Self-Assessment of Nursing Standards of Practice



Self-Assessment of Nursing Standards of Practice

Tammy A. Garcia

Ferris State University

Self-Assessment of Nursing Standards of Practice

As I get closer to graduation I need to assess my knowledge to assure I have met the goals of the BSN program and therefore am competent to work as a baccalaureate prepared registered nurse (RN). My passion is geriatrics. Seven of the twelve years I have been a nurse I have worked with the geriatric population. To better care for the population I have chosen to serve, I will use the American Nurses Association (ANA) Gerontological Nursing Scope and Standards of practice as a measure to analyzing my competency. The standards of practice are the baseline for nursing care. Standards 1-6 are standards of practice. . The standards of professional performance are the baseline for professional nursing behavior. Standards 7-16 are standards of professional performance.

Standard 1: Assessment

“The gerontological nurse collects comprehensive data pertinent the older adults’ physical and mental health or situation” (ANA, 2010, p. 29). I feel that I meet this standard consistently during the course of my daily work. I work to admit patients to skilled nursing and long term care facilities (SNF/LTCF). I assess the patient’s needs and during the assessment, identify not only the patient’s medical needs but psychosocial and socioeconomic needs, support system, and unique cultural needs. I then communicate that to the facility prior to the patient admitting so patient centered care and discharge planning can be initiated upon admission.

Standard 2: Diagnosis

“The gerontological nurse analyzes the assessment data to determine the diagnoses or issues” (ANA, 2010, p. 30). The thorough preadmission assessment I complete for my patients and the subsequent analyzing of the data obtained ensures my competency of this standard. The information I communicate to the facility then helps to guide the patient’s treatment at the facility to achieve the expected positive outcome for the patient.

Standard 3: Outcomes Identification

“The gerontological nurse identifies expected outcomes for a plan individualized to the older adult or situation” (ANA, 2010, p.31). I meet this standard, once again, because of my complete assessment, analysis of the data, and communication of that data to the facility. The data I communicate assists the interdisciplinary team (IDT), with collaboration from the patient and the significant people in the patient’s life, to set measurable, realistic goals that contribute to positive outcomes.

Standard 4: Planning

“The gerontological nurse develops a plan to attain expected outcomes” (ANA, 2010, p.32). The importance of the complete, in-depth initial assessment and the data derived from it are critical to meeting this standard. With that information a treatment plan is established to achieve the outcomes established by the patient, family and IDT. I am able to meet this standard because of my competency with standards 1-3.

Standard 5: Implementation

“The gerontological nurse implements the identified plan” (ANA, 2010, p. 34). Standard 5 has several areas where competency is necessary to meet the standard. Those areas are: standard 5A: coordination of care and standard 5B: health teaching and promotion. Standard 5C and 5D: Consultation and Prescriptive Authority and Treatment, are for the advanced practice nurse and are out of the scope of practice for an RN.

Patient’s I have assessed admit to the facilities with a plan of care that has been implemented by me. This plan is a result of previous steps in the process and is further defined by the facility IDT when the patient admits to the building. I consistently demonstrate competency in all areas needed to meet the multifaceted standard.

Standard 6: Evaluation

“The gerontological registered nurse evaluates progress toward attainment of outcomes” (ANA, 2010, p. 39). Because of the nature of my current nursing position I am not always able to evaluate the obtainment of outcomes personally. If the patient did not experience any medical complications during his/ her stay in the facility, the patient may discharge home without the need for additional medical care in the hospital. In those cases, which are the majority, patient outcomes are discussed at the meetings I have monthly with the three local facilities I represent. I do make adjustments to my assessment and process if needed to increase positive patient outcomes. If the patient does admit back to the hospital during the course of their stay, I gather information from the facility; collaborate with the IDT in the hospital which includes evaluation of the previous plan and development of a new and improved plan based on patient needs. I meet the goal consistently with the situations that involve me. In addition, when working as an RN case manager for a home health care company, evaluation of my patients care plans and goal obtainment was one of my responsibilities. I did meet the standard consistently in that nursing role as well.

Standard 7: Quality of Practice

“The gerontological registered nurse systematically enhances the quality and effectiveness of nursing practice” (ANA, 2010, p. 41). I incorporate new knowledge and information I gather into my practice by continually striving for excellence in patient care. I utilize new information and knowledge into the initial plan of care for patients entering a SNF/LTCF. I meet this standard in every way except being certified in Gerontological nursing, which I will be pursuing after graduation from the RN-BSN program.

Standard 8: Professional Practice Evaluation

“The gerontological registered nurse evaluates his or her own nursing practice in relation to professional practice standards and guidelines and relevant statues, rules, and regulations” (ANA, 2010, p. 42). I met this standard by the evaluation I am currently doing on my practice. I also meet this standard consistently due to an ongoing monitoring and evaluation of my nursing practice. If I find an area that needs additional work or information, I seek that out to maintain competency.

