Carly Legault

September 12, 2013

Self-Assessment Tool – CCP Page 1College of LPNs of Alberta 2nd Edition - Revised October 2008

Self-Assessment Tool – CCP Page 2College of LPNs of Alberta 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 Page 3College of LPNs of Alberta 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 2 3 4 5

Excellent Competent Requires Improvement

Developmental Not Applicable

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.

Not applicable to current role and responsibility.

STEP 1: SELF-ASSESSMENT WITHIN STANDARDS OF PRACTICE

Competency Number

Year2016_

_

Year20__

Year20__

Year20__

Year20__

A: Nursing Knowledge

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.

2

A-2 Applies knowledge of microbiology throughout care, disease prevention, and health promotion.

2

A-3 Applies knowledge of pathophysiology to the nursing care of the client.

3

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.

1

A-7Applies knowledge of pharmacology throughout client care and teaching.

3

Self-Assessment Tool – CCP Page 4College of LPNs of Alberta 2nd Edition - Revised October 2008

Competency Number

Year2016_

_

Year20__

Year20__

Year20__

Year20__

A-8-2Integrates knowledge and skills from the sciences and humanities into the application of the nursing process.

1

B: Nursing Process Rating

(1-5)Rating

(1-5)Rating

(1-5)Rating

(1-5)Rating

(1-5)

B-1 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.

2

B-2-3 Identify and analyze nursing diagnosis. 2

B-3 Implements nursing interventions to carry out nursing care plan.

2

B-3-2 Reassess, review, and modify plan of care to meet the needs of the client.

2

B-4 Evaluates the clients’ response to care and treatment.

2

C: Safety Rating (1-5)

Rating (1-5)

Rating (1-5)

Rating (1-5)

Rating (1-5)

C-1 toC-4

Applies critical thinking and clinical judgment when responding to emergency situations.

N

C-5-1 Effectively uses protective devices to protect client, self, and others.

1

C-6-1 Demonstrates the consistent application of standard precautions.

1

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.

1

D: Communication and Interpersonal Skills Rating (1-5)

Rating (1-5)

Rating (1-5)

Rating (1-5)

Rating (1-5)

D-1 Uses effective verbal and written communication in the practice setting.

2

D-2 Appropriately establishes, maintains, and closes the nurse-client relationship.

2

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.

N

Self-Assessment Tool – CCP Page 5College of LPNs of Alberta 2nd Edition - Revised October 2008

Competency Number

Year2016_

_

Year20__

Year20__

Year20__

Year20__

D-4 Provides client and family teaching. 2

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.

2

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)

Rating (1-5)

Rating (1-5)

Rating (1-5)

Rating (1-5)

W-1-3 Understands the key components of the Health Professions Act-LPN Regulation.

1

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.

2

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.

1

W-9-4 Participates in continuous quality improvement and evidence based changes to nursing practice.

N

W-11 Keeps informed of current research affecting health care delivery.

2

X: Nursing Practice and Leadership Rating

(1-5)Rating

(1-5)Rating

(1-5)Rating

(1-5)Rating

(1-5)

X-1-5 Recognizes own strengths and limitations as a leader.

1

X-3-5 Uses appropriate channels of communication to 1

Self-Assessment Tool – CCP Page 6College of LPNs of Alberta 2nd Edition - Revised October 2008

Competency Number

Year2016_

_

Year20__

Year20__

Year20__

Year20__

report risks within setting.

X-4 Applies critical thinking and clinical judgment when assessing or managing risk.

2

X-7-1 Shares knowledge, skill, and expertise with colleagues and students.

1

X-7-3 Seeks opportunities to teach and mentor others. N

X-7-4 Participates in committees, task forces and professional activities to offer the LPN perspective.

N

SELF-ASSESSMENT SUMMARY

Year Competency Number

Describe the competency areas you want to improve or develop. List all items rated 2 (Competent), 3 (Requires Improvement), 4 (Developmental) in Step 1.

2016 A I want to improve and develop in this competency. I rated myself a 2 in A-1 A-2 because I can apply knowledge of microbiology, anatomy, and physiology but I do still require research. I rated myself a 3 in a-3 because I felt that in order to provide best nursing practice I needed to research certain pathophysiology. I rated myself a 2 in A-5-9 because I do adjust my nursing practice for the needs of the client but I feel I would be excellent in this area with increased experience and confidence. I rated myself a 3 in A-7 because I still research drugs in a drug guide before medication administration.

