Nursing Portfolio as a Method of Formative and Summative Assessment - Coursework Example

PORTFOLIO: NURSING Table of Contents Introduction Page 3 Evidence Summary Table Page 4-9 Justification ment Page 9 Critical Reflection Page 10-12 Conclusion Page 12 References Page 13 List of Appendices Page 13 Appendix 1 Page 13 Appendix 2 Page 14 Appendix 3 Page 14 Appendix 4 Page 15-16 Appendix 5 Page 17 Introduction Nursing Portfolio has been a method of both formative and summative assessment. As nursing students we are required to maintain a portfolio as a component of a programme. A portfolio is a collection and cohesive account of work-based learning that contains relevant evidence from practice and critical reflection on this evidence. As will be evident, the primary purpose is to display achievement of learning and development of knowledge. This portfolio was prepared while as a student I carried with me to prepare and complete while I was actually gaining my practical clinical experience within the clinical practice environment in my placement. It was evident that as I progressed in my placement, I came to know specific details about portfolios as it progressed, but it was mainly a tool for self-directed learning. An important underpinning concept within the portfolio use is its firm entrenchment in learning from nursing practice experience usually in a self-directed manner. This means I had responsibility for completing the portfolio, although there was a relative freedom with task completion, often with minimal direction and guidelines. This portfolio has been designed to improve self-development and assessment as to whether I had been able to develop of the Australian Nursing and Midwifery Council (ANMC) competencies. This portfolio has been based on ANMC competency standard seven (Australian Nursing and Midwifery Council 2006), which speaks about nurses competency for provision of comprehensive, safe, and effective evidence-based care to achieve health outcomes for individuals or groups in an identified population. Evidence summary table: ANMC Competency (Australian Nursing and Midwifery Council 2006) 7. Provides comprehensive, safe and effective evidence–based nursing care to achieve identified individual/group health outcomes comprises the following eight sub headings: 7.1. Effectively manages the nursing care of individuals/groups 7.2. Provides nursing care according to the documented care or treatment plan 7.3. Prioritizes workload based on the individual’s/group’s needs, acuity and optimal time for intervention 7.4. Responds effectively to unexpected or rapidly changing situations 7.5. Delegates aspects of care to others according to their competence and scope of practice 7.6. Provides effective and timely direction and supervision to ensure that delegated care is provided safely and accurately. 7.7. Educates individuals/groups to promote independence and control over their health 7.8. Uses health care resources effectively and efficiently to promote optimal nursing and health care Evidence Summary Table Evidence Title Appendix Specific Subcategory Second Year Clinical placement facilitator comments 1 This document clearly states that I worked on my time management well and improved my nursing skills during placement. 7.1 ● uses resources effectively and efficiently in providing care ● performs actions in a manner consistent with relevant nursing principles 7.3 ● determines priorities for care, based on nursing assessment of an individual/group’s needs for intervention, current nursing knowledge and research 7.6 ● provides support with documentation to nurses being supervised or to whom care has been delegated Health of Infant, children and young people assignment - Child Health Assessment Report, Health Intervention Plan and Mark Sheet 2 This document was prepared that I’m a capability on assessing and conducting the comprehensive nursing care effectively in my own studies. A child health assessment report following by the health intervention plan 7.1 ●uses resources effectively and efficiently in providing care ●monitors responses of individuals/groups throughout each intervention and adjusts care accordingly ● provides education and support to assist development and maintenance of independent living skills 7.2 ● uses a range of appropriate strategies to facilitate the individual/group’s achievement of short and long term expected goals 7.3 ● determines priorities for care, based on nursing assessment of an individual/group’s needs for intervention, current nursing knowledge and research Systems and Organization of nursing care assignment - Plan of care and Mark sheet Health of Adult – management plan for a client with a particular health issue and Mark sheet 3 & 4 This document was prepared as an assessable component on my studies. It is emphasis on my knowledge of acute action plan. The tutor’s mark sheet and comment are included to further substantiate my claims for competency. 