QA Program Learning Plan form

Collection of Personal Information

The College of Nurses of Ontario (the College) collects the information in the QA Program Learning Plan Form if you have been selected for Practice Assessment
under the general authority of the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, the Nursing Act, 1991, S.O. 1991, c. 32, and its regulations; and the
Colleges by-laws. The College collects the information for the purpose of assessing your continuing competence through its Quality Assurance Program. Appropriate
measures are taken to safeguard the confidentiality of the personal information you provide and all documents become the property of the College.
If you have any questions about the collection, use and/or disclosure of this information contact the Manager of Information Management, College of Nurses of
Ontario, 101 Davenport Rd., Toronto, ON, M5R 3P1, 416 928-0900 or toll-free in Ontario 1 800 387-5526.

Jessa Pamaran

Name

Registration Number

QA Year

Class

Long term care

Current Practice Setting

28
Client Population

Learning Needs
What learning needs did I identify through practice reflection and peer input?
Identify a minimum of two (2) to three (3) learning needs.

- a more precise from of documentation

- to gain more knowledge about tracheostomy care

Havent done practice reflection yet? Use

the Practice Reflection worksheet to help
you identify your strengths and learning
needs.

Learning Goal #1
My goal must be based on my learning needs.

I want to learn how to document clearly and precisely where

everyone in the health care team can truly understand what the
problem was, what my intervention was, and what the outcomes
were by using proper terminologies and proper documentation
approach.

Need help creating a goal? Review the

Developing SMART Learning Goals
guide.
Your learning goal must be based on
your current practice setting and one of
the Colleges practice documents.
Please list which practice document

Documentation
Goal #1: Activities and Timeframes
How am I going to achieve my goal? Identify a minimum of three (3) learning activites with timeframes/timelines.

1. I will continue to read all texts that I can find useful i.e. Jarvis Health Assessment, Nursing Theory,
Med-Surg, etc. to gather more terminologies that I can use and relate with my practice until June 1st.
2. While in my current practice setting, I will read past patient notes to earn more knowledge on how
RNs and RPNs document in the facility until May 1st.
3. While in the unit, I will demonstrate on how I do my documentation and ask for my preceptor's or
other healthcare professionals involved in the unit for feedback until May 1st.

Learning Goal #2
My goal must be based on my learning needs.

I want to learn and gain more knowledge about caring for a client
with tracheostomy and to prevent infection while and after doing the
care.

Need help creating a goal? Review the

Developing SMART Learning Goals
guide.
Your learning goal must be based on
your current practice setting and one of
the Colleges practice documents.
Please list which practice document
Decisions About Procedures and Authority

Goal #2: Activities and Timeframes

How am I going to achieve my goal? Identify a minimum of three (3) learning activites with timeframes/timelines.

1. By June 1st, I should be able to read my texts, i.e. Nursing Theory, Health Assessment, and MedicalSurgical Nursing to be able to provide more data on how to do tracheostomy care.
2. By May 1st, I should be able to attend an in-service, LRI, simulations, and labs about tracheostomy
care available in the facility.
3. I will continue to watch videos about tracheostomy care from the Mosby's Nursing Skills available in
my current practice setting and/or social media website like Youtube.

Learning Goal #3
My goal must be based on my learning needs.
Your learning goal must be based on
your current clinical practice and the
Nurse Practitioner practice standard.

Goal #3: Activities and Timeframes

How am I going to achieve my goal? Identify a minimum of three (3) learning activites with timeframes/timelines.

How do my learning goals support my commitment to continuing competency?

How does my learning relate to the competencies of my practice?
Continue to maintain and update your
Learning Plan throughout the year.

Evaluation of changes/outcomes to my practice

What did I learn?
What impact has my Learning Plan had on my practice?

You can print your Learning Plan for your

records.

Dec 2014
2014-99