Subject s Name: Evaluator s Name:

Transcription

1 SELF-REPORTING TOOL: Operative Services OR LPN, LPN/ST Nurses Page 1 of 7 Subject s Name: Evaluator s Name: Requires Evaluati Descriptors (Quality & ) for reference PLANNING & MANAGING CARE 1. Addresses patient safety needs (ex: initiates timeout before procedure for pt id, site, side, operati of equipment, electrical, laser and radiati safety, care of anesthetized pt, positiing, skin care). May be evidenced by absence of safety problems. 2. Applies age-specific/cultural csideratis to care of patient. 3. Identifies and takes acti to decrease costs of patient care. 4. Identifies and takes acti issues that would negatively impact patient flow. 5. Addresses breaks in asepsis and sterile technique as outlined in AORN standards. 6. Understands implicati of evidence based learning current clinical practice by applying applicable policies and guidelines. 7. Manages complex clinical situatis (ex: recognizes early sign of pt deteriorati and prepares for anticipated interventi). 8. Ensures or improves cost effectiveness (or cost/case) in your area (beyd what is expected of everye).

2 Page 2 of 7 CONTINUUM OF CARE PLANNING Planning for next level of care issues (beyd current practice area) 1. Anticipates and reports/plans for transfer to next level of care (SBAR). Ex: Notifies PACU/receiving unit of impending transfer and anticipated needs. 2. Uses internal and external referrals and resources that support pt/families through ctinuum of care. 3. Acts to resolve system breakdowns, knowledge and/or behavior issues that impact ctinuum of care needs (ex: address physician/staff related delays, uses inservice or other methods to share knowledge re ctinuum of care). PATIENT / FAMILY EDUCATION Secti Not Applicable in OR

3 Page 3 of 7 PROBLEM SOLVING 1. Identifies and takes acti to resolve patient safety related problems and other clinical issues. 2. Actively participates in team/group problem solving. 3. Positively supports change. 4. Identifies and takes acti to resolve system (operatial/workarounds) problems. 5. Uses collaborative approach to lead HCT and others in problem-solving projects and evaluates outcomes using data. COMMUNICATION & COLLABORATION 1. Persal behavior positively influences envirment and others (may include attendance, tardiness, team support). 2. Reviews patient record as part of overall care. 3. Participates in multidisciplinary efforts to form plan of care/meet patient s needs. 4. ively communicates and collaborates with staff and other Health Care members. 5. Communicates positively and cstructively in stressful situatis.

4 6. Participates directly in and/or supports orientati of new staff. 7. Models and leads others in cflict resoluti. Page 4 of 7 CONTINUOUS LEARNING LPN 2 0hrs. = 1; <10 hrs = 2; hrs. = 3; hrs = 4; >20 hrs = 5 1. Provide to manager evidence of selfeducatial activities within timeframe designated by manager. *Total # of ctact hours, courses taken, articles read/hours spent in self educati. LPN hrs. = 1; 8 14 hrs = 2; hrs. = 3; hrs = 4; >25 hrs = hrs. = 1; hrs = 2; hrs. = 3; hrs = 4; >30 hrs = 5 2. Participates in quality improvement initiatives. 3. Participates in developing and/or revising evidence based practice guidelines. 4. Leads in the development and/or revisi of evidence based practice guidelines.

5 5. Participated in scholarly/professial activities in the past year. Examples: formal presentatis, publicatis, public policy issues, acti, professial org. activities. 6. Leads quality improvement projects. Page 5 of 7 *You must provide the requested informati for EACH of the level-appropriate criteria above. Reminder: Review you professial goals from last year and report your assessment of their achievement. Prepare your professial goals for next year and bring to the evaluati cference with your manager. Evaluati Scoring Descriptors ive May 2006 For each criteri, evaluator csiders 2 dimensis and chooses ly 1 descriptor for each:

6 How well the subject performs this behavior, the quality or degree of expertise The subject s effect of the team when performing this behavior Page 6 of 7 Quality / team a Does not perform a Unaware or ignores standards and/or directi b Performs incsistently or not to standard b Requires much directi c Csistently competent = performing to standard csistently c Requires some support = what would be expected of a new nurse within their first year d Csistently proficient = model performance exceeding standard with big picture view d Performs independently e Csistently an expert = exceptial, masterful performance, specialist e Role model & resource to others (beyd precepting) = a positive example for others to try to meet; demstrates knowledge & expertise that others recognize and go to (outside the preceptor relatiship), persal behavior demstrates interest in sharing knowledge/expertise with others Benner s definitis for above descriptors: Competent = uses experience-based practical knowledge to apply this criteria appropriately and efficiently while mindful of goals Proficient = has achieved a global big picture perspective, attends to total situati, proactive Expert = highly skilled performance intuitively knowing what to do and expected results Instructis ctinued next/back page f g h Initiates informal coaching 1:1 with others (beyd precepting) = Takes opportunities to share expertise with the intenti of facilitating other s professial development Isn t waiting until asked (resource), sees a situati and sptaneously coaches Not telling how, but uses questis, etc. to prompt critical thinking Random, and perss and topics vary Facilitates improved group practice = beyd 1:1 individual coaching, does something to improve the practice group s performance: In-service Poster, posting, group Develop or update a standard, protocol, etc. Debrief a critical incident for the benefit of the group present Formally mentors individuals &/or groups by mutual agreement = Individual Active, persal relatiship by mutual agreement focused specific persal &/or professial goals Group Commits to perform an operatial or clinical activity or service for a group or practice area, e.g. chart rounds, competency training, review of policies, pathways, area super-user, etc. As the evaluator read each criteria- even above level criteria

7 choose the 1 descriptor for each of the 2 dimensis that fits best with the subject s performance of that specific criteria If above level criteria is not applicable, skip it, do not select any descriptors Page 7 of 7 The selected descriptors eventually are tallied from all evaluati tools into overall key functi scores related to the subject s RN level One specific example is required for each key functi: Planning & Managing Care, Patient/Family Ed, etc. For advancement evaluatis ly: One specific example is required for each level criteria in additi to key functi examples If e example will cover > 1 criteria or key functi, you can refer to it rather than add another