Assessment of External and Internal Environment and Name ...



Self-Assessment of Standards of Professional Performance CompetencyDana RaymerFerris State UniversitySelf-Assessment of Standards of Professional Performance CompetencyFor this assignment, I reviewed the Standards of Professional Performance set forth by the American Association of Critical-Care Nurses (AACN), and I assessed my competency related to each of these standards. Descriptions of behaviors that meet the standards are described, and explanations are provided for the standards that are not met. Professional goals are provided that reflect a strategy to attain and maintain each standard, and an action plan for meeting these goals is presented. Finally, an evaluation plan is developed and explained, which will enable me to measure my progress towards these goals.Standard One – Quality of PracticeThe AACN (2012) defines this standard as “The nurse caring for the acutely and critically ill patient systematically evaluates and seeks to improve the quality and effectiveness of nursing practice” (p. 14). Measurement criteria include participating in quality improvement activities and questioning and evaluating practice in an ongoing manner (AACN, 2012). Additional criteria are identifying barriers to quality care and good patient outcomes and developing and evaluating policies and procedures to improve quality and effectiveness of nursing practice (AACN, 2012). I do believe I meet this standard, because I participate in quality improvement activities at my facility. For example, I complete post-procedural-sedation paperwork that is designed to identify and track possible issues with procedural sedation. Changes in practice are then made to reduce or prevent the issues identified through this quality improvement practice. I also complete post-incident paperwork that systematically describes what led up to an event, such as a fall, so that factors can be identified that might have contributed to the episode and interventions can be put in place so that the incident does not happen again. A goal that I have for my practice is to be involved in a quality improvement committee where policies, procedures or practices will be developed or modified in order to improve the quality and effectiveness of nursing practice at my facility. In order to achieve this goal, I will communicate my interest to my manager and the other quality improvement committee members so that I will be considered for open positions on these committees. In order to measure my progress towards this goal, every six months I will assess whether or not I have been on any quality improvement committees and I will evaluate the number of quality improvement initiatives we have produced in that time frame.Standard Two – Professional Practice EvaluationThis standard calls for the acute care or critical care nurse to evaluate his or her own practice in relationship to professional standards, institutional guidelines, and relevant rules and regulations (AACN, 2012). Measurement criteria include engaging in self-assessment, seeking out constructive feedback regarding performance and competencies, and taking action to achieve goals (AACN, 2012). I believe that I meet this standard, because through my bachelor’s preparation, I frequently am required to evaluate my performance and reflect on myself and my practice. This evaluation includes both strengths and weaknesses. As a newer nurse, I will often seek out feedback of my performance from my coworkers and supervisors so that I can learn from their suggestions. I will ask for advice regarding alternate ways to handle certain situations, and I work to incorporate these suggestions into my practice. A goal I have to maintain competency with this standard will be to engage in a self-assessment of my performance and practice at least once per year, on or before my hire date. At this time, I will develop goals to strengthen my practice throughout the next year. I will also continue to seek out feedback from my coworkers and manager, and I will continuously make an effort to accept their critiques and suggestions with an open mind and a good attitude. In order to evaluate my progress towards these goals, on the anniversary of my hire date, I will assess whether or not I have completed my self-assessment of practice and developed my professional goals for the next year. At this time I will try to identify at least five situations in the previous year where I solicited feedback and suggestions from coworkers and managers and evaluate whether or not I actually acted upon their advice.Standard Three – EducationThe third standard of performance requires that “The nurse acquires and maintains current knowledge and competency in the care of acutely and critically ill patients” (AACN, 2012, p. 15). Seeking out and participating in ongoing learning activities and maintaining records of these learning activities are criteria for meeting this standard (AACN, 2012). I feel that I definitely meet the criteria for competency with this standard, because I seek out and take advantage of educational opportunities whenever possible. For example, I am currently enrolled in the registered nurse (RN) to bachelors of science in nursing (BSN) completion program through Ferris State University, I have become certified in advanced cardiac life support (ACLS), and I have taken a preparation course for the Progressive Care Certified Nurse (PCCN) certification. I also maintain records of my participation in education and training in my file at work. In addition, I actively participate in educational programs offered through my employer, such as critical care skills day where we learn about policy and practice changes and get to practice skills needed in the critical care area of nursing. Two important educational goals for me are to become PCCN certified before May 2013 and to graduate with my BSN in August of 2013. I would also like to participate in conferences that pertain to my area of nursing practice. As far as maintaining records, I would also like to have all of my educational records downloaded into a portfolio file on my computer for easy maintenance. In order to evaluate my progress towards these goals, I can assess whether or not I am on schedule to graduate in the planned time frame and if I will have my certification exam completed by May as intended. Furthermore, at the end of each month I will ascertain whether or not I have additional educational records that need to be filed electronically