Running head: SELF-ASSESSMENT OF NURSING STANDARDS OF PRACTICE
Self-Assessment of Nursing Standards of Practice- Pediatric Nurse
Maia R. Novak
Ferris State University
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Abstract
The focus of this paper is to determine a plan from my career and professional development as a
pediatric nurse. By using pediatric nursing scope and standards of practice I have created short
and long-term goals. The strengths and weaknesses to the specific actions which I will take to
attain these goals will be evaluated. I will compare my current practice to what is outlined by the
Society of Pediatric Nurses (SPN) and the National Association of Pediatric Nursing
Practitioners (NAPNAP)
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Self-Assessment of Nursing Standards of Practice- Pediatric Nurse
Pediatrics nursing is a rewarding profession and one that is constantly changing and
evolving daily. There are certain standards principles, morals, and values that are essential for
pediatric nurses to practice. The purpose of this paper is to examine the standards of practice for
pediatric nurses and where I currently stand. I will discuss my current goals and a method to
evaluate progress towards those goals. I understand that goals and outcomes need to be
measureable, reviewed periodically, and modified. “Pediatric Nursing: Scope and Standards of
Practice is a collaborative effort of the American Nurses Association (ANA), the Society for
Pediatric Nurses (SPN), and the National Association of Pediatric Nurse Practitioners
(NAPNAP)” (Betz, 2008), and I will use those standards to compare my current practices.
Standards of Practice
Quality of Practice
This is a very important part of nursing. Standards, policies, and procedures are
constantly changing and improving because of the impact that nurses have. According to
NAPNAP it is essential to “participate in continuous quality improvement processes to assure
provision of quality health care” (National Association of Pediatric Nurse Practitioners, 2004).
Nurses have to be critical thinkers and evaluate what we do and why. The NAPNAP also
explains that nurses need to “synthesize and use the results of evaluation to make or recommend
changes including policy, procedure, or protocol documentation (National Association of
Pediatric Nurse Practitioners, 2004). One component that I have met as a nurse is improving
quality care by being a preceptor for the new nurses that are hired on our unit. I ensure that they
have the resources that they need to provide their patients quality care in a safe manner. One
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example of how I do this is by asking them open ended questions. I would ask them to “tell me
how you are going to hang that antibiotic”. This helps me determine what steps they are going to
take to complete certain tasks.
I do understand that I have not met the standard component of using data results to make
recommended changes in policies or procedures. I think that this is something that I would like
to be involved with in the future. Some examples of this component are collecting and analyzing
data such as skin audits and fall prevention.
Professional Practice Evaluation
According to NAPNAP Dr. Mott described the standards as the “authoritative statements
that describe the responsibilities for which nurses are accountable” (Betz, 2008).
As nurses, we
are responsible to give our patients the best possible care and to ensure that this care that we
deliver is in line with nursing standards and guidelines. The NAPNAP states that nurses should
“demonstrate practice consistent with legal standards in compliance with any applicable state and
federal regulations” (National Association of Pediatric Nurse Practitioners, 2004). This is
something that comes with time, but what is important to understand is where this information
can be located for reference. An example of how I ensure that I am in compliance with
organizational policies and procedures is by using the reference manual that is located on our
unit. There are many different resources that are included in this manual, some examples being
how to change central lines and low potassium diets for nephrology patients. By evaluating by
nursing knowledge, I understand when it is essential to refer to provided resources.
Education
Education is a standard that is very important to me. I understand the importance of
knowledge and the impact that it has on my patients. The NAPNAP explains the importance of
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maintaining “clinical competency, professional skills, and knowledge through experiences and
formal continuing education programs and independent learning activities” (National
Association of Pediatric Nurse Practitioners, 2004). I am fulfilling this standard by continuing
my education in order to obtain my Bachelor Degree of Nursing (BSN). I have decided to go
back to school for my BSN for a number of different reasons. I want to have more options for
my career path in the future. Maybe I will teach or maybe I will become a supervisor. I don’t
know where I ultimately want to end up, but I know that I don’t want to be told “no” because I
only have an ADN.
Collegiality
Nurses are constantly working with one another as well as with the nurse techs.
Collegiality this is the relationship between colleagues (Betz, 2008). The relationship that is
built between staff is something that does not comes right away. It takes time to know what
others are capable and what their strengths and weaknesses are. Building this standard is
something that has taken some time for me. The staff on our unit is constantly coming and
going, which makes it difficult to build relationships. In addition, I only work two nights a
week, resulting in me working with different staff. Collegiality is a standard that is difficult for
me to fulfill but I realize that there are ways in which this standard can be improved.
