Self-Assessment of Nursing Standards of Practice



Self-Assessment of Nursing Standards of Practice

Terri L. Sand

Ferris State University

Abstract

Nursing standards of practice are written to guide professional nurses as they plan their care for patients. These standards reflect a level of quality that nursing care should meet. Nurses caring for patients in specialized areas must adhere to the standards of care for their specialty. Nursing students approaching graduation must assess their existing practice or readiness for practice, prior to entering the clinical setting. The purpose of this paper is to evaluate readiness for practice upon graduation from nursing school. Presented is the critical analysis of an existing nursing practice which identifies practice standards that are met and the standards that need to be met within their specialty organization. An action plan including identified goals, a timeline, and an evaluation are presented. The professional development plan is clear, precise, and personally significant to the professional growth of the graduate nurse.

Keywords: standards of practice, competency, nursing

Self-Assessment of Nursing Standards of Practice

As I near the completion of my Baccalaureate degree in Nursing (BSN), I have spent some time reflecting on my career accomplishments. This reflection has allowed me to evaluate my professional development currently, and what my goals for the future may be. Because my profession has set high standards for practice, I feel that my practice analysis should not only include competencies from my current nursing specialty, but also the American Nursing Associations (ANA) professional standards of practice. The self-assessment of my current practice will allow me to identify areas in my existing practice that I may need to develop as well as standards that I may need to focus on for future professional practice. Identifying my current level of competence within these standards will allow me to create a plan of action for my professional development. Goals which are clear, specific, and measurable will be established. These goals will be established based on my current practice and in comparison with standards of practice designated by the organization affiliated with my existing specialty. Along with the establishment of goals, this plan will provide a method for measuring progress toward attaining and maintaining these competencies. Personal progress will be measured on a regular basis following a timeline. The timeline will reflect professional growth and accomplishments of my personal practice advancements as evidenced by scheduled progress evaluations.

Standards of Practice

American Nurses Association

The American Nurses Association (ANA) refers to nine standards of practice in which nurses are held accountable for, as a professional. “The nine Standards of Professional Performance describe a competent level of behavior in the professional role—including activities related to quality of practice, education, professional practice evaluation, collegiality, collaboration, ethic, research, resource utilization, and leadership” (ANA, 2004, p.4). Using these standards to analyze my current nursing practice performance, I can identify whether I have met the expected standards for professional nursing practice designated by the ANA. Each standard is listed with evidence to support its attainment.

✓ Quality of Practice: Active participation in the quality assurance activities performed on my unit. Competent in current policies and procedures.

✓ Education: Meets continuing education requirements for current licensure.

✓ Professional Practice Evaluation: Professional performance evaluations completed annually with satisfactory results.

✓ Collegiality: Actively precepts new employees to the department. Contributes to department growth by offering input and feedback at unit meetings.

✓ Collaboration: Enhances the provision of patient care through peer consultation for quality practice and planning patient care.

✓ Ethics: Displays professionalism which promotes advocacy for patients and families. Maintains patient confidentiality and rights.

✓ Research: Provides nursing care which reflects an evidence based practice.

✓ Resource Utilization: Provides patient care with a conscious awareness of cost effectiveness and hospital resources.

✓ Leadership: Active participation as a clinical facilitator. A clinical facilitator is responsible for delegating, assigning, and expediting patient care. Displays the ability to think critically and applies elements of reasoning with decisions.

Association of periOperative Registered Nurses

The Association of periOperative Registered Nurses (AORN) is the professional organization which represents Operating Room (OR) nurses. “The AORN provides education and practice support to nurses in the interest of achieving optimal outcomes in the OR” (AORN, 2011). This professional organization originated in New York in 1954. It was originally known as the Association of Operating Room Nurses but the name was changed to its current name in 1999. “The mission of the AORN Foundation is to advance patient safety by supporting nurses who make surgery safe through education, research and patient safety initiatives” (AORN, 2012). Identified are the recommended practices included in the perioperative standards of care outlined by the AORN. Because I have been a practicing nurse in the OR for some time (26 years), I feel that my current clinical experience meets the standards of practice outlined. The following competencies address the standards of care required by the AORN. An example of my current clinical behavior is provided representing the standards met.

✓ Aseptic Practice: Sterile indicators are checked on all supplies and equipment. Wrappers are checked for holes. Procedures are conducted with respect to the maintenance of sterility, proper hand hygiene, and surgical attire.

