How to write the Competency Assessment Supplement essay

Technology places nurses in a position to deliver quality care and improve patient outcomes. Information communication technologies impact nursing care by modifying ways of planning for treatment, review of care, and documentation of patient information. When I was working in the medical-surgical unit, I came to appreciate the importance of communication technologies in improving the delivery of care to patients. A 70-year-old female patient admitted due to congestive heart failure required urgent care but it was impossible to obtain her history at that time. The patient lived alone and was brought to the hospital with a concerned neighbor. After obtaining some information from the patient, it was realized that she had been a regular client at another healthcare facility. Because it was important to understand her current medications and other comorbidities, I informed the unit manager to organize the transfer of information from the other facility using an electronic health record (EHR) system (Competency #38). the transfer of information helped in planning for the care of the patient because it revealed her current medications and previous diagnostic test results.

Patient-centered care is an approach observed to make care more tailored to the needs of patients, especially those with multi-morbidity. Under this approach, care is provided according to the individual patient’s preferences, needs, and values. When I was working in the pediatric unit, I participated in developing care plans with patients, healthcare teams, and family members. There was a 6-year-old patient admitted following a road traffic accident and she required multidisciplinary care. During the development of the care plan, I realized that the parents required emotional support because they were worried about their only daughter. To meet these needs, I asked the family if they could allow the chaplain to offer spiritual support. I coordinated with the chaplain and ensured prayers were offered at least twice weekly until the patient recovered. Apart from this intervention, I followed up with the physiotherapist to aid the patient in exercise and movements to prevent loss of function during hospitalization (Competency #44).

To provide quality care over time, nurses need a roadmap to guide their actions and desired outcomes. A nursing care plan is a tool that allows nurses to identify the needs of the patient and make interventions to improve faulty aspects. While working in the medical-surgical unit, I was tasked with implementing nursing interventions based on assessment findings, client preferences, and desired outcomes. For example, I once attended to a patient diagnosed with lung cancer. After collecting history, I noticed that the patient was a known alcoholic and a regular smoker. The patient expressed concerns about his inability to quit smoking and that he had tried several options that did not work. To address this challenge, the patient required individual counseling. I linked the patient to a counselor and planned brief cessation interventions to promote abstinence from smoking (Competency #45). The delivery of counseling after several weeks yielded positive results making the intervention helpful.

Nurses are responsible for caring for many patients and have to prioritize their daily needs. An ongoing dilemma for nurses and nursing management is the balancing of competing priorities. Prioritizing the different assessed care needs and managing the consequences of decisions made challenges nurses’ professional and moral values. When I was working in the medical-surgical unit, I attended to a patient who required an emergency chest x-ray to guide in further treatment. The patient’s condition was deteriorating and she was on oxygen which made it difficult to perform multiple procedures like transportation. Because her treatment was dependent on the chest x-ray, the doctors put a lot of pressure on me to ensure the test was done immediately. The patient’s family was also reluctant to understand the risk associated with transporting the patient for an x-ray alone without additional support. I ensured that I had another nurse called from another department to assist in stabilizing the patient before taking her to the x-ray room (Competency #46).

Even people with good literacy skills can find it difficult to understand healthcare information. Although most healthcare professionals assume that information delivered to patients is understood, in reality, this information is misunderstood and can result in serious errors. I once delivered a health message to a patient during discharge and noticed that some information was not understood. To evaluate the patient’s understanding, I requested her to demonstrate self-administration of insulin and state a few complications that may prompt re-hospitalization. I noticed that the patient had not mastered the technique of administering insulin and could only identify one sign of hyperglycemia (Competency #47). I took the time to educate the patient about the importance of understanding discharge information and how the information could help in managing her disease for a long time. After a few more trials, the patient understood how to self-administer insulin and signs that could prompt seeking immediate medical care.

Establishing an environment that promotes health literacy is crucial to achieving optimal patient outcomes. Knowing whether the patient has low health literacy is important to guide decision-making and the involvement of key members like the patient’s family. For example, when I worked in the pediatric unit, I was charged with giving health information to patients and their parents, especially during discharge. During the discharge of a 6-year-old recovering from second-degree burns, it was important to provide information about medication and infection prevention at home. I planned a 25-minute session with the patient and parents to demonstrate wound care practices and infection prevention. To evaluate their understanding, I used the teach-back method where they both described practices to avoid and monitor signs of infection (Competency #48). They both demonstrated a good understanding of the health message before I finalized the discharge process.

Patient information materials and decision aids are essential tools that guide decision-making and sharing of information during care delivery. Providing materials for reading and reference during education can help in reinforcing good practices and also addressing barriers to communication. During care delivery in the medical-surgical unit, I used to refer patients to areas where they can get resources about their conditions. For example, there was a pediatric patient who was diagnosed with autism. It was very difficult for the parents to cope with this diagnosis because they did not understand how they were going to raise the kid. After explaining to the family about the probable course of the patient, I looked for local support groups for autism spectrum disorders and referred the parents to have a look at what they could offer. Additionally, I guided the parents on how to access online material about autism from the CDC and WHO (Competency #49).

