Running head: SELF-ASSESSMENT OF NURSING STANDARDS OF PRACTICE
Self-Assessment of Nursing Standards of Practice
Amy Lampen
Ferris State University
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SELF-ASSESSMENT OF NURSING STANDARDS OF PRACTICE
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Abstract
Working as a hospital medicine nurse correlates closest with Standards of Practice for Health
Care Delivery System Case Management and Transitions of Care Professionals identified by the
American Case Management Association (American Case Management Association, 2013).
Self-assessment is an important trait of being a leader as presented in our leadership class.
Therefore, this paper provides a self-reflection of the application of these practice standards in
my current practice. A Professional Development Plan will be presented to identify goals to
maintain competency, as well as an action plan to meet these goals. Evaluation of the progress
of these goals is outlined as well.
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Self-Assessment of Nursing Standards of Practice
Hospital medicine, or hospitalist, nursing involves comprehensive discharge planning and
preparation, coordination of transition of care, medication reconciliation, multidisciplinary
collaboration and timely communication of information to outpatient providers. Because this
role is highly focused on the discharge process, it is closely aligned with case management.
Standards of practice for nursing, whether specialty or general nursing, “provide the
overall framework for measuring the competency of the professional” (American Nurses
Association [ANA], 2012, p. 33). Self-assessment of expected standards is part of the
performance improvement process.
Standards of Practice
Accountability
The case manager demonstrates shared accountability in collaborative practice, ensures
follow through of commitments of oneself as well as others, contributes to decision-making as
part of a interdisciplinary team and secures the discharge plan in a time appropriate manner
(American Case Management Association [ACMA], 2013).
I attend daily multidisciplinary patient rounds, where I contribute to the discussion of
each patient and offer suggestions for complicated cases. I collaborate with the staff nurse, the
care manager and the physician then I prioritize tasks in order to secure a quality discharge that
meets expected length of stay.
Professionalism
The case manager reflects the organization’s mission, vision and values, commits to
continued learning and professional development, researches and applies evidence-based
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practice, keeps current with health care economics and demonstrates financial stewardship
(ACMA, 2013).
I reflect the organization’s commitment to superior quality, financial strength and clinical
excellence. During the discharge process, I am attentive detail and cost effective decisions for
both the patient and the organization. Professional development is ongoing. In addition to
working towards my baccalaureate degree in nursing, I comply with educational requirements by
my organization. Above my job expectations, I recently presented research to our team
regarding improving the transition of care process for patients leaving the hospital with tests
pending at time of discharge.
Collaboration
The case manager values what other disciplines contribute, communicates with members
of the health care team to achieve optimal outcomes and builds relationships that foster trust
(ACMA, 2013).
Everyday, I review and discuss patient needs with numerous members of the health care
team including outpatient practices, nursing staff, specialists and ancillary staff. I work closely
with the primary care offices to be sure they are notified of any outstanding issues and follow-up
needs. I am also a part of a team that works on day-to-day process improvement. I have
received positive feedback from staff regarding flexibility, being approachable and responsive.
Care Coordination
With careful time sequencing, the case manager facilitates progression of care and
coordinates resources and services to achieve desired outcomes (ACMA, 2013). Early on, the
case manager works to secure a safe and effective discharge plan. He or she evaluates patient’s
and caregiver’s understanding and comfort with the plan of care.
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Prior to discharge, I work with care management to facilitate outpatient services in the
ambulatory treatment unit. I ensure every patient being discharged has a post-hospital follow-up
appointment arranged prior to discharge. I initiate the referral process for patients who may need
first time consultations with specialists such as oncology or vascular surgery. On the day of
discharge, I confirm the discharge plan and coordinate time of discharge with care management,
nursing and the hospitalist physicians.
Advocacy
The case manager discusses cost of services with the patient or caregiver, works with
payers to ensure access of patient benefits, notifies appropriate team members regarding
concerns for abuse, neglect or exploitation and ensures patient wishes are respected (ACMA,
2013).
