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Running head: SELF ASSESSMENT OF STANDARDS OF PRACTICE

Self-Assessment of Standards of Practice in Nursing


Sara Young
Ferris State University

SELF ASSESSMENT OF STANDARDS OF PRACTICE

Abstract
This self-assessment will analyze the American Nurses Association standards of practice and
their meanings within personal nursing practice. An introspective look into the strengths and
weaknesses will assist in developing goals with a clear plan of action and an evaluation process
that will be the topic of discussion in this self-assessment for improvement.

SELF ASSESSMENT OF STANDARDS OF PRACTICE

Self-Assessment of Standards of Practice in Nursing


The career of nursing offers numerous opportunities for advancement and development.
My goal in writing this paper is to explore the standards of nursing, how they apply to me, as
well as create a timeline of achievable goals. As a newer nurse, I am exposed to new challenges
on a regular basis. These challenges or experiences lead me to a higher degree of inquiry as I
explore and develop my senses and expertise. I am in a constant whirl of learning as each
experience builds upon the other. I am hopeful that as my knowledge base grows, so will my
confidence and sense of accomplishment. I will continue to learn not only in the field, but within
my formal education as I advance through the opportunities that nursing offers.
Standards of Professional Performance
Standard 1Assessment
Conducting an assessment is the collection of comprehensive data pertinent to the
healthcare consumers health and/or the situation (ANA, 2012, p. 35). It is very important when
I admit a patient to the progressive care unit that I complete a thorough yet timely assessment in
order to meet the needs of the patients situation. My assessment aids in the delivery of quality
patient care and collaborative efforts of the health care team. Discharge planning begins at
admission therefore the assessment must be comprehensive. I feel I possess strength in this area.
Standard 2Diagnosis
The nurse formulates a diagnosis that uses clinical judgment to draw conclusions
regarding the nature or cause of the health problem based on available data (ANA, 2012, p. 45).
Assessment and diagnosis happen simultaneously. For instance, while assessing the patient and
situation, I am able to determine if they are a fall risk based on the medical diagnosis, home
conditions, current lab values, or prior history of falls. Immediately I determine if the patient is a

SELF ASSESSMENT OF STANDARDS OF PRACTICE

stand-by assist or in need of a walker or any other assistive devices. In this manner, I am
delivering safe and quality care for the patient.
Standard 3Outcomes Identification
Outcome identification refers to the formulation of specific, measureable, achievable,
realistic, and time-framed (SMART) outcomes (ANA, 2012, p. 63). Formulating goals for the
patient involves collaboration with the health care team. A patient admitted with a medical
diagnosis of chronic obstructive pulmonary disease exacerbation that is currently using five liters
of oxygen yet only uses two liters at home, may have a goal of reducing oxygen consumption to
two liters prior to discharge. Another goal would be to increase ambulation by 200 feet at end of
shift with decreased shortness of breath and increased oxygen saturation. Educating the patient
and setting clearly defined goals empowers the patient to be an active participant in their care.
Standard 4Planning
Every stage of the patient care experience requires a plan of action. A plan for the day is
initiated at bedside report while involving the patient in decision making, information sharing,
and goal setting. Plans are individualized based on patient needs: rehabilitation may be needed or
home care might be warranted. Careful planning that involves specialties such as pulmonology,
cardiology, physical therapy or case management will provide comprehensive care. It is a very
important part of my job to initiate and follow the plan of care to optimize health outcomes.
Standard 5Implementation
Implementation requires nurses to combine thinking and doing, as well as feeling,
sensing, and valuing (ANA, 2012, p. 88). I care for very ill patients on my unit. Some are
motivated to return to health and others are not. I feel very confident in my skills to determine

