Running head: SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

Self-Assessment of Nursing Practice Standards

Mary Skrypiec
Ferris State University

Self-Assessment of Nursing Practice Standards

The American Nurses Association (ANA) is an organization that created a set of high
standards for professional nurses (White & OSullivan, 2012, p. xiv). These standards are
required to be upheld by nurses to protect the patients and to help maintain a professional work
environment. The purpose of this paper is to define, evaluate, and give examples of how I have
met these standards. This paper will focus on the specific standards of ethics, education,
evidence based practice, quality of practice, communication, leadership, collaboration,
professional practice evaluation, resource utilization and environmental health.
Guide to Nursing Practice

SELF-ASSESSMENT REGARDING STANDARDS OF PRACTICE

The purpose of the ANA standards are to help create the foundation of nursing practice.
The ANA successfully champions professional nursing excellence by defining the nursing
professions accountability to the public and the outcomes for which registered nurses are
responsible, by developing and implementings standards of practice and by professional
performance using the code of ethics (White & OSullivan, 2012, p. xiv). The nursing program
at Ferris State University utilizes these standards and teaches students to demonstrate them
during class and clinical rotations. As a current student, I find that it is my duty to perform these
standards and reflect on how they are improving my nursing skills.
Standard 7: Ethics
Ethics can be defined as the code, which reflects the professions central and enduring
values, which include service to and duties towards those for whom we care, as well as to
ourselves (Olson, 2012, p. 113). In order to properly demonstrate the code of ethics, nurses
need the knowledge of safety, evidence based care, and to respect patient or family wishes.
Ethical dilemmas can occur when the patients beliefs and medical treatment disagree. I was
able to handle an ethical dilemma during my clinical rotation at the Helen Devos Childrens
Hospital. The patient was a teenage female who was losing blood due to anemia and stomach
ulcers. The treatment suggested was a blood transfusion, however, the family was Jehovah
Witnesses. The parents were aware of the situation and made it very clear to my nurse and I that
a blood transfusion was not an option, even if the time came for their daughter to die. This
situation was an ethical dilemma for me because I could not believe they would let their daughter
die rather than get a blood transfusion. From this situation, I learned that I have to provide the
best care for my patient by respecting their religion and beliefs. This was an ethical dilemma for
me but not for my patient or her family. As a student nurse I need to always respect the patient

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

and provide the individualized care; I believe I handled this situation correctly by respecting the
decisions and providing iron supplements. Ethics can also play a role when interacting with
interdisciplinary teams. I have not personally experienced an ethical dilemma between teams,
however, if I did, I would plan to take my thoughts to the chain of command. An example of an
ethical dilemma would be if the doctor did not respect my patients wishes and ordered a blood
transfusion. If this situation occurred, I would immediately call the doctor and address the
patients religious barriers to the treatment and suggest other options. Ethical dilemmas need to
be handled with individualized care to ensure safe quality of care to patients and in the
workplace.
Standard 8: Education
Education is an important skill for nurses to have while working with patients (Kulbok,
2012). Hospitals are realizing the importance of education and are currently raising the
standards for new graduates to have bachelors degree prepared. Nurses can also engage in
higher levels of education by attending graduate school and receiving a masters degree. I am
demonstrating education everyday that passes by in the program. Ferris State University has
given me the opportunity to study specialized assessments, diseases, and medications in the
classroom setting and then apply my knowledge in my clinical rotation. I was recently able to
obtain education on colostomy care while in my clinical rotation. The nurse educated the
patients husband on how to remove the bag, clean the stoma, how to measure, and replace with a
new bag. This was an opportunity for me to watch and learn so the next time I gave instructions
to the patients daughter. The standard of education is very important when working with
interdisciplinary teams. As a nurse, I will always need to check the compatibility of drugs. I
will be able to access reference manuals and educate myself on the compatibility. In a scenario

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

where I find on the reference manual that two drugs scheduled for the patient are not compatible,
it will be my duty to report the problem to the pharmacist. Once reported, I will be able to speak
with them, and then call the doctor to have a new order of prescription medications written.
Education is correlated to patient care and outcomes (Kulbok, 2012). It important to be
educated and up to date on the most recent evidenced based care so that I can provide my
patients with knowledge of their disease, educate them on self health techniques, and solve
critical thinking situations that may arise.
Standard 9: Evidence-Based Practice and Research
The main focus of evidence-based practice (EBP) is to use critical thinking skills in the
clinical setting to perform the highest quality of care to patients (White, 2012). These critical
thinking skills are learned by training from nursing school, jobs, and by keeping current on new
nursing research (White, 2012). In order to perform this standard correctly, nurses must be
competent in the education standard. Nurses can utilize the education standard to stay up to date
with EBP techniques by finding nursing research databases or articles from nursing journals
(White, 2012). Nurses must also demonstrate a receptive attitude when it comes to changing
techniques because of new EBP research. This is because the new research could decrease
infection rates or provide better patient centered care (White, 2012). I have been able to identify
EBP techniques in the clinical rotation and use them in the classroom setting by creating a
research paper. The introduction to nursing course required students to find nursing journals that
support a current EBP technique used in the clinical setting. I was able to complete this paper
using nursing journals less than five years old to support that temporal thermometers are just as
effective and less invasive than rectal temperatures. Another way I have been able to
demonstrate the EBP and research standard was by meeting with the College of Allied Health

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

Professions librarian who specializes in teaching about nursing databases. She taught me how to
find current reliable EBP articles. EBP can influence interdisciplinary teamwork by providing
open communication to discuss new or current techniques for patients (White, 2012). EBP also
allows these teams to work together to find research to support their practice (White, 2012). In
order to provide the safest and best care for my patients, it is my duty to stay educated and
perform nursing research.
Standard 10: Quality of Practice
The main focus for the standard, quality of practice is for nurses to demonstrate safe EBP
techniques, provide patient centered care and communicate with interdisciplinary teams (Lyon,
2012). Quality of practice can directly affect a patients health positively when performed
correctly or negatively when not executed properly (Lyon, 2012). Nursing skills such as reading
labs, drug compatibility knowledge, sterile techniques, delegation, therapeutic responses, and
effective communication between staff will improve quality of practice (Lyon, 2012). In my past
clinical rotations, I have experience quality of practice not being executed correctly. I have
walked into a patients room and found my nurse giving blood pressure medications without
taking the blood pressure beforehand. I have previously seen a nursing aid document that stated
the patient was at two liters of oxygen and when I performed my assessment, I discovered the
patient was at five liters of oxygen. These experiences have positively affected my practice
because I realize how these mistakes alter and can damage the patients health. I have seen the
importance of making safe medication administration and detailed assessment that relates to the
patient. I have seen positive quality of care when observing interdisciplinary communication
between the nurses, doctors and pharmacy department. I have seen nurses advocate for patients
home or pain medications to be ordered and experienced how the pharmacy can help nurses

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

understand the administration process of unfamiliar medications. The quality of practice that
nurses incorporate into their practice needs to be effective, evidence based, and safe in order to
provide the best outcome for patients.
Standard 11: Communication
This standard can be defined as the registered nurse communicates effectively in a
variety of formats in all areas of practice (OSullivan, 2012, p. 153). The areas of
communication often used in nursing are verbal and written (OSullivan, 2012). The skills
nurses need to master for effective verbal communications are therapeutic responses for patients
and assertiveness with staff (OSullivan, 2012). Nurses need to be able to have the open rapport
using therapeutic responses with patients in order to obtain crucial health details. Nurses need
the assertive communication skill to advocate for patients and their safety by providing clear,
precise information to staff during shift reports or when new health concerns arise (OSullivan,
2012). While using assertive communication techniques, it is important for nurses to remain
calm and open to the other staff members ideas while avoiding hostile remarks. Computer
software programs are able to provide written communication between staff in the hospital
(OSullivan, 2012). Nurses are able to write nursing progress notes to sum up their shift for the
next nurse and can be used to evaluate a patients progress. Computers are effectively used for
interdisciplinary teamwork because they are able to provide nurses consult notes from
specialized health professionals, which help get insight into the plan of care. I have
demonstrated effective communication verbally with staff by alarming my assigned nurse of
concerns found during my assessment. I have provided my patient with therapeutic responses to
address their anxiety, answered questions, provided education, and explained each medication
before administering. I also took my verbal communication to the patients families by providing

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

the same therapeutic responses to them. Communication is an important standard for nurses to
have in order to provide safe patient centered care and to lead to a professional work
environment.
Standard 12: Leadership
The essence of leadership is the act or instance of providing direction, guidance, and
influence (Ponti, 2012, p. 163). This means nurses must be able to be leaders to help motivate
patients to better health outcomes. In order for a nurse to be a leader, they must possess the skill
of effective communication (Ponti, 2012). The skill of communication will guide patients into
living healthier lifestyles. An example of leadership would be a nurse providing instructions on
smoking cessation and addressing options such as nicotine patches or gum. Leadership is
important in interdisciplinary teams because it allows nurses to advocate improvements that need
to be made in the patients plan of care (Ponti, 2012). I have demonstrated leadership by
providing goals for my post op patients and communicating with therapy. When therapy suggest
walking three times during my shift; I will take initiative by helping my patient reach that goal.
Leadership aligns people and provides guidance, inspiration and motivation (Ponti, 2012, p.
169).

Standard 13: Collaboration

Collaboration can be defined as the nurse working with patients, family, and
interdisciplinary teams to provide the high quality care (Brown, 2012). To effectively
demonstrate collaboration in the workplace, nurses must be skilled in communication (Brown,
2012). Nurses need to be able to work with interdisciplinary teams such as nursing aids to create
a daily plan of care for patients. Nurses and nursing aids can collaborate on which patients need

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to been seen first and discuss what tasks need to be completed that day. Nurses demonstrate
collaboration with patients and their family by using effective communication to establish
rapport so the care given is personalized. I have demonstrated collaboration in the clinical setting
when my patient decided he wanted to become do not resituate (DNR). I had shown
collaboration by accepting his decision, arranging a meeting with hospice, alerting the doctor,
and the pharmacy team. The collaboration between all teams was necessary to change his care to
comfort measures. Collaboration is an important standard for nurses to complete in order to have
safe patient outcomes.
Standard 14: Professional Practice Evaluation
Professional practice evaluation can be defined as the registered nurse evaluates her or
his own nursing practice in relation to professional practice standards and guidelines, relevant
statues, rules and regulations (Hickey, 2012, p. 187). This means that nurses must evaluate
themselves to maintain that their care is evidence-based, safe, and will increase the patients
health outcome. Nurses use interdisciplinary teamwork by getting input from colleagues,
preceptors, managers, patients, and families to evaluate that their practice is living up to the ANA
standards (Hickey, 2012). Nurses can also use educational opportunities such as online journals
or seminars to stay up to date on EBP which will keep them practicing professionally. I have
been able to perform self-evaluations at clinical which allowed me to hear feedback from clinical
instructors and change my practice for the better. My evaluations have taught me to not be so
quiet when talking to patients, scan medications in a timelier manner, and how to perform IVs in
a timelier manner. It is important for nurses to demonstrate evaluation on their practice to ensure
high quality care is being given and to allow professional growth (Hickey, 2012).
Standard 15: Resource Utilization

SELF-ASSESSMENT OF NURSING PRACTICE STANDARDS

Resource utilization can be defined as providing services that are safe, effective, and
financially responsible (White, 2012, p. 193). This means that nurses need to perform safe EBP
while only using the materials that are necessary for a patients care. To fulfill this standard,
nurses need to demonstrate advocacy and promote interdisciplinary teamwork (White, 2012).
As patient advocates, the registered nurse has an important role in assessing the healthcare
consumers and family needs, identifying desired outcomes, and assisting them to negotiate and
navigate resources for their health care across the continuum (White, 2012, p. 194). This means
that as a nurse, it will be my duty to work with the interdisciplinary teams to ensure my patient
will be discharged with appropriate medications, supplies, and rehab services. Along with
advocacy, nurses can professionally display this standard by evaluating techniques used bedside.
Nurses need to evaluate that they are using correct cost effective materials such as IV supplies
and bandages. I was able to demonstrate this standard in my clinical rotation when I had a
patient with multiple pressure sores. The night shift nurse had discovered pressure sores on the
heel of the patients feet and applied mepalex bandages to them. While I was with this patient, a
skin specialist saw the sores and recommended to stop using the bandages and switch to foot
pumps because the bandages are so expensive. I was able to realize how expensive the bandages
can be when changing them everyday versus the one time payment of foot pumps. I also realized
that foot pumps should have been applied instead of the bandages and could have prevented the
sores from getting worst. Resource utilization needs to be considered when giving patient care
because the care needs to be safe but yet cost effective for the hospital.
Standard 16: Environmental Health
The environmental health standard is met when the registered nurse practices in an
environmentally safe and healthy manner (Ballard, 2012, p. 201). This means that nurses