Standard 9: Education

“The gerontological registered nurse attains knowledge and competence that reflects current gerontological practice” (ANA, 2010, p. 43). I meet this standard by pursuing continuing education, reading professional journals, and by my enrollment and work in the RN-BSN program at Ferris State University (FSU).

Standard 10: Collegiality

“The gerontological registered nurse interacts with and contributes to the professional development of peers and colleagues” (ANA, 2010, p. 45). I meet this standard by orienting new nurses, holding in services to teach staff the new online system for referrals, and by participating in regularly scheduled meetings with facility staff.

Standard 11: Collaboration

“The gerontological registered nurse collaborates with the older adult, family, and significant others, interprofessional team, community, and other stakeholders in the conduct of nursing practice” (ANA, 2010, p. 46). My competence in this standard is proven by the progression of my career and my ability to hold a job in the nursing field. Collaboration is critical in nursing.

Standard 12: Ethics

“The gerontological nurse integrates ethical provisions in all areas of practice” (ANA, 2010, p. 47). I continually meet this standard on a daily basis by maintaining patient confidentiality, respecting cultural preferences, protecting patient rights and autonomy, and advocating for patients.

Standard 13: Research

“The gerontological nurse integrates research findings into practice” (ANA, 2010, p. 49). I meet this standard by incorporating the best available evidence into my nursing practice. I stay as up to date as possible on best practices for providing nursing care to my geriatric patients.

Standard 14: Resource Utilization

“The gerontological nurse considers factors related to safety, effectiveness, cost, and impact on practice in planning and delivering nursing services” (ANA, 2010, p. 51). I meet this standard in many ways. One of those ways is checking with the attending doctor for more cost effective medication choices if they are available.

Standard 15: Leadership

“The gerontological registered nurse provides leadership in the professional practice setting and the profession” (ANA, 2010, p. 52). I meet this standard by training and mentoring new liaisons within the Trinity system. I am a team player; I hold myself accountable to my own actions and am willing to help others when needed.

Standard 16: Advocacy

“The gerontological nurse advocates to protect the health, safety, and rights of the older adults” (ANA, 2010, p. 54). I meet this standard by teaching patients and families in terms that they understand. If a family member does not understand what is being explained to them regarding their loved ones health, provided there is authorization for information to be shared with them, I work with them trying various methods, to explain their loved ones condition. I do so in an understandable (to the patient and family) language.

Professional Development Plan

To remain competent in nursing, lifelong learning is not only necessary, it is an obligation. Provision 5 of the Code of Ethics for Nurses states “Duty to self and duty to others: The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth” (ANA, 2010, p. 55).

Goals/ Action Plan/ Evaluation Plan

My goals for my nursing career after completing my BSN include: certification in gerontological nursing and geriatric nurse practitioner. In January 2013 I will apply to the ANCC for consideration to test for certification in gerontological nursing. If my application is accepted I will start the process of preparing for the test. I plan to test no later than June 2013.

In March 2013, I will set up a face to face meeting with an advisor from the Michigan State University College of nursing. I plan to formally apply to the program in September 2013. In February 2014 I will be notified as to if I have been accepted into the program, which will start in August 2014.

The adult/gerontological program has 53 credits to complete. I will have 6 years from the time I start to complete the program. I plan to take 6 credits each semester, including summers. If I follow that schedule I will complete the program in 9 semesters or 3 years. That would give me a graduation date of summer 2017. That plan also gives me a cushion of 3 years to allow for a slower pace some semesters if needed. After completion of the program I am undecided which job route I will take and will research each possibility more completely at a later date. If not accepted into the program the first year I apply, I will look at other potential options including online programs.

Evaluation of my plan will be ongoing. I will make adjustments as they are needed to fit my personal, family and work life. The dates stated in my current plan, while subject to change, serve as my evaluation criteria for successful completion of my goals.

Conclusion

The nursing profession is constantly changing based on current evidence based practice recommendations. For a nurse to stay competent in the field, continual self-assessment and learning is needed. Using the nursing process to assess, plan, implement and evaluate my career goals helps to ensure my goals are specific, measurable, realistic, and achievable within a defined time frame (Yoder-Wise, 2011). Performing self-assessments to the criteria of the gerontological nursing standards of practice and professional performance help identify areas that require additional learning. Using the code of ethics for nurses to guide my practice helps me provide quality, safe, ethical, evidence-based nursing to the patients I serve.

References

American Nurses Association (ANA). (2010). Guide to the code of ethics for nurses:

Interpretation and application. Silver Springs, MD: Nurses .

American Nurses Association (ANA). (2010). Gerontological nursing: Scope and standards of

practice Silver Springs, MD: Nurses .

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

Elsevier Mosby.

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