SELF ASSESSMENT OF STANDARDS OF PRACTICE

what barriers exist that might impede implementation of the plan. I am not afraid to sit and talk
with the patient about their feelings or worries or involve family in order to have successful
outcomes. Possessing the skills to connect with the patient is critical to the implementation
process of care.
Standard 6Evaluation
Evaluation is the process of determining progress toward attainment of expected
outcomes, including effectiveness of care (ANA, 2012, p. 105). This also encompasses the
process of revising goals where appropriate. For instance: if breathing treatments for chronic
obstructive pulmonary disease are exacerbating another issue such as tachycardia, it is my job to
notify the health care provider. Treatments and nursing interventions are consistently evaluated
for the promotion of patient safety and well-being.
Standard 7Ethics
Ethics is an integral part of the foundation of nursing (ANA, 2012, p. 114).As I reflect
upon my education thus far, it is clear that ethics must play an important role in our daily
activities as a nurse. We are looked upon by our patients and the public as one with the
knowledge and skills to facilitate health and well-being. We learn in our early formal education
to properly assess, diagnose, identify, plan and implement nursing actions. Patients rely on us to
be thorough in our assessments in order to relay accurate information to other members of the
healthcare team. I feel as one embarks on the nursing career, one agrees to adhere to the ethical
standard of nursing. Doing what is in the best interest of the patient and public is attributable to
the code of ethics. This includes being a leader and advocate of patient safety through use of
evidence based research and quality control.
Standard 8Education

SELF ASSESSMENT OF STANDARDS OF PRACTICE

Education is requisite for acquisition of the knowledge, skills, and abilities needed to
maintain current, safe, and effective clinical practice (ANA, 2012, p. 123). When I graduated
with my associates degree of nursing, I knew that I wanted to further my education with a
bachelors in nursing. At first, I enrolled with the mind-set that it would be a requirement in
many healthcare settings. I am nearly finished with the bachelors program and the insight I have
gained is empowering. I feel better prepared and more comfortable in my critical thinking skills.
Furthering my education was by far the best decision I made. Understanding the importance of
staying current in the latest research is essential to providing quality patient care. There is room
for educational improvement: Progressive Care Critical Nurse (PCNN) certification that I have
discussed with my unit manager and plan to take advantage of for professional enhancement.
Standard 9Evidence-Based Practice and Research
Evidence-based practice uses explicit methods to critically appraise and rate both the
level (strength) and quality of evidence to answer a practice issue or question (ANA, 2012, p.
133). Evidence-based practice leads to best patient practices. Policy and procedure at McLaren is
based on evidence-based practice. Research is integral to the advancement of the nursing
profession to stay competent and current in quality improvement. We began initiating bedside
report at our facility. Evidence-based practice shows that patient safety is one of the greatest
benefits of bedside report, along with employee teamwork, ownership and accountability (Baker,
2010). Further, bedside report increases patients involvement in their plan of care; they feel
more comfortable asking questions; and feel more informed of their care which reduces anxiety
and facilitates compliance (Baker, 2010). While I have not personally conducted any research at
my facility, I hope to eventually become a part of the quality team that develops policies based
on evidence-based research.

SELF ASSESSMENT OF STANDARDS OF PRACTICE

Standard 10Quality of Practice


The registered nurse contributes to quality nursing practice by assuring that patients
receive evidence-based practice care that is patient-centered, safe, effective, timely, efficient, and
equitable (IOM, 2001). When I admit a patient to my unit, I follow a checklist that addresses all
aspects of the patients needs. Care is individualized, clarification of home medications and
allergies is discussed with the patient and a thorough assessment is conducted to be sure I do not
miss anything pertinent such as wounds or sores. Compliance with policy such as identification
bands, allergy bands, fall risk bands, yellow gowns, grippy slippers, and call lights within
reach promote patient safety and quality of practice.
Standard 11Communication
Research has shown that effective communication is essential to safe, quality patient
care and to healthy work environments that lead to nurse satisfaction and staff retention (ANA,
2010, p. 159). Lack of effective communication between the patient and other members of the
healthcare team can be extremely dangerous. There are protocols in place when a patient has a
critical lab value such as an elevated troponin or CO2 level. The lab speaks with the nurse caring
for the patient; the nurse repeats the value back to the lab and a form is filled out. The nurse then
notifies the doctor. Without this sequence of events, patient care may be compromised. Changes
in hospital policy are communicated by the unit manager via monthly meetings. This is also an
opportunity to discuss concerns with current processes that may need improvement. The unit
functions best as a team when communication is open and invited.
Standard 12Leadership
Leaders influence people to change direction (ANA, 2012, p. 164). The fundamental
nature of leadership can be described as the ability to influence others toward accomplishing

