PERFORMANCE PLANNING AND COACHING REVIEW Nurse Practitioner

Rating: MMeets responsibility ND Needs development UC Unable to comment

1. Diagnoses and treats previously undiagnosed patients/clients/residents for undifferentiated diseases, disorders, and conditions within the Nurse Practitioners scope of practice; writes orders for treatment and medications; provides first line care in emergencies.
Please circle: M ND UC

Comments:

Supported by the surgeons, NPs, pharmacists and, clinical associates, I am able to diagnose and treat the common post cardiac surgery problems. I use the established clinical protocols, guidelines and NP scope of practice as my foundations of my nursing practice

2. Monitors ongoing care, orders appropriate screening diagnostic investigations; interprets reports of investigations and analyzes information to monitor progress and plan treatment.
Please circle: M ND UC

Comments:

I regularly review my assessments of my patients including diagnostic investigation results, consultation notes and the patients psychological status with the CVT resident prior to develop the patients treatment plans

3. Establishes priorities for management of health, diseases, disorders, and conditions; provides follow-up treatment; communicates with patients/clients/residents and families about health findings, diagnoses and priorities, outcomes and prognoses; supports and counsels patients/clients/residents in their responses to diseases, disorders and conditions.
Please circle: M ND UC

Comments:

There are disorders or conditions that have a similar signs and symptoms, I use history, physical examinations and laboratory results to verify and confirm my diagnosis. To plan for the appropriate response to the emerging problems, I use the guidelines, protocol as well as the information from the clinical trials. Then I will provide a detailed explanation of the propose treatment including the risks, benefits and the alternative to the treatment plan with the patient s and their families. Together with their inputs, I formulate the treatment plans. I also evaluate the effectiveness of the response daily.

4. Collaborates and consults with physicians or other health care and social service providers as appropriate to assess and diagnose patient/client/resident status. Develops and implements treatment plans.
Please circle: M ND UC

As a novice NP, I often feel less confident about my ability to correctly diagnose my patients problems. I often consult the patients physician, pharmacist or CVT resident prior to order medications and therapies. I find that the weekly disciplinary team meeting is a helpful way to obtain the information about the patients health status from other team members. Together as a team, we usually come up with individual discharge plan
Comments:

5. Prescribes drugs within the statutory and regulatory standards, limits, and conditions for Nurse Practitioners and within applicable employer policies and procedures.
Please circle: M ND UC

I prescribe medications and perform procedures within the scope of practice for NPs, standards, limits and conditions and they are based on my patients needs and St. Pauls hospital policies. Moreover, I work closely with pharmacists and surgeons to confirm the appropriate of the drug selection, the dosage and the potential drug interaction with the patients existing drug therapy
Comments:

6. Participates in research contributing to improved patient/client/resident care and advances in nursing, health policy development and population health.
Please circle: M ND UC

I attend weekly cardiology rounds. I also registered for 24 th annual drug therapy decision making course and the 48 th annual post graduate review in family medicine. I also attend NP resource meeting every four month and APN meeting every three months to update nursing issues and practices in Providence Health Care as well as networking with other advanced practice nurses. I also attended Cardiac Advanced Practice Nurses Journal meeting.
Comments:

7. Maintains population health focus by implementing screening and health promotion activities for populations at risk.
Please circle: M ND UC

for primary prevention, I always encourage my patients to seek annual Flu vaccine and to screen for HIV testing. For secondary prevention for infective endocarditis, I suggest my patient to take antibiotic prior to dental and invasive procedures. For secondary prevention of coronary artery disease, I encourage my patient to quit smoking, to be active, to keep their Blood pressure less than 140/90 and their LDL less than 2.
Comments:

8. Participates in interdisciplinary staff and nursing education.

Please circle: M ND UC

I find the transition care from hospital to home for most my patients are very complex due to their advanced ages. It requires a team approach. I find weekly interdisciplinary staff meeting in one way to tap in the expertise of the team members and to identify the gaps in the discharge planning for individual patients. As an advanced practice nurse, I am able to provide on the spot support nursing staff in order to provide safe patient care As I feel more comfortable in my new role, I recognize most the nurses on 5B are very good at rhythm analysis but they still need some foundation knowledge in reading 12 leads ECG
Comments:

9. Develops implements, and evaluates policies and procedures related to nursing, interdisciplinary care, and health system practices.
Please circle: M ND UC

Comments: I reviewed the Heart Failure Management resource and TAVI patient education
information

10. Decision making/judgment: Determines objectives/plans/priorities Systematically gathers information and sorts through complex issues Seeks input from others uses consensus when possible, communicates decisions
Please circle: M ND UC

Comments:

