Nursing Assignment | Assessment 1

Running head: NURSING ASSIGNMENT
Nursing assignment
Name of the Student
Name of the University
Author Note

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Professional Mission Statement
My mission statement as a nurse is to deliver compassionate and competent care to all
my clients and their family members. I promise to remain refined, honest, and specialized for
the entire period of my occupation. The profession of nursing has been identified to be a
noble occupation and all nurses are expected to strive for continuous health improvement of
their patients, with the aim of providing excellence in the care that is delivered (Mikaelian &
Stanley, 2016). While working as a nurse each day, I intend to display empathy and love
towards all patients, regardless of their backgrounds and ethnicities. My mission statement
also focuses on taking efforts to educate patients who have been diagnosed with substance
abuse, besides working in close association with social workers to help patients overcome
addiction, and live a meaningful life. While working with diverse patients, I intend to never
adopt a judgmental approach and will always try to deliver care that is tailored to the needs
and preferences of the patients.
Professional summary
Artefacts within nursing are considered to be human-made objects, which play an
important role in reflecting both the workplace and professional characteristics such as
norms, myths, values, sagas, rituals, symbols, and ceremonies, in relation to nursing practice.
Patient safety and high quality of the services delivered have been identified by me as the
cornerstone of excellent health care that is imperative for enhancing the health and wellbeing
of patients (Graban, 2018). Moreover, patient safety practices have been recognized as those
that are directly associated with a reduction in risk among patients, in relation to suffering
adverse health events, due to any nursing malpractice. I also have the competence of
conducting evidence based nursing that requires me to make correct decisions about the
health of a patient, relying on my clinical expertise, concomitant with relevant and current

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material or research information that is available on the topic (the disease that my patients are
suffering from). This artefact has greatly enhanced my professional skills owing to the fact
that evidence based nursing is responsible for improving the health and safety of all patients,
while delivering care services in a manner that is cost-effective (LoBiondo-Wood & Haber,
2017). During my tenure as a nursing student, I have taken all possible steps to identify my
patients who are at a risk of suffering falls, in addition to taking necessary effort for the
implementation of successful fall prevention program. This artefact has played a major
influence on my professional role owing to the fact that falls have been identified as a matter
of public health concern.
First and foremost, in order to adorn the role of a successful nurse, it is extremely
important that we should possess both interpersonal and communication skills. While
working as a nursing professional, I am required to interact with several patients, due to
which I have to engage in an effective communication with them, besides making them
understand my intended meanings. In other words, my capability to comprehend and conduct
the directions that have been provided to me by my supervisors is a major strength that
enhances my professional practice. Another area of professional strength that is evident
through my work is the possession of compassion and empathy towards others. Regardless of
the domain or nursing specialty where I have been assigned to work, I most often encounter
patients who suffer from a range of psychological or physical issues. This requires me to
interact with them in a manner that I am able to address a plethora of emotions such as,
depression, anxiety, danger and resentment. I consider this as my strength since I am able to
interact with the patient and help them cope with their concerns.
Another professional strength that has helped me care for my patients in an effective
manner is that I try to be trustworthy and honest towards my clients. It is of utmost
significance that no kind of medical or personal information, relating to the patients must be

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disclosed by a nursing staff under any circumstance. Hence, I remain cautious not to violate
any such rules of the nursing codes, to prevent any disciplinary action against such behavior.
Flexibility and reliability have been identified as core aspects of nursing and are imperative
for professional growth and development. Time and again I have encountered several
situations where the patients have demonstrated the need for delivering specialized care, thus
making it necessary for effectively managing time that is spent while caring for the patients.
Thus, it can be stated that my flexibility and reliability are major strengths since I display an
inclination to work on holidays or weekends, depending on the urgency of the condition, and
have never denied working in a different department, as and when required. I have the
perception that the best approach for addressing huge work load is to formulate a work
agenda at the beginning of the shift that helps me priorities my duties based on their
importance. Thus, effective time management is another notable professional strength of
mine.
However, I encountered several challenges during the nursing program. Faculty
development challenge, lack of support, and bully from the senior nurses were some of the
major challenges that I had to endure. Quality education depends largely on well-trained and
knowledgeable faculty associates (Masters, 2016). Insufficient capacity in the nursing school
and comparatively low pay were major contributing factors that resulted in lack of
appropriate nursing faculty during the program. It has often been established that educators
are expected to integrate nursing theory into practice, by synchronizing the themes (Campbell
& Daley, 2017). Nonetheless, we were not completely equipped with the competencies that
are expected in the healthcare environment of the 21st century. The classrooms were full of
multicultural students that resulted in the manifestation of discriminatory and stereotypic
behavior, thus adding to the difficulties. Furthermore, we also had to deal with bullying and
inappropriate behavior that generally ranged from rolled eyes to social exclusion to outright

