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TRANSCRIPT
Running Head: NURSING STANDARDS OF PRACTICE 1
Self-Assessment of Nursing Standards of Practice
Trevor S. Mattarella
Ferris State University
NURSING STANDARDS OF PRACTICE 2
Abstract
The American Nurses Association (ANA) has developed a list of standards that every nurse is
expected to uphold in order to provide quality nursing care. The ANA supports registered nurses
and provides them with principles to follow, ultimately guiding their practice to promote better
patient outcomes. The following information will provide analysis of my professional nursing
behaviors, and identified weaknesses and strengths. The nursing standards of practice will be
elaborated upon and personal and professional goals will be presented with a timeline for
completion. A critical analysis of my professional development and growth will be demonstrated
through the professional standards of practice.
Keywords: American Nurses Association, evidence-based practice, theory, nursing process
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Self-Assessment of Nursing Standards of Practice
The following information will elaborate on my current nursing skills in accordance with
the ANA standards of practice. According to the American Nurses Association (2010), "As a
professional organization for all registered nurses, the ANA has assumed responsibility for
developing the scope and standards that apply to the practice of all professional nurses and serve
as a template for nursing specialty practice" (p. 1). The sixteen standards of practice will be
explained in the following analysis.
Standards of Practice
Standard 1: Assessment
The first standard of practice presented by the ANA is assessment and I have met this
goal due to my current position as a cardiac nurse. This principle requires the nurse to collect
comprehensive data pertinent to each patient's health and situation. The principle is met due to
my assessment skills and accurate use of medical instruments, interpretation of data and ability
to recognize problems with my patients. My efficient assessment skills are imperative to patient
safety and satisfaction, especially with critical patients that may need to be transferred to the
intensive care unit (ICU). Assessment skills are refined with nursing experience and after
working as a registered nurse (RN) for almost two years, I am confident in my assessment skills.
Nursing assessment skills can always be improved and I am open to new opportunities and more
efficient methods through my future experience.
Standard 2: Diagnosis
The ANA (2010) states, "the registered nurse analyzes the assessment data to determine
the diagnosis or the issues" (p. 34). This standard is partially met due to my minimal experience
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as an RN. Since I have only been an RN for two years, I will improve in my nursing diagnosis
skills through future experience. Determining nursing diagnosis will improve based on
assessment findings, experience, and the multitude of experiences we encounter. My goal will be
to increase my knowledge of nursing diagnosis through participation of evidence-based practice
and current research.
Standard 3: Outcomes Identification
The standard of outcomes identification is met due to the ability to focus on the patients
discharge plan. The ANA states, "the registered nurse identifies expected outcomes for a plan
individualized to the healthcare consumer or the situation" (p. 35). The management of patient
care, medical needs assessments, and discharge planning are my responsibility during their
hospitalization. To achieve these goals, I work directly with all members of the discipline
including social workers and case managers to ensure a safe transition for patients after their
medical outcomes are determined.
Standard 4: Planning
The ANA defines the standard of planning as, "the registered nurse will develop a plan
that prescribes strategies and alternatives to attain expected outcomes" (p. 36). I meet this
standard by designing care plans that meet the patients individual needs and focus on improving
patient outcomes. Health promotion and restoration of optimal health is the goal of my nursing
care. Planning ahead is imperative with the assistance of social workers, case management, and
all other members of the discipline. This planning strategy helps to ensure continuity of care and
patient satisfaction. Each member of the discipline focuses on incorporating a timeline into the
patients planning to ensure that everyone is working towards the same goals and that the family
is informed.
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Standard 5: Implementation
The fifth standard is part of the nursing process and is very important regarding the
individualized care plans for each patient. I meet this standard through my ability to implement
nursing techniques and physician recommendations into the daily care of each patient. According
to the ANA (2010) the nurse must, "utilize evidence-based interventions and treatments specific
to the diagnosis or problem" (p.38). I meet this standard through my implementation of proper
nursing techniques and placing orders for physicians to ensure that each patients care is optimal.
My communication with all members of the discipline including patients and family members is
very important to implementing proper nursing interventions.
