APPRAISALS AND EVALUATIONS

CLINICAL INTEGRATION ASSESSMENT MARKS

Forwarded conversation
PNDistanceLabs <PNDistanceLabs@norquest.ca>
Apr 12
NFDN2003
Good morning Matelyn
Student Registered Name: Matelyn Tolentino
Student ID#: 1027830
Course Registration Date: March 2016
Student email: mtolentino865@mynorquest.ca
Marked By: T. Currie LPN
Matelyn,
I am pleased to inform you that you have been successful in the CIA for NFDN 2003. You scored
an 85%. If you would like to go over your exam you are required to make an appointment with
the lab staff at a time that works for everyone. Your exam may be reviewed over the phone or in
person. Please address any further emails to PNDistanceLabs@norquest.ca.
Once again congratulations on your success in this course.
Treena Currie Licenced Practical Nurse
Instructional Assistant Practical Nurse Program, Distance Delivery
Faculty of Health and Community Services | NorQuest College
T 780.644.6345
10215 108 Street NW | Room A810
Edmonton, Alberta, Canada T5J 1L6
www.norquest.ca

Forwarded conversation
Subject: FW: CIA
PNDistanceLabs <PNDistanceLabs@norquest.ca>
Jan 29
Good morning Matelyn
Student Registered Name: Matelyn Tolentino
Student ID#: 1027830
Course Registration Date: November 2015
Student email: mtolentino865@mynorquest.ca
Marked By: Eastern
Matelyn,
I am pleased to inform you that you have been successful in the CIA for NFDN 1002.
You scored an 80%. If you would like to go over your exam you are required to make
an appointment with the lab staff at a time that works for everyone. Your exam may be
reviewed over the phone or in person. Please address any further emails to
PNDistanceLabs@norquest.ca.
Once again congratulations on your success in this course.

Treena Currie Licenced Practical Nurse

Instructional Assistant Practical Nurse Program, Distance Delivery
Faculty of Health and Community Services | NorQuest College
T 780.644.6345
10215 108 Street NW | Room A810
Edmonton, Alberta, Canada T5J 1L6
www.norquest.ca

Forwarded conversation
Subject: CIA
PNDistanceLabs <PNDistanceLabs@norquest.ca>
5/19/15
HEAS1000
Student Registered Name: Matelyn Tolentino
Student ID#: 1027830
Course Registration Date: Winter 2015
Student email: mtolentino865@mynorquest.ca
Tested By: Daphne
Matelyn,
I am pleased to inform you that you have been successful in the CIA for HEAS 1000. You scored
a 95%. If you would like to go over your exam you are required to make an appointment with
the lab staff at a time that works for everyone. Your exam may be reviewed over the phone or in
person. Please address any further emails to PNDistanceLabs@norquest.ca.
Once again congratulations on your success in this course.

Daphne Schweitzer Liscenced Practical Nurse

Instructional Assistant Practical Nurse Program, Distance Delivery
Faculty of Health and Community Services | NorQuest College
T 780.644.6373
10215 108 Street NW | Room A810
Edmonton, Alberta, Canada T5J 1L6
www.norquest.ca

ASSIGNMENTS MARKINGS

Assignment 2:

Continuing Competency Program

Learning Plan and Record of Professional Activities
Matelyn Tolentino
Key Content

Marking Guide
5
Excell
ent

1: Self Assessment
Assessed all competency
categories on the selfassessment form related to the
Standards of Practice

3: Record of Professional
Activities
Recorded 2-5 professional
related activities on the form and
provided examples of each
4: Summary
Summarized what you learned
and how it will impact your
nursing practice
Comments: Your first learning goal is
very broad and would take a year to
complete. You need to narrow your

1
Minim
al

0
None

5
5
10/1
0

Created a summary of specific

priority competencies to use in
Learning Plan

2: Learning Plan
Learning plan for one
competency complete with
learning objective, resources,
strategies, target date, and
evaluation method
Learning plan for second
competency complete with
learning objective, resources,
strategies, target date, and
evaluation method

3
Satisfac
tory

4.5
8.5/1
0

5/5
5
5/5

focus to certain topics as this is much

too large. Also for evaluation of both
of your goals, what about being able to
effectively work on the unit?
Enhanced patient teaching with
increased knowledge of
Pathophysiology and anatomy? Etc etc
Total:_____________________28.5/30

REPORT ON PROGRESS OF PROFESSINAL PORTFOLIO MARKING GUIDE

TOLENTINO

DESCRIPTION OF ONE SIGNIFICANT LEARNING

EXPERIENCE IN THIS COURSE

Described at least one experience in this course

that made the course content significant to the learner

WHAT I LEARNED

Identified at least one content area, or competency

that was significant

PROFICIENCY RATING

Rated self according to Proficiency categories in

the learning guide

WHY IT WAS MEANINGFUL/SIGNIFICANT

Described the significance of the learning experience

and the content area or competency learned

HOW I WILL APPLY LEARNING IN NURSING PRACTICE

Described how the knowledge and experience will

be applied to nursing practice
Total

Assignment 1:

Reflective

5 /5

Practice
Marking Guide

Marked by Cindy Hoyme Student:

Marking Guide

Key Content Points:

Video recording

Excellent

Submitted video and signed and witnessed consent form; submitted materials on
time at date set by instructor; Voices were audible and participants were visible
and facing the camera

Satis Mi N
facto ni on
ry mal e

5 /5
Comments: Video was clear and audible.
Analysis

Analyzed a minimum of 15 responses

Distinguished between effective verbal responses and blocking verbal
responses

3
5

*If there were no effective listening responses, you will still receive marks as you will have correctly
entered Not Applicable on the Effective Listening Responses and Non-Verbal Behaviour Video
Analysis Guide Form.

