Reflection Questions

Becker College
Department of Nursing
Nursing Program Student Learning Outcome: Reflection Questions
Evidence-Based Practice
Student Name: __JULIA BROWN___ Date: __________________
Respond to the following questions. Do not limit your responses to the space provided; you are
strongly encouraged to expand your responses. Attach additional sheets of paper if necessary.
1. What is the nursing course outcome for Evidence-Based Practice (EBP)?

The successful student completing NURS 1105 will be able to:
Explain the best current evidence coupled with clinical expertise and consideration of
patients’ preferences, experience and values to make practice decisions Explain the
principles of critical reasoning and evidence-based practice essential to the nursing care of
adult and geriatric patients. (ASN – PO # 2).
2. What clinical practice guideline(s) is/are used for nursing care and nursing procedures on
the clinical unit? Where are the guidelines located? Provide one example of how you
used the clinical practice guidelines to provide nursing care to one of your assigned
patients.
The policies and procedures for the nursing unit are located in the nursing desk and in the
nursing managers office. There is also a copy in the supervisors office. The policies and
procedures are not just limited to the facilities policies, but also includes state mandated
policies.
3. Describe one example of how you improved your nursing practice/patient care this week
through the acquisition of new knowledge. Be specific.
One way that I improved my nursing practice was by recognizing the proper PPE to wear for
my patient that was on contact precautions while assisting them with their ADL’s. I was able to
utilize the skills I learned in lab to properly change the dressing with minimal assistance from
my professor.
4. Using one of the patients you were assigned this week, list 2 evidence-based nursing
interventions. Provide the evidence-based rationale for these interventions; include the
EBP reference for each intervention.
Two EBP’s I used were infection control and communication involving changes in a patients
status. For infection control, I wore the proper PPE which included gloves and isolation gown,
along with handwashing before and after patient contact in order to prevent the spread of
contagious bacteria that the patient had in their urine. For communication involving changes in
a patients status, I used SBAR on and SBAR off to communicate the change in my patients status
with the other nurses before and after my shift.
5. Write a short summary that supports your achievement of the course clinical learning
outcomes for evidence-based practice. Refer to the clinical learning outcomes listed on
the course clinical evaluation tool, and provide specific examples of how you met the
learning outcome.
Integrate current research finding and nursing theory coupled with clinical expertise and
consideration of patients
a. use the nursing process to meet the basic needs of adult and geriatric patients
a. during the initial meeting with a patient, I would assess their basic needs and
ability such as ambulation. For nursing diagnosis, I would then make a diagnosis
based off of their needs and what abilities they had to meet that need and plan
an intervention such as ambulation twice a day with their walker for 15 minute
intervals. I would then encourage the patient to ambulate and would join them
to continue with encouragement and to keep them company so it was more
enjoyable. Based off of how the initial implementation process went, I would
make further goals for the patient and would continue to encourage and educate
the patient so that the goals were more likely to be met. After each session of
ambulation, I would evaluate how it went and if any changes need to be made so
that their goal and future goals are more attainable.
b. identify the need for evidence-based decision making in patient care
a. as a nursing student in our first clinical round, we don’t have the chance to
implement much evidence-based decision making, however we are able to use it
for our own educational purposes. The patients that I have been exposed to
don’t require much critical thinking as they are all stable and able to perform
their own ADLs with minimal assistance. As an example, during my shift, limiting
their fall risk by taking extra precautions such as removing unnecessary objects
from their path.
Becker College
Teamwork and Collaboration
Student Name: ____________________________ Date: ____________________
1. What is the nursing course outcome for Teamwork and Collaboration?

