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Self-Assessment

Nurse competence plays a key role in quality care and outcomes however, nursing practice

is complex and therefore difficult to measure.

This self-assessment is modified from the University of Michigan professional nursing

portfolio.

At the basic level, a registered nurse should be able to do the following. Use the guide

below to perform a self-assessment.

Synthesize knowledge from nursing and the physical, biological, behavioral,

psychological and social sciences, and the humanities in the practice of professional

nursing.

Use critical thinking as the basis for professional nursing practice

Participate in interdisciplinary teams and community partnerships to meet the

health care needs of individuals, families, and communities in diverse society with

particular emphasis on needs of vulnerable populations.

Demonstrate effective verbal, written, electronic communication in the promotion

of culturally appropriate care.

Apply innovative technologies to optimize outcomes for self, clients, and

communities.

Demonstrate competency in the performance and evaluation of nursing techniques

and skills.

Incorporate ethical, cultural, and legal principles as professional values in the

practice of professional nursing.

Use the principles of teaching and learning to promote, maintain, restore health, and

prevent illnesses with individuals, families, and communities.

Apply theories and principles of leadership and management to collaborate with

interdisciplinary teams to promote and maintain quality health care for individuals,

families and communities.

Participate in efforts to influence health systems policy on behalf of patients and the

profession.

Use research in the exploration of health problems and the implementation of

evidence based practice.

Assume responsibility for lifelong learning and plan for professional career

development.

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Key For Self-Assessment

1 = No Knowledge/ Experience

2 = Some Knowledge/ Experience

3 = Competent

4 = Competent, with additional experience

5 = Competent, experienced and able to teach others

# Competencies Levels of competency

1 DOMAIN: Clinical Skills and Knowledge. This includes organization and management of care

1.1 Assessment 1 2 3 4 5 Performs assessment & identifies appropriate

nursing diagnosis and/or patient care standard with assistance.

Performs focused assessment of unit standard patient for effective patient care with minimal assistance.

Independently and completely performs focused assessment to provide most effective patient care for a given patient population. Recognizes specialty data.

Independently and consistently performs goal-focused and individualized assessment when caring for all patients, including those with complex pathophysiological and psychosocial needs.

Exhibits highly developed assessment abilities that exemplify a comprehensive understanding of the total patient/family situation.

1.2 Nursing Diagnosis 1 2 3 4 5

Recognizes data and identifies obvious nursing diagnoses.

Identifies key nursing diagnoses to address physical and psychosocial/emotional areas.

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Prioritizes key nursing diagnoses to address physical and psychosocial/emotional areas.

Individualizes nursing diagnoses based on assessment data.

Explore and develop a range of possible care alternatives and approaches with clients.

Individualizes nursing diagnoses based on assessment data and integrates that with the diagnoses & priorities of other disciplines in order to provide holistic care.

1.3 Planning/Implementation/Evaluation 1 2 3 4 5 Practice is guided primarily by policies,

procedures, and standards.

Involve clients in identifying their preferred health outcomes.

Uses evolving clinical experience as a guide for practice.

Practice is driven by theory and experience.

Develop care plans with other health team members to ensure continuity of care.

Practice relies on previous experience for focused analysis of problems and solutions with individual patient modification in order to meet outcomes.

Practice is driven by an intuitive base and is self-directed, flexible, and innovative.

Identifies expected outcomes and nursing interventions to meet identified diagnoses and maintain standards of clinical practice.

1.4 Evaluates patients based on basic standards.

1 2 3 4 5

With guidance, develops, implements, and evaluates plan of care that recognizes subtle changes in patient’s condition.

Independently develops, implements, and evaluates plan of care that recognizes subtle changes in patient’s condition and adapts plan as needed.

Manage multiple nursing interventions for clients with co-morbidities, complex and rapid changing health status.

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Accommodates unplanned events and evaluates/ responds appropriately with speed, efficiency, flexibility, and confidence.

Is consistently effective in providing holistic care that ensures positive change even in the most challenging patient care situations.