Accurately identified the types (categories) of effective verbal responses

and of blocking verbal responses

Accurately identified if non-verbal behaviour was effective or ineffective

for each blocking and effective verbal response

Provided appropriate, alternate, effective, verbal responses for each

blocking response and correctly identified the category of the effective
verbal response

Identified personal areas of strength and areas for improvement through

reflection

Discussed possible effects of blocking responses on the nurse-patient

relationship

Discussed use of reflective practice on an ongoing basis

3
32

/
4
0

/5

Comments: Good job! My only suggestion is you could have expanded on how you view the
ongoing benefit of reflective practice affects the nurse patient relationship.
Format

Comments: No title page

Total:

REFLECTIVE PRACTICE

40 /
5
0

A. Demonstrate depth in Challenging previously help assumptions and attitudes about

communication and relationships, and in exploring new ways of thinking.
It was the moment when one of my close friends in college started to avoid me and did
not replied to my emails. It happened when I did not inform her about my engagement. I did
have plans of telling her but not until I am ready, one more thing was that she works at the

province so I want to tell her in person. She emailed me asking about it but I did not respond, for
me it was ok not to reply for the meantime because she is my friend and that she will understand
anyway.
That time, I was so worried and anxious that I broke our friendship. I wanted to call her
and explain but I did not have the courage to do it. I started to get mad at myself thinking how
stupid and bad I am for not telling her. I feel so guilty about what I did and I dont know how to
face or make it up to her. However, I started to pacify myself thinking that once I get the chance
to talk to her then she will understand my reasons. I thought it was ok for me to not respond to
her email because I am planning for the best time to tell her in person anyway, but I was wrong.
Taking the course NCOM, I learned that ignoring someones message is a negative
communication climate, and that failure to return a phone call or email is an impervious response
(Adler et al., 2006, p.287). It was the exact thing I did to my friend. I ignored her by not emailing
her back.
Writing this experience made me realized that I was not communicating properly. I was
hurt that she avoided me but then now I know I was the one who created the problem after all.
Learning communication helped me changed and improved my communication skills now. With
the acquired knowledge, I will for sure know how to manage my future interactions with the
people around me.

B. Demonstrate depth in reflecting on a personal experience of practicing

communication strategies and techniques in real-life situations.
It was the day my co-worker told me about her marital problem. One afternoon, she
called me crying heavily on the phone. I cant understand what shes saying but I heard she
mention her husband. I was so worried about her so I drove to her place right away. I hugged her

as she cried on my shoulder. I was about to give my opinion and advice but then I stopped and
just silently listened and allowed her to talk. I remembered myself telling her that I understand
how she feel and its ok to cry. I was holding her hand and rubbing her back as she cried.
It was my first time to listen about marriage dispute and the ironic thing was that, shes
not a very close friend of mine. I did not expect her to blurt out her marriage problem to me. That
time, I had mixed emotions; first, I feel so bad about her because I can see that she is hurting so
much and second, I wanted to punch her husband really hard. On the other hand, I was glad that
she called me and was able to express her feelings. I know that after she cried and told me
everything, it eased up her feelings a bit. I know hugging her also made her feel better and
comforted.
The experience showed me that LISTENING is one of the best communication strategies
that I should practice. It can help someone to verbalize their feelings without hesitations, as
NCOM textbook says silent listening can help others solve their problems (Adler et al., 2006,
p. 196). In addition, interview made by Hollender found out that adults reported an increase need
for touch when they were depressed or anxious (Schuster, 2000, p. 151).
After this reflection, I realized that applying communication techniques are indeed vital,
it helped me communicate therapeutically. I will practice it more as I integrate with my family,
friends, and to anybody.
C. Demonstrate depth in reflecting on personal integration of communication theory,
strategies and techniques into nursing practice to manage conflict.
As future LPN, there will be a point that I can be involve in a conflict with a co-worker
about gossiping. Like a co-worker spreading words that I am inconsiderate and insensitive. I
dont feel good about what she did so I asked her if we could talk to clear things out. We finally

talked and we worked things out well. I explained my side and she apologized, she misjudged
me.
I am so mad at her because how would she say something like that. I was hurt at the same
time because I cant accept that I have those qualities and where did she get those idea about me.
I am stressed out and anxious for the reason that my personality is being judge by someone.
Talking to her though was nice because I was able to clarify things and I felt better after that. On
the other side of my mind, maybe she was right that Ive done something or said something that
she misinterpreted.
I learned that talking to the person involved in a conflict is the best way to solve a
conflict. As cited in the book Interplay, assertiveness is probably the best approach to solve a
problem (Adler et al., 2006, p. 324).
Personally, I am not comfortable to be involved in a conflict to anybody especially to a
co-worker for the main reason that I dont want to hold grudge towards someone that I work
with. I always wanted to have a harmonious relationship to my colleagues. Learning the ways to
manage conflict is helpful for me as I can use it whenever it happens in the future. Also, the
lesson I learned from what happened was that, next time I should be aware of the words that I
utter because I might be hurting someone elses feelings.

*Demonstrate depth in reflecting upon personal growth, knowledge, and understanding of

communicating effectively.
The way I interact with my husband is a lot better now. An instance happened when I
found out that my husband did not bring the garbage out for collection. At instant, I was furious
because he forgot to do it. I marched to the bedroom to confront him, but I stopped, composed

myself and thought about the proper way to tell him. Instead of scowling at him I changed my
behaviour and asked him nicely dear.., I guess you were busy the other day that you forgot to
bring out the garbage. He smiled at me and said Im sorry dear, yes I was busy and dont
worry about the garbage I will handle it.
I was so impressed at myself after this encounter because at first I totally had the urge to
fuss and nag about it but I behaved the right way. I became more positive and was already
looking forward for the next encounter where I will practice communicating effectively.
I was a fussy and moody wife before but this experience made me realize the universal
proverb, do unto others what you want others do unto you. Now, I always see positive in things
to both of us. I laugh at his simple jokes which I dont usually do before. And I take things easy
now, as the saying goes dont sweat the small stuff. I feel good now because I am able to
maintain a smooth and understanding relationship with my husband.
It took me time to learn and practice communicating effectively. I can say that its not that
easy because I always have the tendency to be impatient and there are times that I cant control
my temper. But I always think about the positive result of good communication which I used as
guide as I interact daily with my husband and to other people. Effective communication I can say
is a skill to be practiced and polished as the book Interplay stated effective communication is
not a natural ability (Adler et al., 2006, p. 13).
I believe that I have increased my knowledge and understanding on how to communicate
effectively. I will then use these acquired knowledge as I continue my journey with life and my
career.

