Journal Entry Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for im
Journal Entry
Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your clinical strengths and successes.
This week, you will write a Journal Entry, reflecting on your clinical strengths and opportunities for improvement.
To prepare:
- Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in Week 1’s Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
- Refer to your “Clinical Skills and Procedures Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.
- Refer to your Patient Log in Meditrek and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
- Talk about COPD, Hypertension and diabetic wound care patients
Journal Entry (450–500 words):
Learning from Experiences
- Reflect on the three most challenging patients. What was most challenging for each?
Diabetic Wound- Heel ulcer stage III, Acute Chest pain
- What did you learn from this experience?
- What resources did you have available?
- What evidence-based practice did you use for this patient?
- What new skills are you learning?
Wound care
- What would you do differently?
- How are you managing patient flow and volume?
Communicating and Feedback
- Reflect on how to improve on your skills and knowledge and how to communicate that back to your Preceptor.
- How are you doing?
- What type of feedback are you receiving from your Preceptor?
PRAC 6531: FNP Clinical Procedures Self-Assessment Form
Procedure |
Confident (Can complete independently) |
Mostly confident (Can complete with supervision) |
Beginning (Have performed with supervision or need supervision to feel confident) |
New (Have never performed or does not apply) |
Cerumen Impaction Removal (irrigation and curette) |
X |
|||
Fluorescein Staining |
X |
|||
Corneal Foreign Body Removal |
X |
|||
Wood’s Light Examination |
X |
|||
Epistaxis management/nasal packing |
X |
|||
Remove Foreign Body (ear, eye, nose, soft tissue, other) |
X |
|||
EKG Lead Placement and Interpretation |
X |
|||
Peak flow meter Measurements |
X |
|||
Pulmonary Function Tests |
X |
|||
Burn Treatment/dressing |
X |
|||
Cryotherapy |
X |
|||
Shave Biopsy |
X |
|||
Punch Biopsy |
X |
|||
Suturing – Simple Interrupted Sutures and Suture Removal |
X |
|||
Staple Placement |
X |
|||
Skin Adhesive Placement |
X |
|||
Toenail Avulsion |
X |
|||
Incision and Drainage |
X |
|||
Subungual Hematoma Evacuation |
X |
|||
Skin Tag Removal |
X |
|||
Wart destruction/removal |
X |
|||
Wound Care Wound Debridement |
X |
|||
Steri Strip Application |
X |
|||
Tick Removal |
X |
|||
KOH skin slide for fungus |
X |
|||
Hemorrhoid, excision of thrombus |
X |
|||
Local/Field Block for Anesthesia |
X |
|||
Digital Block for Anesthesia |
X |
|||
Trigger Point Injection |
X |
|||
Joint Injection |
X |
|||
Splinting |
X |
|||
Basic microscopy (yeast, BV) |
X |
|||
Contraceptive Placement (Long term) |
X |
|||
IUD Placement and Removal |
X |
Summary of strengths:
My strengths come from my experience in the ER and when I worked as a firefighter/EMT. I work well with others; I believe in a team first mentality and with following the proper protocol. From the checklist above, I truly only feel comfortable with a few procedures such as Fluorescein Staining, Epistaxis management/nasal packing, EKG Lead Placement and Interpretation, Peak flow meter Measurements, Splinting, Tick Removal, and Steri Strip Application. These are procedure I have handled in the ER or overseas in Iraq. |
Opportunities for growth:
I truly believe we have an opportunity to grow daily, in all walks of life. I am open minded, and I learn with visual and hands on approach. I truly excited to see if I can experience some of these procedure in my current clinical location. |
Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.
My goal and objective for 6531 is to 1. assess my competency to conduct clinical procedures on my own. 2. To allow me to gain experience and expertise in a family clinical setting within 10 weeks. 3. To provide myself a chance to apply my current level of experience with the gained knowledge from this course. 4. To learn from the professionals at my clinic as I will be working with a very knowledgeable physician and his team. |
© 2020 Walden University 1
,
NONPF – 1
NURSE PRACTITIONER CORE COMPETENCIES April 2011
Amended 2012*
Task Force Members
Anne C. Thomas, PhD, ANP-BC, GNP – Chair M. Katherine Crabtree, DNSc, FAAN, APRN-BC Kathleen R. Delaney, PhD, PMH-NP Mary Anne Dumas, PhD, RN, FNP-BC, FAANP
Ruth Kleinpell, PhD, RN, FAAN, FCCM M. Cynthia Logsdon, PhD, WHNP-BC, FAAN Julie Marfell, DNP, FNP-BC, FAANP Donna G. Nativio, PhD, CRNP, FAAN
Note: Terms in bold are defined within the glossary found at the end of the competencies.
Preamble
In August 2008, NONPF endorsed the evolution of the Doctorate of Nursing Practice (DNP) as the entry level for nurse practitioner (NP) practice (NONPF, 2008a). Nurse practitioner education, which is based upon the NONPF competencies, recognizes that the student’s ability to show successful achievement of the NONPF competencies for NP education is of greater value than the number of clinical hours the student has performed (NONPF, 2008b).
The Nurse Practitioner Core Competencies (NP Core Competencies) integrate and build upon existing Master’s and DNP core competencies and are guidelines for educational programs preparing NPs to implement the full scope of practice as a licensed independent practitioner. The competencies are essential behaviors of all NPs. These competencies are demonstrated upon graduation regardless of the population focus of the program and are necessary for NPs to meet the complex challenges of translating rapidly expanding knowledge into practice and function in a changing health care environment.