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mental abuse. Hence, all of the aforementioned factors acted in the form of impediments.
However, the coursework helped in meeting the nine program outcomes by teaching us about
the strategies that need to be adopted during oral, interpersonal or written communication. It
also helped in assuming accountability for the delivery of safe and effective care plans that
are in accordance to the legal and professional nursing standards. During the coursework, we
were also taught about the different leadership styles that are expected from a nursing
professional, through hands-on experience that helped us realize the role of a nursing leader,
in relation to patient health and safety. We were also provided training on the steps that need
to be taken during the use of health information technology for reducing errors and
communicating with patients and providers. The coursework also ensured that all of us were
able to utilize our critical thinking skills and deliver care in a patient-centered manner that
was culturally appropriate to the values and beliefs of the patient.
I have fulfilled my role as a detective by using my clinical imaginings together with
nursing knowledge for detecting subtle vicissitudes and nonconformities from anticipated
forms of patient being, in order to avert adverse outcomes. I have also analysed the patient
reports and symptoms of diseases, in order to identify the underlying illness from hidden
clues. Adorning the role of a scientist has been successful since I have participated in several
inquiries that are related to healthcare decision making, utilized principles of evidence based
practice and also disseminated the collected information for enhancing patient health
outcomes. Moreover, as a scientist in nursing professional practice I have been associated
with the unearthing of novel ideas based on evidences, which have been implemented in care
plans for enhancing the general quality of care and patient health outcome.
I have been successful as a manager of the healing environment since the program
allowed me to advocate and coordinate for a deferential, multidisciplinary environment that

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indorses optimal patient wellbeing, and also taught us the importance of affirming the self-
respect and dignity of the patients.
Quality and Safety
Quality and safety in health and social care comprises of the best conceivable health
outcomes that can be obtained if there are sufficient resources, and conditions that are in
accordance to the principles of patient-centered care (Waring et al., 2016). Furthermore,
patient safety and quality are imperative for decreasing the risk of preventable harm to a
tolerable minimum level. Several theorists consider quality health care as an all-embracing
umbrella that encompasses the attribute of patient safety. According to the definition
postulated by the Institute of Medicine (IOM), patient safety has been identified as an
essential component of the delivery of quality healthcare services (Puri & Spevetz, 2018).
Furthermore, quality is also defined as an optimal balance between the framework of nursing
values and norms and realized possibilities. While caring for patients, patient quality and
safety is significantly recognized as an imperative component of an operative, proficient
healthcare system. Ensuring patient safety diminishes the hazard of harm to all patients and
healthcare providers through system success and individual performance (Cherry & Jacob,
2016). The coursework involved evaluating a case study that was based on an older adult,
suffering from dementia, with a fracture in the right hip. I identified the two primary nursing
qualities as restraint prevalence and complications related to pressure ulcer and urinary tract
infection. I also recognized the responsibility of a nursing professional to demonstrate
understanding and awareness of several disempowering factors, at the time of care
administration. I also highlighted the importance of preventing patient fall and increasing
patient satisfaction, in order to ensure high quality care service delivery, which in turn will
guarantee patient safety. I also identified that restraining patient is a major contributor to

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violation of patient dignity and safety, and all efforts must be taken to reposition the patient at
intervals for preventing pressure sore development, rather than using restraints.
While working as a nursing during clinical placement, it is extremely significant that I
take efforts for delivering safe nursing practice, besides providing best quality of care
services to my patients. I always try to implement safety and quality fundamentals while
caring for my patients by recognizing the potential risks through the use of patient identifiers
such as, name and date of birth. I also ensure that I show adherence to the five rights of
medication administration during my clinical rounds. I am also able to successfully use
standardization and technology-based practices such as, utilization of the EHR system and
adhering to the facility procedures that upkeep patient safety and quality. In one such instance
I had to review the laboratory results, along with the MD, of one of my patient who reported
a raised sodium level, prior to the initiation of intravenous fluid administration of patients. I
also ensured patient quality and safety by preventing fall incidents among the patients who
were at an increased risk of fall due to confusion and dehydration. The coursework also
helped me identify the need of protecting the rights of patients, while maintaining their
autonomy and confidentiality. It helped me realize that patients must always be provided with
the discretion of making essential decisions about their health, without the influence of any
healthcare provider. In addition, I took all possible efforts to ensure that
a confidential association between nurses and patient is indispensable for the free exchange
of information essential for all-encompassing medical care. This helped me emphasise on the
need to establish an environment of trust and faith, for increasing patient satisfaction.
The Institute for Healthcare Improvement (IHI) certificate will play an important role
in enhancement and improvement of the profession since it will ensure that while working as
a nursing professional, I will demonstrate a commitment towards advancement of care quality
and health of all patients. This certificate will also ensure that all care services that are being