LEADERSHIP AND MENTORING

As Team Leader and Mentor, I made a daily assignment form assigning the right team member to
meet patients need.
Daily Assignment Form
ROOM

103-1

CLIENT

Mr. Tonn

TEAM
MEMB
ER
ASSIG
NED
Me

COFEE
AND
LUNCH
BREAK
1

RATIONALE SUMMARIZED

Patient is new to the unit, as team leader, it is

103-2

Room

Josie

Mr.

Me

Leisman

Josie

Mrs. Chow

Me

Betty

104

Room

Mrs.

Cheryl

105-1

Howard

Betty

my responsibility to make sure that the patient

meet his needs and that he is also oriented with
the unit. My expertise as LPN will make sure
the tube is intact, patent and clean as presence
of artificial airway place the client at high risk
of infection and airway injury (Potter & Perry,
2014). Since Josie is new, I will orient her
with the unit and mentor her about the patient.
Josie can assist the client with personal needs
(bathing,dressing) and can empty urine bag.
Patient is oriented to person only so I will
assign Betty who has been working here for
years and knows patient really well to attend
for his needs. I will assess Bettys knowledge
with colostomy care before I will delegate the
task to her following assessment and care
planning by a nurse, nurse can choose to teach
and assign care to HCA (Decision making
standards of nurses, 2010). As LPN, I am
responsible of taking clients vital signs and
physical assessment especially that the client
has poor appetite.
Patient does not speak English and only need 1
assistance to get up so I will assign Betty who
knows the patient very well. Betty already
established way of communicating with the
patient, she can help patient with feeding. I
will be the one to check patients vital signs
and will do physical examination. As team
leader and LPN it is my responsibility to make
sure patient does not do any physical exertion
as physical exertion can precipitate an attack
by increasing myocardial demand (Bare, Day,
Paul, Smeltzer & Williams, 2009).
I will assign Cheryl because her expertise and
knowledge match patients needs. Cheryl can
recognize signs of infection on G-tube site and
has the skills of G-tube site care. Cheryls
therapeutic communication skills is needed to
get patient out of bed and do walking exercises.
Nurses has the ability to identify patients
physical, psychological or social barriers to
accomplish effective communication (Sheen,

Room

Mrs.

105-2

Warshawski

Betty

Room

Mrs.

Cheryl

106-1

Verhulst

Betty

Room

Mrs. Auger

Alice

Josie

106-2

2011). Bettys skills meet patients personal

needs. Betty can also do the G-tube feeding
with the supervision of Cheryl as HCA can
provide care that supports the client under the
direct and supervision of a nurse (Decision
making standards of nurses, 2010).
As patient is rude when needs are not met,
Bettys long years of experience in this unit and
knowledge about patients preferences will
meet patients personal needs. HCA providing
care to the same patient on a regular schedule,
knows the client and clients abilities and
specific needs (Decision making standards of
nurses, 2010). I will delegate either Josie or
Cheryl to help Betty with 2 person assist.
Patient is disoriented, assigning Cheryl to
monitor her condition is a need. Cheryl as LPN
knows that the number one priority for
disoriented patient is safety as delirium patient
should have somebody with them day and night
(When patients become confused, 2011).
Cheryl will delegate Betty to meets her
personal needs especially feeding as
companionship and assistance will help
patient eat and drink an adequate amount
(When patients become confused, 2011).
Hypertensive patient needs the expertise of an
LPN so that vitals are monitored. I will assign
Alice as patient is also disoriented. With 3 year
experience in this unit, Alice knows how to
handle this patient. Her knowledge and skills
on G-tube care and feeding will meet patients
nutritional needs. Nurses duty is to check
tube for leakage, blockage and check
surrounding skin for irritation (Hall
B.,Mitchell, S.L.,OConnor, A.M., Rostom, A.,
Villanueve, C., 2008). Josie a new HCA will
help meet the personal needs of patient. Alice
will mentor Josie with feeding and will assess
her skills to evaluate if she can delegate feeding
with her in the future as HCA assist tube
feedings (Health Care Aides Competency
Profile, 2001).

Room

Mrs. Rowe

107-2

Room

Miss Eden

107-2

Cheryl

Josie

Alice

Betty

Room

Mrs.

Alice

108

Demers

Josie

Room

Mrs. Kulak

Cheryl

Patient needs catheter to be changed and has

open areas on coccyx. Cheryls knowledge and
skills are needed to change the Foley catheter
and inspect the coccyx area. The procedure
should be carried out by a nurse or doctor
competent in urinary catheterization (Royal
Childrens Hospital Melbourne). Josie will
meet the personal needs of the patient such as
bathing and feeding. I will inform Cheryl to
mentor Josie with dressing of coccyx so that
she can perform it in the future as HCAs
competency includes assisting with dressing
(Health Care Aides Competency Profile,
2001).
I will assign experienced Alice and Betty as
they know this patient already and vice versa
since patient is only oriented to place and
person. With Alices skills and knowledge, she
can recognize signs of developing pressure
ulcer. Early identification of risk factors helps
the nurse in preventing pressure ulcers (Potter
& Perry, 2014). Betty on the other hand can
assist her with repositioning as HCA can assist
with repositioning which is included in their
competency profile (Health Care Aides
Competency Profile, 2001). Betty will also
meet patients personal needs like bathing,
dressing and feeding.
Patient with decreased peripheral vision and is
depressed requires the skill of a nurse to assist
her needs. Josies expertise with providing and
assisting patient in their personal care meet
patients needs. HCAs basic competency is
providing and assisting with activities of daily
living (Health Care Aides Competency Profile,
2001). Alice with much nursing experience
dealing with relatives and is competent with
nursing communication skills knows how to
deal with controlling husband. Therapeutic
communication techniques used by nurses help
patients and families overcome stress and
adjust to the unalterable (Schuster, 2000).
Since patient is oriented to person only, I will