Interventions to promote health have been developed very the years with health education being the most accurate primary preventive measure. Good health education programs employ educational strategies proven to address probable causes of unhealthy behaviors. Evaluation of the effectiveness of health education can help the provider to add other practices or improve strategies used to offer education to patients. For example, I once delivered health education about the management of asthma to a patient before discharge. I demonstrated how to use the inhaler and provided information about self-management at home. During the follow-up of the patient two weeks later, I realized that the information provided had improved her condition and reduced acute exacerbations. The patient was keen on avoiding allergens, timely intake of medication, and had learned when to use the inhaler (Competency #50).

Quality improvement in healthcare is a process that monitors, assesses, and improves the standards of care to promote good patient outcomes. QI practices ensure that aspects of care like time management, the efficiency of services, safety, and cost are improved. When I was working in the medical-surgical unit, I participated in research to identify best practices to prevent nosocomial infections. Was among the team selected to analyze the effects of hospital-acquired infections on patients and good practices that could promote quality outcomes. Together with my colleagues, we identified poor hand hygiene to be the greatest contributing factor. During the CMEs, I presented about hand hygiene and how to utilize the 6-step hand washing protocol by the WHO (Competency #52). After a few weeks, the management installed more hand washing points in the unit to help in improving hand hygiene practices.

Evaluation of outcomes is an important step during the nursing process that ensures strategic management of the patient’s condition. Comparing expected with actual patient outcomes helps to plan for any changes to meet the set goal during care delivery. For example, when I was working in the pediatric unit, I attended to a 4-year-old kid with severe pneumonia. The plan of care involved improving the patient’s breathing pattern through oxygen supplementation and addressing the underlying cause with antibiotics. Additionally, I anticipated that the patient’s condition could improve after 24 hours and resume oral intake of fluids rather than the IV infusion. During the evaluation of the patient’s condition, I observed a great improvement in his condition but still, fast breathing made it difficult to take oral feeds. To minimize the risk of aspiration, the patient was continued with IV fluids for another 24 hours before regaining shape to feed orally (Competency #53). Evaluating the expected and actual outcomes of the patient helped to prevent complications like aspiration as a result of early oral feeding.

During care delivery, the actual and expected outcomes may differ greatly prompting a revision of the patient’s plan of care. In general, a minimum of 24 hours is required to revise the plan of care in nursing but factors like deterioration of the patient’s condition or patient transfer can alter the time for revision. When I was working in the medical-surgical unit, I formulated a plan of care for a patient with kidney failure. The plan included 4 hourly monitoring of blood pressure, monitoring of postural changes, chest pain assessment, and regular monitoring of activity. The patient’s condition suddenly worsened and he started experiencing confusion, sweating, and dyspnea. The patient was scheduled for hemodialysis the following day but his condition eventually required emergency dialysis. I communicated the findings to the doctor and upon review, he was scheduled for emergency dialysis (Competency #54). After this procedure, the patient’s condition improved indicating the success of the new plan of care.

The safety of the healthcare provider and the patient is a crucial aspect that guides every intervention in nursing. Even nurses with years of experience may be prone to occupational hazards which may affect the overall health and health of patients. Recognizing high-risk practices is an important step toward maintaining and achieving safety in healthcare. During my experience in the medical-surgical unit, many patients required special care including feeding, bathing, and turning. During one of my managerial days, I observed that most nurses divided duties to enable early completion of tasks. There were so many incidences of nurses working alone including struggles to turn or lift heavy patients. This was a risky activity because it could easily lead to injuries and patient falls (Competency #58). during the debriefing sessions, I informed the nurses about the risks associated with lifting patients alone and instructed a team approach to managing patients that required lifting and turning.

Disruptive behaviors cause many problems in the workplace. These behaviors are either verbal or physical and include things like calling names, refusing to work with colleagues, screaming, or violent behavior. If not well managed, disruptive behaviors have a negative effect on therapeutic relationships and patient outcomes. For example, there was a time when the night duty and day shift staff disagreed on the tidiness of the nursing station. The day shift staff reported that they were tasked with organizing files, books, and sheets in the morning before starting their duties. The night duty staff argued that they had a lot of work to deal with and issues with understaffing made it difficult to accomplish their duties. I observed that these differences brought conflict between a few staff making working together and exchange of information difficult. After listening to both parties, I proposed that each team ensures tasks were completed early and that the morning duty staff help in organizing the nursing station when evidence of heavy workload was observed during night shifts (Competency #59).

