Carly LegaultSeptember 12, 2013 Self-Assessment Tool – CCP College of LPNs of Alberta Page 1 2nd Edition - Revised October 2008 Self-Assessment Tool – CCP College of LPNs of Alberta Page 2 2nd Edition - Revised October 2008 TABLE OF CONTENTS SELF-ASSESSMENT TOOL - RATING SCALE..........................................................................4 STEP 1: SELF-ASSESSMENT WITHIN STANDARDS OF PRACTICE.....................................4 A: Nursing Knowledge ...............................................................................................................4 B: Nursing Process..................................................................................................................... 5 C: Safety..................................................................................................................................... 5 D: Communication and Interpersonal Skills................................................................................5 W: Professionalism..................................................................................................................... 6 X: Nursing Practice and Leadership............................................................................................6 Self-Assessment Summary.......................................................................................................... 7 STEP 2: SELF-ASSESSMENT OF SPECIFIC COMPETENCIES..............................................8 STEP 3: LEARNING PLAN......................................................................................................10 RECORD OF PROFESSIONAL ACTIVITIES............................................................................11 Self-Assessment Tool – CCP College of LPNs of Alberta Page 3 2nd Edition - Revised October 2008 SELF-ASSESSMENT TOOL The Self-Assessment Tool is used to assess your professional practice using the LPN Standards of Practice and Competency Profile as a guide. Focus your assessment on your practice as a whole and then those Specific Competencies which are directly related to your role and responsibilities. RATING SCALE Use the following rating scale to complete your Self-Assessment. 1 Excellent 2 Competent 3 Requires Improvement 4 Developmental Demonstrates excellence in the expectations and / or requirements of the competency. Meets the expectations and / or requirements of the competency. Has identified weakness in areas of knowledge, skills, attitudes, or clinical judgment. Requires education and/or orientation to meet the expectations and / or requirements of the competency. 5 Not Applicable Not applicable to current role and responsibility. STEP 1: SELF-ASSESSMENT WITHIN STANDARDS OF PRACTICE Competency Number A: Nursing Knowledge Year 2014 Year 20__ Year 20__ Year 20__ Year 20__ Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) A-1 Applies knowledge of anatomy and physiology of the human body to the assessment of client and delivery of nursing care. 1 A-2 Applies knowledge of microbiology throughout care, disease prevention, and health promotion. 1 A-3 Applies knowledge of pathophysiology to the nursing care of the client. 2 A-4-4 Uses appropriate medical terminology to report and document client care. 1 A-5-9 Adjusts nursing practice to the specific growth and development of the client. 2 A-6 Applies principles of nutrition to the assessment and care of the client. 3 A-7 Applies knowledge of pharmacology throughout client care and teaching. Self-Assessment Tool – CCP College of LPNs of Alberta 2 Page 4 2nd Edition - Revised October 2008 Year 2014 Competency Number A-8-2 Integrates knowledge and skills from the sciences and humanities into the application of the nursing process. B: Nursing Process Rating (1-5) Performs health assessment of client using assessment techniques and a systematic process. 2 B-2-2 Implements the planning process and establishes client priorities involving client in planning. 3 B-2-3 Identify and analyze nursing diagnosis. 1 B-3 Implements nursing interventions to carry out nursing care plan. 1 B-3-2 Reassess, review, and modify plan of care to meet the needs of the client. B-4 Evaluates the clients’ response to care and treatment. Year 20__ Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) 1 C-1 to C-4 Applies critical thinking and clinical judgment when responding to emergency situations. 5 C-5-1 Effectively uses protective devices to protect client, self, and others. 5 C-6-1 Demonstrates the consistent application of standard precautions. 2 C-7-1 Applies principles of medical and surgical asepsis in the delivery of care. 1 C-12 Applies nursing knowledge and clinical judgment to maintain physical safety of client. 2 Rating (1-5) D-1 Uses effective verbal and written communication in the practice setting. 1 D-2 Appropriately establishes, maintains, and closes the nurse-client relationship. 1 D-3 Collaborates with health care team to function as an effective team member. 1 D-3-7 Adheres to the channels of communication within the employing agency. 1 Self-Assessment Tool – CCP College of LPNs of Alberta Year 20__ 1 Rating (1-5) D: Communication and Interpersonal Skills Year 20__ 2 B-1 C: Safety Year 20__ Page 5 2nd Edition - Revised October 2008 Year 2014 Competency Number D-4 Provides client and family teaching. 3 D-5 Reports and documents following legal protocols, agency policy and procedure. 1 D-7 Applies clinical judgment in identifying problems and resolving issues in client care. 3 D-8-1 Effectively manages time and organizes client care to meet priority needs. 2 D-8-2 Demonstrates ability to rank the priority of client needs. 1 W: Professionalism Rating (1-5) W-1-3 Understands the key components of the Health Professions Act-LPN Regulation. 2 W-2-3 Understands the Restricted Activity authorizations in the LPN Regulation. 1 W-3 Understands the CLPNA Standards of Practice. 1 W-4 Adheres to the CLPNA Code of Ethics and Standards of Practice. 1 W-4-5 Acts as an advocate for client and empowers clients and families. 1 W-5-1 Demonstrates accountability for own nursing practice. 1 W-6 Maintains the confidentiality of client information. 1 W-7 Recognizes professional boundaries within the nurse-client therapeutic relationship. 1 W-9 Accepts responsibility for continuing competence and professional development. 