✓ Equipment and Product Safety: Appropriate product selection, attending product in-services, and maintaining competence in the use of surgical equipment.

✓ Patient and Worker Safety: Adhering to policy and procedures written for patient safety, medication safety, surgical counts, specimen care, and the prevention of transmissible infections.

✓ Patient Care: Performing patient care routines which promotes optimal outcomes with the prevention of thrombosis, hypothermia, tissue breakdown, and performing safe patient transfers.

✓ Sterilization and Disinfection: Practicing appropriate handling, cleaning, and disinfection of instruments, equipment, and sterilization techniques.

Attaining AORN certification represents a level of practice which exceeds the standards for perioperative nurses. It is the vision of AORN to “be the indispensable resource for evidence-based practice and education that establishes the standards of excellence in the delivery of perioperative nursing care (AORN, 2012). Becoming certified as an AORN prepared nurse is a goal that I have set for myself once I finish my BSN. Yoder-Wise (2011) states, “Certification plays an important part in the advancement of a career and the profession” (p. 588). AORN status is a goal that I would like to achieve within the next five years.

Professional Development Goals

Setting a goal of attaining my AORN certification is only part of my professional development plan for the future. As a professional nurse, I think it is important that I become a member of a nursing organization and join a nursing committee within my facility. Being active in nursing committees and staying current with medical issues is a responsibility of a nurse with professional status. According to Yoder-Wise (2011), “Belonging to a professional association not only demonstrates leadership but also provides numerous opportunities to meet other leaders, participate in policy formation, continue specialized education, and shape the future of the profession” (p. 589). Subscribing to a professional journal and staying current with key practice issues is an important part of career development. This may lead me into the field of nursing education or advanced practice in a specific specialty. “One of the keys to maintaining competence and versatility is continued learning” (Yoder-Wise, 2011, p. 585). I think it would be rewarding to contribute to the academic development and growth of students entering the profession of nursing. Another career advancement idea is to participate in volunteering. I have always thought about how rewarding it would be to volunteer in the community or perhaps participate in a mission to a poverty-stricken country.

Action Plan

The goals will be placed on a timeline. The timeline will be divided by year with specific recognition at the five and ten year divisions. An annual evaluation of the established goals and their completion will be a tool to measure and evaluate my professional growth.

• 2013: BSN complete! Graduation!!

✓ Annual check

• 2014: Quality Assurance Committee/AORN preparation

✓ Annual check

• 2015: Join Professional Nursing Organization/AORN preparation

✓ Annual check

• 2016: AORN certification/membership

✓ Annual check

• 2017: AORN maintained/continuing education credits/professional journals

✓ Annual check

• 2018: AORN maintained/AORN member/Nursing committee member

✓ Annual check

__________________________________________________________5 years

• 2019: AORN maintained/AORN member/Nursing committee/professional journals

✓ Annual check

• 2020: AORN maintained/AORN member/Nursing committee/professional journals/research nursing clinical instructor positions

✓ Annual check

• 2021: AORN maintained/AORN member/Nursing committee/professional journals/nursing clinical instructor

• 2022: AORN maintained/AORN member/Nursing committee/professional journals/nursing clinical instructor/community volunteer

• 2023: AORN maintained/AORN member/Nursing committee/professional journals/nursing clinical instructor/ mission volunteer

✓ Annual check

_________________________________________________________10 years

Evaluation Plan

The evaluation of my progress will be completed annually. As I evaluate each year, I will report the findings on the annual check, posted below the year on the timeline. Just as a nursing care plan is comprised, “the goal should be specific, measurable, and attainable” (Careplans, 2012). The action plan presented is clear and relevant to the professional goals that I have set for myself. The timeline provided is an accurate and precise tool to measure the development of my nursing career. Following this action plan will assist me in reaching the career goals that I have identified and provides a plan for meeting the expected standards for professional nursing practice. “To be effective in the future, we must embrace the opportunities to think longer term so that more people are affected by our actions” (Yoder-Wise, 2011, p. 599). Evaluating existing practice methods and adjusting them to meet the standards of practice recognized by professional organizations, ensures that the standards for quality care for patients is met and that professional nurses are maintaining competence in their practice.

