,ee"ing o"en communication )ith social )or,ers in the hos"ital& ' learn more a!out )hat is availa!le% Environmental &ealth: The nurse "ractices in an environmentally safe and healthy manner !y attaining ,no)ledge of environmental health conce"ts& "romoting a "ractice environment that reduces ris,s for )or,ers& advocates for the 4udicious and a""ro"riate use of "roducts in health care& and "artici"ates in strategies to "romote healthy communities% #ANA& 212$% The only )ay ' ,no) to meet this standard is to adhere to the "olicies and "rocedures as they relate to



emergencies and disasters in the hos"ital% .ach unit has an emergency "lan )hich serves to ,ee" the "atients safe% ' )ill continue to adhere to those "olicies% ' )ill also remain a)are of the environment my "atients are in and hel" minimi+e any danger% Professional Development Plan 'oals Throughout this "a"er ' descri!ed my intentions in advancing my nursing ,no)ledge commitment to effective nursing care !ased on "rofessional nursing standards% *o)ever& ' do have "rofessional goals )ith a "lan in mind% First ' )ould li,e to com"lete my formal education through the university and o!tain ,no)ledge of the unit through informal meetings& grand rounds and -.U/s% Second& ' )ould li,e to use my education to advance "rofessionally in my 4o! !y !ecoming an educator% Action Plan -om"leting my formal education is my first goal% 3y :SN )ill !e com"lete in the s"ring of 216% At that time ' )ill a""ly for a clinical instructor "osition at a local university to gain

teaching e("erience that )ill !e necessary for a nurse educator "osition% 'n the summer of 216& ' )ill consider an 3SN "rogram to com"lete my formal education and allo) me the o""ortunity to !ecome a "ediatric nurse educator% 3y career goal is to advance as a "rofessional& )hich ' cannot do until ' have o!tained my 3SN degree% 't is my goal to o!tain my 3SN )ithin t)o years after my :SN% 'n the meantime& ' )ill !e 4oining the "rofessional nursing organi+ations such as the Society of Pediatric Nurses and the ANA% Associate nurses are not a!le to vote or hold office& so ' )ill 4oin )hen ' am a!le to !e actively involved% Evaluation Plan

Self-Assessment To evaluate my "rogress to)ard com"leting my :SN& ' )ill continue to follo) the chec,list created !y my advisor and remain diligent in my efforts to com"lete the "rogram in a timely manner& "utting my !est foot for)ard& striving for the !est grade "ossi!le for me% To evaluate my "rogress to)ard o!taining my 3SN& ' )ill create my o)n chec,list addressing the ste"s necessary to a""ly and acce"t a "osition in the "rogram% After !eing acce"ted& ' )ill follo) the chec,list given !y the advisor assigned to me !y the university% -ontinually assessing my grades )ill allo) me to criti1ue my "rogress% !onclusion Ta,ing the time to assess my "rogress in mastering the "rofessional nursing standards

throughout my nursing career& has given me the o""ortunity to reali+e 4ust ho) much ' have done and ho) far ' have come% This assessment has given me an idea of ho) much time ' have left to com"lete my :SN and ho) much time ' )ill need for my 3SN% 't made me a)are of my strengths and )ea,nesses% 't also allo)ed me the o""ortunity to determine the )ays in )hich ' am a!le to gro) in my )ea,er areas% 'n conclusion& ' )ill al)ays fall !ac, on the nursing standards of "ractice%



References American Nurses Association # 212$% Nursing: Scope and standards of practice # S"ring& 37: American Nurses Association%

ed%$% Silver



Grading Rubric for Self-Assessment of Competency regarding Standards of Practice DESCRIPTIO A D A A!"SIS O# CURRENT BEHAVIORS Standards of Practice& Description of standards and supportive evidence (met or unmet) PRO#ESSIO A! DE)E!OP*E T P!A Goals: Articulates clear professional goals which reflect a plan to attain and maintain competency in eac+ standard, These must be specific and measurable! Refer to information on nursing care plans re: writing clear & measurable goals to receive full credit for this section! Action Plan& for goals; to include actions and timelines that are consistent with the goal statements E-aluation Plan& to measure progress toward goals This must be specific and measurable! STA DARDS . APA CRITERIA Critical T+in/ing0%riting& Anal!sis & "lan is presented with accurac!# precision# clarit!# relevance# depth# breadth# logic and personal significance $entence structure# paragraphing# headings# spelling# t!ping# grammar# neatness ' POI TS POSSI$!E '( POI TS A%ARDED

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APA& title page# running head# headers# abstract# margins# font si%e# and references: citations in te&t & reference page A"A chec'list was submitted with name of peer who proofed (aluable feedbac' provided on a peers A"A chec'list TOTA! POI TS


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