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Self Assessment of Nursing Standards

Melissa Hayes

Ferris State University

Self Assessment of Nursing Standards

In preparing to further her nursing career, the author has examined her current practices in relation to the American Nurses Association’s Standards of Practice. In reviewing this paper, the reader will become familiar with the ways in which the author feels she is meeting each of the standards. The reader will also become aware of the goals which the author has set for her future. Timelines and measures of success will also be discussed.

Standards of Practice

Standard 1: Assessment

The author is currently employed as an Infection Prevention Specialist at Covenant HealthCare. The assessment standard of professional nursing practice is met each time the author reviews patient data in order to determine proper placement either into or out of isolation. A comprehensive assessment of patient information is necessary to be certain that proper isolation procedures are taking place. Patient and caregiver safety are also considered. The patient data which is reviewed may include physician notes, labs, physical findings, and anything else which may help in providing a clear patient picture. All of this data provides a mental image of what is going on with the patient without ever physically assessing the patient.

Standard 2: Diagnosis

Analyzing assessment data in order to determine diagnosis and/or safety issues related to a particular patient is something that the author does on a daily basis. Having a nursing position away from the patient care areas is challenging at times. A nurse has to be proficient in using the computer system which is used for documenting changes in a patient’s condition. Knowing where to look for information in a timely manner is not only crucial to that individual patient’s safety, but also the safety of the caregivers and other patients on a unit. If proper isolation is not taking place and it is not brought to the attention of the author either by staff communication or lab result findings, infection may spread at a rampant rate.

Standard 3: Outcome Identification

Identifying outcomes which are individualized to a situation is also something which the author is familiar with. If a patient is diagnosed with an illness or condition which should have called for isolation and proper isolation did not take place in a timely manner, the author has a responsibility to identify infections which potentially resulted related to the lack of timely isolation. This information is helpful in educating not only nurses but also physicians and other caregivers of the importance related to timely isolation practices. It is not always easy to convince staff that isolation is necessary. When a chain reaction of infection complications can be proven, staff is more receptive to following isolation procedures. Infection Prevention Specialists are aware that donning a gown for each entry into a patient’s room is time consuming and bothersome. However, it is a necessity under certain circumstances in order to protect both patients and caregivers.

Standard 4: Planning

The author develops a plan of care in order to attain specific outcomes in each situation in which it becomes necessary to intervene. As an Infection Prevention Specialist, the author does not need to develop a plan of care for each patient encountered. When necessary, isolation standards are established, patients are monitored, and outcomes are achieved. However, the author encounters not only patients who are hospitalized, but also patients who have received outpatient testing, ambulatory surgical services, and ambulatory medical services. In those instances, the patients have already received the care that they sought and the plan is complete. The author is simply monitoring from afar to be certain that any organisms identified as a result of that care were not caused by the caregivers whom these patients encountered.

Standard 5: Implementation

Standard 5A: Coordination of Care

Coordination of care occurs continually in the author’s daily work. The author works together with many professionals including intensive medicine specialists, infectious disease specialists, lab technicians, operating room staff, nurse managers, directors, and many others throughout the hospital in order to ensure that patients are handled according to infection control guidelines and maintain safety. The author attends rounding sessions in each of the intensive care units at Covenant HealthCare and attempts to identify potential infection risks before they occur. For example central lines which are positioned poorly or left in place too long or urinary catheters which are placed without necessity may lead to infectious outcomes. Communicating with the staff caring for these patients is a top priority in an attempt to prevent infection and promote safe outcomes.

Standard 5B: Health Teaching and Health Promotion

Teaching and the promotion of good health is of the utmost importance in the author’s daily work. For example, when a patient is identified as having Clostridium Difficile, both the patient and their family members must receive teaching related to the importance of proper cleaning techniques prior to the patient being discharged. This is necessary because if the patient’s environment is not properly cleaned prior to returning, reinfection may occur. It is also important for others within the environment to know how to contain the organism and prevent the spread of infection. Similarly, healthcare staff is educated on a regular basis regarding ways in which to prevent the spread of infection and promote good health.

Standard 5C: Consultation

The author will defer this section of the implementation standard as it applies to Graduate Prepared Specialty or Advanced Practice Nurses. 

Standard 5D: Prescriptive Authority and Treatment

The author will also defer this section of the implementation standard as it applies to Advance Practice Nurses.

Standard 6: Evaluation

The author currently evaluates progress toward the attainment of outcomes by rounding on each unit and assessing whether or not proper isolation procedures are taking place. Each morning the author evaluates every patient that has been admitted to the facility and whether or not isolation procedures are necessary. A phone call is placed to the nurse caring for patients who may need isolation if it is not properly documented in the chart. A rounding log is created based on computer findings and conversations and walking rounds are completed in order to verify accuracy. Evaluation is of the utmost importance in maintaining patient safety. Professional Development

In her current position, the author feels as though she is meeting each of the standards as set forth by the American Nurses Association. Competency is maintained by attending training sessions which are sponsored by the Association for Professionals in Infection Control [APIC] and the Michigan Society for Infection Prevention and Control [MSIPC]. In each of these educational forums, a group of peers gather to discuss the latest trends in infection prevention and are able to discuss individual struggles that they may be experiencing. Solutions to problems are discussed based on what the best practice guidelines are and according to how other facilities are handling similar situations. The author currently participates in a networking forum at a neighboring facility. Members from differing types of healthcare backgrounds gather to discuss concerns and are able to group think their way to solutions. This group gathers quarterly in person, but is available by email each day of the work week.

Action Plan

The author hopes to attain certification by the board of infection control [CBIC] within the next five years. A coordinating role in infection prevention may also be pursued sometime within the next ten years. For now, the author plans to remain active in her current affiliations in order to maintain compliance with the most up to date isolation standards.

Evaluation Plan

The author is able to continually evaluate progress toward maintaining patient safety by consistently evaluating isolation procedures and tracking infections as they occur in order to determine the cause. The author will continue to strive for certification following successful completion of the BSN program. Success will be measured by the receipt of certification. Only time will tell if the author will be awarded the opportunity to serve in a coordinator role for the department. Success will be measured by attainment of the position within the specified time frame.

Conclusion

Patient safety should be the number one concern of every healthcare worker, no matter what their role. In striving to meet professional goals, the author will not lose sight of that fact. The author’s role in the Patient Safety and Quality department at Covenant Healthcare has been her most fulfilling role thus far. When working in differing units throughout the hospital, the author helped small groups of patients each shift. The author now has the opportunity to help hundreds of patients on a daily basis by maintaining policies and building relationships with healthcare workers throughout the organization. In building and maintaining good working relationships, the author is helping to bring awareness of the importance of maintaining proper handling of patients at all times. At the end of the day, this is what matters most.

References

Ferris State University Standards of Professional Nursing Practice. (2010).

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