Running head: SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE
Self-Assessment of Nursing Standards of Practice NURS 440 Charity L. McKinnon Ferris State University
SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 2
Abstract This paper will discuss the fifteen professional nursing standards of practice and standards of professional performance that relate to my specialty of nursing in obstetrics, the care of women and newborns. This paper will review my progress in meeting each of the standards of practice and will describe goals to maintain or complete the standard. This paper will also discuss an action and evaluation plan to meet my own professional goals in a timely manner.
SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 3
Introduction Working as an obstetrical nurse for almost eight years, I am familiar with the organization of AWHONN (Association of Womens Health, Obstetric and Neonatal Nurses). There are fifteen standards of professional performance and standards of practice that each obstetrical registered nurse should adhere to while caring for these patients. The standards of practice include assessment, diagnosis, outcomes identification, planning, implementation, and evaluation (AWHONN, 2009). The standards of professional performance include quality of practice, education, professional practice evaluation, ethics, collegiality, collaboration and communication, research, resources and technology, and leadership (AWHONN, 2009). By following these standards and guidelines, I will be contributing to my profession and educational goals by providing the highest quality care for women, newborns and their families (AWHONN, 2009, p.4), something that every nurse should be striving towards in each component of patient care. AWHONN Standards of Nursing Practice Standards for Professional Nursing Practice Assessment. My assessment skills of women and newborns have grown significantly since I was a student nurse. Working full-time in the obstetrical specialty setting has done this for my skill set. I have met this nursing standard because I prioritize patient specific assessment needs at the time care is given (AWHONN, 2009). I use current evidence-based practice to deliver optimal care (AWHONN, 2009). I attend conferences and meetings on the trends of guidelines pertaining to labor, delivery, and post-partum care, including stabilization of infants. I educate new parents on infant care and needs appropriately, considering the age and cultural SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 4
factors of the new family (AWHONN, 2009). I am constantly analyzing information with my assessments, for example electronic fetal monitor data. I use proven data trends to deliver safe and effective care in the prenatal, labor, and post-partum phase of the pregnancy (AWHONN, 2009). I am aware of privacy policies for my facility. I take patient confidentiality seriously by keeping my patients healthcare information in appropriate documented and communicative form to only those involved with the direct care of the patients (AWHONN, 2009). I utilize policy and procedure when needed in critical care settings (AWHONN, 2009). An example of this would be administering Magnesium Sulfate to laboring women with a diagnosis of pregnancy induced hypertension and being able to identify trends in condition changes to keep the patient safe and stable. I will continue to work in the acute care obstetrical setting to maintain pertinent assessment skills. Diagnosis. I meet the standard of diagnosis because I am able to identify changes of condition in my patients from a normal baseline (AWHONN, 2009). I am able to do this because of my clinical experience in obstetrical staff nursing and continuing education in fetal monitoring and pregnancy care, in which I will continue to do in order to maintain competence with this standard. I keep my patients and their care providers up to date with assessment findings and plans of care, involving family members when appropriate with respect to the patients confidentiality (AWHONN, 2009). Outcomes Identification. Measuring outcomes for patients is part of my daily nursing practice and I meet this standard by assisting the patient in formulating and achieving goals that apply to their care (AWHONN, 2009). An example of outcomes identification would be SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 5
assisting a first time breastfeeding mother. I assist these patients by describing positioning and latch for the infant. The mother and I discuss feeding times that are recommended by breastfeeding experts and we work in these times during the hospital stay. Goals are set in a twenty-four hour period of how many feedings the infant needs to have and they are met by educating, supporting the patient, or other forms of support such as family members or additional knowledgeable staff (AWHONN, 2009). I communicate well with other care providers and relay any changes in outcome measures so that there are no gaps in continuity of care (AWHONN, 2009). I will continue meeting this standard by listening to the patients that I take care of and will reassess the outcomes of their care when appropriate (AWHONN, 2009). Planning. I have met this standard of practice because I am able to support health promotion, maintenance or restoration needs of women and newborns by staying up to date on current best practices through education (AWHONN, 2009, p. 6). Much like outcomes identification, I will continue to communicate with the patient, family members, and care providers to develop the patients plan of care for a healthy mom and a healthy baby. An example of this standard in my practice is educating women on signs and symptoms to look for in their infant that could cause a problem and interfere with overall health. Much of my time during the post-partum period is spent making sure my patients are equipped with the resources that they may need at home such as a thermometer or bottles for feeding. I will continue to stay current with the information I discuss with my patients by reading nursing journals and attending obstetrical conferences. Implementation. I have met this standard because I am able to take the appropriate actions when assessing abnormal findings. An example of the implementation that I do would be to act on abnormal fetal heart rate tracings in a timely manner using the safest evidence-based SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 6