Identify concepts within nursing and in interdisciplinary teams that foster open communication
and mutual respect. Identify the parameters of effective relationships with patients and
members of the health care team (ASN PO#-3).
2. List your strengths, limitations, and values in functioning as a member of the healthcare
team.
Strengths Limitations Values
 Empathetic  Limited experience  Honest
 Patient  Can’t hand out  Loyalty
 Knowledgeable medications alone  Responsible
 Competent  Trustworthy
 Collaborative
 Good
Communication
 Willingness to
learn
3. Describe one example of how you functioned as an effective member of the healthcare
team during your clinical experience this week.
On the first day of clinical I was there to help my peers with anything they needed because I
had previous experience.
4. List (by title, not name) the members of the healthcare team, including yourself, for one
of the patients you cared for this week. Include the patient and family in this listing;
identify family role (i.e., parent, spouse, sibling, or child). Provide one example of how
each team member contributed to the achievement of patient care outcomes.
Healthcare Team Member Contribution to the Achievement

of Patient Care Outcomes
 Nurse  Made sure vitals were taken and in a normal range.
Medicine administration.
 LPN  Administered medication, providing patient care, ADLs,

patient safety, etc.
 CNA  Made sure patients were fed appropriate meals,

providing care, patient safety, etc.
 Professor  Supervises and ensures we are following protocol and

safety.
 Student Nurses  Made sure patients completed ADLS
 Patient  Follow treatment plans, inform providers if any pain or

un-comfort.
 Spouse  Comfort, company, ensuring that care plan is followed,
advocate.
 Family provides comfort and familiar faces to the
 Family Friends patient
outcomes for teamwork and collaboration. Refer to the clinical learning outcomes listed
on the course clinical evaluation tool, and provide specific examples of how you met the
learning outcome.
Each person within the nursing and in interdisciplinary teams including the patient and his or
her family have an important role to make sure the patients care is appropriate and what they
need to affectively heal or heal the best of their body’s ability. Within this team open
communication and mutual respect is important without the patient telling us he/she is in pain
then we won’t know to help them change their position, bathe them, or provide medicine. If all
the nurses, student nurses, etc. are working separately without communication we will not
know if weights have been taken, vitals have been taken or maybe more than one person has
taken their blood glucose level. We need to communicate to ensure patient safety and care.
Becker College
Communication
Student Name: ____________________________ Date: ____________________
1. What is the nursing course outcome for Communication?

Select effective communication strategies with patients, families, and colleagues, fostering
mutual respect and shared decision making, to enhance patient satisfaction and health
outcomes. (ASN- PO#4).
2. Describe one example from this week’s clinical experience, in which you used clear,
concise, effective communication with a patient, family member, or colleague. Be specific
in describing this example; include the modality of communication used (verbal, written,
or electronic).
This week’s clinical experience was a great opportunity to incorporate clear, concise, and
effective communication with the patient as well as colleagues. This was all verbal
communication. Too start another student nurse and I had to take vitals, one would take a vital
and the other would record. If we were confused or had questions, we would simply ask one
another and help each other. Then we reported our findings to our head student nurse, as well
as the patients RN. This was important because we made sure his vitals were in the normal
range. Then we gave our patient a bed bathe, we communicated with our clinical professor by
asking for assistance, so we do not harm the patient in anyway. She gave us a tip on to make
sure we raise the bed, so we don’t hurt ourselves. We could have taken it as a negative, but
with good communication we knew that she is helping us succeed now so we don’t have
problems in the future. Lastly, we had to take some patients’ blood glucose levels. None of us
have done this before but our clinical professor made to have it demonstrated on herself, so we
knew what we were doing before she sent us on our way. If we were not shown the correct
way to perform this, we could have injured our patient or received a false reading. After we
learned how to take the blood glucose levels, we made sure to inform the patients who we
were and what we were doing. This is another way to ensure good communication, therapeutic
communication is important with patients so they can trust you and what you are doing.
3. Describe one example from this week’s clinical experience, in which you used or observed
unclear, verbose, ineffective communication with a patient, family member, or colleague.
Be specific in describing this example; include the modality of communication used
(verbal, written, or electronic).
One way I observed ineffective communication was when a nurse thought the weights got
taken for the patients. Someone informed her they were taken and written on a paper. When
the nurse found the paper, the weights were not written on it. She then had to ask another
nurse who said they were not taken yet. Somewhere in the mix, there was unclear instruction
or information. In this care it wasn’t an issue because they could just go take the patients
weight, but if information on something else was not communicated correctly it could possibly
cause problems or safety issues.
4. What impact or potential impact did the answer to question 3 have on patient care?
This particular incident did not have an impact on the patients, but if it was anything else being
misinformed it could have potentially harmed a patient, or if this occurred later it maybe could
have effected a patient if they had a rapid weight loss or gain that needed notice.
5. Using one of the patients you cared for this week, identify the actual or potential
physiological, psychological, sociocultural, developmental, and/or spiritual influence on
effective communication. For each influence listed identify 1 EBP strategy to promote
effective communication. You must identify at least 2 actual or potential barriers.
My patient this week has hallucinations, so potentially this patient could be in another reality
when you are speaking with him. One way to communicate effectively with him could be to
acknowledge that he sees these hallucinations, but you yourself do not in order to keep
conversation with the patient open not minimizing his feelings in the situation. He was also
trying to take a nap when I first went to his room, so making sure he didn’t need anything was
my first priority, but then I told him I could come back later to talk once he’s rested in order to
gain the most accurate information.
outcomes for communication. Refer to the clinical learning outcomes listed on the course
clinical evaluation tool, and provide specific examples of how you met the learning
outcome.
I effectively communicated with patients, families, and colleagues, fostering mutual respect and
shared decision making, to enhance patient satisfaction and health outcomes by asking what
the patient preferred, asking what he wanted to wear, if the water was a good temperature,
etc. I want him to feel as comfortable as possible. The patient’s family visited to help keep the
patient calm, since the day before he was yelling out for them.
Becker College
Professionalism
Student Name: _______________________________ Date: ____________________
1. What is the nursing course outcome for Professionalism?