109-1

Room

Betty

Cheryl

Josie

Miss Urban

Josie

Mrs. Gluza

Cheryl

Mrs. Baldor

109-2

Room
110-1

Room

assign Betty because patient knows her and

vice versa. Bettys long years of experience in
this unit make her capable of assisting patient
with hip replacement. HCA that provides care
to the came client on a regular schedule, knows
the client and clients abilities and specific
needs (Decision making standards of nurses,
2010). Patient is also hypertensive so Cheryl
will do the vital signs monitoring and physical
assessment and will help with the 2 person
assist. In hypertension nursing assessment
involves carefully monitoring the blood
pressure at routine intervals (Bare et al.,
2009).
7 days post-op patient needs the expertise and
skills of a nurse to meet her needs. I will assign
Cheryl as she has the skills to assess surgical
wounds and can recognize signs and of wound
infection. Ongoing observation of the wound
identifies early signs and symptoms of
infection (Potter & Perry, 2014). Cheryls skills
in health teachings about the importance of
keeping the legs abducted will help hasten
patients recovery as nurse-teacher provides
information that prompts client to engage in
activities that lead to a desire change (Potter &
Perry, 2014). Cheryl also will mentor Josie
about hip replacement and how to care for them
so that Josie have an idea on how to provide or
assist in personal care.
Patient needs little assistance with care but she
should be in close supervision to prevent
elopement. As team leader, I will also explain
to Josie that since patient is depressed, she is
prone to suicide so that she will watch her
closely as patient with depression is risk for
suicide (Day et al., 2009). As team leader, it is
also my responsibility to help in the
supervision as I am responsible for my unit,
safety and quality is the responsibility of the
team leader (Oshea, 2012).
I will assigned Cheryl and Josie for this patient.
Cheryls knowledge and skills with health

110-2

Josie

education will help the patient cope with

emphysema as patient education is a major
component of pulmonary rehabilitation (Bare et
al. 2009). As LPN Cheryl can perform staple
removal at the same time she can recognize if
there is any signs of infections on the wound.
Josies skills on providing and assisting with
activities of daily living will meet patients
personal needs. In continuing care facility or
acute facility, HCA provide assistance with
personal care to total care (Decision Making
Standards of Nurses, 2010).

As team leader, I will make sure that Mrs. Gluzas room has a sign of Oxygen in Use

and No Smoking to make staffs and visitors aware as oxygen supports combustion.
Cheryl and I will go for 1st break and experienced Alice and Betty together with Josie will
be on 2nd break. Alice is experienced and she can manage the unit while I am on my

break.
As team leader, I have fewer and easier patient because I have other responsibilities like
organizing team assignments, shift reports, mentoring and orienting new staff.

SCHOLARLY PAPERS
Current Based Practice on How to Prevent Pressure Ulcer in Spinal Cord Injury Patients
Pressure ulcers are defined as an area of localized damage of the skin and underlying
tissue caused by pressure, shear, friction or a combination of these. Pressure ulcers usually
occurs over bony prominences and are classified in stages by the degree of damage observe.
Maintaining skin integrity in hospitalized patients is one of the most fundamental and important
goal in nursing practice. Measures to prevent, restore and heal pressure ulcer will shows how
health care team measures their knowledge, critical thinking and caring skills to patients like the

case of spinal cord injury which encounters many kinds of complications. One most common
complications is pressure ulcer and there are many ways to prevent. Positioning is considered as
best practice with evidenced-based result. Positioning is a nursing intervention defined as
deliberate placement of the patient or body part to promote physiologic well-being (Mosbys
medical dictionary, 2013, p. 1425). Positioning includes elevating the head of the bed to 30
degrees or less to decrease shearing forces and a 30-degree lateral position to either side to avoid
lying the client over a bony prominence are done to prevent development of pressure ulcers
(Potter & Perry, 2014, p. 1275). Bed positioning of client with spinal cord injury such as prone
with the use of positioning aids such as pillows and cushions are recommended techniques to
prevent pressure ulcers (Campbell, Houghton & CPG Panel, 2013). In addition, positioning goes
with frequency and interval, as the text book stated that positioning should be changed at least
every 2 hours or as needed (Potter & Perry, 2014, p. 2014). Regular turning also should be
accompanied by small shifts of body weight such as repositioning of ankle, elbow or shoulder
(Bare, Day, Paul, Smeltzer & Williams, 2010). The use of repositioning should be considered in
all at risk individuals and the frequency of repositioning should be influenced by variables
concerning the individual and the support surface in use. An effective repositioning regimen will
be indicated by the absence of persistent redness over bony prominences.
In previous years, positioning of immobilized client in bed includes a 2 hour standard
turning from 30 degree head elevation to 30-degree lateral on either side. Recent handbook
entitled Canadian Best Practice Guidelines for Prevention and Management of Pressure Ulcers in
People with Spinal Cord Injury recommended other position such as prone to prevent skin
breakdown. Prone position works by off-loading many bony prominence areas such as coccyx,
sacrum, ischeal tuberosities, greater trochanters, heels, ankles, scapulae, spinous processes and
occiput (Campbell, Houghton & CPG Panel, 2013, p. 91). Additionally, recent textbook cited

that recumbent position is preferred to the semi-Fowlers position because of increased

supporting body surface in this position (Bare et al., 2010). Previous nursing intervention also
follows the standard interval by turning immobilized client every 2 hours. Research done by
Australian Wound Management Association in collaboration with New Zealand Wound Society,
Singapore Wound Healing Society and Hong Kong Enterostomal Therapist Association found
that there is no optimal time frame for routine repositioning, frequency should be determined by
the individual patients medical condition, mobility and individual preferences (Australian
Wound Management Association, 2013, p. 51). However, the said organizations still
recommend a standard 2 hour turning regimen as the most appropriate management strategy for
pressure injury.
A study was done to observe the effectiveness of turning every 2 hours and turning as
necessary was conducted by two groups in a long term care. Both group was turned every 2-3
hours but one group used a visco-elastic foam mattress, groups with elastic foam mattress has a
significant reduction rate of pressure injury, 3% versus 14.3% (Australian Wound Management
Association, 2013, p. 51). This study showed that frequent repositioning of the client using
support surfaces has significant impact to immobilized client that is why the association further
mentioned that the Registered Nurses Association of Ontario evidenced-based guideline uses one
study to support a recommendation that patients at risk of pressure injury be repositioned
despite use of any pressure management device (Australian Wound Management Association,
2013, p. 51). This means that even though the client has support devices, it is still very
important to reposition client with frequent intervals. Estimates indicate that 1 to 3 million
people in the US develop pressure ulcer each year. According to the Joint Commission in United
States more than 2.5 million patients in acute care facilities suffer from pressure ulcers and
60,000 die from pressure ulcer complications each year. In addition, new information from

