30/09/2017

CHCPRP003 Reflect on and

Improve Professional Practice

Reflect on and Improve professional

practice
 In this learning topic, we will be looking at our ongoing
ability to reflect on and develop our capability to meet
professional standards. This includes the ability to self-
evaluate our knowledge and skills, seek and reflect upon
feedback. This unit describes the knowledge and skills
required to evaluate own work, continuing self-
development and effective supervision within an ethical
code of practice. Seek opportunities for supervision and
incorporate what we learn into improved practice.

Before you start…

 Sometimes it is hard to listen to feedback on our performance. It

can be easy to get defensive and try to shift the responsibility
elsewhere. But if we truly are committed to providing best
practice then we need to be aware of our strengths and the
areas that need further development. So, before you start this
topic ask yourself ‘how open am I to learning new ideas and
techniques?’

1
 30/09/2017

What is the purpose of reflecting on my

own practice?
 All workers in the Community Services Industry need to
reflect on their own practice through self-evaluation in
conjunction with supervisors and peers. Workers need to be
able to provide and receive open and evaluative feedback to
and from co-workers and they should actively seek
constructive feedback relevant to their work role and accept
it non-defensively.

Activity 1

 Reflect on the work that you do day-to-day. If

you are not already in the workforce, think of
other work (for example, at home) or your
studies. If you had to monitor your work, what
questions would you ask?

Define: Reflect

 Think deeply or carefully about…

 Consider
 Review
 Contemplate
 Study

2
 30/09/2017

Self-awareness

 Is knowing yourself, your personality, and

your style.
 Self-awareness comes from knowing
yourself your strengths and weaknesses and
to be able to identify opportunities for
growth.

1. Reflect on own practice

Undertake self-evaluation in conjunction

with supervisors and/or peers
 All workers need to evaluate themselves and think
about possible changes in their work performance
if they want to be effective workers and stay
enthusiastic about their work. This is particularly
so if you want a change in position or a
promotion. Undertaking some form of professional
development is part of working in all industries.

3
 30/09/2017

How do you go about it?

 When you are monitoring your own work

performance, you need to be able to look closely
at yourself and the way in which you complete
the tasks expected of you and recorded in your
job or position description. You need to begin to
become a ‘reflective practitioner’, reflecting
upon the practices that you implement on a day-
to-day basis

 It is important to create and maintain a learning

culture. Basically, a learning culture is one of:
• reflection
• ongoing evaluation
• openness to change
• openness to diversity
• continuous improvement

1.2 Reflect on and

recognise the effect
of values, beliefs
and behaviour in
practice

4
 30/09/2017

What do I reflect upon?

 A good place to start is to list all of the skills,

knowledge and qualities that you consider you
have. These are your identified strengths. Then
you would list those skills, knowledge or
attributes that you know, or think, need to be
developed further. These are your identified
weaknesses or potential areas of development.

Consider this scenario

 Joan, aged 21, was born in Australia but has lived
most of her life abroad (her parents worked in
many countries). The family has returned to
Australia and Joan would like to work in a
community services organisation. She lists her
strengths and weaknesses.

Joan’s strengths and weaknesses

Strengths Weaknesses/Potential areas of

development

• Certificate in community services • Need to gain Australian qualification

studies attended in Portugal in community service industry
Community College, Spain • Needs more practice in written
• Experience working with people in English
community services context in South
Africa
• Multi-lingual (Spanish, Portuguese,
Japanese and English
• Appreciates cultural and linguistic
diversity
• Good communicator, Also cheerful,
outgoing honest and warm

5
 30/09/2017

Write down your strengths and

weaknesses.
 Being aware of your strengths and weaknesses
helps you know where to start with your
professional development.
 It also helps you prepare for and monitor
feedback you may receive from others. You may
also find some direction for your professional
development by identifying areas that you are
interested in learning more about.

 Once you have this reflective and honest

information about yourself, you can begin to
develop some goals and strategies for you to work
towards in your professional development.

It is reasonable to ask yourself ‘Am I doing a good job?

This is especially true when you are working in such a busy

environment as a member of a team with all team members
being just as busy as yourself.
Consider these options:
• self-appraisal
• informal feedback
• formal feedback
• performance appraisal
• professional development.