Standard 6: Evaluation
The evaluation standard is the final step of the nursing process and is important to
successful patient outcomes. This standard is met through my practice and evaluation of nursing
care, represented in my care plans and interaction with physicians. During my evaluation of the
plan of care, I will inquire about orders that may be warranted to maintain patient comfort,
health, and stability. Vital signs are assessed multiple times throughout the day and I am required
to evaluate them and base any care changes on their status. Cardiac nursing requires that we are
always assessing patients for changes in status. We take pride in the high level of autonomy we
have in the evaluation of their care. My documentation of implementation and evaluation is very
detailed, which assists the other team members to identify effective or ineffective interventions
utilized for the patient’s plan of care during their hospitalization.
Standard 7: Ethics
The ethical aspects of nursing are imperative to successful patient rapport and positive
outcomes. I meet the standard of ethics set forth by the ANA through my ethical behavior and
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attempt to preserve the dignity, rights, values, and beliefs of each individual patient. According
to ANA (2010), the nurse must "take appropriate action regarding instances of illegal, unethical,
or inappropriate behavior that can endanger or jeopardize the best interests of the healthcare
consumer or situation" (p. 47). Ethical nursing is very important to me when providing care to
patients and their family. Positive patient rapport is established through ethical nursing. Each
nurse is responsible to be a patient advocate and recognize unethical situations to prevent them
from occurring.
Standard 8: Education
The standard of education proposed by the ANA focuses on the constant educational
opportunities directed to increase the knowledge and quality of nursing care. This standard is met
due to my role in continuing my education and goals to achieve my Bachelor of Science in
Nursing (BSN) next year and enrolling in the Doctorate Nurse Practitioner (DNP) program
afterward. ANA (2010) states, "the nurse should demonstrate a commitment to lifelong learning
through self-reflection and inquiry to address learning and personal growth needs" (p. 49). My
commitment to my education upholds this standard by staying current on the latest evidence-
based practice and nursing research. Continuing education credits are completed periodically as
well to improve my nursing knowledge base and to meet state requirements.
Standard 9: Evidence-Based Practice and Research
This standard incorporates the use of evidence-based practice and research into nursing to
provide quality care to patients. I meet this standard by my use of continuing education on the
cardiac unit and attending staff meetings concerning new techniques or protocols. Our staff
meetings incorporate evidence-based practice into the nursing care and I frequently review
statistics regarding the change in techniques. My goal in the future will be to join a committee
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within my unit to assist in the creation of improved nursing methods based on evidence-based
practice. Guiding practice through research findings is helpful because it has been proven to
work efficiently through multiple qualified healthcare providers.
Standard 10: Quality of Practice
Standard ten focuses on the quality of nursing practice exhibited by a nurse and their role
in improving nursing standards. This standard is met in my practice due to the high quality of
work that I provide to patients and my analysis of opportunities to improve nursing practice.
Quality of practice is not only about providing quality of care, but also is about recognizing
improvements and working with new ideas to advance the quality of nursing care. According to
ANA (2010) the nurse, "demonstrates quality by documenting the application of nursing process
in a responsible, accountable and ethical manner" (p. 52). My practice demonstrates quality due
to the accountability of my actions and others whom I delegate to each day. Patients recognize
the quality of care and it is the responsibility of every nurse to focus on methods of quality
improvement to ensure patient satisfaction.
Standard 11: Communication
The standard of communication is one of the most important standards in nursing practice
due to the severity of possible outcomes with miscommunication. I meet the standard of
communication by collaborating with all members of the discipline to promote efficient nursing
care and keeping my patients and their family updated. According to ANA (2010), "the
registered nurse communicates effectively in a variety of formats in all areas of practice" (p. 54).
My nursing practice utilizes all communication styles depending on the patients personality,
beliefs, or ideals. Connecting with patient’s on a professional level continues to be a goal of my
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professional practice and I take pride in my ability to alleviate confusion by keeping them
updated on their plan of care
Standard 12: Leadership
ANA (2010) states, "The registered nurse demonstrates leadership in a professional
practice setting and the profession" (p. 55). Leadership is a standard that I partially meet since I
have only been a nurse for two years. I possess many leadership qualities and these skills are
used on a daily basis, however more experience in nursing will only provide me with more
efficient leadership skills in the future. The ANA also states the leadership nurse, "oversees the
nursing care given by others while retaining accountability for the quality of care given to the
healthcare consumer" (p. 55). My accountability for the actions of myself and the staff I oversee
is important to quality of care and patient satisfaction. Leadership qualities will only improve in
the future through experience and delegating to other staff members.