In my opinion, the clinical decision making is a complex process that requires the collaboration with team members in priority setting, strategizing and delegating team member to gather information. By working together as a team, we have an opportunity to draw on the individual expertise in caring for patients

11. Communication: Verbal communication: presents ideas, thoughts and feelings clearly and effectively Written communication: creates accurate and punctual reports Delivers presentation, shares information and ideas with others Listens actively and checks with others to ensure understanding Builds strong relationships, respects the positions, views, concerns & feelings of others Is flexible and open minded Negotiates effectively Handles constructive criticism
Please circle: M ND UC

I believe that good documentation is vital in providing safe care. Thus, I always write a comprehensive admission notes and discharge summaries. I communicate with my colleague well. I believe that my team member do care for me when they take the time out of their busy schedule to provide me with their constructive feedback.
Comments:

12. Dependability: Meets commitments Works independently, accepts accountability Handles change Sets personal standards Stays focused under pressure Meets attendance/punctuality requirements of Providence Health Care
Please circle: M ND UC

I am always punctual. I am calm when dealing with emergency situations or unexpected situations
Comments:

13. Problem solving/analysis: Understands underlying issues/systems approach Understands the difference between critical details and unimportant facts
Please circle: M ND UC

Comments:

When I encounter a problem, I follow a systematic approach that includes; history taking, physical examine, and reviewing diagnostic results and reading consult notes. After that, I will integrate the best practice guidelines and protocol into my patients situations. If I am still unsure about the diagnosis, I will consult the physicians or my colleagues prior to make a decision about the plan of care

14. Quality: Potential CQI projects and relevant project teams are identified in area of specialty Ensures that CQI methodology is followed when participating on a project
Please circle: M ND UC

I participate in the following CQI Projects: Hand hygiene, Surgical Site Infection surveillance, UTI identification, Antibiotic stewardship, advanced directive care planning and HIV testing
Comments:

15. Teamwork: Meets all team deadlines and responsibilities Listens to others and values opinions Helps team leader to meet goals Welcomes newcomers and promotes a team atmosphere Works constructively with other department members Is effective as both a team leader and team member
Please circle: M ND UC

I believe two heads are better than one. Thus, I always listen attentively to my team members concerns and suggestions. I always discuss with my team members the reasons of my decision making
Comments:

16. Work Environment/Safety: Promotes respectful workplace environment Actively supports safety programs/legislation
Please circle: M ND UC

Comments:

I believe in nurturing a respectful environment where individual opinions are being heard, as well as promoting a sense of belonging and caring environment for my team members. I read the hospital safety protocols and know what to do in the events of fire, earthquake, bomb threat and abduction

17. Leadership Works towards fulfillment of PHC Mission, Vision and Values Demonstrates system thinking Is seen by others as a nursing leader
Please circle: M ND UC

I work toward the PHC mission how you want to be treated and I always demonstrate the leadership in leading the team in discharge planning for my patients
Comments:

18. What are the significant strengths of this colleague?

I work well with others and always listen attentively to my patients and their families concerns as well as my team members suggestions.
Comments:

19. What behavior or attitude should this colleague focus on improving this year? Comments:

Speaking up in the physicians meeting.

20. General comments: For the first 8 months working as NP on 5B, I did not

encounter a lot of challenges during my transition from RN to NP. I found the interactions between myself and physicians and between other health care team members are similar between the RN and NP position. I did not have to carve out the physical and professional space for my practice. I have received a lot of mentorship from Dr. Abel, Bashir and Dr. Ye. My colleagues: Lisa, Karen and Kati and the pharmacists and CVT residents were always available for consultations and support. I felt more confidence in my ability to diagnose and assume more responsibility in caring for my patients

DEVELOPMENT/LEARNING PLAN FOR UPCOMING REVIEW PERIOD Use the following section to record development and learning commitments.
Commitment #1: 12 leads ECG presentation How will we know this has been achieved? Presentation to nursing staff Timeframe: 6 month Commitment #2:

mentoring NP students

How will we know this has been achieved? Timeframe: 1-2 years Commitment #3:

Improving the ability to prescribe cardiac medications

How will we know this has been achieved? Implement in daily practice Timeframe: 3-6 months Commitment #4: Pilot study of providing patient with person health record on

discharge as a way to improve the transition care from hospital to home

How will we know this has been achieved? Implement in daily practice

Timeframe: 1- 2 years

Commitment #5: Engaging in continuing self- reflection and setting goals for my learning needs
How will we know this has been achieved? Implement into practice Timeframe: on going

SIGNATURE SECTION

Employee Signature

Date

Program Director Signature

Date

Chief of Professional Practice & Nursing

Date