NCAPHNA Conference 2015
Public Health Nursing Skills
Competency
& Nursing Certification
Presenters:Deborah Herring, RN, BSN, MHA – Validation
DON, Pitt County Health Department NC Board of Nursing Member
Evelyn Coley, RN, BSN, MSA - Implementation
DON, Wayne County Health Department
Presenters’ Continuation:
Susan Little, MSN, RN, APHN-BC, CPHQ –
Certification
NC Department of Health and Human Services Nurse Consultant, Division of Public Health Local Technical Assistance and Training Branch
NC Board of Nursing Perspectives
Purpose – Mission Statement of the North Carolina Board of Nursing is to protect the public by regulating the practice of nursing.
NCBON Consultants for
Competency Validation
BON Staff assigned to Public Health for consultation: Joyce Winstead, MSN, RN, FRE Practice Consultant
Crystal L. Tillman, DNP, RN, CPNP Manager – Education & Practice
Foundation for Today’s
Presentation
Credit Given to Eileen C. Kugler, RN, MSN, MPH, FNP
Kugler, E. C. (2010, Fall). Validation of nursing competence: What does it mean for you? Nursing Bulletin: Official Publication of the North Carolina Board
of Nursing. Retrieved from https://sph.unc.edu/files/2014/02/nciph-chrm-f15-comp-valid.pdf
Validation of Nursing Competence:
What Does It Mean for You?
Purpose – is to ensure the individual has the right knowledge, skills, and behaviors to do the work that is required to fulfill the mission of the organization and the nursing plan of care.
The National Council of State
Boards of Nursing (NCSBN)
Defines competence as the application of knowledge, and the interpersonal, decision-making and psychomotor skills expected for the nurse’s practice role within the context of
public health, welfare and safety (NCSBON, 2009)
Defines competence assessment as the
evaluation of the nurse’s knowledge, skills and abilities.
Assessment Mechanisms:
Demonstration and Observation Self-reflection
Examination Peer Review
Being Competent… NCBON Perspective
Remember or Consider: Just Culture
Right Touch Regulation Novice to Expert
Nursing’s Historical Stereotype – “eating their young”
The Four Cornerstones of a Just
Culture
As Leaders we must establish a fair and “Just Culture”
Focus on using unanticipated outcomes to be used as a learning process where
learning can occur – rather than focus on grounds for punishment.
The Four Cornerstones of a Just
Culture
1. Create a Learning Culture – recognizing risk at both the individual and
organizational level. Be accountable for your practice choices.
2. Create an Open and Fair Culture – move away from an overly punitive culture and strike a middle ground between punitive and blame free.
The Four Cornerstones of a Just
Culture
3. Design Safe Systems – by reducing opportunities for human error. Try to capture errors before they become critical.
4. Manage Behavioral Choices – by coaching each other around reliable
Right Touch Regulation
Should be ……. 1. Proportionate 2. Consistent 3. Targeted 4. Transparent 5. AccountableNovice to Expert
Competence does not mean expert…. According to > Novice to Expert:
Excellence and Power in Clinical Nursing Practice (1984), Patricia Benner – applied the Dreyfus Model of Skill Acquisition to nursing.
Novice to Expert - continued
Five levels of proficiency:
1. Novice – no actual experience in area 2. Advanced Beginner – perform
methodically 3. Competent
-Novice to Expert - continued
4. Proficient – comes with experience
5. Expert – integrate theory & experience to function at higher level. Analyze data,
adapt/modify plans, problem solve, utilize resource to achieve desired outcomes.
How to Meet the Challenge:
Being Competent…
NCBON Perspective
1. Nurses are accountable for attaining knowledge and competency that reflect current nursing practice.
2. NC Nursing Law and Rules hold all nurses accountable for accepting only the
assignments for which they are competent.
How To Meet The Challenge –
Continued:
3. Registered Nurses (RN) are accountable for “supervising , teaching and evaluating those who perform or are preparing to perform nursing functions” and for “providing for the maintenance of safe and effective nursing care whether
rendered directly or indirectly”. (NC Pursing Practice Act 2009)
How To Meet The Challenge –
Continued:
4. Nursing managers are held responsible for assessing the capability and
competence of personnel in relationship to client status, plan of nursing care and for delegation responsibility or assigning nursing care functions to qualified
personnel.
How To Meet The Challenge –
Continued:
5. Nursing administrators are further held accountable for ensuring a mechanism is in place to validate the qualifications, knowledge and skills of nursing
How To Meet The Challenge –
Continued:
6. The administrator must provide educational opportunities related to expected nursing performance; and ensure the implementation of a system for periodic performance of staff.
Responsibility For Competence
Individual Nurse Managers
Supervisors
Why Do We Need to Check Skills?
ASSURE COMPETENCY
(Knowledge, Skills, Behaviors)
BON Practice Requirement Assess New Hires Skills
Validate Ongoing Competency Identify Performance Deficits
Provide Performance Improvement Feedback and Training
Conduct an Accurate Performance Appraisal
Methods of Assessment
Observation Record Review/Audits Demonstration Peer Review Examination CertificationFrequency
Upon Employment
Annually or According to Agency Policy More Frequently when Needed
New Procedure/Intervention New Assignment Policy Change
Tools
Job Descriptions
Evaluation Tools
Record Audit Tools
Skills
Communication History Collection Documentation Counseling/Education Physical Assessment Case Management HIPAA ComplianceCan Use Technical Components of Job Description
Provide Employee Feedback
Within 1 day of AssessmentDiscuss Assessment
Acknowledge Good Performance
Identify Areas that Need Improvement Develop an Improvement Plan:
What Needs Improvement Date Needs Improvement
Toolbox for PHN Competencies
http://www.ncpublichealthnursing.
org/publications.htm
Toolbox for PHN Competencies
Toolbox for PHN Competencies
CALL
TO
ACTION
Public Health Nursing Skills
Competency Validation
Professional Certification
•
Certifications r/t PH & PHN
• ANCC – APHN‐BC • NBPHE – CPH•
Professional PHN Organizations
• NCAPHNA • NCPHA – Nursing Section • APHN•
Exemplar
Professional Certification
• Increased access to job‐related power • High perceptions of empowerment • Nurse managers expressed a preference for hiring certified nursesProfessional Certification
• Certification enabled me to . . . "experience personal growth," "feel more satisfied as a professional nurse," "feel more competent in my skills as a professional nurse," "be seen as a credible provider," "feel more accountable as a professional nurse," and "experience more confidence in my practice."Cary, Ann H. PhD, MPH, RN, A-CCC, Certified Registered Nurses: Results of the Study of the Certified Workforce. American Journal of Nursing, Issue: Volume 101(1), January 2001, pp 44-52