6
 30/09/2017

1.3 Share two-

way, open and
evaluative
feedback with co-
workers or peers

Self-appraisal

 You self-appraise by monitoring your own work

performance. You do that through observing other
team members and the way that they work and
then evaluating your own standard of work and
completion of activities.

Informal feedback
 Ask for informal feedback from your colleagues or
supervisor about your standard of work. This means that
your supervisor or another team member will oversee
what you are doing on a day-to-day basis and will then be
able to evaluate your contributions and strengths and
ascertain where you might need to improve.
 It is, therefore, a good idea to be able to approach your
supervisor and ask for feedback about your work
performance. While this may be a rather scary thought,
remember that by seeking feedback you are showing that
you are willing to make changes and eager to perform at
your best. By acting on feedback, you will gain support
from your colleagues and supervisor.

7
 30/09/2017

Formal feedback

 Ask for formal feedback or assessment from your

supervisor or colleagues, known as a performance
appraisal. These tools usually directly relate to
your job specification and will give you feedback
that relates directly to the standards expected in
the workplace

Performance appraisal
 Being aware of your own strengths and weaknesses helps
you to know where to start with your professional
development. It also helps you prepare for and monitor
feedback you may receive from others. In your workplace,
you may also undergo an annual performance appraisal.
This is a formal process undertaken by your manager,
team leader or supervisor, which should compliment
regular supervision.
 A performance appraisal is a review of work undertaken in
the previous 12 months. It should focus on new learning
and provide the basis for professional development and
work planning over the next 12 months.

 To undertake a performance appraisal workers and

organisations need the following:
• job description that identifies roles and responsibilities
• the organisation’s work plan that identifies annual goals
and outcomes
• standards of performance
• observation and feedback on the worker’s performance
• a tool to conduct the appraisal
• a plan to development performance.

8
 30/09/2017

Preparing yourself for a performance

appraisal
 Let’s look at preparing yourself for a performance
appraisal using the following outline. If you are
not working in the industry, use the following
scenario about a workplace where you can
imagine that you are the worker preparing for an
appraisal. Complete the questions to the best of
your ability, remembering that your supervisor
would be considering similar questions about you
before meeting you.

Professional development

 In the Health Care Facility, staff turn-over is high and

recruitment is expensive and time consuming. So it is in
the best interests of everyone if training and professional
development is incorporated into the work plan of the
organisation and each of the workers.
 The quality of a Health Care Facility is a direct reflection
of the commitment and vision of its workers.
 Organisations need to demonstrate a commitment to
providing training and staff development.

 As workers we have a responsibility to our

clients, our workplace, our colleagues and
our industry to maintain our professional
development and continue education to
enhance our knowledge and skills.

9
 30/09/2017

1.4 Actively seek

and reflect on
feedback from
clients,
organisations or
other relevant
sources

Seeking and receiving feedback

 What do we mean by ‘feedback’?

 Can you think of situations when you’ve been asked for
your feedback? Or when you have asked for feedback (e.g.
‘What do you think of my suggestion?’)
 Put simply, feedback is about what you think of something
you have seen or experienced. In your feedback, you
might voice a concern, complain, point out a factual error
or express your opinion or thoughts.

Guidelines for seeking feedback

 Ask for feedback as soon as possible after you have done
something that you would like feedback about. The only
exception to this is if you are very angry, as it may come
across as a demand rather than a request.
 Choose the time and place for feedback. If your supervisor
is obviously very busy or stressed, it may not be advisable
to seek immediate feedback. It is also not appropriate, for
example, to ask for feedback in front of clients.
 Sometimes immediate feedback won’t be possible. If that
is the case, carefully prepare your questions as close to
the event as possible. This way, when you get a chance to
ask for feedback, your recollection will be better.

10
 30/09/2017

Receiving feedback

 Listen carefully.
 Don’t immediately reject or respond to it.
 It is better to ‘digest’ what has been said.
 Check your understanding.
 Ask for clarification if you are unsure or unclear.