practice care, which would be maternal positioning, IV fluid bolus, and oxygen administration (AWHONN, 2009). This confirms that I utilize guidelines of care and collaborate with my team members in a situation that requires me to act in a quick, safe manner (AWHONN, 2009). I feel that I document my findings efficiently to facilitate communication and this keeps my patient on the plan of care for a safe childbirth experience with coordination of the policies in place on my unit (AWHONN, 2009). Implementation of health promotion and teaching has been met because I educate women and their families during outpatient visits to the hospital on signs of labor. I educate during the labor and delivery process involving the patients family on effective pushing techniques and the best positioning for optimal delivery of oxygen to the baby in the second stage of labor appropriate to the situation (AWHONN, 2009). I am always following up on methods used during a labor and delivery to seek out answers and make each patient encounter a learning opportunity by discussing specifics with colleagues (AWHONN, 2009). During the discharge process, I document education given to mothers and their families so that co-workers are able to visualize what has been done for the patient (AWHONN, 2009). Evaluation. I have met the standard of evaluation because I continually evaluate progress of my patients plan of care and goal outcomes (AWHONN, 2009). An example of this standard would be when evaluating a newborn in the post-partum period. Within a twenty-four hour period the infant should have produced one void, one stool, and be capable of physically maintaining a body temperature between 97.7-99.0 axillary (Charlevoix Area Hospital, 2014). If the infant is not meeting these goals I notify the infants primary care provider. Orders are received for supplementation if voiding and defecation are an issue. I place the infant under the radiant warmer if temperature instability is an issue, all of which are under the plan of care SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 7
protocol (Charlevoix Area Hospital, 2014). I will continue to meet this standard by following policy and procedure of care for all of my patients and by using nursing judgment for the patients to meet their goals (AWHONN, 2009). AWHONN Standards of Professional Performance Standards of Professional Performance Quality of Practice. I have met this standard of professional performance because I evaluate my patient assignment systematically to improve my nursing practice thereby improving patient care (AWHONN, 2009). Being involved in a labor patient assignment is a one nurse to one patient ratio (AWHONN, 2010). This allows me to focus on quality monitoring of the patient and complies with the safety and effectiveness of nursing practice (AWHONN, 2009, p. 8). Being in an assignment such as this also allows me to collect and analyze assessment data appropriately to develop a safe plan of care for a safe and preferred birth experience for the patient (AWHONN, 2009). This is very important to me as first class quality of care given to my patients is the ultimate priority every time I set foot into a nurse-patient setting. If in a multiple patient assignment, I use my nursing judgment by identifying the patient that should be seen first by clinical situation. For example, a person who is one hour post- partum remains the priority versus a patient that is ten hours post delivery. I will continue to meet this standard by using critical thinking skills and building assessment skills through each experience that I encounter through regular review and revision of care for the benefit of my patients (AWHONN, 2009, p. 8). SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 8
Education. I value education and will continue to meet this standard throughout my nursing career. I understand that medicinal practices are always changing. I attend in-services on up-to-date guidelines for perinatal emergencies that offer insight on best evidence-based practice. I participate in mandatory competencies monthly that educate staff on medications and procedures pertaining to nursing. I keep a professional record on my file for my manager to accurately keep track of educational experiences and readings that I have completed. I have maintained my professional nursing license, am certified in basic life support, neonatal resuscitation, and have completed the national cognitive evaluation for learner/provider in the stabilization of infants. I am a member of Sigma Theta Tau International Honor Society of Nursing of the 243 Kappa Epsilon-at-Large Chapter and this society of research in nursing provides me with numerous educational materials that I have access to. I have completed and passed the advanced fetal monitoring course for obstetrical nursing, and this demonstrates that I maintain specialized knowledge pertaining to the professional performance standards (AWHONN, 2009). I will continue to research and seek out up to date information for the benefit of my patients and the nursing profession to maintain this standard. Professional Practice Evaluation. I have met this standard because I actively participate in conversations with peers and physicians about my own professional development and care-giving. An example that I just encountered that applies to this standard was when I faced an impending precipitous delivery of a patient. I called the physician and pediatrician with the assessment findings that the patients family were able to provide me over the telephone which were that she was feeling the urge to push and that yellowish-green fluid was noted on her peri-pad, indicating meconium stained amniotic fluid. When the patient arrived, the obstetrician and pediatrician were in attendance. According to evidence-based guidelines, the room was SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 9
