Professional Growth Narrative Maria C. Reyes April, 1012

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1 Professional Growth Narrative Maria C. Reyes April, 1012 Zaccagnini and White (2011) assert that nurses can no longer rely on tradition and task orientation as their substantive base, nurses need facility with obtaining and maintaining the most current and evidence-based knowledge to inform their practice, hence the development of the Doctor of Nursing Practice (DNP). DNP graduates are prepared to investigate and solve the complex problems facing the health care system in the current environment. DNPs are able to navigate the complex systems that are facing today s dynamic and fragmented health care complexities with the most recent knowledge and are equipped to excavate the latest available knowledge. The DNP preparation equips graduates in many different roles, including but not limited to, researcher, leader, health policy advocate, educator and clinician (Chism, 2010). The DNP Essentials serve as the foundational outcome competencies essential for all DNP graduates regardless of specialty (AACN, 2006). The past two years have allowed for professional growth while meeting with the following DNP Essentials: Essential I: Scientific Underpinnings for Practice o Integrated collaborative professional partnerships with an interdisciplinary team to provide comprehensive health care services to children at risk for childhood obesity o Provided consultative services to families facing risks for preventative conditions at the local clinical practice i.e., family nutritional counseling, in order to thwart preventable chronic conditions o Developed strategies to address the issue of the increased cases of childhood overweight and obesity at the clinical practice by including a collaborative intervention approach o Incorporated research-based practice standards in current clinical practice. o Incorporated nursing theory-based practice standards in current clinical practice. Used Nola Pender s Health Promotion model theory in current clinical practice to empower Hispanic parents with necessary tools to thwart preventable chronic diseases in Hispanic children.

2 Essential II Organizational and Systems Leadership for Quality Improvement and Systems Thinking o Investigated evidence-based research relevant in the prevention of Hispanic childhood obesity o Sought opportunities to attend Advanced Practice Conferences with specific interest and in Childhood obesity o Developed leadership and collaborative skills in both the professional and clinical role as a DNP o Developed and expanded analytical skills when searching current literature for evidence-based clinical and professional practice o Developed strategies to increase clinical experiences for A.D.N. students in the form of clinical simulation Essential III Clinical Scholarship and Analytical Methods for Evidence-Based Practice o The DNP graduate will seek to fill roles as educators and will use their considerable practice expertise to educate the next generation of nurses (AACN, 2006). Nursing education continues to experience a severe nursing faculty shortage. Chism (2010) states that although the Essentials of Doctoral Education for Advanced Nursing Practice do not speak directly to the educator role, there are competencies in every Essential that are important and relevant to nurse educators. Undergraduate nursing faculty plays a critical role in the education of entry level registered nurses. Additionally, in response to the IOM Future of Nursing Report, associate degree nurses are prepared from the onset to continue their nursing education by transitioning to a bachelor s degree and beyond. o Attendance and class participation will increase the level of scholarship within the DNP professional role o Represented the A.D.N. Program by attending the HPSN 2012 Conference to evaluate implementation of increased clinical simulation teaching methodologies to enhance clinical experiences for the A.D.N. students o Completed Capstone Project with emphasis on synthesis of statistical analysis on Hispanic Childhood Obesity o Presented Poster presentations at the TWU Denton Campus for the Student Creative Arts & Research Symposium presentation of Capstone Project; Infant Feeding Methods as Key Predictor for Obesity in Hispanic Children; Case Study Poster; The Value of Newborn Screening: A Case of Hereditary Tyrosinemia Type I Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care o Participated in a Peer Review Field trip to Southwestern Medical Center and El Centro Community College to increase knowledge of the use of simulation in nursing education. o Researched evidence-based methods and strategies to increase knowledge of clinical simulation education methodologies. o Attended Conference Sessions: 1. The Simulation Learning System: Session provided the first look at CAE Healthcare and Elsevier s combined learning management system for human simulators.

3 2. Getting Sims Moving Without Laxatives! RX: Mind Maps & Emotional Intelligence: Presentation discussed concepts which offered a model in approaching simulation and increasing participation of the simulation participants. Additionally, the presenter discussed strategies to reduce stress and anxiety for the simulation participants by developing emotional intelligence and mind maps. 3. How to Use Technology to maximize Your Learner s Simulation Experiences: Information presented about available technology that can be applied to simulation and learning environments. Comparing and contrasting smartphones, digital drawing boards, and tables to enhance simulation experience. 4. The Art and Science of Simulation Debriefing: Discussion on the importance of debriefing after a simulation experience. Included judgmental, nonjudgmental debriefing. 5. Utilizing METI edose to Develop Newly Hired Nurses: Implementing METI edose to evaluate medication assessment tool in an eleven hospital system. 6. Writing for Publication: From Idea to Published Article: Beth Ulrich EdD, RN, FACHE, presented a guide for participants which included the steps in developing a manuscript for publication. Discussion on the basic concepts in turning an idea into a manuscript for publication, selecting the journal to submit to and understanding the steps in the manuscript submission and review process. Also discussed from a journal editor s perspective, what distinguishes a manuscripts submission to be more likely to be accepted or rejected o Represented Houston Community College by attending the Texas Medical Center Quality and Patient Safety Council s quarterly meeting. Presentation of Strategic Health IT Advanced Research Projects (SHARP) Program and EHR Usability presented by Dr. Amy Franklin, Assistant Professor, National Center for Cognitive Informatics and Decision Making, School of Biomedical Informatics at The University of Texas Health Science Center. Comprehensive presentation on the importance of EHR usability in clinical practice. (SHARP.com) Essential V: Health Care Policy for Advocacy in Health Care o Developed management strategies to collaborate with outside resources to consult and refer children with risk factors for childhood obesity o Advocated for clinical practice standards that follow healthcare policy when treating vulnerable populations such as Hispanic children at risk for childhood obesity. Essential VI Interprofessional Collaboration for Improving Patient and Population Health Outcomes o Continued to identify children with a propensity for the risk of overweight and obesity at the clinical practice setting. o Collaborated with Texas Children s Hospital Keep Fit Program to identify and refer children and adolescents age under the Texas Children s Health Plan to attend the cost-free program comprised of exercise and nutrition classes. o Began to focus on a family-centered educational strategy for overweight and obese children.