Collaborative practices occur when multiple health workers from different professional backgrounds come together to formulate plans of care for patients. This practice fosters trust and respect between teams and leads to quality patient outcomes. One crucial aspect of interprofessional collaboration is recognizing each other’s roles to enable a smooth flow of events. For example, when I was working in the medical-surgical unit, we formed an interprofessional team to manage patients with pressure ulcers. The team included members from the nutrition department, doctors, nurses, and physiotherapists. During care delivery, my role was to provide pressure area care, turn patients two-hourly, and ensure the treatment was given. The doctors were charged with evaluating the condition of the pressure ulcers and performing timely debridement when necessary. The nutritionists ensured that patients with pressure ulcers had individual meal plans to replenish their stores while the physiotherapists dealt with exercise and recommended position changes for patients (Competency #69). after successful collaboration, the unit realized tremendous results in reducing the number of pressure ulcers.

Cultural competence is a crucial aspect of care that entails recognizing the values, beliefs, and practices of patients and incorporating them into routine care delivery. Creating a space for indigenous healing practices in patient care plans is important to promote the acceptance and engagement of patients. When I was working in the pediatric unit, I encountered an African family deeply rooted in tradition. Their child was admitted due to epilepsy. History-taking revealed that there were issues with compliance with medication because the family believed their child was possessed by demons. This traditional belief made it difficult to administer medication and there were differences among family members concerning the admission of the patient. To address this issue, I consulted with the religious leader who then allowed the family to perform a few rituals in the hospital. After a few days, the patient’s condition improved and the family accepted the use of medication alongside other traditional herbs recommended by their healer (Competency #70).

Quality professional practice environments are associated with productivity, job satisfaction, and good patient outcomes. A quality practice environment supports the delivery of competent care to patients and enables nurses to fulfill their legal, professional, and legislative duties. When I was working in the medical-surgical unit, there was a huge problem with overhead paging at night. The patients found it difficult to sleep at night because of overhead paging that created unnecessary distractions. To address this issue, an evidence-based practice involving maintaining quiet hours between 10 pm and 4 am was proposed. During this time, all communication was made through phone calls and the result was improved silence that allowed patients to sleep adequately (Competency #73). The use of this strategy improved patient satisfaction because silence was maintained in the unit at night.

A good health environment encourages the exchange of information with patients and questioning of practices. Patients have the right to know what is happening in the institution and raise concerns regarding practices that are considered unsafe or unnecessary. For example, there was a time when patients were unsatisfied with the type of meals served in the hospital. While passing around in the wards, I notices that many did not know how to raise their concerns including how to communicate the issue to the top management. To follow up on this issue, I wrote a letter to the matron explaining the concerns of the patients. Additionally, I formulated a questionnaire that allowed patients to anonymously state their concerns (Competency #74). These interventions ensured that the patients’ issues were represented and it led to the opening of a remarks and concerns section in their online portals to channel their issues directly to the hospital management.

Mentoring is an effective strategy that can help to improve employee performance, retention, and development. Nurse mentoring is a synergistic relationship that exists between experienced and less experienced individuals to encourage mutual professional growth. For example, when I was working in the medical unit, I mentored a few students who found it difficult to perform some tasks. Among the areas that I focused on was improving their communication skills and level of confidence when dealing with patients. I could use the debriefing sessions to explain how best situations could be handled after critical events and I was entirely present when they faced certain difficulties (Competency #75). I maintained open communication and the mentorship relationship turned out to be effective in improving the student’s patient care skills.

Group dynamics deals with how members in their relationships operate and organize service delivery. When working in groups, certain rules should be followed to ensure equal participation of members and representation of every individual’s views. For example, I was part of an interprofessional team formed to investigate the causes of increased wound infections in the surgical department and propose solutions to address the issue. During meetings, I noticed that some members were not active and perceived that only nurses knew the sources of infection. To address this concern, I informed the members about the principle of belongingness which allowed each individual to be equally represented. In subsequent meetings, there was an improved change in how members contributed to discussing the healthcare issue including proposing solutions without fear (Competency #76).

Patient transfer from one unit to another is common in healthcare because of the diverse needs that must be addressed. During the patient transfer, it is important to inform patients about the process and coordinate well with other teams to minimize harm and other complications. An example of the transfer of patients that I remember well involved moving a patient diagnosed with dementia to a nursing home. To prepare for the transfer, I informed the patient and her family about the reason why care at a nursing home could be the most appropriate solution. Although they had capital concerns, I consulted with the nursing home about acceptable methods of payment and ascertained that bills could be covered by the patient’s insurance. During the process, I coordinated with the hospital finance department to transfer the patient’s insurance to the other facility and coordinated with the It department regarding the transfer of the patient’s medical records (Competency #79). After clearing with the hospital, I coordinated with the medical doctor to write a transfer letter and the transport team to safely move the patient to the nursing home.

How to write the Competency Assessment Supplement essay

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