Recognize factors essential to practicing with legal accountability, professional integrity, ethical
responsibility, caring, and advocacy (ASN PO# 5).
2. Using one of the patients you cared for this week, describe 1 patient care situation that
evidenced your professional accountability.
I helped feed my patient thickened water and changed her when she soiled her brief. When I
changed her, I noted her declining skin integrity
3. Based upon your clinical experiences this week, describe on instance in which you acted
as a patient advocate. Be specific, and include the outcome of your advocacy.
I advocated for my patient by charting her skin condition and reporting it to my professor and
the nurse
4. Describe a patient care experience from this week where you applied ethical standards of
nursing practice.
I made sure the patient’s bed was dry and unsoiled. I made the bed up so it can boost skin
integrity and provide comfort.
5. Describe a patient care experience from this week where you applied legal standards of
nursing practice.
I maintained privacy by closing the curtain during morning care, as well as blacking out patient
identifiers on printed paperwork to uphold HIPPA.
outcomes for professionalism. Refer to the clinical learning outcomes listed on the course
clinical evaluation tool and provide specific examples of how you met the learning
outcome.
I show up to clinical early and on time, I come to clinical prepared and open to learn, I complete
all tasks in a timely manner, I ask for help if I need it, I accept constructive criticism, and
maintain a positive attitude throughout the shift and in front of all patients.
Becker College
Informatics and Technology
Student Name: ________________________________ Date: ____________________
1. What is the nursing course outcome for Informatics and Technology?

Identify basic technology, and describe how they are used to analyze as well as synthesize
information, and collaborate in order to make critical decisions that optimize patient outcomes.
(ASN PO# 6).
2. List and describe 3 examples of how you used informatics and technology to provide patient care
this week.
Informatics and Technology Example Use in the Provision of Patient Care
1. Paper Charts 1. If we don’t have computer access for the
EMR, we do have access to the paper
charts
2. SBAR 2. Allows the students to get use to

documenting SBAR in addition to giving
verbal report to nurses for on shift and off
shift
3. Daily Care Plans 3. In addition to the daily care plans that I

