PRAC 6540: AGPCNP Clinical Skills and Procedures Self-Assessment Form

 PRAC 6540: AGPCNP Clinical Skills and Procedures Self-Assessment Form

 

PRAC 6540: AGPCNP Clinical Skills and Procedures

Self-Assessment Form

Procedure Confident
(Can complete independently)		 Mostly confident
(Can complete with supervision)		 Beginning
(Have performed with supervision or need supervision to feel confident)		 New
(Have never performed or does not apply)
Biopsy (excision or punch) ü      
Cerumen removal ü      
Clinical breast examination ü      
Digital rectal exam ü      
EKG 12 lead placement and interpretation ü      
Epistaxis management/nasal packing ü      
Fluorescein stain of the eye     ü  
Gait and balance assessment   ü    
Herpes culture   ü    
I &D abscess ü      
CXR interpretation ü      
KOH skin slide for fungus   ü    
Laboratory/diagnostic testing-order and/or interpret ü      
Mini Mental Status Exam ü      
Nail examination and removal/nail trephination/subungual hematoma ü      
Nasal packing, removal of ü      
Pap smear   ü    
Peak flow meter   ü    
Prostate examination   ü    
Remove foreign body
(ear, eye, nose, soft tissue, other)		   ü    
Skin tag removal,

tick removal

   ü    
Suturing ü      
PFT interpretation   ü    
Vision/hearing ü      
Wart destruction/removal       ü
Wound care ü      
Radiology reports: Interpret chest X-ray, constipation ü      
Inject local anesthetics ü      

 

Summary of strengths:

            As an adult-gerontology primary care nurse practitioner (AGPCNP), I am going into this practicum feeling confident in a number of skills and procedures. These are tasks or clinical skills/procedures that I can now do independently, correctly, and without any supervision or assistance whatsoever. There are only a few that I can still complete under supervision and only one that I have never performed before (and that I look forward to perform in this practicum). Presently I am able to perform biopsy excision and the extraction of cerumen impacting the external ear canal under no supervision. In the same vein, I am now skilled and independent in correctly performing a clinical breast examination and a digital rectal examination to rule out masses and prostate enlargement respectively (Ball et al., 2023). I can now correctly perform and interpret a 12-lead electrocardiogram (EKG) with no assistance. I will start by first placing the 12 leads by myself and then doing the procedure followed by interpreting the graph – all independently.

The other clinical skills I can undertake independently include the management of nasal bleeding or epistaxis, as well as nasal packing. In addition to this, I am able to independently perform an incision and drainage (I&D) procedure on an abscess with no preventable complications (Jameson et al., 2022). I can skillfully interpret a chest X-ray (CXR) without help. But I can also independently order laboratory/diagnostic tests and interpret the results. This I do after taking history and performing physical examination, with a view to confirming the tentative diagnosis. As an AGPCNP, I am also expected to assess my patients for suspected mental health disorders, before referring them to mental health specialists like the psychiatric-mental health nurse practitioner or PMHNP. On this, I am now able to independently and correctly do a mini mental status examination (MMSE) and come up with a tentative psychiatric diagnosis (APA, 2022). The other clinical skills and procedures that I am now able to do alone and confidently with no help are nail examination and removal, nail trephination and care of a sub-ungual hematoma, the removal of nasal packing (which I stated above that I can insert independently), injection of local anesthetics (Rosenthal & Burchum, 2020), assessment of vision and hearing, suturing, interpretation of radiology reports such as chest X-rays, management of constipation, and wound care. PRAC 6540: AGPCNP Clinical Skills and Procedures Self-Assessment Form

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Opportunities for growth:

            I feel that opportunities for growth for me exist in those areas of clinical skills and procedures in which I still require assistance or supervision to perform. These are the areas in which I am planning to work on during this practicum to achieve independence and proficiency. As such, the clinical skills and procedures that I still feel I cannot complete without supervision include extraction and mounting of the potassium hydroxide (KOH) skin slide for fungus, preparation of a herpes culture to grow, and gait and balance assessment (Ball et al., 2023; Jameson et al., 2022). Others are the removal of a foreign body (from the ear, the eye, the nose, soft tissues, or other locations), Pap smear taking, peak flow meter reading, pulmonary function test (PFT) interpretation, the removal of skin tags, and tick removal. The one clinical skill/procedure in which I still feel like a beginner is fluorescein stain of the eye. On the other hand, the one procedure that I have never done eve under supervision (and which I hope to do in this practicum) is wart removal or destruction as a sexually transmitted infection or STI.

 

Now, write 3–4 possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

            My practicum goals/objectives for this placement are:

a.      To become proficient and independent in all the clinical procedures and skills in which I still need supervision to perform, by the end of this practicum.

b.     To become most confident or completely confident (independent) in performing fluorescein stain of the eye by the end of this practicum placement.

c.      To perform for the first time under supervision the removal of warts or destruction of the same by the end of this practicum placement.

 

 

 

References

American Psychiatric Association [APA] (2022). Diagnostic and Statistical Manual of Mental Disorders-Text Revision (DSM-5-TR), 5th ed. Author.

Ball, J., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2023). Seidel’s guide to physical examination: An interprofessional approach, 10th ed. Elsevier.

Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2022). Harrison’s principles of internal medicine, 21st ed. McGraw-Hill Education.

Rosenthal, L.D., & Burchum, J.R. (2020). Lehne’s pharmacotherapeutics for advanced practice providers, 2nd ed. Elsevier. PRAC 6540: AGPCNP Clinical Skills and Procedures Self-Assessment Form