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Gerald Jocson
RN, BSN
BSN Competencies
Patient Centered Care
The competency of patient-centered care is about ensuring that the care provided has the patient's best interests in mind. This requires the nurse to know the patient's wants and needs for treatment and ensure that the healthcare team works in accordance with those wants. An example of this would be pain treatment. Since pain is personal to the patient, nurses should ensure that the patient's pain is completely covered according to their own needs.
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I learned this competency during my clinical rotation. Since the patient has the sole power to refuse or accept care, they make the final decision regarding their own planning for their treatment. When I become a nurse, I want to ensure that my patients are able to preserve their autonomy in their treatment regimen. We must compromise with the patient's wishes and the current treatment to ensure that the patient has the best quality of life after discharge.
An example I have of this competency is from my multiple volunteer shifts with the Lighthouse of Hope Food Pantry. While handing food out to the community, some regulars would want the food to be placed a certain way in their care. While their demeanor made some other volunteers uncomfortable, I was able to adhere to the requests in a compassionate manner. I've learned that sometimes, helping people is a thankless job but the self-satisfaction I get from helping others makes it worth it
Quality Improvement
Quality Improvement is the process of creating treatment plans using evidence from prior statistics and data. Basically, they look at the data and determine various trends and issues based on what the recorded majority conveys. Then they develop plans to improve the care that they provide to patients. Because of quality improvement, we were able to discover things like how hand-washing prevented infection or even how some medications work better than others in treating certain conditions.
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I learned the competency through my clinical experiences where they convey data trends on certain issues like CLABSI statistics or iatrogenic sepsis cases. Even the implementation of scanning before administering medication was an evidence-based practice developed after the data indicated high trends of medication error present in various hospitals around the U.S.
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I would show competence in my practice by adhering to evidence-based practice and adapting to newer procedures and protocols as data suggests. Similar to how students had to adapt to virtual learning for a period of time, we also must adapt to this hybrid type of teaching as circumstances are presented. One of the most important qualities a nurse should have is the ability to adapt to new situations alongside advancements in technology and medicine.
Safety
The safety competency analysis, though an overview of healthcare in general and through each individual's patient care performance, ensures that they are providing care that will give a high chance of benefit to the patient with as minimal a chance as possible for complications. So the competency analyzes what is currently going on in patient care and develops new technologies and procedures to ensure that the patient remains as safe as possible in this setting. This can also be seen by providing proper communication, even when admitting to a certain error, to ensure that the patient's condition doesn't worsen.
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I learned the competency in my clinical rotations as nurses would use barcode scanners to ensure that the right medication is given to the correct patient at the correct time. As a result of the barcode scanner, the rising trend of complications caused by medication errors continually decreases. This competency is also seen during nursing huddles at the beginning of the morning to make sure that each nurse is up to date with the current procedures and protocols prior to providing patient care in the morning.
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I would show competence towards Safety by adhering to the current protocols and procedures provided by my hospital. Each protocol provided by hospital policy is implemented from evidence-based data as a means to ensure that current issues and risks become negated within the hospital. I would also ensure that Safety is promoted for the patient by acting as the patient's advocate in effectively communicating for optimal patient care to my interprofessional healthcare team. If an error is made for the patient, I will engage in finding the root cause for the error rather than blaming the team when an error occurs.
Evidence-Based Practice
Medicine should always be advancing and so nurses would implement the most effective procedures based on evidence. If a procedure isn't as effective in treating patients as it theoretically was supposed to, then they would look at the data and find a more effective treatment. Treatment would not be implemented because the nurse/doctor believes that the proper approach is a certain way. Instead, the nurse/doctor will look at current literature and see how helpful the treatment is
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I learned the competency in my clinical rotations. After clarifying the physician's orders, the nurse would ensure that the ordered treatment has the best possible outcome before administering the treatment. Also during the nursing huddle, the team discusses new and updated policies/treatments based on the current literature. If they find that washing hands prior to interacting with the best significantly decreases the rate of infection, based on current literature, then they would implement the practice.
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I had the golden opportunity to perform evidence-based research to improve the implementation of targeted temperature management. After reviewing the literature, I found that future studies should focus on finding key prognostic factors to determine TTM efficacy to resolve the current debate. I would consistently pursue my education after receiving my nursing licensure to ensure that the treatment I give to my patients is evidence-based and current. While the software in most hospitals is current/up-to-date, it is still the nurse's responsibility to progressively pursue advancing treatment
Teamwork and Collaboration
The QSEN competency known as Teamwork and Collaboration requires nurses and other members of the health profession to work effectively as a team to help solve a patient's problem. To do this, the team to acknowledge their own strengths and weaknesses to effectively contribute their strengths to the issue and communicate their weaknesses to the team. This open communication should also be implemented when members of the team discover their own findings of the patient's problem. To effectively practice this competency, each team member must respect the unique attributes that each person brings to the team.
I learned the competency on the QSEN Institute website and through my Critical Care textbook. When dealing with fast-paced and urgent situations in the critical care setting, teamwork and collaboration are crucial factors to have. The patients that enter through the door of the Emergency Department generally remain unpredictable and therefore require a healthcare team that is consistently effective in their teamwork.
There have been multiple school projects during nursing school that required a sense of time management and teamwork in order to finish on time in addition to the intense workload that a 12-week semester would provide. One project included the Community Integration project which required my group and I to explore a specific community and determine if the community had optimal resources for a hypothetical Breast Cancer patient. While balancing multiple tests and essays, I decided to communicate a plan to the team regarding which person would complete which part of the project (Nutrition, Excercise, Supplies, Support groups, etc.). My group included an exercise science major, so I felt that he would be perfect for the role while I allowed the other group member to choose which part of the project she would be comfortable completing. We would effectively communicate our concerns and updates on the project throughout the semester, and I would try to help them complete their parts in any way that I find possible to do.
Informatics
Nurses use up-to-date technology to improve patient care and ensure that errors are prevented. Using new technology saves time that could be used by nurses to take the time to ensure that patient procedures and interactions remain of the best quality possible. This same technology is used to ensure that all members of the healthcare team can be up to date about the patient's progress and that each member can communicate their plan effectively.
I learned the importance of informatics through my clinical rotations. Nurses would document the patient's progress through the EPIC system and would send updates to the healthcare team through text messages. As a result of text messaging the team, each member can review the information and clearly communicate their plan without issues of misinformation and miscommunication. A message can be efficiently communicated to the team without taking extra time paging the other team.
I would exemplify competence by navigating through the EPIC system to help complete the assigned CARE plans in my clinical rotations. Each rotation I would complete a CARE plan that requires me to find the patient's history of present illness, physician's plan of care, previous nurse notes from other shifts, and scheduled medications for the day. These plans help me to familiarize myself with current technology and see the process of planning care for the patient.