References

American Nurses Association (2004). Nursing: Scope and standards of practice. Silver spring, MD:

Association of periOperative Registered Nurses (2012). Retrieved from

Careplans (2012). What is a Care Plan? Retrieved from

Yoder-Wise, P. S. (2011). Leading and managing in nursing (5th ed.). St Louis, MO: Mosby.

Appendix

CHECKLIST FOR SUBMITTING PAPERS

|CHECK | |

|DATE, TIME, & |PROOFREAD FOR: APA ISSUES |

|INITIAL | |

| |1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. |

| |40)] |

| |2. Running head: Does the Running head: have a small “h”? Is it on every page? Is it less than 50 spaces total? Is the title|

| |of the Running head in all caps? Is it 1/2” from the top of your title page? (Should be a few words from the title of your |

| |paper). [p. 229 and example on p. 40] |

| |3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the|

| |page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary|

| |of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract and know|

| |what to find in your paper. [p. 25 and example on p. 41] |

| |4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use ‘Introduction’ as a |

| |heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and |

| |example on p. 42] |

| |5. Margins: Did you leave 1” on all sides? [p. 229] |

| |6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in |

| |special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] |

| |7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] |

| |8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. |

| |9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a |

| |person’s name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. |

| |[p. 87-88] |

| |10. Typeface: Did you use Times Roman 12-point font? [p. 228] |

| |11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106-111] |

| |12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing |

| |many times…this is what you are supposed to be doing! [p. 170] |

| |13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: |

| |“The variables that impact the etiology and the human response to various disease states will be explored” (Bell-Scriber, |

| |2007, p. 1). |

| |Please note where the quotation marks are placed, where the final period is placed, no first name of author, and inclusion |

| |of page number, etc. Do all direct quotes look like this? [p. 170-172] |

| |14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] |

| |15. Paraphrase: A paraphrase citation would look like this: |

| |Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007). |

| |It may also look like this: Bell-Scriber (2007) found that…… |

| |[p. 171 and multiple examples in text on p. 40-59] |

| |For multiple references within the same paragraph see page 174. |

| |16. Headings: Did you check your headings for proper levels? [p. 62-63]. |

| |17. General Guidelines for References: |

| |A. Did you start the References on a new page? [p. 37] |

| |B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often |

| |they are not and must be adapted. Make sure all fonts are the same. |

| |C. Is your reference list double spaced with hanging indents? [p. 37] |

| | |

| |PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE |

| |18. Did you follow the assignment rubric? Did you make headings that address each major section? (Required to point out |

| |where you addressed each section.) |

| |19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing unless punctuation is present. If you |

| |become breathless or it doesn’t make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did|

| |you do this? |

| |20. Wordiness: check for the words “that”, and “the”. If not necessary, did you omit? |

| |21. Conversational tone: Don’t write as if you are talking to someone in a casual way. For example, “Well so I couldn’t |

| |believe nurses did such things!” or “I was in total shock over that.” Did you stay in a formal/professional tone? |

| |22. Avoid contractions. i.e. don’t, can’t, won’t, etc. Did you spell these out? |

| |23. Did you check to make sure there are no hyphens and broken words in the right margin? |

| |24. Do not use “etc.” or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.? |

| |25. Stay in subject agreement. When referring to 1 nurse, don’t refer to the nurse as “they” or “them”. Also, in referring |

| |to a human, don’t refer to the person as “that”, but rather “who”. For example: The nurse that gave the injection….” Should |

| |be “The nurse who gave the injection…” Did you check for subject agreement? |

| |26. Don’t refer to “us”, “we”, “our”, within the paper…this is not about you and me. Be clear in identifying. For example |

| |don’t say “Our profession uses empirical data to support ….” . Instead say “The nursing profession uses empirical data….. |

| |27. Did you check your sentences to make sure you did not end them with a preposition? For example, “I witnessed activities |

| |that I was not happy with.” Instead, “I witnessed activities with which I was not happy.” |

| |28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? |

| |29. Did you have other people read your paper? Did they find any areas confusing? |

| |30. Did you include a summary or conclusion heading and section to wrap up your paper? |

| |31. Does your paper have sentence fragments? Do you have complete sentences? |

| |32. Did you check apostrophes for correct possessive use. Don’t use apostrophes unless it is showing possession and then be|

| |sure it is in the correct location. The exception is with the word it. It’s = it is. Its is possessive. |

Signing below indicates you have proofread your paper for the errors in the checklist:

___________________________________Terri Sand_____________DATE:_11/12/12________

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