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delivered by me are in accordance to current and pertinent evidences, and that I always put
my patients and their family members at the center of care delivery.
Evidence-based practice
Evidence-based practice (EBP) refers to the process that is reliant on different
scientific evidences for decision making and guidance, in relation to care delivery for
patients. Practices that are not based on evidences generally rely on intuition, tradition, or
other unconfirmed methods. Several theorists elaborate on the fact that the objective of EBN
is to advance the health and safety of all patients, besides ensuring that the health amenities
and facilities are cost-effective (Townsend & Morgan, 2017). This in turn helps in improving
the health outcomes for the patient, thereby enhancing the reputation and success rate of the
healthcare system. In other words, EBN refers to a procedure that is established on the
assortment, interpretation, assessment, and incorporation of effective, clinically noteworthy,
and appropriate research (Dang & Dearholt, 2017). Thus, EBN integrates substantiation with
clinical proficiency that has been confirmed and reinforced with standards for delivery of best
healthcare services (Cherry & Jacob, 2016).
During my clinical practice, I utilized the principles of EBN during infection control.
I tried to collect information from contemporary scholarly articles that focused on strategies
for preventing pathogen transmission and infection control. I also demonstrated adequate
EBP skills by practicing the six steps of hand hygiene, each time prior to and after entering
and leaving the room of a patient, and after any contact with the patient body. I was also
entitled with the duty of caring for a patient who had been diagnosed with Clostridium
difficile infection, and during that instance, I used personal protective equipment such as,
gloves, apron, mask and safety footwear, to prevent transmission of the germs. Thus, it can be
stated I demonstrated adequate EBP skills, with the sole objective of improving the health-
related quality of life of my patients.

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I try to determine the relevance and believability of the data that I have obtained
during EBP by assessing whether or not the article should be considered for healthcare
delivery. I also assess the methodological quality of the published articles, while
implementing high quality and cost-effective nursing principles and interventions. I also use
the CRAAP approach for determining the currency, relevance, authority, accuracy, and
purpose of the article that is pertinent to the clinical practice scenario. This helps to assess
whether the date of article publication, information that is presented, author credibility are
relevant to the clinical scenario (Lewis, 2018). I also try to distinguish between quality
improvement and research. I hold the opinion that quality improvement encompasses data-
guided and systematic activities that are formulated with the aim of bringing about immediate
enhancement in the delivery of healthcare in different settings. While implementing evidence
based practice, the research question that I had formulated as a part of my coursework was
“Does providing companions as a safety measure reduces the rate of patient falls?”. I
conducted a systematic review to evaluate the effectiveness of fall-prevention techniques and
provided detailed information that conducting safety rounds in hospitals, employing safety
companion, and identifying the high-risk patients are most effective strategies that can be
implemented.
I use the Plan-Do-Study-Act (PDSA) model for quality improvement of patients. This
model is generally applied for establishing a causal relationship between health facilities and
patient outcomes (Leis & Shojania, 2017). One such instance where I have delivered this
model was related to caring for a patient who was suffering from diabetic foot ulcer. During
my clinical placement, on most circumstances I have applied the concept of research,
particularly while working for infection control and management of pressure ulcer. I am also
well aware of the fact that while primary research comprises of collecting fresh data from
participants, secondary research encompasses the use of data that has already been published