7.1● provides education and support to assist development and maintenance of independent living skills ● uses resources effectively and efficiently in providing care 7.2 ● uses a range of appropriate strategies to facilitate the individual/group’s achievement of short and long term expected goals 7.3 ● determines priorities for care, based on nursing assessment of an individual/group’s needs for intervention, current nursing knowledge and research 7.4 ● implements crisis interventions and emergency routines as necessary Second Year Clinical Placement ANMC log entry by self this would be strengthened by RN signature 5 This document is from my own clinical placement log indicating how I provide comprehensive, safe; evidence based nursing care during placement. 7.3 ● determines priorities for care, based on nursing assessment of an individual/group’s needs for intervention, current nursing knowledge and research 7.6 ● uses a range of direct and indirect techniques such as instructing, coaching, mentoring, and collaborating in the supervision and support of others Justification Statement The appendix 1 shows the item of evidence. This contains the feedback from my facilitator. My facilitator had been instrumental in development of my nursing skills and professional development which were important in my competency development. She had commented that I demonstrated willingness to participate in the team environment. As per her evaluation, my clinical skills had improved over time, and I could interact with the patients in a friendly and empathic manner. My communication style was good, and I sought clarification while interacting with the patient and the staff. This indicated that I had achieved competency standard as delineated in ANMC competency 7.1. This evaluation also indicates that I was able to provide safe and effective evidence-based care with confident attitude taking care of safety of the clients. Appendix 2 is the assessment report on child health, which I performed. From this assessment, I developed the health intervention plan. From the document, one can easily presume how I used my nursing assessment skills to assess this childs health status. To develop a nursing care plan, evidence from research was used. The care plan also included provision of health education and support to enable and assist the patient to develop a positive health status through independent living skills. The attached mark sheet also demonstrates that I had appropriate nursing knowledge to complete my work. The evidences in appendix three and four demonstrate the utilization of my nursing knowledge and skills. I could effectively use knowledge and my skills to devise a care plan for an acute patient. This also highlighted my ability to respond to rapidly changing situations where unexpected clinical situations may be encountered. The entire acute action plan for this patient demonstrated my ANMC competency 7.4. The care plan indicated my competency in crisis interventions and emergency routines. I also educated clients so they can effectively maintain their health status, and it was an important part of the care plan. This may be interpreted as my ability to effectively manage the nursing care of individual/groups. The evidence in appendix 5 shows the progress of my learning during this placement. It demonstrates that I delivered safe, comprehensive, evidence-based care. As indicated in my learning log, I could use the principles of administration of oral medication to my client, although my medication knowledge can be termed as poor. I did not know the names and pharmacological actions of many medications, although I could administer medications according to the priorities. Critical Reflection According to Oermann (2002), there is necessity on the part of the nurse to be selective about the evidence when there are many evidences. Therefore selection based on quality could determine whether an evidence will be included or excluded from the portfolio. Andre and Heartfield (2007, p.26), indicate the tangibility of a quality evidence, and these should be truthful, current, and from both primary and secondary sources. A good portfolio must also have clarity in organisation, evidence of experience, critical discourse, and cross referencing (Wilkinson, 1998 in Emden, Hutt and Bruce 2003). Andre and Heartfield (2007) state “Tangible evidence is information in a form that another person can view independently in order to judge its quality.” (p. 26). The evidence in this portfolio can be considered “tangible” from that point of view, since it is included as appendices in this portfolio. Thus they can be easily viewed and examined, the context of which can be evident from the justification statement. Thus the evidence is not “out of context” (Andre and Heartfield, 2007 p 27). Andre and Heartfield also make the point that “issues of privacy and consent are important when associated with portfolio evidence” (2007 p 27). I have taken all care to omit the patient’s identity but have provided scanned copies of originals proving their authenticities. There are both primary and secondary evidences in this portfolio. Andre and Heartfield (2007 p.27) define “primary” as items which are “derived directly from practice outcomes such as client care activities” whereas “secondary” evidence is considered to be provided from a secondary person such as a supervisor (p27). Cooper and Emden (2001) refer to these as “direct” and “indirect” evidences respectively. Thus