and complete that process if necessary.Standard 4 - CollegialityStandard four calls for nurses to actively contribute to the professional development of their peers (AACN, 2012). This includes sharing knowledge and skills, providing constructive feedback, and contributing to a supportive and healthy work environment (AACN, 2012). I do think that I am beginning to contribute more in this area of practice. I recently began working in a new facility, and I went from being one of the less-experienced nurses on my old unit to one of the most experienced on my new one. I think that the very stressful time I had with the transition from nursing school to actually being a nurse has helped me strive to be a good mentor for the newer nurses on our unit. I always make myself available when these nurses are unsure of a clinical skill, have questions or need help. By doing this, I am able to help them learn and understand what they need to know. Hopefully this also reduces the stress associated with their new role. I think that I have set an example with my encouragement of new staff, and this has helped shape a positive work environment between the new staff and most of the experienced nurses on our unit. I also encouraged experienced staff to seek out specialty certification when it was offered at a nearby hospital which resulted in additional nurses sitting for the exam. After this group is certified, there will be twice as many certified nurses on our unit than there were before. A goal I have for this standard involves a new position I recently accepted. I was chosen to be our hospital’s new wound care nurse. This will involve education and training about wound care myself, and then I will use this knowledge to educate the nurses at our facility and also nurses in the community, such as in nursing homes or home health care. This will directly improve the practice of our area’s nurses and improve patient care and outcomes. My goal is to have my training completed by May 2013, and to have my presentation and educational plan completed and in practice for my capstone class that will be undertaken in the summer 2013 semester. Evaluation of these goals will be done at these times. Evaluation plans to assess the effectiveness of my staff wound education program will be developed when the actual program is planned.Standard Five – EthicsThe AACN (2012) states that “The nurse’s decisions and actions are carried out in an ethical manner in all areas of practice” (p. 16). The nurse’s practice should be guided by the American Nurses Association (ANA) Code of Ethics, and the nurse must maintain confidentiality and ensure that patients are cared for in a nonjudgmental and nondiscriminatory manner (AACN, 2012). Reading through ANA’s Guide to the Code of Ethics for Nurses, I am confident that I practice nursing in an ethical manner (Fowler, 2008). I respect my patients, whether an individual or a family, and I accept their decisions regarding their lifestyles and treatments, whether I agree with the decisions or not. Sometimes I have to seek out help to do this from colleagues, but I understand the importance of the patients’ right to choose when they understand their options and the results of their choices. I always preserve my patients’ privacy and dignity, and I strictly maintain confidentiality in a lawful and ethical manner. Furthermore, I am responsible and accountable for my practice, and I collaborate with others to improve all areas of our healthcare environment and our professional practice (Fowler, 2008). One area of ethical practice that I need to focus on is related to the ANA Code of Ethics standard nine, which encourages nurses to carry out their professional responsibilities through professional associations (Fowler, 2008). At this time, I do not belong to any professional associations, so my goal related to this standard is to join one general nursing association, such as the ANA, and one specialty nursing association, such as the AACN or Wound, Ostomy, and Continence Nurses Society (WOCN) within one year. I will evaluate the progress towards this goal on my anniversary date of licensure and again when I graduate from Ferris’ BSN program. Standard Six – CollaborationStandard six calls for collaboration with the patient, their family and other disciplines in order to ensure a safe and caring environment (AACN, 2012). Measurement criteria include using skilled communication to effect change and improve outcomes, and also working with patients and families to help patients transition smoothly from one care setting to another (AACN, 2012). My communication skills continue to improve as I gain more and more experience as a nurse. The ability to collaborate with other disciplines effectively is something that takes practice, and I acknowledge that my collaboration abilities are still a work in progress. I am still learning what programs and resources are available for patients and families, so my skills at making proper referrals are also being refined. I do think that I am developing strong professional relationships with my peers and other disciplines, so I am forming the framework for future collaboration and referrals. A goal that I have for this standard involves my desire, through my wound care nurse position, to teach patients, families and other care givers proper wound care and prevention techniques. For example, I would like to work with nursing staff at local extended care facilities in order to develop wound care plans that will work with the time and resources they have available. This will help to ensure that patients with pressure ulcers or other sores will have consistent, evidence-based wound care provided outside of the hospital. I will need to collaborate with my managers and nursing home administration and staff in order for this to occur. I would like to have this partnership planned by May 2013 and active within one year. In order to evaluate my progress towards this goal, I will assess whether I have a tentative plan in place in May 2013 and then will assess whether that plan has been acted upon by August of 2013 upon graduation from Ferris. Standard Seven – Research/Clinical InquiryThis standard requires that nurses caring for acutely or critically ill patients inquire about clinical practices and incorporate the findings into their practice (AACN, 2012). Criteria to meet this standard include using best evidence in practice and participating in research activities to the best of their ability (AACN, 2012). I do believe that I