Collaboration
Collaboration is a standard that when performed correctly it can be very beneficial for the
patient. Collaborating with other health care providers is necessary. Collaboration is being able
to “partner with other disciplines to enhance care through activities such as education,
consultation, collaboration, development of new management and therapeutic strategies, or
research” (National Association of Pediatric Nurse Practitioners, 2004). I use good
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communication not only with the patients that I care for, but with other staff as well. Caring for
patients to determine that their needs cannot be done by one person alone; it takes a group effort.
We collaborate together as a multidisciplinary team of nurses, physicians, residents, pharmacists,
physical therapy, dietary, case managers, social work, and occupational therapy. Good
communication is essential and the focus of the team is to meet the patient’s needs. Our
physicians round on our patients day and night and this is a great chance to ensure that all
healthcare providers are on the same page and can agree on short-term and long-term goals for
the patient.
Ethics
Ethics play a big role in the nursing profession. There is a standard that nurses need to
follow in their practice. It is essential to “use an ethical framework to evaluate issues regarding
care” (National Association of Pediatric Nurse Practitioners, 2004). Although it is sometimes
difficult to do so, this is a standard that have I been able to accomplish so far in my nursing
career.
I work on a pediatric orthopedic and trauma floor. I once had a patient that was admitted
with multiple fractures, all of which were in different stages of healing. This is a red flag with
pediatric patients because many times it is a sign of child abuse. It was difficult not to be
judgmental of these parents while I was caring for their child. It was a good thing that I treated
them with dignity and respect because their child was diagnosed with osteogenesis imperfecta.
This is a disease where the bones are extremely brittle. I was thankful that I was not judgmental;
especially since the children was not even diagnosis yet. I do the best that I can and I have
compassion for all of my patients and their families. I treat them that way that I would want to
be treated and as though they were my family members in the hospital.
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Research
I have always enjoyed research and think that it is always interesting to learn something
new and expand my knowledge. I understand the importance of modifying my practice so that it
is “consistent with current practice guidelines and clinical recommendations for the health care
of children in all settings, including but not limited to primary, acute, critical, long-term, and
chronic care settings” (National Association of Pediatric Nurse Practitioners, 2004). This is a
standard that I have continued to achieve. I am constantly exploring new nursing research in
every nursing course that I complete. It is essential to use evidence-based practice as a guide for
the care that I provide my patients. An example of how I fulfill this standard is by encouraging
my patients that are bedridden to turn every two hours. I explain to them that although it might
increase their pain level this is something that we need to accomplish in order to prevent pressure
ulcers. The increased pain is something that we can treat, but if a patient develops a pressure
ulcer this will delay their care. I educate my patients about what I am doing and why it is
important. I encourage them to ask questions and be active participants in their care.
Resource Utilization
It is essential to understand what resources are available and how these resources can be
utilized. Nurses can help “coordinate care, make appropriate referrals, and facilitate health
systems intervention to assure quality care” (National Association of Pediatric Nurse
Practitioners, 2004). There are many examples that come to my mind of how I display this
standard. One example that comes to my mind is when there is a new patient that is admitted to
our floor. I inform the nurse tech when a patient does need to be on telemetry. I do not know
exactly how much each of these packets of leads costs, but I acknowledge the fact that if it is not
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needed then I will not waste it. I will continue to maintain competency in this standard by
always thinking about ways to I can save the patient and their family money.
Leadership
As nurses we need to “support the education and role development of novice
practitioners by serving as preceptors, role models, and mentors” (National Association of
Pediatric Nurse Practitioners, 2004). I believe this absolutely true. We all need to be good
teachers and educators by working together and sharing knowledge. I am team player and I do
help to contribute to a healthy work environment. My personal philosophy makes me who I am.
One way that I display this standard is by making myself available for the other nurses,
especially the new graduates. We work through issues and problems together instead of me
simply telling them what to do. I think that this helps them become critical thinkers.
I do believe that there are many ways that I could improve my leadership skills. One way
that comes to mind is becoming a charge nurse. Nurses already come to me for advice and
guidance. By being charge nurse this would help me develop my problem solving strategies and
also communication skills, which are both characteristics of strong leaders.
Advocacy
Being an advocate is providing support and encouragement to others. It is the actions
that I take to help promote the well-being of my patients. The SPN and the NAPNAP explain
that nurses must advocate for children and their families (National Association of Pediatric
Nurse Practitioners, 2004). There are many ways that nurses can be advocates for their patients.
One example that comes to mind was when I admitted a patient. The first task that we completed
what starting an IV and drawing labs. It took multiple pokes and this was very frustrating for the
family because their baby was constantly crying. All the labs were processed when the resident
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came to me a stated that he forgot to order a certain lab. Many times this is not a big deal, so I
called down to the lab to see if they could run this specific test with the blood that they already
had. They stated that they could not because the blood needed to go in a separate vial. I called
the resident and explained to him that I wasn’t going to have this baby poked again tonight
because he had gone through enough already. I asked if we could just wait until the morning
labs were drawn and this test to be added then. He started that would be appropriate. I was
thankful that I was able to save this patient from getting an unnecessary poke. The family
appreciated me being an advocate for their child.