have to fill out as a student, the nurses on
the floor also have to fill out daily care
plans for the patients
3. Describe an example of how you maintained privacy and confidentiality for your assigned
patient’s protected health information obtained from electronic health records. If the
electronic medical record (EMR) is not used in the healthcare setting, how are records
maintained. Would the EMR be beneficial in this setting?
As a student, sometimes we don’t have access to patients EMR, so we review their paper
charts in the clinical setting. I maintain privacy and confidentiality for my assigned patients
health information by not discussing it with other students who weren’t assigned to that
patient, or any other individual that was not pertinent to the patients health. I also made sure
to stay behind the nurses station when reviewing their chart, and to not write down their name
on my daily management of care, instead I used a patient ID consisting of their initials and room
number.
4. Describe at least one example of how you used technology and information management
to promote quality and safety for one of your assigned patients.
As a student, there is minimal to no technology that we are permitted to use. Instead, I

review the patients paper charts after I print them out and make note of important information
that has to do with patient safety such as assistive devices used, past surgical and medical
history, and their history of falls. By making note of those things, I was able to perform my daily
care of the patient in a way that kept them safe by being aware of their history.
outcomes for informatics and technology. Refer to the clinical learning outcomes listed
on the course clinical evaluation tool and provide specific examples of how you met the
learning outcome.
An achievement of mine is that I am now able to read a paper and electronic chart, I know
where to find certain information in it, and how to apply that information into patient care.
Knowing how to utilize a paper and electronic chart is important because if anything were to
happen and the EMR’s weren’t accessible, the paper charts would have to be used and I would
be prepared for such scenario.
Becker College
Safety
1. What is the nursing course outcome for Safety?

Describe the nursing action to minimize risk of harm to patients and providers through both
system effectiveness and individual performance (ASN PO#-7).
2. Describe at least 3 cognitive and/or physical limitations noted in your assigned patients
that affected their safety.
-dementia
-warfarin
-incontinence
3. According to the answer for question 2, list 1 strategy for each limitation that you used (or
should have used) during your patient care activities this week to reduce risk of harm to
patients. Include why you used these strategies.
-remind patient not to get up without help
-use non-slip footwear
-have patient on a toileting schedule
4. List 3 strategies you used during your patient care activities this week to reduce risk of
harm to yourself. Include why you used these strategies.
-raised bed to my hip level to prevent back injury
-asked for help when boosting patient

-stretched before preforming morning care
5. If you were to commit a patient care error, which could include a medication error, how
would your respond to and report this error? Be specific, identifying the “error” and your
appropriate response.
Error – wrong glucose reading
Response – recheck the glucose level before medication administration, notify nurse for proper
documentation
outcomes for safety. Refer to the clinical learning outcomes listed on the course clinical
evaluation tool and provide specific examples of how you met the learning outcome.
I raised the bed to reduce the strain on my back while carrying out morning care. After, I
lowered the bed to reduce the potential of a fall for the patient.
Becker College
Quality Improvement
1. What is the nursing course outcome for Quality Improvement?

Relate how data is used monitor the outcomes of care processes, and uses improvement
methods to design and test changes to continuously improve the quality and safety of health
care systems (ASN PO# 8).
2. Describe one quality improvement initiative that is taking place at the clinical facility
where you have your clinical practice experience. Be brief, but be specific.
The improvement of patient transfers is a quality improvement initiative that is currently taking
place at Harrington Hospital. The facility implemented the use of slideboards to aid care givers
while moving patients and to also help protect the patients and care givers from unnecessary
injuries.
3. List at least 3 nursing activities that you employed or should have employed to improve
patient care outcomes during this clinical week. Be specific about how the activity would
have contributed to an improved outcome.
- I should have decreased noise levels while providing patient care, high noise levels can disrupt
a patients’ sleep and their ability to rest and recover.
- During patient care I could have played soothing music. Music therapy can minimize both
chronic and postoperative pain as well as reduce blood pressure.
- I also should have collaborated more with staff. The perception of teamwork and strong care
coordination are key indicators of a positive patient experience.
4. List 2 recommendations to improve nursing practice on the clinical unit; include why you
are making these recommendations.
To improve nursing practice at Harrington Hospital I recommend the staff to improve their
communication skills. How you communicate information is just as important as what you say.
Ineffective communication skills can lead to miscommunication and confusion. Also, I would
recommend the staff to spend more one on one time with each patient. Spending the extra
time with each patient will improve the quality of care.
outcomes for quality improvement. Refer to the clinical learning outcomes listed on the
course clinical evaluation tool and provide specific examples of how you met the learning
outcome.
One of the course clinical learning outcomes for quality improvement was to use improvement
methods. During my clinical experience I adhered to every quality improvement method that
proved to be efficient and safe. For example, while transferring patients who were unable to
use their legs, I utilized a sliding board. Harrington Hospital implemented the use of sliding
boards as a quality improvement initiative. By using the sliding boards, I improved the quality
and safety of transfers with all of my patients, which allowed me to meet the learning outcome
for quality improvement.
Becker College
Leadership
1. What is the nursing course outcome for Leadership?