2 Safety 1 2 3 4 5 Can identify report and take action on actual or

potential safety risks to clients, self and others.

Recognize, seek immediate assistance, and help others, in a rapidly changing situation that could affect client health or safety.

Verify that clients have and understand essential information and self-care skills.

Have the knowledge and skills to use medical equipment, instrumentation and tools safely

Have the knowledge and skills to apply the principles of standard precautions.

Have the necessary knowledge of fire safety policy, procedures, and staff responsibilities in the event of a fire in our health care setting.

Have the knowledge and skills to handle and dispose of hazardous materials and bio-medical waste.

Have the knowledge and skills to apply self-protection / prevention techniques to prevent job related injuries.

Recognize and report near misses and errors and take action to minimize harm arising from these adverse events.

Report and document client care and its ongoing evaluation in a clear, concise, accurate and timely manner.

Challenge questionable orders, decisions or actions made by other health team members.

1.6 Patient care equipment 1 2 3 4 5 Can differentiate between peripheral lines,

central lines, implanted ports, and etc.

Can use a variety of infusion therapy equipment.

Know the different types of central lines and the terminology used by my agency.

Practice safety precautions when using and maintaining oxygen therapy from wall outlets, portable tanks, and oxygen concentrator.

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Can perform the care of a tracheostomy using appropriate equipment and supplies.

Know how to recognize the complications, clinical manifestations, and nursing interventions related to tracheostomy care.

Know the equipment and supplies required to care for a client with a chest drainage system.

1.7 Technology 1 2 3 4 5

Utilizes standard unit technology and with assistance uses advanced technology as appropriate.

Utilizes standard unit technology. With guidance uses advanced technology as appropriate.

Utilizes standard unit technology and uses advanced technology as appropriate.

Have knowledge of nursing informatics and the communications technologies used in health care.

Becomes expert and resource for use of standard unit technology and advanced technology as appropriate.

Takes a leadership role in evaluating technology and its potential for use.

Utilizes computer correctly for basic functions. Such as

o Order entry o Lab requisition o Documentation o Medication administration o Obtaining patient information and

assessments

Utilizes computer for basic functions.

Utilizes computer for basic functions as well as reference on patient conditions and treatment.

Incorporate evidence from research, clinical practice, client preference and other available resources to make decisions about client care.

Becomes resource for use of computer.

Able to conduct literature search through library functions— CINAHL, Cochrane, Medline, PubMed.

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1.8 Patient/Family Education 1 2 3 4 5 With assistance, identifies basic patient/family

learning needs. Initiates teaching using patient teaching protocols, patient care standards and critical paths.

Identifies basic patient/family learning needs.

Verify that clients have and understand essential information and self-care skills.

Initiates and evaluates teaching using patient teaching protocols, patient care standards and critical paths.

Accurately assesses patient/family’s readiness to learn, organizes and executes individualized teaching plan, evaluates patient’s understanding and modifies approach as necessary.

Identifies learning needs of designated populations. Works collaboratively to develop strategies to meet these learning needs.

Anticipates patient/family learning needs and utilizes a variety of teaching strategies appropriate to the patient’s needs.

Serves as expert resource and facilitates other staff in improving patient education.

Collaborates with other disciplines to develop and/or implement patient/family teaching programs.

Utilizes patient education resources on the unit.

Involve clients in identifying their preferred health outcomes.

Seeks out additional patient education resources beyond unit.

Revises and develops patient education materials.

Seeks out challenging patient/family education opportunities.

Policy/Procedure/Protocols

Identifies location of and utilizes hospital policies and unit procedures and protocols.

Consistently utilizes hospital policies and unit procedures and protocols.

Demonstrates ease in application of hospital policies and unit procedures and protocols.

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Teaches and functions as a resources in the application of hospital policies, and unit procedures and protocols.

Researches, revises, and develops hospital policies and unit procedures and protocols utilizing appropriate channels and resources.