Agency for Healthcare Research and Quality indicates that pressure ulcer-related hospitalization
increased by an alarming 80 percent from 1993-2006. Data from 1999 indicates the cost of
treating the ulcer may range to $5 to 8.5 billion annually. Factor in 7% per year for health care
inflation and this equates approximately $9.2 to 15.6 billion dollars in 2008 ( NPUAP, 2009 ).
Pressure sores impact on the Spinal Cord Injury individual and those around them. Treatment
often necessitates activity modifications and restrictions that can have a negative psychosocial
impact on individuals and their families, including social isolation, alteration of body image and
loss of income. Pressure ulcers can lead to serious complications and can even be fatal.
Complications include local and systemic infection, osteomyelitis, pelvic abscess and
malignancy. As a consequence of these complications further interventions maybe required such
as surgery and amputation. Pressure ulcers are one of the many factors that influence the
functional status of individuals. One study found that motor function at discharge from
rehabilitation was related to severity of pressure ulcers. Patients with more severe ulcer grades
were discharged with lower levels of motor function. Pressure ulcers reduced the ability of
individual with Spinal Cord Injury to participate in community, daily activities and quality of life
is lower.
Education on prevention of pressure ulcer is vital. Education of health care workers is
important as authors claimed that education is critical, so that those checking the skin are able
to recognize vulnerable skin and detect the early signs of skin damage (Campbell, et al., 2013, p.
88). Significant others and family plays a great role in preventing pressure ulcer especially at
home, as family or significant other are the main care givers of the client. Teaching the family
and client about the prevention of pressure ulcer such as proper turning, proper use of support
devices and adequate nutritional intake are of most important as education is required to ensure
caregivers know how to carry out repositioning maneuvers safely and place positioning devices

properly (Campbell, et al., 2013). Furthermore, client teaching about the signs and symptoms of
developing pressure ulcer is necessary to promote clients health. Provide patient education
specific to the individual which includes potential causes and risks of pressure ulcer development
and methods of self-monitoring (Campbell, et al., 2013, p. 39). Education is indeed significant
not only to health care personnel such as registered and practical nurses but also to the client and
family as a whole. Prevention of pressure ulcers begins from the time of injury, through initial
acute care, rehabilitation and on into the home and community setting. Intensive education and
skills training in the rehabilitation phase focus on the spinal cord injured person learning and
using variety of preventive measures to manage at home. Most of this information is conveyed at
the time the person is an inpatient and they and their family may suffer from information
overload. Education and skills training maybe required at intervals throughout their lifetime
when changes occur. Pressure ulcer prevention is more cost effective than treatment and
pressure ulcers are potentially preventable.

CARE PLAN

A. Nursing Care Plan (Spinal Cord Injury)

Priority Nursing
Diagnosis
1. Impaired
physical
mobility
related to
motor and
sensory
impairment.

Goal

Interventions

Evaluation

Client Goal:
Client will be able
to move body parts
and flex all joints
gradually in 2-4
weeks
independently.

1. Reposition
frequently at least
every 2 hours or
as needed.
Rationale:
Repositioning helps
prevent the development
of contractures with
immobility and muscle
paralysis (Bare et al.,
2010, p. 1942).

Achievement of
Expected outcome:
Goal met. Client is
able to change his
position and can flex
all joints without any
help.

Expected
Outcome:
After 2-4 weeks
client can
reposition himself
and is flexing all
joints
independently.

2. Perform passive
range of motion
exercises.
Rationale:
Range of motion
exercises help preserve
joint motion and
stimulate circulation
(Bare et al., 2010, p.
1942).
3. Explain the
importance of
frequent
repositioning and
the use of
positioning aids
to the client.
Rationale:
Teaching promotes
learning and provides
information that prompts
the client to engage in
activities that lead to a
desired change (Potter &

Client Responses
and findings:
Repositioning and
passive range of
motion exercises
helped client to regain
body function.
Teaching the
importance of
positioning and
exercises helped
gained the
cooperation of the
client.
Further Nursing
Action:
During discharge, I
will reiterate health
teachings to client and
family about the
importance of
mobility to make sure
client recalls it and
will perform it at
home which then
prevents development
of skin injury.

Perry, 2014).
Potential Nursing
Diagnosis

Goal

Interventions

Risk for impaired

skin integrity
related to
immobility.

Client Goal:
Clients skin
will remain
intact
throughout
hospitalization.

1. Reposition every 2
hours and as needed
Rationale: Positioning
reduce pressure and shearing
force to the skin (Potter &
Perry, 2014, p. 1275).
2. Use positioning aids
when repositioning
such as pillows, foam
wedges and cushions.
Rationale: Positioning aids
off load or bridge vulnerable
areas (Campbell et at., 2013,
p. 87).
3. Educate about the
importance of
repositioning and
positioning aids
including the
importance of
adequate nutritional
intake and the signs
and symptoms of
developing skin
breakdown.
Rationale: Teaching
promotes learning and
provides information that
prompts the client to engage
in activities to provide
change (Potter and Perry,
2014). Adequate nutritional
intake is essential for wound
prevention (Potter & Perry,
2014, p. 1256).

Expected
Outcome:
Clients skin
shows no signs
and symptoms
of skin
breakdown
throughout
hospitalization.

Evaluation
Achievement of
expected outcome:
Goal is met. Clients
skin is intact
throughout
hospitalization.
Client responses:
Frequent
repositioning with the
use of positioning aids
helped the client
maintained good and
intact skin. Health
teachings at the same
time promoted clients
understanding of the
importance of
changing positions
frequently and made
the client cooperative.
Further Nursing
Intervention:
Continue to educate
the client and family
about the relevance of
positioning and
adequate nutritional
intake and the signs
and symptoms of
developing skin
breakdown before
discharge because
skin breakdown can
easily happen if
clients skin is
neglected.

