American nurses association standards of practice for rn

Definition/Introduction

The American Nurses Association (ANA) defines standards for registered nurses. The Scope and Standards for Nursing Professional Development (NPD) describe the competencies that NPD practitioners should perform. Just as nursing has continued to evolve with the changing healthcare landscape, the roles and responsibilities of NPD practitioners have also evolved. The ANA and specialty organizations periodically review and revise standards; the latest edition of the NPD scope and standards was published in 2016 by the Association for Nursing Professional Development. This edition of the standards emphasizes advancing the specialty of NPD. A research study on key roles for NPD practitioners conducted by Warren and Harper informed changes in the latest edition of the standards.[1] Using a modified e-Delphi technique, they identified seven key roles for NPD. These roles included partner for practice transitions learning facilitator, change agent, mentor, leader, champion of scientific inquiry, and advocate for NPD specialty.

The NPD practitioner's role as a champion of scientific inquiry is to promote the generation and dissemination of new knowledge. Two themes emerged from the qualitative data: managing transitions in healthcare worker roles and managing transitions in the NPD role. NPD practitioners need to prepare nursing staff members to assume new roles in our ever-changing healthcare system as healthcare moves away from acute care into outpatient and community settings. The NPD practitioner roles are also expanding, with a focus on interprofessional continuing education and collaboration. The term NPD practitioner is the encompassing term that describes a registered nurse who influences professional role competence and professional growth of learners in various settings. The revised standards differentiate two levels of competencies, practiced by NPD generalists and NPD specialists, respectively, which is consistent with the ANA standards of practice for nursing.

The NPD generalist is a bachelors-prepared nurse with or without NPD certification OR a graduate-level prepared nurse without NPD certification. An NPD specialist has a graduate degree in nursing or a related field and maintains NPD certification. If the graduate degree is in a related field, a baccalaureate degree must be in nursing.[1]

Issues of Concern

The revised standards include a new systems practice model composed of inputs, throughputs, and outputs. Price delineated the key points of this model as a strategy used to realign their department with the revised standards.[2] Inputs include the NPD practitioner, who continuously conducts environmental scanning, and the learner. Throughputs occur in the context of the interprofessional practice and learning environments and include seven NPD roles and six key areas of responsibility. The standards define a learning environment as "any environment in which NPD practice is delivered." Areas of NPD responsibility are:

1. Orientation and onboarding

2. Competency management

3. Education

4. Role development

5. Collaborative partnerships

6. Research/evidence-based practice/quality improvement

The NPD practitioner promotes professional role development by identifying and developing strategies to facilitate a continuous maturation process through lifelong learning. Standards of practice serve as the core of the model, with the cogs on the central gear of the standards representing the NPD roles. Responsibilities are in a circle on the outside the cogs signifying that NPD practitioners can engage any of the responsibilities simultaneously as they guide the learner toward the desired outcomes. Outputs include learning, change, and professional role competence and growth, which contribute to the optimal care and health and ultimately the protection of the public.[1]

Following the ANA guidelines format, the NPD standards are divided into standards of practice and standards of professional performance. The standards of practice outline the educational planning process.

• Standard 1, Assessment of Practice Gaps, states, "the nursing professional development practitioner analyzes issues, trends and supporting data to determine the needs of individuals, organizations, and communities in relation to health care."

• Standard 2 describes how the NPD practitioner collects data and information to validate an identified professional practice gap and determine if it is a knowledge, skill, or practice gap.

• Standard 3 summarizes how the NPD practitioner identifies the desired outcomes of the education plan.

• Standard 4 outlines how the NPD practitioner establishes a plan to achieve the expected outcomes.

• Standard 5, implementation, has three associated standards dealing with coordination, facilitation of positive learning and practice environments, and consultation (NPD specialist only).

• Standard 6 describes how the NPD practitioner evaluates programs in relation to the attainment of outcomes. There are ten standards of professional performance.

• Standard 7 outlines how the NPD practitioner integrates ethics in all aspects of NPD practice.

• Standard 8 summarizes how the NPD practitioner maintains current knowledge and competency both in nursing and NPD practice. Evidence-based practice and research is an important aspect of NPD practice.

• Standard 9 describes how NPD practitioners act as champions of scientific inquiry, generating new knowledge and integrating the best available evidence into practice.

• Standard 10 focuses on the quality of NPD practice and how the NPD practitioner systematically enhances the quality and effectiveness of NPD practice.

• Standard 11 is a new standard pertaining to change management, which identifies how NPD practitioners act as change agents within all settings.

• Standard 12 addresses leadership; there is a separate article on NPD leadership.

• Standard 13 outlines how the NPD practitioner collaborates with interprofessional teams, leaders, stakeholders, and others to facilitate nursing practice and positive outcomes.

• Practice evaluation is an important aspect of any specialty, and standard 14 identifies how the NPD practitioner evaluates their practice.

• Standard 15 relates to resource utilization and how the NPD practitioner considers factors related to quality, safety, effectiveness, and cost regarding professional development activities and outcomes.

• The last standard for professional performance is mentorship and advancing the profession. This is a more recent standard in the 2016 edition and focuses on how NPD practitioners advance the specialty through mentoring and contributions to the professional development of others.[3]

Clinical Significance

All NPD practitioners need to know about and adhere to the NPD standards of practice.[4] NPD practitioners can use them in a variety of ways to enhance NPD practice and advance the specialty. Harper, Maloney, and Shinners provided exemplars of how various organizations operationalized the NPD scope and standards in their settings, including developing roles of the NPD practitioner, developing a departmental purpose and goals, applying the standards to educational programs, and describing challenges identified.[5]

Nursing, Allied Health, and Interprofessional Team Interventions

As already stated above, nursing as a professional involves lifelong learning. The healthcare landscape is constantly evolving on a number of fronts, and new standards of care emerge constantly. Nursing staff cannot remain static in their development, or they will literally be "left behind" as newer nurses enter the field armed with the latest knowledge, techniques, and standards of care. Nurses must keep pace so that optimal patient care can be the result of improved standards. [Level 5]

Review Questions

References

Harper M, Maloney P. The Updated Nursing Professional Development Scope and Standards of Practice. J Contin Educ Nurs. 2017 Jan 01;48(1):5-7. [PubMed: 28099670]

Price MG. Scope It Out: What's In and What's Out. J Nurses Prof Dev. 2017 May/Jun;33(3):156-158. [PubMed: 28472003]

Morrison V, Hauch RR, Perez E, Bates M, Sepe P, Dans M. Diversity, Equity, and Inclusion in Nursing: The Pathway to Excellence Framework Alignment. 2021 Oct-Dec 01Nurs Adm Q. 45(4):311-323. [PubMed: 34469389]

Taylor I, Bing-Jonsson PC, Finnbakk E, Wangensteen S, Sandvik L, Fagerström L. Development of clinical competence - a longitudinal survey of nurse practitioner students. BMC Nurs. 2021 Jul 16;20(1):130. [PMC free article: PMC8283382] [PubMed: 34271923]

Harper MG, Maloney P, Shinners J. Looking Back and Looking Forward Through the Lens of the Nursing Professional Development: Scope and Standards of Practice, 3rd Edition. J Nurses Prof Dev. 2017 Nov/Dec;33(6):329-332. [PubMed: 29023253]

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