meet the criteria for this standard, because I continually seek out the best evidence for my nursing practice and in turn try to inform others so that they can make the appropriate changes to their practice also. I currently am studying to become PCCN certified and expect to sit for the exam in the beginning of 2013. This certification, offered through the AACN, will validate my knowledge and practices when compared to national standards. I subscribe to printed journals, such as MedSurg Nursing, and online resources, such as Medscape, in order to learn of latest best practices and results of current research. I make an effort to critically review articles from these sources and if found to be reliable, I will make these changes to my practice or seek out further information. A goal for me related to my new wound care nurse position is to become certified by the WOCN Society within one year and to subscribe to the Journal of Wound, Ostomy and Continence Nursing, which provides information regarding the latest research and practice issues. In order to evaluate my progress towards this goal, upon graduation from Ferris, I will assess if I have enrolled in a WOCN certification review class and will enroll in one at that time if I have not already done so. I will plan on sitting for the certification exam in December of 2013, so on December 1, 2013 I will assess if a test date has been selected and will select one at that time if I have not already done so.Standard Eight – Resource UtilizationThis standard states “The nurse caring for the acutely and critically ill patient considers factors related to safety, effectiveness, cost, and impact in planning and delivering nursing services” (AACN, 2012, p. 17). Criteria for this standard include the ability to consider factors related to safety, effectiveness, cost and effects on outcomes when choosing interventions and also assisting the patients and their families to understand the options and their cost, risks and benefits (AACN, 2012). I feel that I am becoming increasingly proficient in the criteria to meet this standard. With experience, I am learning to understand the various factors such as cost, availability and effects of many interventions, and I am becoming more skilled at helping my patients and families understand these factors so that they can make an informed decision regarding their care. Still, I do believe that I need to continue to gain experience in order to properly assess and relay all of the factors involved in planning care. A goal that I have related to this standard is to once a month discuss an actual scenario with our night shift doctor and explore other options for treatment or care, including reasons why the other options were not chosen. In order to assess my progress towards this goal, during the third week of each month, I will assess whether or not I have had this discussion with the provider, and if not, I will make an effort to discuss a situation with him in the final week of the month. If I find that I am repeatedly having difficulty making this happen, I will approach a senior nursing staff member and set up specific times to meet with him or her each month to review these scenarios and alternatives.Standard Nine – LeadershipStandard nine calls for nurses to provide leadership by encouraging colleagues and peers, participating on committees and councils and promoting advancement of the profession through participation in professional organizations (AACN, 2012). Furthermore, the nurse should demonstrate flexibility in the rapidly-changing health care environment and should be able to appropriately coordinate care of patients (AACN, 2012). This coordination includes overseeing unlicensed personnel and properly delegating tasks (AACN, 2012). I believe that I meet part of the criteria for this standard but also need to continue to work and gain experience before I am proficient in other criteria. As previously discussed, although I hold no formal position, I know that a lot of the staff on my shift look to me for guidance when exploring options or seeking information. I also am now able to consistently coordinate care of my patients within the hospital by organizing needed tests, activities and interventions while keeping patient needs and preferences in mind. Coordination of care of patients once they leave the hospital is a skill that I believe I need to continue to work on, because I know as a professional nurse I need to be able to identify barriers to health that my patients have outside of the hospital and know what resources are available to reduce those barriers. A goal that I have is to be on a committee or council at the facility where I work, such as our shared governance committee or safety council. I would like to do this within six months. I will start by letting my manager know that I am interested, and in four months, I will assess whether or not I have served on any committees. If not, I will find out if there have been any committee openings available in that time frame and remind my manager of my interest. Two months later, I will again reassess my progress towards this goal and possibly seek opportunities outside of the hospital, if needed.DiscussionFor this assignment, I was required to perform a self-analysis of my competency in regards to AACN’s Standards of Professional Performance and develop a professional development plan that would allow me to attain and maintain each competency. When compared to my previous professional development plan that was written at the beginning of the nursing program, it was interesting to see how much I have already grown as a nurse since the first class and how much closer I am to becoming a professional nurse now, because of what I have learned during my BSN preparation. This analysis helped me to identify strengths and weaknesses of my practice and form an action plan to improve in these areas. I have made a list of the goals that I have set forth in order to reach these standards, and I have set reminders of the progress checks into my calendar so that I am more likely to follow through with my professional development plan and reach my goals. ReferencesAmerican Association of Critical-Care Nurses (AACN). (2012). AACN scope and standards for acute and critical care nursing practice. Retrieved from , M. D. (Ed.). (2008). Guide to the code of ethics for nurses, interpretation and application. Silver Spring, MD: American Nurses Association. ................
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