Standard 13: Collaboration
Collaboration is another main focus within the nursing standards of care for registered
nurses. The standard of collaboration is met through my ability to include all members of the
discipline in the patients' plan of care. The patients safety is ensured through proper
communication techniques and collaborating with the physicians, case managers, nursing
assistants, family, and most importantly, the patient. Registered nurses are responsible to
collaborate with the patient and family to ensure they understand the plan of care and goals for
their future health. According to ANA (2010), "The registered nurse collaborates with healthcare
consumer, family, and others in the conduct of nursing practice" (p. 57). Leadership,
collaboration, ethics, quality of practice, and communication all work together to create safe
nursing care and effective results.
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Standard 14: Professional Practice Evaluation
The professional practice evaluation standard is another important part of my nursing
career. I meet this standard because throughout the BSN program at Ferris State University, I
have been required to periodically evaluate my professional practice against the nursing
standards approved by the ANA. This analysis is an example of providing a professional practice
evaluation, in order to make improvements that may be needed for my career. ANA (2010)
states, "the registered nurse evaluates her or his own nursing practice in relation to professional
standards and guidelines, relevant statutes, rules, and regulations" (p. 59). Annually, we are
required to submit an evaluation to our manager and receive feedback on our overall job
performance. The formal feedback assists in our professional development and goals for the
future.
Standard 15: Resource Utilization
Utilizing resources within a nursing unit are very important to efficiency and
productivity. According to ANA (2010), "The registered nurse utilizes appropriate resources to
plan and provide nursing services that are safe, effective, and financially responsible" (p. 60). I
meet the standard of resource utilization in a variety of methods including using the correct
amount of supplies for the job and asking the charge nurse for help if necessary. Patient
satisfaction is important and asking our charge nurse for help is directed at patient safety and
improving results. Utilizing the resources we have, such as the pharmacy, physicians, and other
professionals assists in providing effective patient care. Every day I consult with the pharmacists,
physicians, and other resources to find answers quickly and efficiently, to assist with patient
outcomes and continuity of care. Resource utilization is necessary to effectively running a
hospital and providing money-saving opportunities to supplement revenue.
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Standard 16: Environmental Health
The standard of ensuring environmental health is imperative in the operation of any
hospital or healthcare facility. I uphold this standard by practicing in an environmentally safe and
healthy manner. (ANA, 2010). I am sure to always use hand sanitizer before and after patient
contact to ensure the spread of bacteria is eliminated. According to ANA (2010) a competent
nurse, "promotes a practice environment that reduces environmental health risks for workers and
healthcare consumers" (p. 61). By precepting nursing students, I have demonstrated upholding
this standard by my teaching of aseptic techniques and strategies when providing patient care.
Cleaning around the unit is a task that I perform on a daily basis to ensure patient safety and to
reduce the risks of infection. If we are not careful about ensuring environmental health, our
patients can become septic and have possible life-threatening complications. Quality
environmental health improves patients outcomes, benefits the hospitals reputation, thus
increasing revenue and the number of patients in the facility.
Professional Development Plan
Professional Goals
My professional goals are going to be outlined in the following professional development
plan. An honest reflection of my nursing skills has been elaborated upon throughout this paper
for the purpose of identifying whether I have met or am partially meeting the ANA Standards of
Nursing Practice. After reviewing my nursing practice, I feel that I meet fourteen of sixteen
standards of nursing care. The diagnosis and leadership standards are the only two standards that
I found to be partially met, due to my inexperience in being a nurse for only two years. The goal
to improve the nursing standard of diagnosis is through continuing education credits and through
evidence-based practice. The next goal will be to improve my leadership skills by volunteering
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to work as the charge nurse of the cardiac unit within the next two months. The rest of the
standards are met currently, however continuing education is imperative to practice safety and
effectively as a registered nurse.