Provide open and evaluative feedback to

co-workers
 This doesn’t mean that all feedback to co-workers
is negative and is going to create an equally
negative response from the co-worker. If we focus
on our feedback being open and evaluative then it
will be received by the worker in the spirit that it
is given. If a worker sets out to undermine
another worker’s job role then the likely response
is going to be one of defense.

 Seek advice from appropriate persons on areas for

skill and knowledge development
 The best way to ensure your professional
development is to be open to learning new ideas and
techniques and to gain as many suggestions as
possible as to how this might be done. Therefore be
sure to spend some time discussing this with others.

11
 30/09/2017

Enhance own practice

2.1 Determine
improvements
needed based on
own evaluation
and feedback
from others

 Workers need to identify areas of skill and knowledge that

require further training and development. The
identification process can occur through the following:
• Job description
• Changes in work practices
• Performance appraisal
• Evaluation
• Feedback
• Self-reflection.

2.2 Identify
potential support
networks both
internal and
external to the
organisation

12
 30/09/2017

 Professional development training is regularly

provided and/or advertised by the following:
• Professional associations such as the Australian
Institute of Welfare and Community Workers
• The Centre for Community Welfare Training
• NSW Council of Social Services (NCOSS)
• Australian Council of Social Services (ACOSS)
• Local Community Service Association (LCSA)

2.3 Seek
specialist advice
or further
training where
need is
identified

Identify options for accessing relevant skill

development opportunities and initiate
action in consultation with manager
 The quality of community services organisations
depend on the knowledge, skills, attitudes and
abilities of all their workers. The value of the
human resources involved in providing this service
cannot be reinforced enough. Staff require
opportunities to develop their knowledge and
skills through the provision of training and
additional support within the workplace.

13
 30/09/2017

Communicating clearly

 It is now your responsibility to communicate your need for

additional support to your supervisor, in order to improve
your performance.
Before you do that, make sure you are familiar with:
• effective communication strategies
• service policies, practices and procedures
• job roles and responsibilities.

Reporting a need for training

 Management is responsible for providing the financial

support for staff to attend in-service training and
development. This may mean providing for the costs of a
particular training course or meeting the costs of the
replacement staff for the absence of a staff member who
is attending a training course. The extent to which the
management financially supports the in-service training
and development of staff will vary from service to service.

 2.4 Recognise
requirements for
self-care and
identify
requirements for
additional support

14
 30/09/2017

Competence

 in the workplace refers directly to the

skills, knowledge and attitude
demonstrated by organisational members
and employees. • It is knowing how to do
something, knowing why it should be done
and when it should be done.

Self-care

 Is being proactive about ensuring your own

health & wellbeing, including mental health.
 Self-care strategies are designed to reduce
stress and contribute to short and long term
health.

The areas of life that can influence self

care needs are
 Work or professional life
 Physical
 Psychological
 Emotional
 Spiritual
 Relationships

15
 30/09/2017

 Facilitate ongoing
professional
development

 Set development goals.

 Look for opportunities
 Share your learning
 Share you feedback

3. Facilitate
ongoing
professional
development

16
 30/09/2017

3.1 Access and

review information
on current and
emerging
developments and
use these to
improve practice

 The world of Healthcare is changing rapidly

and continuing professional development has
become a core issue for several reasons.
 CPD is the means by which members of the
professions maintain, improve and broaden
their knowledge, expertise and competence,
and develop the personal and professional
qualities required throughout their
professional lives.

 Theobjective of CPE is to enhance member

knowledge, to assist members to remain up to date
with legislative and technological changes and
professional accounting standards, and to recognise
that there is a public interest in the profession
which expects that members will commit to
ongoing training to enhance their skills so they can
provide the services clients reasonably expect of
them to a high professional standard

17
 30/09/2017

 To provide a process that supports quality

nursing care to the public.
 To support nurses in their professional
commitment to lifelong learning and
excellence.
 To provide annual reporting on the Continuing
Competence Process as a means to
demonstrate the nursing profession’s
accountability to the public.

 Itis imperative that nurses maintain their

proficiency and skill in their chosen area of
work by equipping themselves with tools for
safe and efficient practice.

 These tools include education and training,

as well as updates and information on
current issues pertinent to the clinical
arena. Areas of significant importance are
documentation, medication management,
infection control and risk management in
addition to mandatory training like abuse
and restraint.