Define leadership principles used to Influence the behavior of individuals or groups of
individuals within their environment in a way that will facilitate the establishment and
acquisition/achievement of shared goals. (ASN PO# 9).
2. List at least 3 examples leadership strategies to practiced direct nursing care, effect
change and achieve health care goals observed for your assigned patient, another patient,
or group of patients on the clinical nursing unit. Be specific and describe each situation.
The first example of leadership strategies I want to mention is “acknowledge and reward”
that came from our clinical instructor. Our professer didn’t let us figure things out ourselves,
she made sure that she didn’t have expectations we could not meet, she went out on the floor
and made sure we knew how to do everything it was expected from us on our assignment.
When she saw any of us doing things properly, she would always acknowledge and praise us.
The second example of leadership strategy was also on our first day when we had the
opportunity to share a patient. My peer was less experienced and confident than I was and she
did not care if she was doing a more work than I was, I helped teach my peer how to change a
brief, she wanted to actively learn. True leaders lead by example and not by words only.
Lastly, the unit itself is staffed with highly skilled nurses who are always making sure
that patients are accomplishing their short and long term goals. One of my patients needed to
be weighed and needed to attend PT, the nurse was always on top of things, by checking if the
patient had already been weighed and if the patient was ready to be picked up by PT.
3. Describe 1 critical thinking and problem-solving processes that occurred in the clinical
unit, specific to nursing leadership.
On one of my clinical days, my patient was confused and extremely swollen. I told my
professor and we worked together to elevate his extremities and report our findings to the
nurse
4. Describe how the process of delegation is used on the clinical unit/healthcare facility.
From what I observed each member of the team already knows what their responsibilities
are, so in the morning when they come in, they give and take report, and the nurse follows up
to make sure that their tasks are getting done.
5. Define the roles and skills of the health care team on the clinical unit. Respond only for
those personnel that practice on the patient care unit where you are assigned for clinical.
 Registered nurse: assesses patient, passes medications, updates patients charts,
documents findings, takes vitals
 Licensed practical nurse: provides routine care, assists RN, passes medications
 Unlicensed assistive personnel (UAP, CNA, Patient Care Technician): assists patients with
ADL’s, notifies RN of normal and abnormal findings
 Physician: their the medical officer which officiates the total care of the patient as well
as managed their care
 Social worker: manages patients well-being outside of healthcare aids in community

assistance and access to resources
 Clergy or spiritual support staff: meet spiritual needs of the patients to help with coping
 Other (Identify title/role): can represent secondary levels of care such as housekeeping
and kitchen staff
outcomes for leadership. Refer to the clinical learning outcomes listed on the course
clinical evaluation tool and provide specific examples of how you met the learning
outcome.
The day I was the charge nurse, it was very interesting to see how having leadership
skills help things flow better amongst the team. My peers were able to come to me to ask for
any help and support they needed and I relayed the message to our clinical instructor when I
could not help them myself. I was able to come up with solutions for little problems, like making
a pulse oximeter and thermometer work properly to facilitate the acquisition of shared goals,
which was to assess our patients by taking their vital signs.
Becker College
Systems-Based Practice
1. What is the nursing course outcome for Systems-Based Practice?