Nurse Practitioner graduates have knowledge, skills, and abilities that are essential to independent clinical practice. The NP Core Competencies are acquired through mentored patient care experiences with emphasis on independent and interprofessional practice; analytic skills for evaluating and providing evidence-based, patient centered care across settings; and advanced knowledge of the health care delivery system. Doctorally-prepared NPs apply knowledge of scientific foundations in practice for quality care. They are able to apply skills in technology and information literacy, and engage in practice inquiry to improve health outcomes, policy, and healthcare delivery. Areas of increased knowledge, skills, and expertise include advanced communication skills, collaboration, complex decision making, leadership, and the business of health care. The competencies elaborated here build upon previous work that identified knowledge and skills essential to DNP competencies (AACN 1996; AACN, 2006; NONPF & National Panel, 2006) and are consistent with the recommendations of the Institute of Medicine’s report, The Future of Nursing (IOM, 2011).
At completion of the NP program, the NP graduate possesses the nine (9) core competencies regardless of population focus.
* Amended as result of additional validation through the 2011-2012 Population-Focused Competencies Task Force. Competencies 7, 6, & 7 added to “Leadership,” “Practice Inquiry,” “Health Care Delivery Systems” core, respectively, to reflect that they cross all populations.
NONPF – 2
Nurse Practitioner Core Competencies
Scientific Foundation Competencies
1. Critically analyzes data and evidence for improving advanced nursing practice.
2. Integrates knowledge from the humanities and sciences within the context of nursing science.
3. Translates research and other forms of knowledge to improve practice processes and outcomes.
4. Develops new practice approaches based on the integration of research, theory, and practice knowledge
Leadership Competencies
1. Assumes complex and advanced leadership roles to initiate and guide change.
2. Provides leadership to foster collaboration with multiple stakeholders (e.g. patients, community, integrated health care teams, and policy makers) to improve health care..
3. Demonstrates leadership that uses critical and reflective thinking.
4. Advocates for improved access, quality and cost effective health care.
5. Advances practice through the development and implementation of innovations incorporating principles of change.
6. Communicates practice knowledge effectively both orally and in writing.
7. Participates in professional organizations and activities that influence advanced practice nursing and/or health outcomes of a population focus.
Quality Competencies
1. Uses best available evidence to continuously improve quality of clinical practice.
2. Evaluates the relationships among access, cost, quality, and safety and their influence on health care.
3. Evaluates how organizational structure, care processes, financing, marketing and policy decisions impact the quality of health care.
4. Applies skills in peer review to promote a culture of excellence.
5. Anticipates variations in practice and is proactive in implementing interventions to ensure quality.
NONPF – 3
Practice Inquiry Competencies
1. Provides leadership in the translation of new knowledge into practice.
2. Generates knowledge from clinical practice to improve practice and patient outcomes.
3. Applies clinical investigative skills to improve health outcomes.
4. Leads practice inquiry, individually or in partnership with others.
5. Disseminates evidence from inquiry to diverse audiences using multiple modalities.
6. Analyzes clinical guidelines for individualized application into practice
Technology and Information Literacy Competencies
1. Integrates appropriate technologies for knowledge management to improve health care.
2. Translates technical and scientific health information appropriate for various users’ needs.
2a). Assesses the patient’s and caregiver’s educational needs to provide effective, personalized health care.
2b). Coaches the patient and caregiver for positive behavioral change.
3. Demonstrates information literacy skills in complex decision making.
4. Contributes to the design of clinical information systems that promote safe, quality and cost effective care.
5. Uses technology systems that capture data on variables for the evaluation of nursing care.
Policy Competencies
1. Demonstrates an understanding of the interdependence of policy and practice.
2. Advocates for ethical policies that promote access, equity, quality, and cost.
3. Analyzes ethical, legal, and social factors influencing policy development.
4. Contributes in the development of health policy.
5. Analyzes the implications of health policy across disciplines.
6. Evaluates the impact of globalization on health care policy development.
NONPF – 4
Health Delivery System Competencies
1. Applies knowledge of organizational practices and complex systems to improve health care delivery.
2. Effects health care change using broad based skills including negotiating, consensus-building, and partnering.
3. Minimizes risk to patients and providers at the individual and systems level.
4. Facilitates the development of health care systems that address the needs of culturally diverse populations, providers, and other stakeholders.
5. Evaluates the impact of health care delivery on patients, providers, other stakeholders, and the environment.
6. Analyzes organizational structure, functions and resources to improve the delivery of care.
7. Collaborates in planning for transitions across the continuum of care.
Ethics Competencies
1. Integrates ethical principles in decision making.
2. Evaluates the ethical consequences of decisions.
3. Applies ethically sound solutions to complex issues related to individuals, populations and systems of care.
Independent Practice Competencies
1. Functions as a licensed independent practitioner.
2. Demonstrates the highest level of accountability for professional practice.
3. Practices independently managing previously diagnosed and undiagnosed patients.
3a). Provides the full spectrum of health care services to include health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative, and end of life care.
3b). Uses advanced health assessment skills to differentiate between normal, variations of normal and abnormal findings.
3c). Employs screening and diagnostic strategies in the development of diagnoses.
3d). Prescribes medications within scope of practice.
3e). Manages the health/illness status of patients and families over time.
NONPF – 5
4. Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making.
4a). Works to establish a relationship with the patient characterized by mutual respect, empathy, and collaboration.
4b). Creates a climate of patient-centered care to include confidentiality, privacy, comfort, emotional support, mutual trust, and respect.
4c). Incorporates the patient’s cultural and spiritual preferences, values, and beliefs into health care.
4d). Preserves the patient’s control over decision making by negotiating a mutually acceptable plan of care.
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