2 W-9-4 Participates in continuous quality improvement and evidence based changes to nursing practice. 5 W-11 Keeps informed of current research affecting health care delivery. 5 X: Nursing Practice and Leadership Rating (1-5) X-1-5 Recognizes own strengths and limitations as a leader. 2 X-3-5 Uses appropriate channels of communication to report risks within setting. 1 Self-Assessment Tool – CCP College of LPNs of Alberta Year 20__ Year 20__ Year 20__ Year 20__ Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Rating (1-5) Page 6 2nd Edition - Revised October 2008 Year 2014 Competency Number X-4 Applies critical thinking and clinical judgment when assessing or managing risk. 3 X-7-1 Shares knowledge, skill, and expertise with colleagues and students. 5 X-7-3 Seeks opportunities to teach and mentor others. 5 X-7-4 Participates in committees, task forces and professional activities to offer the LPN perspective. 5 Year 20__ Year 20__ Year 20__ Year 20__ SELF-ASSESSMENT SUMMARY Year 2014 2014 Competency Number A-3 A-5-9 A-6 A-7 A-8-2 Applies knowledge of pathophysiology to the nursing care of the client. Adjusts nursing practice to the specific growth and development of the client. Applies principles of nutrition to the assessment and care of the client. Applies knowledge of pharmacology throughout client care and teaching. Integrates knowledge and skills from the sciences and humanities into the application of the nursing process. B-1 Performs health assessment of client using assessment techniques and a systematic process. Implements the planning process and establishes client priorities involving client in planning. Demonstrates the consistent application of standard precautions. Applies nursing knowledge and clinical judgment to maintain physical safety of client. B-2-2 C-6-1 C-12 2014 2014 2014 Describe the competency areas you want to improve or develop. List all items rated 2 (Competent), 3 (Requires Improvement), 4 (Developmental) in Step 1. D-4 D-7 D-8-1 Provides client and family teaching. Applies clinical judgment in identifying problems and resolving issues in client care. Effectively manages time and organizes client care to meet priority needs. W-1-3 W-9 Understands the key components of the Health Professions Act-LPN Regulation. Accepts responsibility for continuing competence and professional development. X-1-5 X-4 Recognizes own strengths and limitations as a leader. Applies critical thinking and clinical judgment when assessing or managing risk. Self-Assessment Tool – CCP College of LPNs of Alberta Page 7 2nd Edition - Revised October 2008 STEP 2: SELF-ASSESSMENT OF SPECIFIC COMPETENCIES In this section, describe, assess, and rate the competencies specific to your area of work, specialty, role and responsibility. Review the competency sections in the Competency Profile to guide your assessment of the Specific Competencies. Seek feedback from another health professional. Year Competency Number 2014 D-4-6 Demonstrate ability to evaluate the effectiveness of teaching and learning through appropriate responses, demonstration of skill, or change in behaviour. 2014 G-5-4 Rating (1-5) Describe & Assess Specific Competencies 3 Provided patient with DVT exercises via demonstration during my rotation in orthopedic surgery unit Demonstrate knowledge and ability to insert, care for, and remove urinary catheters Performed insertion of catheter on both a male and female patient, successfully removed catheter as per post surgery orders 3 2014 Self-Assessment Tool – CCP College of LPNs of Alberta Page 8 2nd Edition - Revised October 2008 2014 2014 Self-Assessment Tool – CCP College of LPNs of Alberta Page 9 2nd Edition - Revised October 2008 STEP 3: LEARNING PLAN This page is intended to document your Learning Plan for one year. Photocopy this BLANK page for each additional year. Your Learning Plan must consist of at least TWO objectives for each year. You are required to fill out all FOUR columns for each objective. Transfer your Learning Plan onto your Annual CLPNA Registration Renewal Form. Please refer to the Guidelines at www.clpna.com for more information. YEAR 2013 Learning Objectives Resources & Strategies Target Date Evaluation (What I am going to learn?) (What will I do to meet objectives?) (Realistic time frame for achievement) (How will I know I learned it?) March 2, 2015 (This is the start of the next clinical placement) I will be able to describe and inform a patient with the complications that are associated with the disease ____________ _ _____________________ 1) A-3-4 I will increase my knowledge of the pathophysiology related to diabetes, more specifically, the complications related to diabetes ____________________ 2) U-7-3 I will improve my efficiency in hanging IV medications and using the smart pump. Name: Alana Chan Self-Assessment Tool – CCP College of LPNs of Alberta Reviewing the pathophysiology textbook in regards to diabetes. Researching medical journals on library database that relates the complications that diabetes presents in patients _____________________ Practicing how to use pumps in open labs at the college Reviewing videos provided from labs/ lab manual on how to hang IV medication March 2, 2015 (By Next clinical start date) I will be able to efficiently, in under 10 minutes, hang IV medication and set up the IV smart pump I will have decreased questions for my buddy nurse about the pump CLPNA Registration #: ____________ Page 10 2nd Edition - Revised October 2008 RECORD OF PROFESSIONAL ACTIVITIES Date Professional Activity (include course, seminar, research, hours, details) Sept 1,2014 A-3-4 Internet research and use of textbook to review the pathophysiology of Hypertension Oct 1, 2014 1 Hour G-5-1 Attended a buddy shift at the U of A orthopedic surgery unit, observed and assisted buddy nurse in dressing change on post-operative patients Summary of Learning I learned how to detect hypertension in patients (what is the systolic/diastolic number that indicates HTN), signs and symptoms of HTN, complications associated to HTN and some common medications to help treat HTN I reviewed how to perform sterile dressing changes on a post-operative wound 6 Hours Self-Assessment Tool – CCP College of LPNs of Alberta Page 11 2nd Edition - Revised October 2008 Name: Alana Chan Self-Assessment Tool – CCP College of LPNs of Alberta CLPNA Registration #:__________ Page 12 2nd Edition - Revised October 2008