Recognize the essential resources and healthcare system components to provide care that is of
optimal quality and value (ASN PO# 10).
2. List 3 positive and 3 negative effects nursing students have on the operation of the nursing unit.
Positive Effects Negative Effects
1. Tasks could get done faster as students 1. Some nurses see student nurses as
are eager to learn and willing to help out followers instead of individuals who are
willing to learn. When the unit becomes
busy they may believe the students are
more in the way than helpful.
2. Allows more time for therapeutic 2. Nurses may not have trust in their
therapy students and only allow them to do basic
tasks. This will limit the students clinical
learning skills.
3. Having student nurses could potentially
3. Having students be one on one with affect the patients. Some residents may
patients allows for the nurses on the unit not have the patience for a student who
to have more time to focus on other may take longer to complete tasks.
patients or important tasks
3. How did your presence on the clinical unit, including the care you provided to your
assigned patients, contribute to the effective operation of the nursing unit?
I made sure I obeyed the rules to ensure patient safety and excellent patient care. Not only
that, I also made sure I had good communication skills with the unit’s staff to obtain
information about my assigned patient.
4. Provide 2 examples of how nurses on the clinical unit work with other departments to
provide supplies, medications, equipment, or information for quality patient care, in a
timely manner and accurate fashion.
The nurses work with the physical therapists as they help supply assistive devices to the
patients who need them. Nurses also work with the kitchen staff to make sure the patients are
getting the proper meals according to their diets and extra snacks the patients may need or
want.
5. Identify one problem or inefficiency encountered this week in your patient care activities
involving providing supplies, medications, equipment, or information for quality patient
care, in a timely manner and accurate fashion. How did you work to solve this problem?
A problem we always face is relying on technology to do a lot of things for us, like the
automatic bp, pulse ox, etc., so sometimes when they don’t work it becomes a bigger problem
and delays care of our patients. We have run out of batteries on those equipment, and we
always end up having to replace the batteries on them.
outcomes for systems-based practice. Refer to the clinical learning outcomes listed on
the course clinical evaluation tool and provide specific examples of how you met the
learning outcome.
Providing care to patients on this unit has been a challenging but also a very fulfilling
experience. Because I am a nursing student there are things that I am still unable to do which
makes it challenging having to wait for someone who is available to help at the time needed,
but also fulfilling to see the staff coming together to help to ensure patient safety and that the
best quality care is being provided.

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Becker College

Student Name: __JULIA BROWN___ Date: __________________

1. What is the nursing course outcome for Evidence-Based Practice (EBP)?

Teamwork and Collaboration

Student Name: ____________________________ Date: ____________________

1. What is the nursing course outcome for Teamwork and Collaboration?

Healthcare Team Member Contribution to the Achievement

 LPN  Administered medication, providing patient care, ADLs,

 CNA  Made sure patients were fed appropriate meals,

 Professor  Supervises and ensures we are following protocol and

 Patient  Follow treatment plans, inform providers if any pain or

Student Name: ____________________________ Date: ____________________

1. What is the nursing course outcome for Communication?

Student Name: _______________________________ Date: ____________________

1. What is the nursing course outcome for Professionalism?

Informatics and Technology

Student Name: ________________________________ Date: ____________________

1. What is the nursing course outcome for Informatics and Technology?

2. SBAR 2. Allows the students to get use to

3. Daily Care Plans 3. In addition to the daily care plans that I

As a student, there is minimal to no technology that we are permitted to use. Instead, I

Student Name: _______________________________ Date: ____________________

1. What is the nursing course outcome for Safety?

-remind patient not to get up without help

-use non-slip footwear

-have patient on a toileting schedule

-raised bed to my hip level to prevent back injury

-asked for help when boosting patient

Error – wrong glucose reading

Student Name: ________________________________ Date: ____________________

1. What is the nursing course outcome for Quality Improvement?

Student Name: ________________________________ Date: ____________________

1. What is the nursing course outcome for Leadership?

 Social worker: manages patients well-being outside of healthcare aids in community

Student Name: _______________________________ Date: ____________________

1. What is the nursing course outcome for Systems-Based Practice?

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