equipped with resuscitative equipment for the delivery of a meconium stained fluid delivery, which is a risk factor in neonatal resuscitation. I was able to discuss with the physician after the delivery the acuity of the situation and things that could have possibly gone smoother. My colleagues and I have frequent discussions regarding educating our patients and deliberate on what is best practice at this time in accordance with guidelines (AWHONN, 2009). I will continue to seek feedback to maintain the standard of professional practice evaluation. Ethics. I feel that I have met the standard for ethics. I consult the appropriate resources when needed like the American Nurses Association (ANA) Code of Ethics as well as the neonatal resuscitation guidelines on ethical care of women when a newborn passes. I belief that when something as life changing as a pregnancy that does not go to full term happens, the patients rights, values, and beliefs are the priority as stated in the ANA handbook (2004). I listen to the wishes of the parents. I have never encountered a parent who did not wish to have their baby resuscitated if the infant was deemed viable by the obstetrician according to gestational age, but I would follow the recommended guidelines of carrying out resuscitation when appropriate according to the neonatal resuscitation handbook. I will maintain this standard by continuing to deliver care in a manner that is not judgmental and that is empathetic in order to maintain the patients value and rights (AWHONN, 2009). Collegiality. I have met the standard of collegiality. I am privileged to be able to come to work with a group of people that I consider like family. I share knowledge and skills with them in a respectful manner without intimidation (AWHONN, 2009). I expect my colleagues to share their experiences and knowledge so that I may have the opportunity to learn as well. I contribute to a productive working environment (AWHONN, 2009). An example of this would be when I am asked to assist a student nurse that comes to obstetrics for a learning experience. I SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 10
guide the student in the patients plan of care so that they are able to experience nursing practice of a post-partum mother or newborn in a safe environment (AWHONN, 2009). A way that I can improve my nursing collegiality is to participate on a committee, which I plan to do when my baccalaureate degree is completed. This is how I will continue to meet and improve this standard. Collaboration and communication. I meet this professional performance standard. I communicate with patients and families on best practices of care for their newborn (AWHONN, 2009). An example of this would be teaching families on safest sleep position for infants, which is their back. I collaborate and communicate with fellow nurses and primary care providers on best plans of action for the patient. An example of this would be promoting and administering the TDAP (Tetanus, Diphtheria, and Pertussis) vaccination. The patients are educated on the recommendations of this vaccine at the womens health care office then sent to the obstetrics department for further education and IM administration. The consent is then faxed and posted on the patients chart as given. Another example of performing this standard is keeping the patient and family informed of the plan of care during labor. Often the obstetrician will communicate to the nurse the next step in procedures and I will then communicate this with the family with an in depth explanation of what the procedure entails and what the patient should expect (AWHONN, 2009). Continuous communication with the obstetrician is used when an emergency situation is occurring. I reiterate drug dosages and am not intimidated to make my voice heard for the patients benefit and safety in a respectful manner (AWHONN, 2009). SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 11
Research. I am unable to say that I have met the standard of research at this point in my career and am at a novice level of understanding the concept of nursing researchs complexity. As a member of Sigma Theta Tau National Honor Society for nurses, I understand the importance of nursing research for advancing care practices to the best possible level for the patients we all care for. I utilize the best available evidence to guide my nursing decisions (AWHONN, 2009) and I also evaluate the effects of new practices on how patients respond to a new treatment (AWHONN, 2009). An example of this would be the introduction of a new medication recommended for labor pain control. I have administered pain medication enough times to understand that effects of medications are individualized, but have found this new drug to be very successful as a safe form of pain control for laboring women. I consider this critiquing research (AWHONN, 2009). I have not participated in official data collection, research programs, group panels or on an institutional review board (AWHONN, 2009). I will continue to improve this standard by reading research articles and keeping current with policies and protocols for labor, delivery, post-partum, and newborn care. Resources and technology. I have met this standard of professional practice because I am familiar with the resources my department has and if a new resource is available, I ask to be in-serviced on providing it (AWHONN, 2009). A couple of years ago our department began to practice amnio-infusion treatments for women who were experiencing decreased fetal variability and decelerations on the external fetal monitor strip during labor. I was not familiar with this particular procedure, but I read the written documentation on it and asked the patients primary care provider to guide me through my first attempt. This is utilizing resources and technology in a safe manner that affects the patient (AWHONN, 2009). I documented the procedure appropriately to facilitate communication among providers (AWHONN, 2009). SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 12