The goal to continue meeting all of the standards of the ANA will be attained through
continuing education, attending monthly unit meetings, reviewing current policies and
procedures, reading through educational material, and attending cardiac lecture series. After
reviewing current policies and procedures in addition to continuing education, it will promote
safe patient care and better outcomes. Attending monthly meetings and cardiac lecture series will
assist in my professional development as a registered nurse. Another important goal for myself
after completing the BSN at Ferris State University is beginning the DNP program at Saginaw
Valley State University
Action Plan
My action plan will be explained in this section to assist with communicating the
methods to achieving my goals stated in the professional development plan. The first step will be
to register for Nursing 450 to begin in this Fall 2013 toward finishing my BSN. After completing
this course, I will register for my final course of this program, Nursing 495. This will set my
graduation from Ferris State University (FSU) with my BSN in May 2014. After achieving the
BSN degree from FSU, I plan to continue working in the cardiac unit. I would like to consider
joining a committee and starting evidence-based practice projects to improve patient care within
the unit and throughout the hospital. In addition, continuing education will strengthen the scopes
and standards of practice that are necessary to improve my leadership and diagnosis with patient
safety and plan of care. I will begin completing at least one continuing education credit each
month to stay current on the changing trends in nursing care and to meet the state requirements
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of a registered nurse. The next step in my education after achieving my BSN at FSU will be to
apply to the DNP program at Saginaw Valley State University (SVSU). If accepted, I plan to
start the DNP program in fall 2014. The program is projected to be continuous over the course of
nine semesters or four years. This will tentatively place graduation as a DNP in Fall 2018 after
completion of the program at SVSU. The goal after completing this program will be to work
within a large hospital on a cardiac unit, specializing in critical care. The cardiac aspects of
clinical nursing care is very rewarding to me and this future position as a DNP will be the perfect
mixture between challenges and rewards.
Evaluation Plan
The evaluation plan of my educational goals will be imperative to be successful and
prepare for the future as an advanced practice provider. Upon completion of the next two classes
towards my BSN, my grades will determine if I can be accepted into the DNP program. By
having a 3.0 grade point average or higher, I will qualify to be accepted into the program by fall
2014. The program will be four years long and evaluation of my skills will be demonstrated by
each professor throughout the semesters. I will personally evaluate myself annually in terms of
leadership and diagnosis, as represented through the ANA standards of nursing care. My unit
manager will evaluate my nursing care and management as a charge nurse every six months to
ensure improvement. Continuing education will be completed every month and cardiac lectures
will be attended when they are offered at least every two months. The evidence-based practice
and research is imperative to quality nursing care. Through evaluation of my nursing practice, I
will ensure my nursing care complies with the standards set forth by the ANA and the hospital.
Doctorate Nurse Practitioner is a very difficult degree to achieve but my passion for direct
patient care and advanced practice will be the most important indicator of my future success.
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References
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver
Spring, MD: Nursesbooks.org.
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CHECKLIST FOR SUBMITTING PAPERS
CHECKDATE, TIME, & INITIAL
PROOFREAD FOR: APA ISSUES
4/26/13 HW
1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)]
4/26/13HW
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]
4/26/13HW“NEED”
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]
4/26/13HW
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]
4/26/13HW
5. Margins: Did you leave 1” on all sides? [p. 229]
4/26/13HW
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]
4/26/13HW
7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229]
4/26/13HW
8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions.
4/26/13HW
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]
4/26/13HW
10. Typeface: Did you use Times Roman 12-point font? [p. 228]
4/26/13HW
11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106-111]
4/26/13HW
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]
NURSING STANDARDS OF PRACTICE 15
4/26/13HW
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]
4/26/13HW
14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172]
4/26/13HW
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.
4/26/13HW
16. Headings: Did you check your headings for proper levels? [p. 62-63].
4/26/13HW
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
4/26/13HW
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.)
4/26/13HW
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?
4/26/13HW
20. Wordiness: check for the words “that”, and “the”. If not necessary, did you omit?
4/26/13HW
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?
4/26/13HW
22. Avoid contractions. i.e. don’t, can’t, won’t, etc. Did you spell these out?
4/26/13 23. Did you check to make sure there are no hyphens and broken words in the right
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HW margin?4/26/13HW
24. Do not use “etc.” or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.?
4/26/13HW
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?
4/26/13HW
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…..
4/26/13HW
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.”
4/26/13HW
28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck?
4/26/13HW
29. Did you have other people read your paper? Did they find any areas confusing?
4/26/13HW
30. Did you include a summary or conclusion heading and section to wrap up your paper?
4/26/13HW
31. Does your paper have sentence fragments? Do you have complete sentences?
4/26/13HW
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:
_______Trevor Mattarella___________________________DATE:________4/28/13________
A peer needs to proofread your paper checking for errors in the listed areas and sign below:
______Holley West________________________________________DATE:____4/26/13_____
Trevor,
Please add an abstract to your paper as it is required by ANA. Also you will need to reword some
sections and revise the formatting on the references page. Be careful using singular and plural
nouns together. Great job!
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