SELF ASSESSMENT OF STANDARDS OF PRACTICE

common goals (ANA, 2012, p. 163). This is an area that I still at times struggle with, however,
since starting the bachelors program and gaining more experience as a nurse, I have gained
more confidence. I feel that I am ready to take on the challenge of charge nursing and have
talked with the floor manager about this goal. I enjoy being a preceptor to new graduates by
encouraging and motivating them.
Standard 13Collaboration
The registered nurse is expected to be proficient in collaborating with health care
professionals and to be an effective part of an inter-professional health care team that provides
high-quality and safe patient care to individuals and populations (ANA, 2012, p. 175). This is an
area of strength for me. I used to be uncertain about when to notify a doctor or sometimes I
would be afraid to call for fear of seeming incompetent. I toughened up real fast. I also realized
that it was not about me: it was about the patient and being a patient advocate. Patient outcomes
have a better chance for success when the health care team communicates and collaborates
together.
Standard 14Professional Practice Evaluation
The professional registered nurse has a responsibility to engage in evaluation activities
to maintain and enhance her or his professional performance as part of accountability to the
healthcare consumer and to the profession (ANA, 2012, p. 187). I maintain professional
performance by following policy and procedure at my facility, seeking evaluation from my
peers, upholding the ANAs standards of practices, and furthering my education. I spend a lot of
time re-evaluating myself and my actions throughout the shift. I seek support and feedback from
my co-workers. I find that I have learned a great deal about myself as a professional through the

SELF ASSESSMENT OF STANDARDS OF PRACTICE

bachelors program at Ferris State University. Professional performance evaluation is an


important aspect in nursing to remain current in the delivery of quality patient care.
Standard 15Resource Utilization
The registered nurse utilizes appropriate resources to plan and provide nursing services
that are safe, effective, and financially responsible (ANA, 2012, p. 193).This is an area of
strength for me. I find that in talking with my patients, I usually can discover a need in a
particular area such as education, medications, counseling, or even shelter. I have utilized case
management and social work to help with these needs and offered printed educational materials
for procedures, treatments, medications, and diet. Patients are often very grateful for the help and
information. I also try to facilitate the discharge process when necessary especially if it means a
financial savings for the patient. For example, I will relay to the hospitalist when another
specialty such as infectious disease has signed off on the case. This not only can be a realization
of savings to the patient, but it supports the business of the hospital.
Standard 16Environmental Health
Nurses need to practice in an environmentally safe and healthy manner (ANA, 2012, p.
207). This is an area that I feel I could be more proactive in. I think the noise factor could be
addressed at our facility especially at night. As far as being a safe environment, I tend to
straighten patient rooms by fastening pump cords, picking up clutter, linens, and the like to
remove fall hazards. I really cannot think of any particular chemical hazard that I come in to
contact with on my unit but I do tend to be very environmentally conscientious at home. The use
of personal protective equipment should be utilized where required to reduce potential exposures
to infectious diseases.
Professional Goals and Plan of Action

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I respect and appreciate the dedication of peers in the nursing field to promote power and
knowledge for the betterment of health care related outcomes, patient advocacy, and self-worth. I
am motivated and empowered to strengthen and improve upon the areas of education, evidencebased practice, research and leadership during my career as a professional nurse.The following is
an outline of goals and plan for improvement.
Education
I currently need seven credits at Ferris State University to complete my bachelors of
science in nursing (BSN). I am thrilled that the end is near with graduation in December 2014. I
have strongly considered obtaining my masters as a family nurse practitioner (FNP). It is
predicted that by 2015, the U.S. will be facing a shortage of about 63,000 doctors, according to
the Association of American Medical Colleges (Lopatto, 2012).This will increase the need for
advanced practice registered nurses. Sadly, Ferris does not offer a masters in FNP. I have looked
into Chamberlain School of Nursing online and Saginaw Valley State University as options to
complete this goal. I will take the spring semester off to research more options and by summer
2015, I will have decided on a school of study. I also plan on completing the PCCN certification
by summer 2015 and will take advantage of the hospital reimbursement, the $500 bonus for
completion as well as the enrichment the certification provides.
Evidence-Based Practice and Research
This is an area that I would like to take more of an active part in. My goal is to become a
part of the quality management team that develops and supports hospital policies and procedures
with supporting evidence-based research. Once my BSN is complete, I will contact Sue Meister,
RN, who is part of the quality team at McLaren-Lapeer Region by January 2015. I hope to be
able to participate in research studies and be of assistance in the search for best practices. In

