Running head: SELF-ASSESSMENT OF NURSING STANDARDS

Self-Assessment of Nursing Standards

Hillary Colbry
Ferris State University

SELF-ASSESSMENT OF NURSING STANDARDS

Self-Assessment of Nursing Standards of Practice

This paper addresses the standards of professional performance outlined by the American
Nurses Association [ANA] Scope and Standards of Practice. I will analyze standards seven
through sixteen, and address how I have fulfilled each standard in the clinical setting. I will
identify areas I need to improve, as well as areas that I have not yet had the opportunity to meet.
I will then reflect on my practice and make goals to improve my current and future practice.
Standards of Practice
The ANAs standard of practice was created as a resource and reference for nurses to base
their practice on. It outlines the expectations of the professional role of the registered nurse
(American Nurses Association [ANA], 2010, p. xvii). The Standards of Professional Nursing
Practice is split into standards of practice and standards of professional performance. The
standards of practice covers the steps in nursing process, whereas standards of professional
performance cover areas of ethics, communication and resource utilization.
Ethics
The ANA (2010), states that, The registered nurse practices ethically (p. 47) which
means a registered nurse delivers care in a manner that preserves and protects healthcare
consumer autonomy, dignity, rights, values, and beliefs (ANA, 2010, p. 47). Ethics is a basis
for the practicing nurse in all aspects, as well as in how nurses present themselves in life. I was
surprised to find that there was a difference between morals and ethics in nursing. Ethics from
the nurses standpoint is not always what feels right, unlike morals. Sometimes it is choosing the
best option for a patient out of many good options. Ethical practice is the balance between
advocating for the patient, while respecting what the patient wants for their care. Providing

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ethically sound care also involves being competent in the up-to-date research so the nurse is
aware of all possible options for the patient.
In the clinical setting I am developing my ethics by watching my assigned nurses.
Ethical nurses are trustworthy and are always trying to improve patient care. Ethical nurses are
not afraid to admit mistakes, and they are accountable for their actions which shows an
understanding about ethical practice. When I encounter an ethical dilemma I think about how I
would want to be treated as a patient, as well as what evidence based practices can lead to
positive patient outcomes. I believe that using both of these aspects together can result in ethical
practice. My ethical practice is constantly evolving and adapting to the changing healthcare
system. I will stay open to these changes and always be an advocate and a support system for
my patient. This will help me to gain and maintain high ethical standards in my practice.
Education
The standard of education states that the registered nurse attains knowledge and
competence that reflects current nursing practice (ANA, 2010, p. 49). As stated in the previous
section nurses are held accountable for educating themselves and using up-to-date evidencebased practice. The attitude of the nurse about education for themselves and others is extremely
important for practice. As stated earlier, the healthcare system is changing all the time. If a
nurse has a negative attitude about change, then the evidence of their practice will be out dated in
a few years. Practice may then be considered nontherapeutic or unsafe. Evidence based practice
is not only practiced by the nurse but also by the interdisciplinary team. Nurses are trusted
advocates of the patient. It is important that the nurse is aware of changes in the practices of
other professions that involve their patient. An open and receptive attitude to educational change
is a part of the nursing practice.

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Through clinicals I have used information I have learned through class to provide
education to my patients. I will continue to practice and perfect ways to therapeutically
communicate with patients, to best reflect my knowledge and competence as a nurse. I believe it
is important for a nurse to seek information on their own instead of waiting for a manager to
bring in new information. Nurses can utilize resources such as nursing journals, and nursing
societies to maintain education in the nursing field.
Evidence-Based Practice and Research
Evidence-based practice (EBP) is intertwined with education very deeply. Nurses must
educate themselves about what practices are evidence-based by reading research articles that
support these practices. Nurses are expected to perform skills that are supported by research and
evidence. Without EBP and research skills practiced by nurses could be unsafe EPB supports
health practices and propel change in practice which is why healthcare is constantly changing.
EBP is important to me because it prompts me to utilize skills that are supported with evidence
which results in good patient outcomes. To achieve this standard nurses have to put aside any
personal thoughts about how a situation should be handled and look at the EBP. Personal
opinions are not always safest for both the nurse and patient, therefore EBP and research is in
place to outline safe practices. The ANA states that the nurse should share personal or thirdparty research findings with colleagues and peers (2010, p.51). It is important that a nurse share
research findings to promote change on a broader level rather than just individual
In class I am meeting the educational standard by writing research papers. I have
researched evidenced-based practice articles on how different therapies impact treatments. I
make sure any research I read is within the last five years, peer reviewed, and unbiased. These
steps are taken to ensure the evidence and study is the best information to date. At this time I am