Nursing
Diagnosis
(Educational
Need)
Knowledge
deficit about the
preventive
measures of skin
breakdown
related to
unfamiliarity
with the causes.

Goal

Client Goal:
Client will know
causes of skin
breakdown and
identify 5
ways/techniques
to prevent skin
breakdown most
especially proper
positioning.
Expected
Outcome:
After 30-45
minutes of client
teaching, client
enumerates 3
causes of skin
breakdown and
identifies 5 ways
to prevent it such
as use of
positioning aids,
familiarity of the
signs and
symptoms of
developing skin
breakdown and
most especially
positioning
techniques.

Intervention

1. Determine clients
ability, readiness
and barriers to
learning.
Rationale: Ability to learn
can be impaired by many
factors such as sensory
impairment and physical
strengths (Potter & Perry,
2014, p. 298). Learning is
enhance when they are
ready to learn (Potter &
Perry, 2014, p. 300).
2. Explain clearly,
avoiding medical
terminology, jargon
and acronyms
the causes of skin
breakdown such as
friction, moisture and
shear and ways to prevent
it such as knowing the
signs and symptoms of
developing skin injury,
adequate nutritional intake
and most especially
positioning.
Rationale: Medical
terminology, jargon and
acronyms are not familiar
with the patient (Potter &
Perry, 2014, p. 305).

Evaluation

Achievement of
expected outcome:
Goal is met because after
the 30 minutes health
education, client was
able to identify factors
that causes skin
breakdown and 5
ways/techniques to
prevent it.
Client responses and
findings:
Client understands
preventive measures and
identified positioning
techniques, using of
positioning aids,
importance of adequate
nutritional intake and
knowing the signs and
symptoms of developing
skin injury. Client also
enumerated the factors
that will lead to skin
breakdown.
Further nursing action:
I will reiterate the
importance of doing the
preventive measures to
the client at home.

3. Provide
information about
additional learning
resources such as
internet or websites
about prevention of
skin breakdown.
Rationale: Internet
resources may be
interactive and includes
demonstrations, video
clips, self- directed
modules, web-based
learning (Potter & Perry,
2014, p. 303).

PROFESSIONAL GOALS
My passion is working with the elderly and other specific groupr of population so that my
main goal after completing my PN program in November 2016 is to seek employment as LPN to
any Assisted Living Facility where I can work and practice my nursing skills to care for the
elderly. After gaining experience as LPN in an assisted living for 2 years, I will further my
studies specializing in Geriatric Nursing so that I will learn geriatric care in depth. In 5 years
time or by 2019, I am confident that I have the enough experience as lead LPN so that I will
apply as Wellness Manager of the facility. For this to be possible, I will make sure to update my
education and leadership skills so that I can handle the job efficiently. I am giving myself a
longer period to attain this position as I am planning to have a kids and allowing myself a 1 year
maternity leave is included in my 5 year plan.
Education for me is unending process. I think that furthering my education allows me to
increase the knowledge and skills in my nursing profession and also widening my scope of
practice. My skills will not only for medication administration, performing basic, intermediate
and advance nursing skills but I will have the ability to work as unit supervisor or case manager.
For this goals, I would like to do laddering education to become a registered nurse. I would set
aside another 5 years, 2025 will be my set year for completing my RN education. Again, I gave
myself 5 years for this goal because I would like to concentrate also to my family. I will do the
laddering slowly.

CPRNE STUDY PLAN

After completing my PN program, I will start right away preparing for the CPRNE exam
in May 2017. Four to six months is more than enough for me to prepare so I will use the time
wisely. The following are my to do checklist.

I will set aside at least 2 hours a day to read and study and 3-4 hours during my off-duty.

I will keep all the flashcards that I made and will bring it with me at work or anywhere so
that I can glance and read during my free time.

I will make a study cheklist especially the nursing concepts that I have difficulty with.

I will use my CPRNE prep guide to review all the concepts I learned from the program.

I will familiarize myself wih the practice exam instructions, test-taking strategies,
question rationales and sample answer sheets to enhance my test taking skills.

I will also use the CPRNE predictor test to know my readiness for the exam and at the
same time I will be able to know my weakness and I will give more time in that area.

I will join group study and brainstorming activity with my classmates.

Then I will register for the Norquest College CPRNE Prep Workshop to help me fully
prepare for the exam.

I believe that if I will do all the above list, I will be successful in the CPRNE.

CONTINUING COMPETENCY

SELF-ASSESSMENT TOOL

The Self-Assessment Tool is used to assess your professional practice using the LPN
Standards of Practice and Competency Profile as a guide. Focus your assessment on your
practice as a whole and then those Specific Competencies which are directly related to your role
and responsibilities.

RATING SCALE Use the following rating scale to complete your Self-Assessment.
1

Excellent

Competent

Requires
Improvement

Developmental

Not Applicable

Demonstrates
excellence in the
expectations and /
or requirements of
the competency.

Meets the
expectations and /
or requirements of
the competency.

Has identified
weakness in
areas of
knowledge, skills,
attitudes, or
clinical judgment.

Requires
education and/or
orientation to
meet the
expectations and /

Not applicable to
current role and
responsibility.

or requirements of
the competency.

STEP 1: SELF-ASSESSMENT WITHIN STANDARDS OF

PRACTICE

Competency
Number

A: Nursing Knowledge

Year
2016_

Year
20__

Year
20__

Year
20__

Year
20__

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

A-1

Applies knowledge of anatomy and

physiology of the human body to the
assessment of client and delivery of
nursing care.

A-2

Applies knowledge of microbiology

throughout care, disease prevention, and
health promotion.

A-3

Applies knowledge of pathophysiology to

the nursing care of the client.

A-4-4

Uses appropriate medical terminology to

report and document client care.

A-5-9

Adjusts nursing practice to the specific

growth and development of the client.

A-6

Applies principles of nutrition to the

assessment and care of the client.