in the portfolio, there are both primary and secondary evidences to prove my points (p. 97). To claim my competence, past assignments and reports from clinical placements are the only sources. Despite that, I have collected evidence from a range of primary, secondary, direct and indirect sources and placed them in the appendix. These support my clinical skills, but those that underpin my clinical understanding are evidently missing here. For example, the assessment provided demonstrates that I have the ability to reflect on my practice or would demonstrate my areas of weakness where I need to work to improve on, whilst the evidence from my facilitator comments indicates that I can communicate effectively in both written and verbal form and have demonstrably strong interpersonal skills while it is in the team setting with other staff or the patients. My claim of competence (Andre & Heartfield 2007, p.27) has been substantiated by evidence of all possible forms. These may serve as the proofs of my abilities in the clinical setting or as commented, observed, or assessed my clinical facilitator, who is an expert in this area. Her comments have definitely supplemented my claims on my ANMC competence, and these same criteria may be used by other evaluators to adjudge my competence. The evidence I have provided is contemporary (within the last nine months), from a range of sources (both direct and indirect), and is a combination of primary and secondary sources. Andre and Heartfiled (2007) express concern that portfolio evidence can be “concocted” (p 27). While it may be considered that I have concocted those items which do not have a signature my claim for veracity of this evidence is that four independent secondary sources from varying institutions hold similar opinions regarding my competence in this field. That they all concur is clear demonstration of both the integrity and likely veracity of my claims for competency in this area. The inclusion of several items of evidence also underpins the relevance of the claims of competence being made. Thus more than one item of evidence which intend to support the individual sections of the competency, can also provide a solid evidence base to my claims. As will be evident from this analysis, I can also link the evidence to multiple sub categories of the competency standards, which can be cross-referenced from my justification statements which demonstrates that the chosen documents fulfill the criteria for quality evidence as is described in the Andre and Heartfield (2007) text. There were some items of evidence which I have not kept or could not locate which may have been useful for the purposes of this portfolio. Oermann (2002) suggests that nurses need to develop and maintain a portfolio. She suggests that the portfolio should be started early, in order to avoid lost opportunities to save documents for it. I am now aware with so many career opportunities available for nurses, the portfolio might be needed at any time when the nurse is pursuing a promotion in the clinical setting, considering or applying for a new position. Furthermore now that this portfolio has been started, I can maintain and review it periodically to monitor growth and development and to document progress in meeting career goals. Conclusion As expected, this portfolio will also be accompanied by an evidence summary table, a statement of justification, and a critical reflection on practice. The standard 7 has several subcategories, and hence the evidence summary table will demonstrate all the eight subcategories which will be justified by the statements of justification on these eight subcategories that would access the student standards of performance. It has been acknowledged and agreed that within University Education, the students would not passively receive the knowledge but would rather be actively involved in attaining own learning goals. Applying this belief to portfolio use, nursing students provided with a range of lectures on a variety of aspects of nursing and subsequently immersed in clinical experience are often expected independently to put this prior learning together in portfolio format, to demonstrate their ability to apply their initial learning. In this portfolio, the justification statements will be identified, and the evidence will point to ANMC competency 7. This would therefore demonstrate achievement of competency, and it would thus serve as a tool to educate and maintain RN professional development. Reference List Australian Nursing and Midwifery Council 2006, National Competency Standards for the Registered Nurse Andre K & Heartfield M 2007, Professional Portfolios – Evidence of competency for nurses and midwives, Elsevier, Marrickville Cooper & Emden C (2001) Portfolio assessment: a guide for nurses and midwives Praxis Education Western Australia C Emden, D Hutt, M Bruce (2003)– Portfolio learning/assessment in nursing and midwifery: an innovation in progress http://www.atypon- Contemporary Nurse, - eContent Management available online at link.com.ezlibproxy.unisa.edu.au/EMP/doi/abs/10.5555/conu.2003.16.1-2.124 Oermann, MH (2002) Developing a Professional Portfolio in Nursing. Orthopaedic nursing 21 (2) pp 73 ff Read More