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meeting this standard by reading research on current evidence-based nursing practices to

understand why nurses do the practices they do, today. In clinicals I have observed turn
schedules for patients at high risk of skin breakdown. This decreases pressure sores on patients
while they are in the hospital. To meet this standard in the future I plan to read evidence-based
research that is applicable to my field of practice, or specialty, and present it to my colleagues if I
find differences in research and current practice.
Quality of Practice
The word that catches my attention in this standard is contributes. The nurse contributes
to quality nursing practice (ANA, 2010, p.52). The word contributes emphasizes that the
standard needs to be taken as a conscious action to put into practice. Quality of practice is not
just following the new rules as they come. The standard expects nurses to analyze data to
identify opportunities for improving nursing practice (ANA, 2010, p.52). The title of this
standard implies that the standard will identify quality actions so the best practice is ensured,
which is does. I was surprised that the standard also outlined the expectation of nurses using
their practice to ensure quality. I think it really resonates with the theory involving changes
coming from the bottom and going up through a business. Nurses are the ones practicing, why
wouldnt nurses be the ones determining what quality is?
Spectrum Butterworth Emergency Department implemented a quality practice that has
stuck with me. On the wall by the nurses station where many employees pass there are gold
slips on a white board full of other important notices. Next to the gold slips was an open folder
and the gold slips could be taken by any employee on which they could write an idea for the unit
on it. It could be a very small change or a large change to solve a problem on the unit. A
committee would take the slips and review them. My instructor told me that many of the best

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changes on the unit had been from employee gold slips. I believe that technique can impact a
floor in a positive way and I hope something like that will be in practice on the floor I work on in
the future. As a result, I have kept realizing I have realized ideas I have about improving a might
benefit the whole floor. I hope to use that in my practice on any floor I go to.
Communication
The ANA suggests the nurse to communicate effectively in a variety of formats in all
areas of practice (2010, p.54). Those areas include, healthcare consumers, families, colleagues,
and the interprofessional team. It is the nurses job to identify which type of communication is
needed depending on who they are talking to. The nurse needs to educate his/her self on the
effective methods of communication to fulfill this standard. When talking with Doctors SBAR is
important to know. SBAR stands for situation, background, assessment, and recommendations
to Doctors. It provides a short, effective, and widely used method for nurses to communicate
important parts of a patients status to the Doctor. Nurses need to know the right way to talk to
patients with different mental diagnosis, trauma, and dementia. Communicating delegation to
staff is important. I think this is something that takes practice for most people entering the
healthcare system because in one day there are so many levels of communication used.
Before entering nursing school a communication class is required. In that class I learned
the common pitfalls of communication methods and how to make them therapeutic. There are
differences in how to be effective, like seating or addressing, in groups versus individuals. In the
role of the charge nurse utilizing methods of communication can result in effective leadership.
Sense I had learned the basics of communication I have used effective methods in clinicals.
While I shadowed a charge nurse a patient had to be transferred out of the hospital in a timely
manner while also accepting another patient into the same room. It was important to manage

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communication between the two patients, their families, the physicians, and the nurses.
Preferred communication methods of each person was used, which involved a system called
PerfectServe, face-to-face, calls, and texting. Using the best communication for each person
involved in the transfers resulted in a smooth exit of one patient and enter of another onto the
floor.
Leadership
A leader can be anyone who oversees nursing care, abides by the vision of the healthcare
organization, mentors colleagues, seeks ways to advance nursing, or treats colleagues with
respect, trust, and dignity as well as other attributes outlined by the ANA (2010). The ANA did
not mention having a title or being in a position on power, because that is not what defines
leadership. A quality in nursing leadership is the willingness to help others.
For nursing I took a leadership class in which I reviewed the styles of leadership and
which are most effective. In clinical leadership is analyzed and on multiple occasions I have
followed a charge nurse. It is interesting to see the charge nurses role and how dependent the
flow on the floor is on him/her. It requires to-the-point communication, understanding, and
knowledge of the floors workings. Watching the charge nurse puts into play all of what the ANA
standard book defines as leadership. In clinicals one of my instructors also has one of the
students be a student in charge of all the others. This student will create a schedule for the day
and assign patients to nurses. It gives us the responsibility and awareness that even at the level
as students, leaders can still be identified. I have not have this position yet but I am going to
utilize the aspects of the standard as outlined by the ANA.
Collaboration