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doing so, I am demonstrating a contribution that supports Standard 9 of the American Nurses
Association scope of practice. It further demonstrates intention to grow professionally.
Leadership
I have already taken the necessary steps toward the goal of developing my leadership
skills. I spoke with Brian Groff, RN, Nurse Manager of the progressive care and intensive care
units at McLaren-Lapeer Region. We mutually decided that on the next work schedule, he will
allow time for me to orientate with one of our charge nurses. I expect that by August 2014, I will
have initiated this training and hopefully be a part of the rotation of charge nurses on the unit. I
also plan to discuss adding additional days of training new hires and graduates with Stephanie
Wilson, RN, Nurse Educator at McLaren-Lapeer Region by January 2015. Demonstrating an
active interest in developing leadership skills supports Standard 12-- leadership. Although I have
only been practicing for two years, I feel more confident and comfortable with my skills and
ready to accept the challenge.
Evaluation
I will successfully complete my BSN by December 2014. I feel very strongly about
obtaining FNP licensure and am motivated by a thirst for knowledge and a challenge to succeed.
I will use the break in August 2014 between Ferris summer and fall semesters to research and
evaluate my progress in leadership as well as research more options for furthering my nursing
education. In December 2014, I plan to evaluate my progress with a role in quality assessment as
well as involvement as a preceptor. January 2015 will bring about a much needed break from
studies: my husband and I have planned a vacation to Punta Cana. I value the importance of
taking a break to refresh and revitalize the soulonce I return, I will continue the search for the
education that will best suit my needs and forge ahead with enrollment in a masters program.

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Conclusion
The world of nursing continues to provide opportunities for advancement and calls upon
its own to be leaders in the profession. Growth and advancement occurs when we are empowered
to remain active through research, education and awareness. This self-assessment has allowed
me to critically examine areas of strength and weakness and develop a plan that will enhance my
contributions in the profession of nursing.

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References
American Nurses Association [ANA] (2012).The essential guide to nursing practice: Applying
ANAs scope and standards in practice and education. Silver Spring, MD: Author.
Baker, S. J. (2010). Bedside shift report improves patient safety and nurse accountability.
Journal of Emergency Nursing,36, 355-358. doi: 10.1016/j.jen.2010.03.009
Institute of Medicine (IOM). (2001). Crossing the quality chasm:A new health system for the 21st
century.Washington, DC: National Academies Press.
Lopatto, E. (2012, March 22). Nurse practitioners, handmaidens no more. Bloomberg
Businessweek. Retrieved from http://www.businessweek.com/articles/2012-03-22/nursepractitioners-handmaidens-no-more

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CHECKLIST FOR SUBMITTING PAPERS


CHECK
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PROOFREAD FOR: APA ISSUES


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 persons 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. 106111]
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]
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]

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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 doesnt 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: 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?
22. Avoid contractions. i.e. dont, cant, wont, 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, 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?
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..
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. 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.

SELF ASSESSMENT OF STANDARDS OF PRACTICE


Signing below indicates you have proofread your paper for the errors in the checklist:
Sara L. Young, RN
6/26/2014
________________________________________________________DATE:________________
A peer needs to proofread your paper checking for errors in the listed areas and sign below:
_______Robert J. Young, RN______________________________DATE:___6/26/2014____________
Revised Spring 2010/slc

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