18
 30/09/2017

 Nurses also need to focus on the areas of

their chosen speciality such as behaviours
that challenge for those who work with the
populations affected with dementia and end
of life care for those working in elderly care
facilities.

 reflect on one’s practice and thereby determine learning needs,

 efficiently and accurately search for learning resources and critically
appraise them,
 apply these resources to clinical and other questions,
 manage large and changing bodies of evidence,
 evaluate one’s competencies and practice based on internal and
external feedback,
 understanding of evidence-based healthcare and critical appraisal,
 familiarity with informatics and literature search and retrieval
strategies,
 practice-based learning and improvement methods,
 self-reflection and assessment, and
 other skill sets related to knowledge management

 3.2 Assess and

confirm own
practice against
ethical and legal
requirements and
opportunities

19
 30/09/2017

Ethics, values and Legal Aspects of

Nursing
 Ethics and values are part of nursing and nursing
practice. Legal aspects of nursing focuses on the
relationship
 between nursing practice and the law.
 A system of valued behaviors/beliefs that direct
individual manner or behaviors to protect
individual rights.

 Recent changes in the provision of

health care have made knowledge of
this relationship more important than
before and many topics are involved.
These topics include; nursing
legislation, standards of care, patient
rights, informed consent, malpractice
liability, patient safety, and
documentation and confidentiality.
Every nurse should have a basic
understanding of the law.

Definition of terminology
Values:
 Personal belief about the worth of a given idea,
attitude, or object
Personal values:
 Beliefs and ideas that form basis for behavior; moral
& non-moral beliefs
Morals :
 Standards of right or wrong, how things get done

20
 30/09/2017

Ethical Principles and Importance to

nursing practice
 Autonomy – individuals have the right to determine
own actions, make own decisions
 Beneficence – “the doing of good”, inflict no harm
 Veracity – telling the truth. No deception (trick)
 Fidelity– faithfulness, Faithful to address ethical
issues, practicing within scope of nursing, Code of
Ethics, keeping commitments. Basis of nurse-patient
relationship

Philosophical analysis of moral

phenomena in the practice of nursing
Laws:
 Rules of social conduct devised to protect society.
Nursing ethics:
 Philosophical analysis of moral phenomena in the practice
of nursing
Code of Ethics
 A written list of a profession’s values and standards of
conduct, it is also a framework for decision making and
orientation towards day to day decision making

 Purpose of the Code of ethics Purpose of the

Code of ethics It gives guidance for decision-
making concerning ethical matters, 3-serves as
a means for self-evaluation and self-reflection
regarding ethical nursing practice and provides a
basis for feedback and information

21
 30/09/2017

Foundation for ethical decision making

in nursing

 Advocacy Active support of an

important cause
 Nurse as advocacy: defender
patient’s rights
 Assistant to patient to make
decisions based on his/her values
and lifestyle

Foundation for ethical decision making

in nursing

 Accountability health, prevent

illness and to alleviate suffering.
Cooperation Active participation
with others to obtain quality care
for patients Caring Kind
nurse/patient relationship

Ethical decision making process

 1-Collect,analyze, and interpret data (State the

dilemma)
 2- Consider choices of action
 3-Analyze pros/cons of each choice (what is for
and what is against)
 4- Make a decision about how to resolve the
dilemma

22
 30/09/2017

Nursing Values and Responsibility

Statements

 Safe, Competent and Ethical Care

 Nursesmust strive for the highest quality in
determining and expressing their own moral
choices

Safe, Competent and Ethical Care

 Nurses should be sufficiently clear and
reflective about their personal values to
recognize potential value conflicts
 Nurses must maintain an acceptable level of
health and well-being
 Nurses must base their practice on relevant
research findings and acquire new skills and
knowledge in their area of practice their
career.