A-7

Applies knowledge of pharmacology

throughout client care and teaching.

Integrates knowledge and skills from the

sciences and humanities into the
application of the nursing process.
B: Nursing Process
A-8-2

1
Rating
(1-5)

B-1

Performs health assessment of client using

assessment techniques and a systematic
process.

B-2-2

Implements the planning process and

establishes client priorities involving client
in planning.

Competency
Number

Year
2016_

B-2-3

Identify and analyze nursing diagnosis.

B-3

Implements nursing interventions to carry

out nursing care plan.

B-3-2

Reassess, review, and modify plan of care to

meet the needs of the client.

B-4

Evaluates the clients response to care and

treatment.

C: Safety
C-1 to

Year
20__

Year
20__

Year
20__

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

1
1
Rating
(1-5)

Applies critical thinking and clinical judgment

when responding to emergency situations.

Year
20__

C-4

C-5-1

Effectively uses protective devices to

protect client, self, and others.

C-6-1

Demonstrates the consistent application of

standard precautions.

C-7-1

Applies principles of medical and surgical

asepsis in the delivery of care.

C-12

Applies nursing knowledge and clinical

judgment to maintain physical safety of
client.
D: Communication and Interpersonal Skills

Rating
(1-5)

D-1

Uses effective verbal and written

communication in the practice setting.

D-2

Appropriately establishes, maintains, and

closes the nurse-client relationship.

D-3

Collaborates with health care team to

function as an effective team member.

D-3-7

Adheres to the channels of communication

Competency
Number

Year
2016_

Year
20__

Year
20__

Year
20__

Year
20__

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

within the employing agency.

D-4

Provides client and family teaching.

D-5

Reports and documents following legal

protocols, agency policy and procedure.

D-7

Applies clinical judgment in identifying

problems and resolving issues in client
care.

D-8-1

Effectively manages time and organizes

client care to meet priority needs.

D-8-2

Demonstrates ability to rank the priority of

client needs.

W: Professionalism

Rating
(1-5)

W-1-3

Understands the key components of the

Health Professions Act-LPN Regulation.

W-2-3

Understands the Restricted Activity

authorizations in the LPN Regulation.

W-3

Understands the CLPNA Standards of

Practice.

W-4

Adheres to the CLPNA Code of Ethics and

Standards of Practice.

W-4-5

Acts as an advocate for client and empowers

clients and families.

W-5-1

Demonstrates accountability for own nursing

practice.

W-6

Maintains the confidentiality of client

information.

Competency
Number

Year
2016_

W-7

Recognizes professional boundaries within the

nurse-client therapeutic relationship.

W-9

Accepts responsibility for continuing

competence and professional development.

W-9-4

Participates in continuous quality improvement

and evidence based changes to nursing
practice.

W-11

Keeps informed of current research affecting

health care delivery.

X: Nursing Practice and Leadership

Rating
(1-5)

X-1-5

Recognizes own strengths and limitations as a

leader.

X-3-5

Uses appropriate channels of

communication to report risks within
setting.

X-4

Applies critical thinking and clinical judgment

when assessing or managing risk.

X-7-1

Shares knowledge, skill, and expertise with

colleagues and students.

X-7-3

Seeks opportunities to teach and mentor others.

X-7-4

Participates in committees, task forces and

professional activities to offer the LPN
perspective.

Year
20__

Year
20__

Year
20__

Year
20__

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

Rating
(1-5)

SELF-ASSESSMENT SUMMARY
Year

Competency
Number

A-1
2016

Describe the competency areas you want to improve or develop. List all items rated 2
(Competent), 3 (Requires Improvement), 4 (Developmental) in Step 1.

To be able to perform physical assessment effectively in relation to the

anatomy and physiology of the human body. I will rate as 3 which
requires improvement.

A-2

2016

A-3

2016

A-5-9
2016

D-3
D-3-7
D-4
D-5
D-7

2016

W-4
W-4-5
W-9

To be able to prevent the spread of infection and to promote health by

carefully following the infection prevention control. I will rate as 2
(competent).
To be able to describe disease process related to respiratory system. I
rated myself as 3.
To be able to provide care in accordance with the developmental stage of
the client especially in patients with developmental disabilities. I rated
myself as 2.
To be able to give constructive feedback to team member. I rated myself
as 2.
To be able to employ a proper way of communication to prevent conflict.
I rated myself as 2.
To be able to improve my skills in developing teaching plan to clients. I
rated myself as 2.
To be able to document nursing care given in a timely manner using
approved medical terminology in a clients chart. I will rate myself as 3.
To be able to deal effectively with common conflict situation in health
care setting. I rated myself as 2.
To be able to enhance my leadership knowledge and skills in my
practice. I will rate myself as 2.
To be able to improve my skills in advocating the client family. I rated
myself as 2.
To be able to assess my competence constantly and identify strength and
learning needs. I rated myself as 2.

STEP 2: SELF-ASSESSMENT OF SPECIFIC COMPETENCIES

In this section, describe, assess, and rate the competencies specific to your area of work,
specialty, role and responsibility. Review the competency sections in the Competency Profile to

guide your assessment of the Specific Competencies. Seek feedback from another health
professional.

Year

2016__

Competency
Number

Describe & Assess Specific Competencies

O-1-4

Improve knowledge to plan and implement activities that

would promote wellbeing of elderly clients.

Rating
(1-5)

Effectively assess cognitive changes to provide the best

possible care.

O-1-6
Improve knowledge and ability to assess pain level of
patient with dementia.

O-2-3
Enhance knowledge on Personal/Advance directives,
guardianship/trusteeship including mourning and
bereavement support.
O-2-10

O-3-1

Develop critical thinking and clinical judgment during the

provision of daily care to geriatric client.

Improve my understanding of the cognitive changes related

to dementia and the normal cognitive changes of aging.

Improve my ability to recognize and manage distress related

behavior to protect patient and staff from getting hurt.
O-4-2
2

STEP 3: LEARNING PLAN

This page is intended to document your Learning Plan for one year. Photocopy this BLANK page for each additional
year.