I am able to delegate appropriately based on the patients clinical condition and complexity of the case (AWHONN, 2009). An example of this would be when completing a newborns physical assessment and morning care. I complete the vital signs and physical assessment. If I am busy with another patient I will delegate the bath to ancillary staff if the infant is in stable condition, using delegation appropriately (AWHONN, 2009). Another aspect of successful utilization of resources and technology that I assist women and families with is breastfeeding support. I direct them to resources for ease of breastfeeding and by getting them the facility contacts they will need for a breastpump if they need one (AWHONN, 2009). I also assist women who are looking for practicality when nursing an infant by helping them find their correct size in nursing bras at a breastfeeding boutique that is located in the obstetrics department. This is an example of helping women find available services to address health- related needs (AWHONN, 2009, p. 11). I inform women on the risks and benefits of care when a procedure is performed, for example, a pitocin induction increasing risk of a cesarean delivery (AWHONN, 2009). I will maintain this nursing standard by always utilizing my colleagues for information if unknown and keep an open dialogue with my patients to facilitate questions and good communication. Leadership. I feel that I am meeting the leadership standard and am constantly improving these skills. My last performance evaluation remarked that in the last year my assessment and decision making skills have superiorly improved. I am able to lead and guide my colleagues through difficult patient cases to create the best scenario possible regarding safety and quality (AWHONN, 2009). I am flexible in assignments and consider myself a team player, for example, taking turns with complex patient cases when the same nurse and I work three twelve hour shifts in a row (AWHONN, 2009). I value people and always mention to my fellow nurses SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 13
when someone has complimented their care. I direct care of unlicensed personnel when working together efficiently. I also promote the advancement of the profession through participation in professional organizations, being a member of Sigma Theta Tau (AWHONN, 2009). I will be improving the leadership standard by participating on a public relations committee in the fall of 2015 for the promotion of Charlevoixs obstetrical nursing department. I will also be volunteering for a ministry called the Joppa House each Monday beginning the first week of July, assisting and teaching homeless women and children life skills. Professional Development Plan Goals In May of 2015 I plan to have obtained my Baccalaureate of Science in Nursing through Ferris State University. After this achievement, I will begin studying for the Registered Nurse Certified Exam (RNC) in obstetrical nursing to be ready to take the exam in September 2015. Earning both of these will assist me with meeting all of the nursing standards for professional nursing practice in the care of women and children by furthering my education and demonstrating leadership to fellow nurses and colleagues. I plan to continue working in the obstetrics department because I believe in empowering the women that I take care of to make healthy decisions for their families, benefiting not just themselves but the community as well. I will continue to further my education in maternal-child nursing through conferences and reviewing current evidence-based practice findings by becoming a member of the organization AWHONN in June 2015.
SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 14
Action Plan I will achieve my baccalaureate of science degree in nursing through Ferris State University by taking one class each semester. I will take one capstone this fall of 2014 and the final capstone in the winter semester of 2015. After completing these courses, I will graduate. After taking a two week break, I will order the book for the current RNC exam and begin studying the contents in the first week of June through the end of August. I will keep a calendar of tasks to complete so that I am sure to study successfully and pass the exam. Benefits of joining AWHONN will allow me to have access to numerous amounts of information on current evidence-based practice nursing. Evaluation Plan At the end of the nursing 440 course, I will sign up for the first capstone to complete my degree. I will budget for monthly tuition installments to ensure that the class will be completed. I will do the same for the winter semester. At completion, I will have met my goal by obtaining my degree. The same standard of evaluation for the RNC exam will occur. I will save the money for the exam and obtain the certification, meeting my goal. After graduation, I will complete my last goal to become a member of the organization of AWHONN by submitting the application and dues to make this a reality. Conclusion By reviewing and critically analyzing the fifteen standards for professional nursing practice in the care of women and newborns recommended by AWHONN, I have learned how advanced my nursing practice has become from a novice level seven years ago. This process has shown me the skills that I need to develop to enhance my nursing practice to a higher level and SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 15
how I will do that by evaluating my goals. The standards of my specialty will assist me in my educational pursuits and continue to allow evaluation of myself for years to come. I will continue to grow professionally by frequently reassessing my competency in each of these.
SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 16
References American Nurses Association. (2004). Nursing scope and standards of practice. Silver Springs, MD. Nursebooks.org Association of Womens Health, Obstetric and Neonatal Nurses (AWHONN). (2009). Standards for professional nursing practice in the care of women and newborns. (7 th ed.). Washington, DC. AWHONN. Association of Womens Health, Obstetric and Neonatal Nurses (AWHONN). (2010). Guidelines for professional registered nurse staffing for perinatal units. Retrieved from: https://www.awhonn.org/awhonn/ Charlevoix Area Hospital. (2014). Newborn Infants Care Plan. Retrieved from: https://cvhaks.cernerworks.com/Prod/site/default
SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 17
CHECKLIST FOR SUBMITTING PAPERS
CHECK DATE, TIME, & INITIAL
PROOFREAD FOR: APA ISSUES Charity McKinnon 6-26, 2300, CMc 1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)] 6-26, 2300, CMc 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] 6-26, 2300, CMc 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] 6-26, 2300, CMc 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] 6-26, 2300, CMc 5. Margins: Did you leave 1 on all sides? [p. 229] 6-26, 2300, CMc 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] 6-26, 2300, CMc 7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] 6-26, 2300, CMc 8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. 6-26, 2300, CMc 9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a persons name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. [p. 87-88] 6-26, 2300, CMc 10. Typeface: Did you use Times Roman 12-point font? [p. 228] SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 18
6-26, 2300, CMc 11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106- 111] 6-26, 2300, CMc 12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing many timesthis is what you are supposed to be doing! [p. 170] 6-26, 2300, CMc 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] 6-26, 2300, CMc 14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] 6-26, 2300, CMc 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. 6-26, 2300, CMc 16. Headings: Did you check your headings for proper levels? [p. 62-63]. 6-26, 2300, CMc 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 6-26, 2300, 18. Did you follow the assignment rubric? Did you make headings that address each major SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 19
CMc section? (Required to point out where you addressed each section.) 6-26, 2300, CMc 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 doesnt make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did you do this? 6-26, 2300, CMc 20. Wordiness: check for the words that, and the. If not necessary, did you omit? 6-26, 2300, CMc 21. Conversational tone: Dont write as if you are talking to someone in a casual way. For example, Well so I couldnt believe nurses did such things! or I was in total shock over that. Did you stay in a formal/professional tone? 6-26, 2300, CMc 22. Avoid contractions. i.e. dont, cant, wont, etc. Did you spell these out? 6-26, 2300, CMc 23. Did you check to make sure there are no hyphens and broken words in the right margin? 6-26, 2300, CMc 24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.? 6-26, 2300, CMc 25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they or them. Also, in referring to a human, dont 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? 6-26, 2300, CMc 26. Dont refer to us, we, our, within the paperthis is not about you and me. Be clear in identifying. For example dont say Our profession uses empirical data to support . . Instead say The nursing profession uses empirical data.. 6-26, 2300, CMc 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. 6-26, 2300, CMc 28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? 6-26, 2300, CMc 29. Did you have other people read your paper? Did they find any areas confusing? 6-26, 2300, CMc 30. Did you include a summary or conclusion heading and section to wrap up your paper? 6-26, 2300, 31. Does your paper have sentence fragments? Do you have complete sentences? SELF ASSESSMENT OF NURSING STANDARDS OF PRACTICE 20
CMc 6-26, 2300, CMc 32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is showing possession and then be sure it is in the correct location. The exception is with the word it. Its = it is. Its is possessive. Signing below indicates you have proofread your paper for the errors in the checklist:
_Charity L. McKinnon_______________________________________DATE:___6-26-14_______
A peer needs to proofread your paper checking for errors in the listed areas and sign below: