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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


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


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.


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


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


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


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.


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.


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


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


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.


References

American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver

Spring, MD: Nursesbooks.org.


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]


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


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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