Your Learning Plan must consist of at least TWO objectives for each year. You are required to fill
out all FOUR columns for each objective. Transfer your Learning Plan onto your Annual CLPNA
Registration Renewal Form. Please refer to the Guidelines at www.clpna.com for more
information.

YEAR 2016

Learning Objectives

Resources & Strategies

Target Date

Evaluation

(What I am going to learn?)

(What will I do to meet

objectives?)

(Realistic time
frame for
achievement)

(How will I know I learned it?)

B-1 To demonstrate the

ability to perform
physical assessment
systematically and
accurately.

*Review latest health

assessment books and
videos.
Perform physical

*Within the
next 3-6
months.

*Improved knowledge,
skills and confidence in
physical assessment.
*Demonstrate ability to

assessment to assigned
patient in the unit as
required.

D-5 To demonstrate
ability to document the
care provided following
the legal protocol,
agency, policy and
procedure.

*Review the important

medical terminologies,
approved abbreviation,
metric system and
subjective and objective
data.

*Attend the regularly

scheduled in service on
documentation in the unit.

take and record vital signs

accurately during physical
assessment.

1-3 months

*Demonstrate ability on
quality documentation on
clients chart.
*Improved understanding
on the importance of
quality documentation in
relation to patient care
and legal issues.
*Demonstrate ability to
apply knowledge and
skills on quality
documentation towards
daily care of patients in
the unit.

Name: Matelyn Tolentino

Student I.D. : 1027830

CLPNA Registration #: ____________

RECORD OF PROFESSIONAL ACTIVITIES

Date

Professional Activity

Summary of Learning

(include course, seminar,

research, hours, details)

June 22,
2016

Basic Life Support (CPR)

In this course, I learned how to perform Cardiopulmonary

resuscitation or CPR. I learned that high-quality CPR
improves a victims chances of survival. That there are
critical characteristics of high-quality CPR: 1) chest
compression should be started within 10 seconds of
recognition of cardiac arrest, 2) push hard, push fast which
means compress at a rate of at least 100/min with a depth of
at least 5cm for adults, approximately 5 cm for children and
approximately 4 cm for infants, 3) allow complete chest
recoil after each compression, 4) minimize interruptions to
less than 10 seconds, 5) give effective breaths that make the
chest rise and 6) avoid excessive ventilation. I also learned
how to use the Automated External Defibrillator (AED) for
adults and children. I also learned adult, children, and infant
CPR with one and two rescuer. This learning experience has
a great impact on me as a future practical nurse because I
will be working in the community and hospitals providing
care. At any time, things happen such as cardiac arrest and if
I have the training and knowledge about CPR, I can perform
the skill helping the client survive. In this way, I am
upholding the standards of practice which is service to the
public and responsibility.

August
10, 2016

HBPE Course Certification

In this course, I learned that blood-borne pathogen is hazard

in workplace and that health care workers, emergency
personnel, mortuary workers, clinical lab workers, etc. are
considered to be most at risk. I learned that there are
different types of exposure incidents to pathogen such as
cuts, contacts with eyes, nose and mouth. That the hands are
the most common site for exposure. I learned that Hepatitis
B and C and Acquired Immunodeficiency Syndrome (AIDS)
are the high- risk diseases. The principle of Standard

(Human Blood-borne
Pathogen Exposure)

precautions is to consider that all blood and body fluids are

potentially infectious and therefore treated the same by all
who may come into their contact. I learned that in health
care setting, control measures involve using gloves, gowns,
face shields and eye protection when dealing with blood,
blood products and body fluids. Additionally, wash hands
often especially after contact with each client and also after
removing gloves. Also, health care workers are taught not to
recap needles to reduce their risk of infection by accidental
needle sticks. Furthermore, I learned that there are protocols
and exposure guidelines to follow whenever a health care
worker is exposed to a blood-borne pathogen such as
making an incident report about the exposure so that
appropriate management is done. This for sure has a great
impact on me as future practical nurse because my
profession is to care for the people, on the other hand I am
also at great risk for human blood-borne pathogen exposure.
However, because I had training and education about it, I
know how to protect myself and my clients of blood-borne
exposure and transmission. I will perform hand washing at
any times, I will use protective equipment such as gown,
mask and gloves whenever I will be in contact with blood
and body fluids. Through these knowledge I am able to
protect myself and my clients from exposure to blood-borne
pathogen.

March
2016

March 2,
2016

WHMIS Course
Certification

Belite Training ( 4 hours )

In this course, I learned that it is very important to know

about the hazardous chemicals in the workplace so that we
are able to protect ourselves from harm. I learned how to
identify hazardous chemicals with just the signs. That there
are corrosive, flammable, and combustible chemicals that
they should be handled with extra care to prevent exposure.
I learned that being knowledgeable of the labels, Material
Safety data sheets and other identifiers provides the workers
idea on how to handle the hazardous chemicals. I learned
that employees most especially RNs, LPNs, HCAs and
Housekeepers should know where the MSDS is located in
their unit so that in case of exposure, they know where to
locate it. As practical nurse, WHMIS course is very
important because we encounter hazardous chemicals at
work. I know that in hospitals and all other health care
facility, compressed air and chemicals for cleaning are
always present in the building. Therefore being
knowledgeable on proper handling is of great importance to
prevent accidents in the workplace.

I have learned the proper body mechanics in transferring a

client to keep myself from injury and for the safety of the
client.
I have learned the proper way of using transferring device
such as mechanical lift, sit stand lift, transfer board etc.
I have learned the importance of using a slider sheet when
repositioning patient especially when they are heavy.

October
2, 2015

Non-violent crisis
intervention

I have learned how to manage or handle psychiatric patients

in the hospital after my training. I knew the different
strategies or techniques in dealing with those violent or
aggressive patients.

Name: Matelyn Tolentino

CLPNA Registration #: ____________

Student I.D.: 1027830

References
College of Licensed Practical Nurses of Alberta. (n.d.) CLPNA mission and vision. Retrieve from
www.clpna.com/about-clpna/vision-mission-mandate/
Potter, P. & Perry, A. G. (2014). Canadian fundamentals of nursing (5th ed.). Toronto, ON:
Elsevier Canada.