1.9 Promoting Culture of Safety 1 2 3 4 5 Adheres to standards related to medication

safety: o Order writing conventions o Correct administration considerations o Double checks as indicated

Identifies and intervenes when there are concerns related to medication safety.

Identifies and intervenes when there are concerns related to medication safety, providing feedback to staff members involved.

Unit expert and resource on medications applicable to their unit/clinical setting.

Advocates for culture of safety through knowledge, problem solving, and system changes.

Familiar with and follows standards related to patient and staff safety.

Identifies concerns and intervenes related to patient and staff safety.

Anticipates and intervenes related to patient and staff safety.

Facilitates others related to patient and staff safety; actively works toward prevention of potential injury.

1.10

Documentation 1 2 3 4 5

Admission assessment, flow sheets, MARs, and other applicable documentation forms are

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completed in a timely manner according to legal standards with minimal guidance.

Admission assessment, flow sheets, MARs, and other applicable documentation forms are completed in a timely manner according to policy.

Consults documentation to identify trends in patient status and enhance continuity of assessment and ongoing nursing care.

Involved in ongoing quality monitoring of documentation of nursing care and patient outcome.

Participates in the development of documentation tools, standards, and/or policy.

2 DOMAIN: Therapeutic Relationships: An intentional interactive relationship with

patients and families that is caring, clear, boundaries, and is positive and professional. 2.1 Therapeutic Communication 1 2 3 4 5 Recognizes how the nurse: patient/family

relationship influences the patient experience.

Establishes patient/family /nurse relationship.

Begins to identify how own values affects the patient/family/nurse relationship.

Possesses clarity on one’s own values and how they affect interactions, relationships and boundary setting.

Consistently role models individualized therapeutic communication based on patient and family needs.

Intuitively uses expert therapeutic communication with patient/family.

Introduces self as a Nurse and describes role. Wears identification.

Individualizes communication based on assessment of the patients and families.

Initiates consultation / leadership with the healthcare team to share and promote collaborative approach to patient and family care.

Shares and promotes collaborative approach to patient and family care.

Establishes open communication.

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2.2 Empowerment—Nurse, Patient, Family 1 2 3 4 5 Recognizes the need for patient and family to

participate in care.

Seeks help as appropriate to assess readiness for participation in care

Involves patients and families in care.

Incorporates patient/family in planning and implementing care.

Invites patients and families to actively participate in plan of care to foster growth and competence.

Maximizes patient/family participation in decision-making and goal setting along the continuum of care.

2.3 Compassion 1 2 3 4 5 Actively listens to patient/family concerns in a

respectful manner.

Actively listens and responds to patient/family concerns.

Demonstrates empathy in interactions with patients/families.

Plans and provides nursing care that promotes intentional caring.

Intuitive understanding of patient/family experience and is proactive in providing creative approaches to optimize comfort and support.

Shows kindness and caring with patient/families.

2.4 Advocacy and Ethics 1 2 3 4 5 Recognizes, respects, and supports

patient/family rights and maintains confidentiality.

Seeks resources in response to situations that have the potential to negatively impact patient/ family outcomes.

Mobilizes appropriate resources in response to situations that have the potential to negatively impact patient/ family outcomes.

Challenges situations and/or decisions that obstruct positive patient outcomes and works to reduce barriers.

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Challenges and adapts systems to maximize the benefits for patient care.

2.5 Valuing of Diversity with Patients and Family 1 2 3 4 5 Aware of and values the diversity in patients and

families.

Begins to incorporate diversity considerations in patient care.

Identify own values and beliefs and use this self-awareness to offer culturally safe client care.

Demonstrates openness to the uniqueness of others.

Begins to explore one’s own biases and how they impact patient care.

Engage in relational practice with clients through a variety of approaches that demonstrates care behaviors appropriate for clients.

Seeks to learn about and optimize the unique contribution inherent in the diversity and culture of each individual.

Demonstrates actions that incorporate the rich traditions, beliefs, and values of patients and families.

Embraces visible and invisible diversity; seeks out perspectives from those of different backgrounds and cultures.

Integrates understandings of populations into patient care.