Professional Development Plan
Goals
I would like to attain and maintain competency in each of these standards. Some of the
standards I am stronger at than others. The eight standards of care that are the focus of this
paper are quality of practice, professional practice evaluation, education, collegiality,
collaboration, ethics, research, resource utilization, leadership, and advocacy. I plan to attain the
quality of practice standard by becoming involved in committees at work. These committees
ensure that policies and procedures are adequate to meet the safety needs of the patient. The
second standard discussed was professional practice evaluation. I will continue to maintain this
competency by using accessible resources to review policies and procedures that I am not
familiar with. Education is a standard that I am currently attaining by obtaining my BSN.
Communication and collaboration are standards that go hand in hand. These are standards that I
will continue to maintain because they come natural for me and you cannot have one without the
other. I will maintain the standard of ethics throughout my nursing career by continuing to use
research as a guide for how I care for my patients. Resource utilization is a standard that is many
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times forgotten, but I will be mindful of this in my nursing practice. It is important for me to be a
strong leader and also advocate for my patients and their needs.
Action Plan
I plan to maintain quality of practice standard by becoming a member of the skin audit
team within the next year. This is a good way to collect data and help determine if policies that
are currently in place need to be improved to better care for the patient. By understanding what I
am capable of and becoming familiar with policies and procedures I will attain the standard of
professional practice evaluation. I will continue to use my resources in order to follow state and
organization regulations. When I complete this program I will maintain my nursing license by
ensuring that I complete my continued education credits every two years. My plan is to continue
to use effective communication and collaboration with others by being open to others and their
suggestions. I will continue to be approachable and responsive to the staff that I work with. My
plan is to always remember the standard of ethics and to treat my patients and their families with
dignity and respect. The standard of research is very essential to maintain. Science and research
is constantly changing, so I plan on maintaining this standard by continuing to use evidencebased practice. I plan to maintain the standard of resource utilization by using my resources and
by thinking what supplies I are essential in order to care for my patients and what are not. The
standards of leader and advocate are similar in my eyes. I will continue to maintain these
standards my being the best nurse that I can be and by providing the best possible care to my
patients.
Evaluation
I think that it will be important to evaluate my plan. Every year I meet with my manager
and we discuss my nursing skills over the past year, but what we don’t discuss are goals for the
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upcoming year. I think that this is something that I will suggest that she and I do together. This
will be a way to hold myself accountable for the goals that I set. Together, we could come up
with a one year and five year goal checklist. The one year goal list would consist of me
maintaining quality of practice standard by becoming a member of the skin audit team. This list
will also remind me to annually evaluate my own practice to ensure that I am meeting nursing
guidelines and maintain this standard. I will complete my nursing degree next May and this will
help me maintain my education standard. This checklist will also include the use of research and
evidence-based practice as a reminder to annually search new ways to care for my patients.
Within the next year I will construct a list that will consist of my own resources that I use most
often. I will make a portfolio of guidelines that are most pertinent to my patient population.
I will evaluate my use of open communication and collaboration by determining it
effectiveness and the impact that it has between my co-workers and myself. I will evaluate my
fulfillment of the ethics standard by ensuring the I am consistent with the care that I provide my
patients and I am able to keep my personal thoughts and opinions aside. In order to evaluate the
standard of resource utilization I think that it would be a good idea to look into the cost of the
most frequent supplies used. By knowing how much each item cost, this would be a reminder to
me not to be wasteful. I plan to evaluate myself as strong leader and advocate by assessing what
I do, why, and the impact that it has on others around me.
Conclusion
Exploring these standards has been a challenging task. I have really had to think about
how I have accomplished some of these standards and how I plan to attain others. I have been
reminded of my strengthens and my weaknesses and now it is my goal to expand my nursing
skills. I understand that I am constantly growing and developing my knowledge. By analyzing
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who I am as a nurse, I can envision what I want to become and the impact that I want to have on
others. Accomplishing these standards will assist me along the way.
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References
Betz, C. (2008). Pediatric nursing: Scope and standards of practice. Journal of Pediatric Nursing,
23(2), 79-80. Retrieved from http://www.pediatricnursing.org/article/S08825963(07)00440-X/fulltext
National Association of Pediatric Nurse Practitioners. (2004). Scope and standards of practice.
Retrieved from http://www.amddprogram.org/conference/assets/Resources/General
Resources and Tools/NAPNP_NP Scope of Practice_2004.pdf