Nursing values and Health and Well-

being
 Nurses should respect and value the
knowledge, skills and perspectives of the
persons in their understanding
 Nurses must foster comfort and well-being
when persons are terminally ill and dying
 Nurses should recognize the need to address
organizational, social, economic and political
factors influencing health

23
 30/09/2017

Choice
 Nurses respect and promote the
autonomy of persons and help them to
express their health needs and values
and obtain desired information and
services so that they can make
informed decisions.
 Nurses must be committed to building
trusting relationship and rapport

Choice
 Nurses should provide the desired
information and support required so
people are enabled to act on their
own behalf in meeting their health
 Nurses must continue to provide
opportunities for people to make
choices and maintain their capacity to
make decisions, even when illness or
other factors

Dignity
1- Nurses recognize and respect the inherent worth
of each person and advocate for respectful
treatment of all persons
2-Nurses must be sensitive to an individual's needs,
values and choices.
3-Nurses must recognize the vulnerability of persons
4-Nurses must respect the physical privacy of
persons when care is given.

24
 30/09/2017

Confidentiality
1- Nurses must respect the right of each
person to informational privacy
2- Nurses must protect the confidentiality of all
information gained
3-Nurses must intervene if other participants in
the health care delivery system fail to
maintain their duty of confidentiality

Confidentiality
4- Nurses should inform the persons
in their care that their health
information will be shared (informed consent).
5-Nurses must advocate for and respect policies
and all information gathered

Accountability
1- Nurses are answerable for their practice, and they act in a
manner consistent with their professional responsibilities
and standards of practice
2- Nurses must respect and practice according to the values and
responsibilities in this Code of Ethics for Registered Nurses
3- Nurses, in clinical, administrative, research or educational
practice, have professional responsibilities and
accountabilities
4- Nurse educators, to the extent possible, must ensure that
students will possess the required knowledge, skills and
competencies

25
 30/09/2017

Legal aspects of care Standards of Care

A standard of care tells us what a person should do.
One standard of care can describe what you should
do
 Scope of Practice
 the scope of practice for nurses, doctors, nursing
assistants and others. They list what a person can
and cannot do in the job eg;
 a registered nurse's scope of practice may list that
the nurse can give medicines.

Malpractice
A person who does not give care with same
level of skill that they learned e g:- when a
nursing assistant does NOT wash their hands
between patients and some of the patients
get a serious infection, this nursing assistant
can be found guilty of malpractice.

Negligence
 Negligence is when a person does not act the
way they should. For example, a nursing
assistant is negligent when they do not take
vital signs when they should have . For example,
a nursing assistant can be found guilty of
criminal negligence if their falls risk patient
falls and dies after they were left alone for
hours in a bath tub.

26
 30/09/2017

3.3 Identify and

engage with
opportunities to
extend expand own
practice

 Healthworkforce shortages have for some time

caused concern in Australia. A number of
studies have emphasised an underlying need to
develop a more sustainable and responsive
health workforce, while maintaining a
commitment to high quality and safe health
outcomes

 Thenumbers of health professionals have

increased. However, demographic changes,
such as the ageing of the population and of
the various health workforces, have
combined with increasing demands for
health services to escalate the problems
associated with shortages.

27
 30/09/2017

 Professionalpractice standards, such as,

providing an opportunity for the profession to
more clearly articulate the scope of practice
of a nurse in a particular clinical setting or
when providing care for a defined consumer
group

 The core professional Standards for the

registered nurse and enrolled nurse in this
document reflect the Bachelor of Nursing and
the Diploma of Nursing as the minimum
education qualifications for nurses,
respectively

 Enrollednurses seeking to practice beyond the scope of

the performance indicators in these Standards are
encouraged to seek professional development
opportunities to facilitate their transition to formal
university education. Without the completion of a
Bachelor of Nursing (or equivalent) the enrolled nurses’
practice is limited to their educational preparation in
accordance with their registration to practise as an
enrolled nurse with the NMBA.

28
 30/09/2017

Professional Practice
 As health professionals it is important
that nurses build and maintain
professional relationships with other
nurses and demonstrate nursing
leadership. In order to promote
understanding of the role of nursing in
General Practice it is vital that all
nurses advocate for the role of nurses
in General Practice.

Nursing Care
 Nurses have the knowledge and ability to provide
comprehensive, evidence-based nursing care in the
general practice setting. Nurses are integral to
planning, implementing, co-ordinating, monitoring
and evaluating health care within General Practice.
This involves not only assessment and management
of the immediate problem, but also includes health
screening, preventive care, understanding the
social and psychological context, health promotion
and health maintenance.

