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Running head: EVALUATING PRACTICE Evaluating Your Own Current Practice Megan M. Childers Ferris State University 1 EVALUATING PRACTICE 2 Evaluating Your Own Current Practice Nurses should strive to avoid becoming complacent when delivering patient care. Continuous evaluation of his/her own practice should be conducted to ensure quality patient care. Nurses may evaluate their current practice by reflecting upon and pursuing continuous education, how they help others within the profession, being a member of a healthcare team, nurse ethically, and whether they uphold the standards of care. Reviewing evidence-based research and his/her nursing practice can contribute to the nurse’s professionalism and can significantly impact the outcomes of patient care. Quality care ensures the best possible outcomes for patients. Quality patient care could also be defined as attaining the standard of care for each and every patient. To assess whether I deliver quality care, I am always cognizant of each task at hand. Removing any and all distractions from performing nursing interventions minimizes the potential for errors. As a critical care intern in the Intensive Care Unit (ICU), I have a preceptor that gives daily reviews on my patient care. This informal discussion has both positive and constructive criticism that refocuses tasks to ensure quality care is being delivered. I apply the feedback from the preceptor to enhance my nursing practice and to remain the best healthcare advocate for my critical patients. Continuous learning, constructive feedback, and education contribute to quality patient care. The internship requires completion of weekly learning modules that focus on the pathophysiology of each body system. The modules have assessments to determine and evaluate the intern’s knowledge. I continue my education by researching each patient case, disease, and/or syndrome. Research and reviewing evidence based practice articles allow me to deliver up to date care and interventions to my patients. The ICU staff educator has developed an online EVALUATING PRACTICE 3 database for nurses to utilize. The data base outlines current interventions for numerous disease processes, and prompts nurses to seek supplemental resources for quality care. Another basis for learning is self-evaluation. I evaluate my nursing practice daily, if not hourly. A personal flaw I have is being my own worst critic. I evaluate my practice in comparison to the veteran ICU nurses. I ask numerous questions of my preceptors and nursing staff to ensure I am delivering the standard of care. My evaluation of nursing practice is based on assessment skills, communication skills, collaboration with the multidisciplinary team, and determining priorities. Evaluation from my preceptors is focused on my ability to delegate responsibilities, apply critical thinking, my knowledge of ICU’s policy and procedures, computer and documentation skills, medication knowledge and safe administration, my desire to learn, mastery of technical skills, patient/family satisfaction, and my interaction with other professionals. Whenever possible, I always seek out ways to help others in my profession. I frequently ask other colleagues if I can assist them. My logic and rationale for this is to treat others as you would like to be treated. I have helped others by bathing patients, assisting with an admission from the emergency department, helping the nursing aides with their duties, and lending personal support when needed. As the new ICU intern, I have and will strive to continue to work well with others. I observe people before I interact to gain insight on how they practice nursing. I remain positive and enthusiastic regarding nursing care. I choose to walk away from negativity and the back talking that unfortunately occurs. My outlook and demeanor will hopefully be contagious and help other members of the interdisciplinary team stay focused with regard to patients in their greatest time of need. EVALUATING PRACTICE 4 The ICU grants numerous opportunities to work as an interdisciplinary team. The nurse is consulted to inform each team member, including the patient and patient’s family, on crucial information and correlate care to achieve the best outcome for the patient. Communication is vital to the success of an interdisciplinary team. An example of how I worked as an interdisciplinary team member was communicating the status of a neurologically declining patient. This particular patient was an organ donor. In order to progress with organ recovery, I contacted neurology to perform a neurological assessment to deem the patient brain dead. After the neurology report was finalized, I communicated this to the consulting physician and Gift of Life nurses to proceed with the orders for organ recovery. Furthermore, I assisted the Gift of Life nurses on finding recipients for the recoverable organs and arranged for University of Michigan surgeons to perform the recovery. My nursing practice in this patient situation fulfilled the nursing code of ethics. After reviewing the code of ethics, my nursing practice will continue to respect the integrity of the code. My primary commitment is to the patient. I practice safely, show compassion, and preserve respect for the patient and patient’s family. I collaborate with every member of the multidisciplinary team to ensure the patient is receiving holistic care. My sole responsibility is keeping my patient safe and advocating for his/her best interest. I will also delegate responsibilities to accountable and competent staff. Patient education is an important component in my nursing practice. Incorporating and including patients in their own care will yield optimum patient outcomes. Education and research are fundamental components of the nursing profession. Personally, I haven’t conducted scientific research. My practice has been influenced because of research. One of the newest research topics in the ICU is catheter associated urinary tract EVALUATING PRACTICE 5 infections. Many evidence-based articles were circulated throughout the department that indicated the length of time a catheter remain indwelling and the development of urinary tract infections had a direct correlation. ICU nursing practice has changed due to this research, and nurses evaluate the patient’s need for a catheter on a daily basis. Prompt removal of catheters is sought, if plausible. I agreed with the research and implemented the evidence-based research into my practice. The ICU has documented the monthly occurrence of urinary tract infections, and the numbers have decreased since implementing this daily nursing evaluation. Evidence-based practice has also shown the benefit of patient referral. Patients are continuously referred to supplemental resources within the ICU and outside referrals are made based upon patient need. Frequent referrals I make are to social work, Community of Mental Health, and Alcoholics Anonymous. Several cost effective referrals available to patients are the Meds Program and Munson Manor. The Meds Program assists referred patients with attaining medications at a discounted price or arranges for free prescriptions. The Munson Manor is located on the Munson Medical Center campus and provides hospitality for the families of patients. The Munson Manor has low price for out of town guests. I strive to be cost effective in my nursing care while providing the patient with referrals to ensure quality care and overall health is maintained. Team cohesiveness could affect the delivery of quality patient care. I am a team player. I am more than willing to assist other staff members with their patient’s needs. I have a strong work ethic, contribute to staff development and interdepartmental relationships, and focus my day solely around the ICU patients. I am enthusiastic and open to learning from each opportunity presented to me. I am not afraid to do the least attractive jobs on the unit. A healthy work environment supports learning and radiates respect to each member of the healthcare team. I EVALUATING PRACTICE contribute to a health work environment by counseling distressed coworkers, diffusing tension, and providing laughter to lighten the intense atmosphere around the nursing stations. I remain empathetic to people’s needs and will continue to provide balance to a very sensory stimulated environment. Working within the ICU will allow me to become the best nurse I can be. As a member of a multi-disciplinary team, I have access to the most up to date research available from continuing education as well as many individuals and their life experiences. Ultimately, as healthcare providers, the patient and the best possible outcome for a particular patient is the greatest goal that must be strived for while maintaining patient dignity and respect. 6