Competency Based Nursing

Bedside competencies need to be measured not only by educational degree, but also by level of experience and the particular environment in which the nurse practices. For example, in a large university level teaching hospital, both the ADN and the BSN prepared nurses have access to clinical nurse specialists, clinical nurse educators, on site social workers, case managers and chaplaincy services. Nurses in this environment also have access to Journal Clubs, in-services taught by multi-disciplinary teams and participate in research studies concerning their patient populations.

The overall goal through all phases of The Quality and Safety Education for Nurses (QSEN) is to address the challenge of preparing future nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. In order to accomplish this goal, six competencies were defined. These competencies from the Institute of Medicine (IOM) are patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics and safety. Over a decade has passed since the Institute of Medicine’s reports on the need to improve the American healthcare system. The Quality and Safety Education for Nurses

In relation, to the AHPRA’S Scheme, which came into effect of 1st of July, 2010, the operations are governed by the health and practitioner regulation national law Act, 2009 (QLD) and each state and territory. In addition with the national scheme, responsibility was taken over for the regulation of nurses and midwifes in Australia, and taken ownership of the national competency standard for registered nurses. The minimum care standards for a nurse in Australia are

The Nurses of the Future Nursing Core Competency model is composed of ten competencies. Some of these competencies include patient centered care, collaboration, and teamwork. One particular is safety, which I believe to be one of the most important of the competencies. Safety is minimizing the risk of harm to patients and healthcare providers. This is important to nursing because insuring the safety of a patient is a number one priority, without safety is the care of a patient successful? Nurses are the first line of defense when it comes to safety towards patients and providers. In order to ensure safety there must be a plan of action and then set the plan in motion in order to avoid unsafe outcomes.

Since emergency rooms in the hospitals provide rapid care to the patients, the triage nurse is to select the patient who develops sudden and serious symptoms of disease. The triage nurses are a very

Because patients need round-the-clock care, working hours include days, nights, weekends and holidays. Nurses spend considerable time walking, bending, stretching and standing, so they must follow proper body mechanics to guard against injury. Because of the fast-paced and variable environment of emergency rooms, ER Nurses must possess good stress coping skills and be able to relate to people of all ages and backgrounds. They must be able to work accurately around frequent interruptions. Nurses may face hazards from exposure to chemicals and infectious diseases. In addition, they treat patients that may be confused, irrational, agitated, and/or uncooperative. Along with all this you need. At a minimum for most entry-level emergency room (ER) nursing careers, applicants must have a diploma from an accredited

The AHPRA develops standards, codes and guidelines for nursing, as well as assessing overseas trained practitioners who wish to practise in Australia. ( Nursing and Midwifery Board of Australia 2016, para. 2). Through AHPRA, safe and effective care of patients is achieved as standards, codes and guidelines protect safety of patients, as well as ensure effective care of patients. Through assessment of overseas trained professionals, AHPRA is also able to ensure the safety of patients by ensuring all overseas trained practitioners are adequate for working in the nursing field within

“The emergency nurse acts with compassion, integrity and respect for human dignity while recognizing and safeguarding the autonomy of the individual”, (ENA, 2015). While this provision appears simply stated, most nurses find it difficult to remember their patient as a human being with intricate needs and basic human rights. As an emergency nurse, I have to keep these needs and rights at the forefront of my thoughts during the care of the patient during a very vulnerable time. Patients come in under stress, sometimes involuntary and at the most desperate times in their lives. I constantly have to make a concerted effort to communicate with the patient during a chaotic time, take time to listen to the patients fears and concerns and communicate those to the team.

An emergency room nurse may assist in moving patients, taking blood labs and must use care and compassion while treating or informing patients of their condition. They may help physicians during exams and treatments, and monitor and record patients conditions, evaluate patients response to treatment and notify the doctor when appropriate. The information collected will be used by the emergency room nurse to identify factors related to discharge and advise the patient and family on how to continue their proper health care after leaving the hospital. Upon discharge the ER nurse will provide referrals to other health care individuals for follow up treatment to ensure continued care.

The helping role domain contains proficiencies associated with starting a healing bond, offering comfort, and including patient in the management of care. The teaching-coaching domain involves education and goal setting at the appropriate time during patient care. The diagnostic and patient monitoring domain concerns competencies of continuous assessment and patient goal setting (Brykczynski, 2014). The effective management of rapidly changing situations domain contains competencies involving rapid response with resources during emergency conditions. The administering and monitoring therapeutic interventions domain concerns competencies associated with avoiding difficulties associated with hospital admissions, wound management, and medicine treatment (Alligood, 2014). Monitoring and ensuring the quality of health care practices domain concerns competencies involving safety, quality, technology, and partnership with physicians (Brykczynski, 2014). The organizational and work-role competencies domain involves competencies in important situations, group development, organizing and delivering care (Brykczynski, 2014). The domains describe competencies that are utilized and intersect during the nursing care for a

Due to the pace and volume of healthcare provided in ED’s, the need for constantly improving quality and safety processes is essential. Emergency rooms are a likely the testing grounds for many of the initiatives introduced by the QSEN initiative. Additionally, the nurses that work in ED’s must achieve a high level of competency in all areas identified by this initiative.

In the article “What Do Nurses Really Do?”, Suzanne Gordon explores what nurses truly do. She concludes that nurses “save lives, prevent complications, prevent suffering, and save money” (Gordon 2006). Nurses provide care for their patients in the physical and emotional sense. Emotionally caring for a patient and being sensitive to his or her needs result from interacting with patients while performing the skills and using the knowledge that nurses learned in school. Nurses grow in their skills, knowledge, and attitudes through practice. Quality and safety education for nursing incorporates competencies that all nurses must use in their practice. These nursing competencies include evidence-based nursing practice, quality improvement, safety, teamwork and collaboration, patient-centered care, and informatics.

For the most part, hospitals are places where one comes for healing and it is place where our clients should feel safe and away from harm. Nurses have an important role as a patient advocate and are to provide all clients with safe, compassionate, and quality care at all times. Nonetheless, the hospital can also be a dangerous place for inpatients. It is a foreign environment to clients and there may be alterations in their medical condition in regards to their physical and/or mental status. With this said, there is a need to improve upon how we care for our clients, especially those who are at most risk for various incidents.

Nurses need many different job skills in order to succeed within this profession. Attention to detail is important due to the fact that he or she will help doctors operate, administer medication, and work with treatments that could be crucial to the individual. Another job skill is the need to be calm under pressure. Nurses are faced with many emergencies such as life-or-death situations where they will need to exhibit compassion to the pain and trauma of the individual (Bratcher, 2015). These professionals work with a range of patients, from those who are healthy (and are proactively trying to stay that way), to those who are pregnant and bringing new life, to those who are nearing the end of life and hoping for a peaceful death.

During my preceptor shifts in the Emergency Department health teaching was the main priority before discharging patients. Nurses have to conduct in depth health teaching to the patients based on their diagnosis during their stay. The health teaching is focused on what diagnosis they have, prevention of complications, home-care, follow-up instructions, and medications prescribed focused on side effects and how to properly take them. The biggest reason why ED nurses need to conduct in-depth health teaching is to prevent the patient coming back into the hospital for the same health problem.