2016B I rated myself 2 in all categories on this competency number because I feel

that I am competent in all categories but will become excellent with more experience and confidence.

2016D I want to improve in categories D-1, D-2,D-4, D-7, and D-8.1 I rated myself a

2.D-1 – I have competent communication but I feel this could be improved by reporting sooner, or documenting more often. D-2 – As a student nurse being nervous can be seen by the client, I feel I will be excellent in this category as my confidence grows.D-4 - I want to improve and client and family teaching I am competent in this category but I want to demonstrate more confidence and organization during teaching sessionsD-7 I rated myself competent in this category because as a student nurse I second guess myself when identifying a problem and ask for a second opinion with practice will be able to acknowledge and use clinical judgment

Self-Assessment Tool – CCP Page 7College of LPNs of Alberta 2nd Edition - Revised October 2008

to identify any issues. D-8.1 I rated myself competent because I have good time management but tend to get slightly flustered when really busy.

2016W I rated myself a 2 in W-5-8 because I advocate for my patients competently

but I feel with more confidence and experience I would be able to be excellent.I rated myself a 2 in W-11 because I need to be more informed with current nursing news.

2016X

I rated myself a 2 in X-4 because as a student nurse I asked for a second opinion when assessing or managing a client at risk. With experience I feel like I could do this with excellence independently.

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 Describe & Assess Specific Competencies Rating

(1-5)

2016A-1

I rated myself a 3 in this competency because although I have been provided the knowledge of anatomy and pathophysiology during my clinical experience I felt as though I had to do research and review certain diseases to be able to provide best nursing care.

3

2016A-7 I rated myself a 3 in this competency because I am not familiar

with all medications and to administer them confidently I feel the need to research in the drug guide. With further experience and research, I will be able to become more knowledgeable with pharmacology and will become competent in this category.

3

Self-Assessment Tool – CCP Page 8College of LPNs of Alberta 2nd Edition - Revised October 2008

2016

2016

2016

Self-Assessment Tool – CCP Page 9College of LPNs of Alberta 2nd Edition - Revised October 2008

STEP 3: LEARNING PLANThis 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 2016 Learning Objectives

(What I am going to learn?)Resources & Strategies

(What will I do to meet objectives?)

Target Date(Realistic time

frame for achievement)

Evaluation(How will I know I learned it?)

A-3 To increase knowledge in pathophysiology by 30% so that I can more confidently make clinical judgments by September 2016.

A-7To increase knowledge in pharmacology by 40% to provide safe medication administration by September 2016.

To meet increase my knowledge in pathophysiology I will review textbooks and research diseases to be improve and become more knowledgeable

Using drug guides to research, and practicing more medication admin will allow to me to be more familiar with common medications.

September 2016

September 2016

I will do a self evaluation, I will know I achieved this learning outcome by being able to identify common pathophysiology without referring back to research.

I will evaluate this learning need by being able to identify the specific common medications used during daily medication administration.

Name: Sydney Elliott Student ID # 1037096

Self-Assessment Tool – CCP Page 10College of LPNs of Alberta 2nd Edition - Revised October 2008

Self-Assessment Tool – CCP Page 11College of LPNs of Alberta 2nd Edition - Revised October 2008

RECORD OF PROFESSIONAL ACTIVITIES

Date Professional Activity (include course,

seminar, research, hours, details)

Summary of Learning

November 2015

Social work inservice NPRT 10011 Hour

During this in-service I learned the role of a social worker and how they work collaboratively with nurses.

November 2015

Dietician inserviceNPRT 1001 1 hour

During this in-service I learned the role of the dietician in a long term care facility, how to recognize the need for a swallowing assessment. I also learned about dietary supplements and got to taste them, also got to sample thickened liquids.

September 2015

CPR During this course I learner how to provide CPR and use a defibrillator.

Name: Sydney Elliott Student ID # 1037096

Self-Assessment Tool – CCP Page 12College of LPNs of Alberta 2nd Edition - Revised October 2008