Nursing encompasses many competencies. The list continues to grow as nursing move toward evidence-based practices intertwined with emerging technologies. The competency based knowledge list can topically be summarized to include knowledge and skills in the areas of:
- General and specialty nursing education and knowledge
- Patient centered-care modalities
- Professional Role
- Systems-based practice
- Informatics and technology
- Teamwork and collaboration
- Quality Improvement
- Evidence based practices
- Professional standards: Rules and regulations
The following materials are intended to be of assistance in defining nursing standards of practice, scope of practice, and to define a framework for future growth and development.
PROPOSED DEFINITIONS OF COMPETENCY AND COMPETENCE
A “competency” is an expected level of purposeful performance that results from an integration of knowledge, skills, and personal abilities and characteristics. Likewise, an individual who demonstrates “competence” is performing successfully at an expected level.
“Purposeful performance” means action of intent. The integration of knowledge, skills, and personal abilities and characteristics occurs in both formal and informal learning experiences, including reflective learning. Nursing knowledge encompasses all pertinent information, including the scope of practice, standards of practice, standards of professional performance, science, humanities, practical experience, and personal strengths and weaknesses.
Skills include habits of mind; psychomotor, communication and interpersonal skills; and diagnostic and ethical reasoning capabilities. “Habits of mind” reflects a person’s individualized pattern of thinking, problem solving, and decision-making. Personal abilities and characteristics represent those attributes which can affect an individual’s ability to effectively function, for example, listening ability, honesty, self-knowledge of strengths and weaknesses, positive self-regard, emotional intelligence, and openness to feedback.
The ability to function at the expected level of purposeful performance can be influenced by the nature of the situation, which includes consideration of the setting and the person. That is, situations can either enhance or detract from the ability to perform. The competent registered nurse contributes to efforts to influence factors that facilitate and enhance competent practice and to efforts to remove barriers that constrain competent practice.
The ability to demonstrate the expected level of purposeful performance requires an iterative process of continual life long learning. The competent registered nurse must revisit competencies and identify needs for additional knowledge, skills, personal growth, and integrative learning experiences. The successful evolution from novice to expert relies on such an iterative process.
The expected level of purposeful performance should reflect variability when defined using a particular framework. Examples of such frameworks for registered nurses include the American Nurses Association’s standards of practice and professional performance for all registered nurses, the specialty nursing practice standards, the learning objectives of academic or other professional development educational curricula, statutory and regulatory language, or credentialing and privileging requirements.
The Standards of Nursing Practice are the authoritative statements defined and promoted by the profession by which the quality of practice, service, or education can be evaluated. Each standard is a descriptive statement of the expected level of purposeful performance of a competent RN for that nursing process or professional performance category. Each measurement criterion is a behavioral, cognitive, or motor competency required to be able to function in accordance with each standard.
(Standards → competencies → measurement criteria)
The Texas Board of Nursing: Competency, Continuing Education & Lifelong Learning
All nurses with an active Texas license are required to demonstrate continuing competency for relicensure. The mission of the Board of Nursing (BON) is to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely. In 1991, rules were adopted requiring nurses to complete 20 contact hours of continuing nursing education (CNE) every two years for relicensure. CNE is defined as programs beyond the basic nursing preparation that are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice, thus improving health care to the public [§216.1 (12)]. In 2009, rules were adopted to allow nurses to demonstrate competency through achievement of an approved national nursing certification in the nurse’s area of practice or completion of 20 contact hours of CNE. In 2010, rule changes require contact hours to be in the nurse’s area of practice. If the nurse does not have a current area of practice, the nurse refers to the prior area of practice.
Professional Role Competence
ANA Position Statement - Approved 5/28/08
The public has a right to expect registered nurses to demonstrate professional competence throughout their careers. ANA believes the registered nurse is individually responsible and accountable for maintaining professional competence. The ANA further believes that it is the nursing profession’s responsibility to shape and guide any process for assuring nurse competence. Regulatory agencies define minimal standards for regulation of practice to protect the public. The employer is responsible and accountable to provide an environment conducive to competent practice. Assurance of competence is the shared responsibility of the profession, individual nurses, professional organizations, credentialing and certification entities, regulatory agencies, employers, and other key stakeholders.
Links of Interest
ANA Scope and Standards
COPA Model of Competency
Definition of Competence
WEBSITES OF INTEREST
American Nurses Association is the official website of ANA. Several scholarly articles related to competency are available from the Online Journal of Issues in Nursing which can be accessed from this website. Publications including the Code for Nurses with Interpretive Statements, Nursing: Scope and Standards of Practice, and Nursing’s Social Policy Statement are available for purchase at reduced rates for members.
American Nurses Credentialing Center
is the leading credentialing center for nurses. The ANCC site provides information on nurse certification, professional portfolio development, continuing education provider certification, and Magnet® designation.
Institute of Medicine
website contains a wealth of information on health care and quality including the three hallmark reports on patient safety: To Err is Human
(1999), Crossing the Quality Chasm
(2001), and Keeping Patients Safe