3 DOMAIN: Professional Relationships: An intentional interactive relationship with the health care team that is marked by mutual regard, trust, and active engagement.

3.1 Collaboration with the Health Care Team

1 2 3 4 5

Recognizes role of each member of the health care team.

Initiates collaborative communication.

Recognizes and values professional collaborative communication and the positive effect on patient outcomes.

Acts as resource to nursing and health care team.

Through shared values and a clear professional identity, demonstrates and role models an interdisciplinary collaborative approach to patient care.

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Aware of importance of team collaboration and with guidance, begins to initiate collaborative communication.

Recognizes the impact of one’s behavior on others.

Identifies and utilizes collaborative resources.

Show initiative, confidence, and self-awareness and encourage collaborative interactions within the nursing and health care teams.

Is sought out by members of the multi-disciplinary health care team.

Use relational knowledge and ethical principles when working with students and other health care team members to maximize collaborative client care.

Use basic conflict resolution strategies in which conflict situations are transformed into healthier interpersonal interactions.

Use established communication protocols within and across health care agencies and with other service sectors.

Participates and/or leads team care conference.

Initiates referrals.

Monitors referrals.

Frequently initiates consults with health care team.

Actively collaborates with other health professionals in delivering care.

Recognizes need and calls for team conference.

3.2 Valuing Teams/Teamwork

1 2 3 4 5

Identifies self as member of nursing and health care teams.

Meets professional commitments consistently.

Functions as an independent and supportive team member.

Respect the knowledge, skills, ideas, opinions, and expertise of all members of the health team.

Fosters mutual regard, respect, and trust.

Demonstrates team values that orient people to care about performance and success of others.

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Begins to generate trust, respect, and compassion within the workgroup.

Seeks assistance with resolving conflict.

Provides assistance to others.

Demonstrates active engagement to enhance patient care and promote a positive workplace.

Recognizes value of conflict in individual and organization learning and growth.

Takes responsibility for developing beginning team relationships.

Demonstrates empathy and compassion in interactions with team members.

Demonstrates flexibility. Creates conditions and relationships that promote creative, innovative, and positive processes and outcomes.

Asks for and accepts help when needed. Acknowledges when conflict exists.

Approaches conflict situations in a constructive manner.

Role models behaviors that demonstrate compassion and caring.

Fosters other's development of compassionate care.

3.3 Valuing of Diversity in Team

1 2 3 4 5

Aware of and values diversity in all members of the health care team.

Establish and maintain appropriate professional boundaries with clients and other team members.

Recognizes own biases and begins to demonstrate empathy as a member of the health care team.

Seeks to learn about and optimize the unique contribution inherent in the diversity and culture of each individual on the health care team.

Role models and helps to establish group norms that promote valuing of all health care team members.

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Depends on diversity of workforce to enrich and build great places to work.

3.4 Delegation

1 2 3 4 5

Functions as part of nursing team; able to describe and begin to use 5 Rights of Delegation when delegating to UAP:

Uses 5 Rights of Delegation when delegating to UAP.

Readily able to delegate to UAP according to the 5 Rights of Delegation.

Recognizes and values interdependent relationships.

Adaptable, flexible, and consistently effective in delegation.

o Right task o Right circumstances o Right person o Right communication o Right supervision and evaluation

Recognizes value of nurse-to- nurse delegation.

Facilitates continuity of care and nursing work flow through nurse to nurse delegation.

Recognizes strengths of other team members that would benefit the patient and the team—aligns skill sets of individual nurses/UAP to specific patients.

Successfully organizes and coordinates multiple activities, requests, and needs.

Develops work processes that maximize team work.

Demonstrates foresight in anticipating and planning to meet patient and family concerns.

4 Professionalism 1 2 3 4 5

Familiar with the legislation, policies and regulations that affect the nursing profession in my jurisdiction

knowledge of the health care systems within which I practice

Knowledge of scope of practice as outlined in legislation and regulations

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Aware of the physical / mental capacity necessary for a nurse to provide quality care.