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practice disease prevention, teach health promotion and work in a healthy environment. A skill
that is needed for this standard is education. An example would be the need to stay educated on
vaccines and answer any concerns the patients may have. Nurses also need to be up to date on
health promotion topics such as healthy eating, smoking cessation options, alcohol cessation, and
health problems that are arising in the community (Ballard, 2012). Nurses are able to
demonstrate this standard while working in interdisciplinary teams by advocating for a healthy
work environment. Nurses can use their voice with all team members to promote no smoking in
uniforms and to assist in training for hazardous environmental conditions such as chemical
exposure (Ballard, 2012). I experienced a situation of a hazardous environmental condition that
occurred in the operating room while on my clinical rotation. The air ducts were circulating the
air backwards in the operating room, making it unsterile. I saw interdisciplinary teams work
together by informing all working staff members and having the staff relay the message to
patients. Nurses need to educate patients on a safe healthy environment as well as provide a
healthy work environment.
Goals
In order to complete my ANA standard goals, I must first achieve the goal of passing the
nursing state board exam; the NCLEX. Once that is achieved my goals will be to perform all of
the ANA standards to the highest ability. I specifically need to focus on education, safe quality of
practice, resource utilization, and leadership. I also want to stay highly educated on EBP
techniques by subscribing to nursing journals and attending seminars. This will allow me to
perform the safest care to my patients. A way to achieve my goal of having effective safe quality
of practice is to enhance my interdisciplinary skills. I can enhance those goals by joining
committees within the hospital. This will allow me to get other colleagues point of views and

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could enhance my critical thinking skills. One standard that I can improve on is resource
utilization. Until my recent clinical experience, I never thought about resource utilization.
Hospitals are a business and each nursing skill needs to be completed safe and effectively while
thinking about the finances. I want to be a strong leader for my patients by establishing a strong
rapport and advocating their needs to the other team members. This is an important role because
having a strong leadership basis for my practice can guide my patients to make better health
choices. I have many goals that I want to achieve relating to the ANA nursing standards. By
continuing to work on these goals, I will be improving my patient centered care.
Conclusion
The purpose of this paper was to reflect on how I am able to incorporate the ANA nursing
standards into my practice. After this reflection paper, I am able to evaluate how much I have
learned from each standard and how each standard changed my practice for the better. I was able
to learn that the ANA created these standards to guide nurses to collaborate with health care
consumers and others to assess, diagnose, identify outcomes, plan, implement, and evaluate
care for patients (White & OSullivan, 2012, p. 5).

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References
Ballard, K. (2012). Standard 16, environmental health. In K. M. White & A .OSullivan (Eds.),
The essential guide to nursing practice (pp. 201-214). Silver Spring, MD:
Nursesbooks.org.
Brown, P. (2012). Standard 13, collaboration. In K. M. White & A .OSullivan (Eds.),
The essential guide to nursing practice (pp. 173-187). Silver Spring, MD:
Nursesbooks.org.
Hickey, V.V. (2012). Standard 14, professional practice evaluation. In K. M. White &
A. OSullivan (Eds.), The essential guide to nursing practice (pp. 187-192). Silver
Spring, MD: Nursesbooks.org.
Kulbok, A. P. (2012). Standard 8, education. In K. M. White & A .OSullivan (Eds.), The
essential guide to nursing practice (pp. 123-133). Silver Spring, MD: Nursesbooks.org.
Lyon, L. B. (2012). Standard 10, quality of practice. In K. M. White & A .OSullivan (Eds.),
The essential guide to nursing practice (pp. 145-152). Silver Spring, MD:
Nursesbooks.org.
Olson, L. L. (2012). Standard 7, ethics. In K. M. White & A .OSullivan (Eds.), The
essential guide to nursing practice (pp. 113-122). Silver Spring, MD: Nursesbooks.org.
OSullivan, A. (2012). Standard 11, communication. In K. M. White & A .OSullivan (Eds.),
The essential guide to nursing practice (pp. 153-162). Silver Spring, MD:
Nursesbooks.org.
Ponti, D. M. (2012). Standard 12, leadership. In K. M. White & A .OSullivan (Eds.),
The essential guide to nursing practice (pp. 163-172). Silver Spring, MD:
Nursesbooks.org.

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White, M. L. (2012). Standard 9, evidence-based practice and research. In K. M. White & A

.OSullivan (Eds.), The essential guide to nursing practice (pp. 133-144). Silver Spring,
MD: Nursesbooks.org.

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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).
It may also look like this: Bell-Scriber (2007) found that
[p. 171 and multiple examples in text on p. 40-59]

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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
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.
Signing below indicates you have proofread your paper for the errors in the checklist:
Mary Skrypiec Date:03/06/2015
A peer needs to proofread your paper checking for errors in the listed areas and sign below:
**Took my paper to Sharon Colley Online Session DATE: 03/03/15**