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Effective collaboration occurs when the interdisciplinary team surrounding the patient
takes measures to ensure quality care, resulting in positive patient outcomes. Examples of
collaboration for nursing are communication with the healthcare consumer, family, and
healthcare providers, adherence to standards and codes of conduct for cooperation and trust, and
engaging in teamwork (ANA, 2010). Nurses have to be aware of the importance of collaboration
for the patient.
I had the opportunity to experience how collaboration positively affects patient outcomes
during a project for nursing school. This project involved collaborating with 3 pharmacy
students to focus care on one patient. Through interviewing and reviewing the health of a
volunteer of the community I was able to see the differences in technique between the pharmacy
students and me. The experience helped me understand the importance of certain assessments
nurses focus on, as well as earning respect for what pharmacy students contribute to patient care.
It verified how important collaborations of disciplines is surrounding a patient. I will always
remember this experience and apply what I have learned to my nursing practice in the future. On
my clinicals on an orthopedics floor the nurses collaborate often with the physical and
occupational therapists. It is hard to the therapists to work with the patients if they are hooked
up to IV lines. The therapists put a sign in the patients room identifying when they will be
working with the patient. In turn the nurses make sure to unhook any unneeded lines from the
patient. This collaboration between the nurses and therapists optimizes the freedom of the
patient during their exercises and the time it would take for the therapist to get a nurse into the
room to unhook the patient after the therapist has arrived.
Professional Practice Evaluation

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Professional practice evaluation applies a seeking to improve attitude. The nurse that is
always ready to learn to matter how long in practice will fulfill this standard. The ANA states
that to succeed in this standard that the nurse should engage in self-evaluation, participate in peer
reviews, provide evidence for practice, provide constructive feedback to peers, and take actions
to achieve goals from evaluations (ANA, 2010). Nursing is not a career that someone can stop
improving in with certain amount of time in the practice. Our best practice is always changing
and nurses can always improve. Nurses that are looking for opportunities for improvement will
achieve the standard. It is hard to tell someone constructive criticism if they are not open to
improvement.
As I am still a student I am figuring out how to adapt and improve my own practice on a
more basic level, such as effective communication and knowing the medication side effects. In
my clinical setting I review my experiences and accept constructive criticism. At the end of each
clinical week I review my achievements, and identify areas in my practice that need
improvement. I fill these findings out on a document that my instructor can review and add her
own suggestions of improvement. I take this tool very seriously, and accept constructive
criticism to better improve my practice. Each week I try to apply improvements so that I can
achieve a more distinguished practice as a nurse. I believe that a responsible nurse should
constantly evaluate their current practices and look for areas of improvement, and I plan to apply
this mindset as I move forward in my nursing career.
Resource Utilization
Resource utilization is a vital part of the hospital and its finances. Nurses use an
abundance of the resources the hospital provides for daily care of patients. The ANA states that
the nurse formulates innovative solutions for healthcare consumer care problems that utilize

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resources effectively and maintain quality (ANA, 2010, p.60). I initially thought a committee
was in charge of creating solutions for healthcare, but was surprised to see that nurses can have
an active role. To fulfill this standard nurses have to be aware of the way they are doing tasks
and also keeping an open eye for ways to improve. Standards are in place to maintain continuity
and improve patient safety, efficacy in treatment, and finances. It is important for a nurse to
understand that standards can be improved through their input, and that their input in valued
because nurses perform these tasks and know how to best improve patient safety.
In the clinical setting I have seen how nurses can impact resource utilization and finances
within the hospital. The clean utility room houses all the supplies needed for patient care, and
each bin is labeled with a barcode and price. I have noticed the prices of common supplies such
as oxygen tubing, gauze squares, and bandages. I realized that many nurses grab large amounts
of these supplies, such as gauze pads, and they go unused and to waste at the hospitals cost.
Through this realization I have made the conscious effort to not grab more supplies than I need in
order to save on hospital cost.
Environmental Health
Nurses are a large force of the hospital, so it is also nurses jobs to be aware of
environmental health because it creates positive care outcomes for patients. This standard
includes attaining knowledge of environmental health concepts, such as implementation of
environmental health strategies (ANA, 2010, p.61). Nurses are also expected to be advocates
for the judicious and appropriate use of products in health care (ANA, 2010, p.61). On the floor
of a hospital daily nursing tasks can create a negative or positive environment for the patient.
The nurse can tidy a patients room, keep the halls quiet, and promote and delegate others to do
the same.