4 o Developed a follow-up method to enable me to follow patients and prevent them from falling through the cracks. DNPs serve as change agents in clinical practice by providing evidence-based interventions to improve patient outcomes. Essential VII: Clinical Prevention and Population Health for Improving the Nation s Health o Developed an ongoing referral system to facilitate the process for applying to the local county healthcare system for acquisition of the Gold Card for pediatric patients not eligible for Medicaid healthcare benefits. o Sought opportunities to address the problem of children who are not covered by Medicaid healthcare services. o Provided educational opportunities to parents who may neglect to renew their children s Medicaid application. o Expanded knowledge and expertise in statistical evaluation of capstone project data and apply findings to clinical practice. o Expanded knowledge in the topic of Pediatric Childhood Obesity by completing Capstone Project Statistical Analysis. o Applied knowledge gained in the development and completion of the capstone project to the clinical practice. o There is ample opportunity for providers to offer health education and health promotion. However, since the clinic serves a high volume of Hispanic children, the pace is fairly fast. Since, I speak Spanish, as do all the other providers at the clinic; I am able to offer targeted education appropriate to the clinic visit. o Provided targeted nutritional counseling to parents/family members of Hispanic infants at critical time periods, (i.e., first visits, well visits), to increase knowledge on healthy nutrition and prevention of childhood overweight and obesity. o Encouraged Hispanic mothers to prepare meals at home and decrease use of processed foods to increase their knowledge on healthy nutrition and meal preparation o Supported Hispanic families in maintaining traditional foods/meals which contain fewer calories/fats/processing, such as beans, lentils, corn tortillas, fruits and vegetables. Essential VIII Advanced Nursing Practice o Continued to practice at the Parra Medical Clinic with an increased emphasis in collaborative and interdisciplinary health care approach. o Initiated a standardized referral process to weight management resources for Hispanic children presenting with overweight and obesity. o Continued to develop expanded clinical practice experiences. o Advanced clinical practice to include increased interdisciplinary collaborative experiences such as increasing the number of referrals made to the Nutrition Clinic for patients with abnormal weight gain. o Increased evidence-based interventions by researching best practice interventions for the pediatric patients at the Parra Medical Clinic. o Expanded knowledge base in relation to current Professional Role of Interim Program Director for an Associate Degree Nursing Program.

5 o Develop an effective patient education intervention on prevention of Hispanic Childhood obesity for the patients at the Parra Medical Clinic: Essential VIII prepares the DNP graduate to design and implement therapeutic interventions based on nursing science and other sciences (AACN, 2006). o I would like to provide an educational intervention at the clinic for Hispanic parents of infant children, specifically infants approaching their 1 st year birthday. This will provide an opportunity to encourage families to discontinue the bottle feedings after the child s first birthday and to provide a more balanced diet which will not include large quantities of whole milk. o Continue to practice professionally at the pediatric practice serving high volume underinsured and uninsured Hispanic pediatric population. o Develop and evaluate educational interventions directed at the prevention of chronic disorders and health promotion to the Hispanic pediatric population and their families o Examine evidence-based practice guidelines to improve the health of the Hispanic pediatric population served at the Parra Medical Clinic. o Continue to expand knowledge and expertise in statistical evaluation of capstone project data and apply findings to clinical practice. o Expand knowledge in the topic of Pediatric Childhood Obesity by completing Capstone Project Statistical Analysis. o Expanded clinical practice assessments to incorporate and implement scientific data based on individual, and population health. (Realizing that patient teaching opportunities are often encountered when treating one member of the family). o Based on evidenced-based interventions incorporate physical assessment techniques that will allow for more comprehensive examinations. (Ensure complete assessment of red reflux in newborn exams upon clinic visits) o Maintain cultural awareness and competence when promoting health in a culturally appropriate manner. At the DNP level, knowledge of the impact of health policy on access to health care and the intersection of these factors with cultural diversity and psychosocial dimensions allows the DNP to perform a more in depth analysis than the master s level APRN for guidance regarding how to develop and implement health promotion and disease prevention interventions appropriately for individuals and groups in the target populations (Zaccagnini, 2011).

6 Reference American Association of Colleges of Nursing (AACN). (2006). Essentials of doctoral education for advanced nursing practice. Retrieved from Essentials.pdf Chism, L. (2010). The doctor of nursing practice: A guidebook for role development and professional issues. New York: Jones and Bartlett Publishers. Zaccagnini, M. E., & White, K. W. (2011). The doctor of nursing practice essentials: a new model for advanced practice nursing. New York: Jones and Bartlett Publishers.

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