6560 FINAL

PRAC 6560

PRAC 6550: Clinical Skills and Procedures Self-Assessment Form

Procedure	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or need supervision to feel confident)	New (Have never performed or does not apply)
Alternative drug administration (inhalation, transdermal)	X
Presenting history of present illness		X
Airway management (oral and nasal airway placement, intubation, extubation)				X
Ventilator settings (manages AC, SIMV, CPAP; analyzes ABGs to guide settings/Fi02, PEEP			X
Non-invasive CPAP / BIPAP	X
Vital sign measurements	X
Advanced circulatory management (central line placement and removal, intra-osseus lines, arterial lines)			X
CPR	X
Cardioversion				X
Arterial and venous sheath removal			X
Performs arterial puncture for ABGs			X
Epicardial pacing, assessment, and management		X
Permanent pacemaker (assessing function and management				X
12 lead EKG interpretation	X
Cervical spine trauma assessment for possible neurologic injury	X
Burn assessment and management		X
Immobilization device application / management		X
Organ donation (identifying potential donors)	X
Intracranial monitoring (assessment and management)		X
Reduce dislocated joint			X
Remove foreign body (from ear, eye, nose, soft tissue, other)			X
Radiology reports (interpret CT, Xray and MRI)			X
Sedation (manages procedural sedation)			X
Chest tube placement, management, and removal			Removal yes / placement no
Compartment pressure measurement and management			X
Wound management (stage 1-4 pressure ulcer management, incises/drains/debrides wounds, suture/steri-strip/dermabond use)	X
Digital nerve block				X
Thoracentesis				X
Epistaxis management/nasal packing	X
Performs gastric lavage		X
Nail bed closure			X
Nail trephination
Injects local anesthetics

Self-Reflection on Clinical Skill Development and Practicum Planning

It is imperative that I critically examine my history, knowledge, and experience as I get closer to my final advanced practice nursing practicum in order to evaluate what I bring to this crucial juncture in both my academic and professional career (D'Aoust et al., 2022). Examining what I already know, what I need to know, and what I hope to learn in the upcoming practicum are all part of this reflective process. This essay seeks to highlight my accomplishments from the prior three practicum classes, point out areas for development, and lay out plans and objectives for the upcoming practicum.

Strengths Gained

Throughout my previous practicums, I have honed several skills that will undoubtedly aid me in having a fantastic final practicum. One of my most important skills is knowledge of the transdermal and inhalation routes—two additional medication administration techniques (Leppert et al., 2018). This skill shows my technical expertise and my confidence in my ability to manage difficult procedures independently. In addition, my ability to comprehensively account for my current illness highlights my excellent communication skills and comprehensive understanding of patient evaluation.

I have proven knowledgeable in vital subjects like CPR and advanced circulatory care, which includes putting and taking out central lines (Panchal et al., 2020). These abilities help me be prepared for complex clinical circumstances in general and are crucial in critical care and emergencies. In addition, my involvement in complex wound care and my proficiency in diagnosing and managing burns have improved my ability to offer all-encompassing patient care.

Opportunities for Improvement:

I am conscious of my areas of strength and have determined a few more where I can improve. I am exceptionally knowledgeable about ventilator settings. Even though I have experience with ventilators from prior practicums, I am keen to learn more about the intricacies of controlling AC, SIMV, CPAP, and evaluating ABGs to help set adjustments (Tripp et al., 2021). Participating in this activity can further my professional development and give patients the best respiratory care possible.

I still need to work on deciding which imaging tests to order better. Despite acquiring a basic understanding, I aim to further my knowledge of diagnostic imaging to ensure accurate and efficient use in patient assessment and management.

Furthermore, I am committed to enhancing my engagement in intricate wound care and actively seeking opportunities to enhance my understanding of wound management procedures (Farahani & Shafiee 2021). This involves being updated on the latest advancements in wound care and incorporating evidence-based treatments into my repertoire of clinical procedures.

Goals and Objectives for the Final Practicum

1. Enhance Proficiency in Ventilator Management:

· Objective 1: Independently manage various ventilator settings, demonstrating a comprehensive understanding of respiratory care.

· Objective 2: Analyze ABGs proficiently to guide and optimize ventilator settings based on patient needs.

2. Master the Art of Ordering Appropriate Imaging Tests:

· Objective 1: Develop a comprehensive understanding of different imaging modalities and their indications.

· Objective 2: Independently order appropriate imaging tests based on clinical presentations and evidence-based guidelines.

3. Excel in Complex Wound Care:

· Objective 1: Stay updated on the latest advancements in wound care through literature review and continuing education.

· Objective 2: Incorporate evidence-based wound management techniques into daily practice.

In conclusion, the self-assessment of my clinical skills and experiences from the last three practicums provides valuable insights into my strengths and areas for improvement. Leveraging these insights, I am well-positioned to make the most of my final practicum. By setting clear goals and objectives, I aim to continue growing in key areas while addressing opportunities for improvement. This reflective and proactive approach is fundamental to achieving a successful and enriching practicum experience.

References

D'Aoust, R. F., Brown, K. M., McIltrot, K., Adamji, J. M. D., Johnson, H., Seibert, D. C., & Ling, C. G. (2022). A competency roadmap for advanced practice nursing education using PRIME-NP.  Nursing outlook,  70(2), 337-346.

Leppert, W., Malec–Milewska, M., Zajaczkowska, R., & Wordliczek, J. (2018). Transdermal and topical drug administration in the treatment of pain.  Molecules,  23(3), 681.

Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., ... & Berg, K. M. (2020). Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.  Circulation,  142(16_Suppl_2), S366-S468.

Tripp, C. M., Papalski, U. H. W., FP-C, U. S. N., Honnoll, H. R., NR-P, U. S. N., Scarborough, H. T., ... & Shackelford, C. S. A. (2021). Mechanical Ventilation Basics (CPG ID: 92).

Farahani, M., & Shafiee, A. (2021). Wound healing: From passive to smart dressings.  Advanced Healthcare Materials,  10(16), 2100477.