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The ANA describes environmental health factors as any that can potentially affect the
health of present and future generations (White & OSullivan, 2012, p. 201). When I go into
my patients room for my morning assessment I tidy up their room unless they would like
otherwise. Their room in their place to heal and it is my job to help it be mentally and physically
therapeutic. I also understand and partake in the importance of hand washing. EBP proves that
hand washing is one of the most important actions health care workers can do to stop the spread
of infection, anywhere they are providing care. The environment for a patient can be disrupted
by any chemical or bodily accidents on the floor. I clean up any of these factors I come in
contact with in a safe manor because I know how important it is for the floors environmental
health.
Goals
My goal is to attain and maintain competency in each of the above standards. I plan to
keep myself educated to that I may teach others in need and also be open myself to teaching. I
will keep myself educated with evidence-based research as it is the basis of nursing care. I am
still now observing how nurses communicate with interdisciplinary professionals and applying it
to my practice. I understand that I need to be exposed to more areas to practice leadership, and
hope to continue improving in confidence to someday take on a leadership role. I will constantly
be motivating my practice and fulfilling professional practice evaluation by reviewing
constructive criticism.
Conclusion
This paper has helped me organize my thoughts about nursing practice and has helped me
apply them to my own practice. I have looked a little further into my future practice and now
have goals for the type of nurse I want to be. Now I can know the type of nurse I want to be is

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backed by the ANA Standards of Practice. I also now know more about the information in the
Scope and Standards book so if I am having trouble, I know where I can go for reference.

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References
American Nurses Association (2nd ed.). (2010). Standards of professional performance. Scope
and Standards of Practice (47-61). Silver Spring: MD: American Nurses
Association
White, K., & OSullivan, A. (2012). The essential guide to nursing practice: Applying ANA's
scope and standards in practice and education. Silver Spring, MD: American Nurses
Association.

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CHECKLIST FOR SUBMITTING PAPERS

DATE, TIME,
& INITIAL

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 New Roman 12-point font? [p. 228]
11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106111]. Remember, no abbreviations in the title of the paper.
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]
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).

X
X
X
X
X
X
X
X
X
X

X
X

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X
X

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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 re: use of year.
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]
D. Formatting of different types of titles: see page 185.
E. Check formatting of all types of authors and sources before submitting your
paper.

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
X
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?
X
21. Conversational tone: Dont write as if you are talking to someone in a casual way. For
X
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?
X
23. Did you check to make sure there are no hyphens and broken words in the right margin?
X
24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for
X
improper use of etc. & i.e.?
25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they
X
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
X
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?
X
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?
X
29. Did you have other people read your paper? Did they find any areas confusing?
X
30. Did you include a summary or conclusion heading and section to wrap up your paper?
X
31. Does your paper have sentence fragments? Do you have complete sentences?
X
32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is
X
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:

_____Hillary Colbry______________________DATE:____3/7/2015 ____

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A peer needs to proofread your paper checking for errors in the listed areas and sign below:
_____Maria Licari____________________________________DATE:___3/7/2015_______
STANDARDS OF PRACTICE
DESCRIPTION AND ANALYSIS OF CURRENT BEHAVIORS
Needs improvement
Competent
Proficient
Exceeds expectations
1 points
3 points
5 points
7 points
Does not reflect on
Used the LEARN steps of Used the LEARN steps
Used the LEARN steps of
professional standard at
reflective practice.
of reflective practice.
reflective practice/
all, and no examples are
Reflects on professional
Demonstrates an ability
Demonstrates an ability
provided. Reflection
standard and
to reflect on professional
to reflect on professional
entries do not refer to
improvements in
standard and change in
standard and apply
standard criteria.
knowledge, skills, and
knowledge, skills, and
knowledge, skills, and
attitudes on occasion, but attitudes by providing
attitudes by always
does not consistently
examples of activities or
providing examples.
provide examples.
new actions most of the
Reflection entry
Reflection makes a brief
time. Reflection entries
demonstrates
reference to standard
demonstrate awareness
comprehension of
criteria.
of the standard criteria.
standard criteria.
Discussed how the
professional standard
can be used to influence
interdisciplinary
standards of care and
improve quality and
safety of health care
delivery in the critical
care environment.
Standard 7
Standard 12
Standard 8
Standard 13
Standard 9
Standard 14
Standard 10
Standard 15
Standard 11
Standard 16
Goals: Articulates clear professional goals which reflect a plan to
attain and maintain competency in each standard. These must be
30
specific and measurable! Refer to information on nursing care plans re:
writing clear & measurable goals to receive full credit for this section!
TOTAL POINTS
100
WRITING STANDARDS & APA CRITERIA
Writing: Reflection is presented with accuracy, precision, clarity,
relevance, depth, breadth, logic and personal significance. Sentence
structure, paragraphing, headings, spelling, typing, grammar, neatness
Up to
APA: title page, running head, headers, abstract, margines, font size,
30 point
and references: citations in text & reference page.
deduction
APA checklist submitted with name of course peer who proofed.
(Points will earned if no APA errors found by course instructor)
FINAL POINTS EARNED