 Working in Australian General Practice

presents nurses with a range of unique
challenges. To work effectively in this setting
the nurse requires specific knowledge and
skills relating to General Practice, and its
role within the broader primary health care
environment

29
 30/09/2017

 Nurses in General Practice also require skills in

the use of information technology and in data
management to prompt intervention and
promote best practice. As health professionals,
nurses also play an important role in quality
improvement, practice-based research and the
development, implementation and evaluation
of relevant policies and procedures.

 We have significant gaps between optimal

care and existing practice
 Nurses need to adequately prepared for
advanced roles in prevention

Career pathways and training

 Advanced scope of practice is an
increase in clinical skills, reasoning,
knowledge and experience leading to
the nurse being an expert working
within the scope of traditional
practice.

30
 30/09/2017

 Expanded or extended scope includes

expertise beyond the currently recognised
scope of practice of the nursing
profession.

 clinicalcare
 clinicalorganisation
 practice administration, and
 integration.

Collaborative Practice

 Nursesare often recognised as leaders in

collaboration with others to enable the
integration of care, particularly in the
general practice setting.

31
 30/09/2017

3.4 Regulatory
participate in review
processes as a
commitment to
upgrading skills and
knowledge

 You can maintain competence by using several

methods of lifelong learning:
 Reflection
 Attending workshops
 Reading nursing health journals
 Participating in workplace discussions
 Research online
 Graduate Education
 There will be several resources at your disposal
including nursing websites, libraries, and in-services at
your workplace. Take advantage of this.

Maintaining an Active and Current License

“In order to maintain current
licensure the board requires a nurse
to renew their license on time and
complete all of their continuing
education requirements. The board
does not require that a nurse
practices in order to maintain
current licensure.”

32
 30/09/2017

Continuing Education Unit (CEU)

 What are CEU's?
A unit of credit equal to ten hours of participation in
an accredited program designed for professionals
with certificates or licenses to practice various
professions.
 Proof of credits earned is necessary in order to
renew a license to practice. The number of credits
required varies by industry and state.
 During a typical continuing education participation
period (24 months) an RN must participate in 24
contact hours of continuing education.

How to obtain/submit CEU's

 Many professions organize national conferences to
provide members with an opportunity to meet,
network and learn.
 Activities which may meet continuing education
requirements may be fulfilled in one of three ways:
1. Obtain a current nursing specialty certificate
2. Participate in continuing education activities
offered by providers of continuing education, or
3. Participate in certain professional activities

CEU's: Professional Activities

 Publication of an article or book on nursing or health related issues
 Delivery of a professional paper related to nursing or health care
 Participation on a professional panel that addressed nursing or
health related issues
 Participation in quality assurance or risk management studies
 Participation in nursing or health care research
 You cannot claim more than 10 contact hours for professional
activities
 Complete the professional activity during your participation period
 Maintain a copy of the evidence of the professional activity for two
years after using the activity for renewal.

33
 30/09/2017

Advanced Nursing Practice

 A nurse educationally prepared at the post-graduate level
with advanced didactic and clinical education, knowledge,
skills, and scope of practice applied within the nurse/patient
relationship to achieve optimal outcomes through clinical
analysis, problem solving, and evidence based decision
making.
 4 types of APN degrees
 Certified Registered Nurse Anesthetist (CRNA)
 Certified Nurse Midwives (CNM)
 Clinical Nurse Specialist (CNS)
 Nurse Practitioners (NP)

Advanced Nursing Practice

 Educated differently depending on specialty,
yet require attainment of at least a master’s
degree in respected concentration (Masters of
Science in Nursing).
 Programs will then offer a Doctor of Nursing
Practice (DNP).
 (Grandfather Exception)

 Certified Registered Nurse Anesthetist

 Certified Nurse Midwives
 Clinical Nurse Specialist
 Nurse Practitioner
 Doctorates in Nursing
 Med/Surg and Oncology Certification
 OB and Pediatric Certification
 Critical Care and Mental Health Certification

34