Recognize limitations of practice and seek assistance as necessary.

Exercise professional judgment when using agency policies and procedures, or when practicing in the absence of agency policies and protocols.

Integrate quality improvement principles and activities into nursing practice.

Accept responsibility for maintaining my professional competence through life-long learning

Participate in a variety of professional activities related to nursing practice.

Keep current with new knowledge, developments and technologies that change, enhance and support nursing practice.

Know and follow the nursing Code of Ethics.

Respect the confidentiality of all health information and especially the client's personal and health data.

Engage in nursing and health research by reading and critiquing research reports and identifying research issues.

5 DOMAIN: Personal and Professional Development: Committed to the professional development of self and others.

5.1 Self 1 2 3 4 5

Engages in self-assessment related to orientation and initial learning needs and seeks out unit resources to assist in meeting needs.

Engages in self-assessment related to ongoing learning needs.

Completes mandatory / competency requirements during orientation and annually.

Sets goals for knowledge/skill enhancement within the practice setting.

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Seeks out additional learning experiences within practice area

o Unit specific certifications o Consultation with experts o Inservices / rounds o Collaborating with other

Sets goals for knowledge/skill enhancement within and beyond the practice setting.

Attends in-service(s)/CE’s within and beyond practice area

Sets goals in self-directed manner and actively seeks out opportunities for knowledge/skill enhancement within and beyond the practice setting.

Support nursing and health research by conducting, participating in, and/or applying research.

Evidence of advancing professional identity (at least one):

o Certification in specialty o Active participation in a professional

organization.

5.2 Contributions to Others

1 2 3 4 5

With guidance, provides respectful feedback to preceptors, peers, and manager related to orientation and initial learning experience.

Begins to participate in providing and accepting respectful feedback.

Participate in peer feedback.

Takes a leadership role in building and maintaining an environment where all team members thrive.

Works to create and sustain a culture that is supportive and rewards and recognizes professionalism.

Expands knowledge of the process: * Formal training - authentic, accountable, respectful, relevant to clinical performance * Identifiable / attributable (not anonymous)

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Recognizes professional strengths in others and builds upon them.

Mentors nurse colleagues in achievement of professional framework progression.

Contributes to others knowledge and skill development in practice setting.

May act as preceptor of new and present staff when applicable. Utilizes own knowledge/skills to improve professional development environment on the unit.

Shares in/contributes to others knowledge/skill development in practice setting, examples include:

Conducts in services Develops staff education tools.

Acts as a clinical resource/liaison beyond the unit setting

o Specialty

6 DOMAIN: Advancing Practice through Innovation and Research: Demonstrates ongoing innovation by reviewing, critiquing and applying existing evidence to

practice. Continually improves practice by applying performance improvement methodologies.

6.1 Research

1 2 3 4 5

Reads clinical articles.

Demonstrates an awareness of current literature in area of practice, including journal club, in-services, etc.

Reads evidence based articles related to area of practice.

Implements change in practice for a population of patients based on the application of current research findings and evaluates effectiveness of practice changes.

Participates in unit/area based Continuous Quality Improvement projects.

Identifies individual patient problems which require investigation.

Participates in institution’s unit/area Continuous Quality Improvement projects.

Makes recommendations for changes in practice based on findings.

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Participates in unit/area based research, as appropriate.

Presents at unit based educational forums.

Shares findings of Continuous Quality Improvement projects, such as:

o Unit presentation o Rounds

Applies current literature/ research to problems in practice area.

6.2 Innovation (creative solutions to everyday problems)

1 2 3 4 5

Has knowledge of and supports established nursing improvement projects / endeavors in practice setting.

Actively participates in established nursing improvement projects / endeavors in practice setting.

Identifies areas for creative improvement in practice setting and seeks out resources and avenues to address them (unit practice council, content experts, etc.).

Takes on leadership role in relation to innovations/ improvements in practice setting.

Independently seeks out opportunities to share information and influence evidence based nursing practice.

Evaluates effectiveness of innovation/practice

changes.