I advocate for the patient in various ways. I look for free or reduced price medications
and verify formulary use of certain medications at time of discharge. Often times, patients are
capable to make their own decisions. Staff can become frustrated when that patient declines
professional recommendations. I do my best to be a patient advocate by reminding staff that we
need to ultimately respect patient wishes.
Resource Management
The case manager evaluates available resources, secures the appropriate payer
authorization needed, reviews utilization of medical necessity, complies with regulatory
requirements, identifies unnecessary costs that impact the hospital, implements strategies to
avoid these costs and refers quality or risk management issues as necessary (ACMA, 2013).
I have developed a close working relationship with the local clinics who serve the under
and uninsured. I utilize their resources for established patients as well as new patients. I look for
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indigent programs for medications and other reduced cost options. I am an active member of the
team working on strategies to reduce cost by avoiding readmissions, anticipating discharge needs
in a timely manner and addressing necessity for continued hospitalization.
Certification
“Certification validates a case manager’s knowledge, competency and skills” (ACMA,
2013, p13). As stated earlier, my current practice has some similarities to case management.
However, it is not considered a case management role so certification is not applicable.
Professional Development Plan
Goals and Action Plan
As a reflection of the above standards of practice, I have established goals to maintain
competency. As we continue to review process improvement strategies, I will strive to consider
all stakeholders involved. I will continue to keep an ongoing journal of issues that are brought to
my attention. These areas of concern will be disseminated and discussed at monthly team
meetings. Progress and outcomes will be shared at subsequent meetings.
In accordance with the application of evidence-based practice, I will focus on another
area to research in the transition of care process. Within the next two weeks, I will meet with my
director to discuss current initiatives. Within one month I will begin researching evidence-based
findings on the topic to be decided.
With the new changes in the health care system, I plan to focus on getting a better
understanding of the Affordable Care Act. In order to best manage resources, I need to know
how these changes financially impact our facility and our community. By weekly readings and
open discussion with other health care professionals, I would like to be able to identify three
local challenges with health care reform by the end of this year.
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Finally, as I consider my professional future, I need to plan my next academic step. My
long-term goal is to become a nurse practitioner. I plan to complete the BSN program in the fall
of 2015. The organization I work for has an educational partnership with Chamberlain College
of Nursing. I have will be scheduling a 40-minute phone appointment in the next week to
discuss their online MSN to FNP track.
Evaluation
As previously discussed, I will measure the progress of process improvement by way of
monthly follow-up meetings. I will solicit feedback from stakeholders and re-evaluate for
stakeholders that may have incidentally been overlooked. Tasks will be delegated by
management as deemed appropriate.
Within one month, my director and I should have come to a consensus on an area to
research for process improvement. By this time, I should have our facility librarian pulling some
scholarly articles. I would like to have some well-organized information to present in two
months.
Following an informational call with Chamberlain’s advisor, I will hopefully have a plan
laid out for application to the program and a projected start date. I will then have an estimate of
tuition cost so I can work on personal budget planning as well.
Conclusion
As described in the guidelines of this assignment, “Insight gained from self-reflection or
self-assessment can be very revealing” (Bishop, 2014, p. 15). By identifying our professional
standards, recognizing if we are meeting the expectations and developing a professional plan, we
can exemplify our leadership skills.
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References
American Association of Colleges of Nursing (2014). Your guide to graduate nursing programs.
[Brochure]. Retrieved from http://www.aacn.nche.edu
American Case Management Association (2013). Standards of practice & scope of services for
health care delivery system case management and transitions of care (TOC)
professionals. [Brochure]. Retrieved from http://www.acmaweb.org
American Nurses Association. (2012). The essential guide to nursing practice Applying ANA’s
scope and standards in practice and education. Silver Spring, MD: Nursesbooks.org.
Rhonda, B. (2014). NURS 440 Leadership in nursing [Syllabus]. Ferris State University.
Welcome, Holland Hospital nurses!. (n.d.). In Chamberlain College of Nursing. Retrieved
September 24, 2014, from http://www.chamberlain.edu/info/hollandhospital