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in other primary research articles. I have conducted primary research twice where I had to
determine the perception of older patients on refusal of appropriate food intake, and when I
had to assess the effectiveness of EHR and their usability, based on the perception of nurses.
While I conducted surveys for the first research, focus group was my chosen data collection
procedure for the second research. In contrast, I conducted secondary research while
conducting systematic reviews that focused on infection control with Chlorhexidine
washcloths, role of wearable device in fall prevention, and efficacy of EHR in reducing
medication error.
Applied leadership
Applied leadership refers to the power and competency of a nursing professional to
exert and influence on others, whole trying to enhance the care quality, besides directly
participating in the clinical care process (Riggio, 2018). Applied leadership affects the quality
of patient care owing to the fact that it focuses on continued education and augmentation of
clinical skills to attain positive patient outcomes. I demonstrate this leadership by
implementing critical thinking and taking efforts to acquire new knowledge and awareness on
different nursing aspects. Demonstrating the capability to multitask and prioritize, while
applying EBP are some key characteristics. During my clinical experience, I have always
implemented leadership abilities by empowering my patients, ensuring timely and effective
administration of medications and other non-pharmacological interventions, lowering rates of
medication errors. While adorning the role of a leader, I have also demonstrated excellent
work ethics, and have always tried to act as role model for my juniors and colleagues. I have
also tried to implement the systematic procedure of FMEA that consists of seven steps
namely, employing the team, group communication, having a list of let-down modes in the
organisation, ordering of risk factors in ascending order, assessing the results, and exploiting
the risk precedence number for operative implementation.

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Collaborative care in nursing also forms a crucial aspect of leadership since it aims to
enhance patient health outcomes by fostering interprofessional cooperation. According to
Moss et al. (2016) effective collaboration also encourages active participation of the patients
and their family members during the treatment, which in turn improves their health. I have
always tried to encourage collaborative care while working with allied health professionals
such as, physiotherapists, dieticians, and medical specialists. My skills of applied leadership
were also demonstrated during the conduction of a root cause analysis (RCA) in a scenario
that involved emergency admission of an elderly patient with leg pain, who suffered brain
death after being referred to another hospital due to collapse of pulse. I identified lack of
appropriate training as the root cause, and also recommended critical care training as an
effective strategy. My coursework also involved writing a proposal about an issue related to
low nurse: patient ratio that was creating significant workload and negative health outcomes
among the patients due to fall incidents or medication errors. I analysed the situation and
concluded that less remuneration, recruitment issues, and financial crisis were the major
reasons that contributed to this issue. As a leader, I proposed that the hospital must recruit
more nursing staff for delivery of high quality care services, and reducing the pressure on
existing nurses. I also suggested that the hospital must procure government funds for
recruiting nurses and the HR department must use new strategies for the same.
Community and Population Health
Community and population health refer to the protection, maintenance, and
enhancement of health status of different people, belonging to diverse population groups,
residing in a particular community. While working as a nurse in the community, nurses are
expected to take all possible efforts to prevent disease outbreak, while providing patient
education to increase awareness and health literacy (Stanhope & Lancaster, 2015). It is
imperative for a public health nurse to promote disease prevention over treatment. While

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working in the community, I encouraged the development of safe work and home
environment, by evaluating the patients and their setting for health hazards risks. I assessed
the geriatric population and identified falls risks as major contributing factors that
deteriorated their health outcomes. Some major risk factors identified were incontinence,
impaired mobility, and lack of sensory and cognitive awareness, thus lowering the proportion
of prolonged hospitalizations, preventable surgery, and disability.
The American Museum of Natural History (AMNH) certificate will also play an
important role in my professional development since it will help me gain information on
genomics and genetic discoveries and will also enhance my capability to assess family
history, while caring for patients who are at a risk of suffering from genetic diseases. It will
increase my competence in integrating genomic and genetic information, in relation to
community care and will also help me refer patients suffering from life-threatening
conditions to specialized care services. This will eventually help in management of genetic
disorders, and lower associated rates of mortality and morbidity.

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References
Campbell, S. H., & Daley, K. (2017). Simulation scenarios for nursing educators: Making it
real. Springer Publishing Company.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model
and guidelines. Sigma Theta Tau.
Graban, M. (2018). Lean hospitals: improving quality, patient safety, and employee
engagement. Productivity Press.
Leis, J. A., & Shojania, K. G. (2017). A primer on PDSA: executing plan–do–study–act
cycles in practice, not just in name. BMJ Qual Saf, 26(7), 572-577.
Lewis, A. B. (2018). What Does Bad Information Look Like? Using the CRAAP Test for
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appraisal for evidence-based practice. Elsevier Health Sciences.
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Mikaelian, B., & Stanley, D. (2016). Incivility in nursing: from roots to repair. Journal of
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professionals: a call for action. American Journal of Critical Care, 25(4), 368-376.

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Puri, N., & Spevetz, A. (2018). QUALITY ASSURANCE AND PATIENT SAFETY IN
THE INTENSIVE CARE UNIT. Critical Care Secrets E-Book, 71.
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