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Clinical Reflections Paper

Name: _______________________________

As part of your clinical requirements for Clinical in Alternate Settings, you will complete a guided reflective paper that demonstrates progression to the RN manager of care role by using an actual care conference exercise. The purpose of this assignment is for you to recognize the RN role in a care conference setting.

Instructions for this paper:
· Your clinical instructor will assign you to a resident who is scheduled for a care conference when you are at your long-term care clinical site.
· Follow the criteria under each QSEN competency as listed below.
· This assignment is to be typed as a paper. Do not simply list answers to the questions. References (using APA format) are to be included at the end of the paper. The paper is worth 100 points. Points will be deducted for poor writing mechanics and failure to address each competency thoroughly.

A. Patient Centered Care

Competency Definition: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
a. Identify specific concerns (i.e. med management, safety, personal care services, etc.) identified in the care conference for your client and their family? (5 pts.)

b. Identify team member roles (professional and nonprofessional) and what they can contribute to your client’s plan of care. (5 pts.)

c. What ethical and legal aspects of your client’s care were discussed or might be discussed at the care conference? (5 pts.)

B. Teamwork and Collaboration

Competency Definition: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
a. What mutual client goals were established at the care conference? (5 pts.)
b. Discuss techniques of communication between care conference team members that
will serve to facilitate mutual-goal setting between your client, their family and team
members and to foster effective quality care.
(5 pts.)

c. How were conflicts between team members, client and family handled? (5 pts.)

C. Evidence-based Practice

Competency Definition: Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
a. Find one scholarly nursing article that relates to “continuity of care” or that pertains to the needs of your client (must provide a link to the article, a doi number, or attach the article). (10 pts.)
b. Summarize and apply the article findings to your client’s unique situation. (10 pts.)
D. Quality Improvement
Competency Definition: Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and
safety of health care systems.
a. Describe how nurses can affect quality pt. care outcomes by organizing a care
conference. (10 pts.)
b. Discuss how a care conference can promote continuity of care (refer to the evidence-based article you read). (10 pts.)

E. Safety

Competency Definition: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
a. Provide and discuss examples of how effective communication and planning during an interdisciplinary conference could promote safety. (5 pts.)

b. Provide and discuss examples of how poor communication during an inter-disciplinary care conference is linked to a safety risk to the client. (5 pts.)

F. Informatics

Competency Definition: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
a. Provide examples of how technology and information management may be used to
plan and manage a care conference. (5 pts.)

b. Explain why information and technology relate to safety and quality in patient care. (5 pts.)

G. Professional Writing:

a. APA guidelines are used to cite within the paper.
b. Reference list is provided and written with APA guidelines.
c. Proper use of grammar and spelling accuracy are reflected in the paper.
(10 pts)

Total Points Earned: ______________/100 pts

This clinical assignment was developed using the Quality and Safety Education for Nurses (QSEN) core competencies of patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety and informatics (


Caputi, L. (2010). Application of QSEN and IOM in health care education. Presented at Health
Educators Conference, Chaska, MN April 16, 2010.

Murray, M.E., Douglas, S. & Girdley, D. (2009). Teaching quality improvement. Journal of
Nursing Education. 49(8), 466-469.

Preheim, G. J., Armstrong, G. E., & Barton, A.J. (2009). The new fundamentals in nursing:
Introducing beginning quality and safety education for nurse’s competencies. Journal
of Nursing Education. 48(12), 694 – 697.

Quality and Safety Education for Nurses. Retrieved from and

The Joint Commission. Retrieved from and

Few Highlights to Clarify on assignment

Please contact me with any other concern(s).

For this assignment, the first YouTube video title “Care Plan Meeting” and “The Monologue of Ertha Williams” below, were used for the care conference aspect. So basically, you decide which scenario to use in answering the questions. Or you could pick points from the two scenarios help with answering. The second video is just to help with more understanding on Care Plan.

The Monologue of Ertha Williams
We were assigned to a role to play during the mock care conference we had on Zoom. The various roles were, charge nurse, social worker, dietary, PT, doctor, activity director, Ertha, family member, (Ertha’s daughter in-law).
Here is more background information about Ertha.
Ertha describes her journey over the past year. She talks about Henry’s hospitalization and says she doesn’t know what she will do if she ever loses her Henry. She relates that she has some good days and some bad days, and gets very anxious and cries when she recognizes she is confused and realizes that she has forgotten some important life events. Ertha tries to describe what it’s like to know she is getting confused and forgetful and how it feels to be so dependent on others. She is hoping the doctor can give her some medicine to help her get better. She says she likes the new apartment and she gets to go in the van a few days a week to a nice center where they have a lot of activities.

Simulation Scenario 1

The staff at the assisted living facility has noticed that Henry covers for Ertha a lot. Henry admits to the staff that his concerns about Ertha are increasing. He says that recently he has had trouble convincing Ertha to bathe and change her clothes and he doesn’t sleep well because he hears Ertha up at night wandering in the apartment. He has put chairs in front of the door and uses the chain lock so Ertha doesn’t get out. Ertha’s physician prescribed a sleeping pill, Ambien, but it hasn’t helped. Henry has been giving her Benadryl during the day when she is “anxious.”

Simulation Scenario 2

It is six months later; Henry passed away three months ago. Ertha is more confused, cries frequently, and looks everywhere for Henry. She is not eating well and has lost weight. The nurse at the assisted living facility does not feel she meets their guidelines any longer and will need a higher level of care. She asks Ertha’s daughter-in-law, Betty, to come in to discuss a move to a long-term care, skilled nursing facility. During the scenario Betty reports that Ertha calls her frequently every day, forgetting that she has called earlier.

Simulation Scenario 3

It is four months after Ertha’s transfer to the long-term care facility. She is even more confused, going into other patient’s rooms looking for Henry and stealing items. She recently began striking out at other residents, and staff finds food stashed under her mattress. She has been taking two antidepressant medications, an anti-anxiety agent and Aricept for the past four months but there has been no improvement

For the Evidence-base practice portion, she wants article less than 5 years old. Addressing “continuity of care” example using the first YouTube video on Fall and fall prevention could be a good one.
Informatics-should be on technology nursing homes use to communicate and manage patient care and so on.


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