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00124645-201011000-0001100124645_2010_26_290_bradley_standards_6miscellaneous< 61_0_20_1 >Journal for Nurses in Staff Development (JNSD)© 2010 Lippincott Williams & Wilkins, Inc.Volume 26(6)November/December 2010pp 290-293Scope and Standards[Departments:Scope and Standards]Section Editor(s): Bradley, DoraEditor's note: Now that the Nursing Professional Development Scope and Standards of Practice (National Nursing Staff Development Organization and American Nurses Association, 2010) has been published, I hope you have a copy. I also hope you are thinking how the Scope and Standards will affect the future of your practice and your department processes.Mary Harper, PhD, RN-BC, is a member of the work group that revised the Nursing Professional DevelopmentScope and Standards, is a National Nursing Staff Development Organization Board member, and is the contributor of this column on the new Nursing Professional Development Specialist Practice Model. As you review this column, think about how components of the model can be operationalized in your current practice environment.THE MODELThe practice of the nursing professional development (NPD) specialist is illustrated using a systems model with inputs, throughputs, outputs, and feedback (see Figure 1). Nursing professional development is defined as "a specialized nursing practice that facilitates the professional development of nurses as they participate in lifelong learning activities to enhance their professional competence and role performance, the ultimate outcomes of which are protection of the public and the provision of safe, quality care" (National Nursing Staff Development Organization [NNSDO] & American Nurses Association [ANA], 2010, p. 3).FIGURE 1. Nursing professional development specialist practice model. From the National Nursing Staff Development Organization and American Nurses Association. (2010). Nursing Professional Development (NPD) Scope and Standards of Practice. Silver Spring, MD: Nurses books.org. Reprinted with permission.ENVIRONMENTThe context or environment in which the NPD specialist practices is subject to multiple influences. The practice of NPD specialists is continually influenced by regulatory demands, healthcare reform legislation, and the employing organization's available resources. Some organizations may have learning management systems and high-fidelity simulation equipment; others may not. Reporting structures, position descriptions, and organizational goals and expectations will create variations in how the NPD role is practiced. While the NPD specialist's practice is influenced by the environment, the NPD specialist influences the practice environment through ongoing efforts to promote interdisciplinary collaboration and transformational leadership.INPUTThe process of NPD is activated by the input of the NPD specialist and the learner. An NPD specialist is defined as "a registered nurse with expertise in nursing education who influences professional role competence and professional growth of nurses in a variety of settings" (NNSDO ANA, 2010, p. 4). Learners are individuals or groups "with an educational need who participate in professional development activities" (NNSDO & ANA, 2010, p. 4). The role of the NPD specialist is to promote and facilitate the learning process to meet the educational needs of the learner.THROUGHPUTThe NPD specialist employs a variety of processes to meet the educational needs of learners. Although different methods may be used, all education processes have, as a foundation, evidence-based practice (EBP) and practice-based evidence (PBE).EBP and PBEEvidence-based practice is "the integration of the best research evidence, educational and clinical expertise, and learner values to facilitate decision-making" (NNSDO & ANA, 2010, p. 5). Practice-based evidence is what works in practice. Practice-based evidence has evaluation measures to support its effectiveness in lieu of formal research data. The nature of NPD practice requires that the specialist be knowledgeable of both EBP and PBE related to educational techniques and patient care. For example, if a critical care unit is trying to decrease its rate of ventilator-associated pneumonia (VAP), the NPD specialist must access the evidence related to prevention of VAP. In addition, the NPD must determine the most effective manner for teaching the VAP prevention guidelines. On the basis of evidence, the NPD specialist must decide whether it is more effective to conduct inservice classes on the unit or to develop a self-learning module on the guidelines.OrientationOrientation is defined as "the educational process of introducing individuals who are new to the organization or department to the philosophy, goals, policies, procedures, role expectations, and other factors needed to function in a specific work setting" (NNSDO & ANA, 2010, p. 5). Often, NPD specialists are responsible for the orientation of nursing staff and other healthcare personnel.Competency ProgramThe ANA (2008, p. 3) defines competency as "an expected level of performance that integrates knowledge, skills, abilities, and judgment." Competency programs assess and evaluate performance to ensure that it meets expectations. The NPD specialist must be knowledgeable about the assessment and documentation of competence to meet organizational and regulatory requirements.INSERVICE EDUCATION"In-service educational activities are those learning experiences designed in the work setting to assist individuals to acquire, maintain, and/or increase their ability to perform job functions within a given agency or institution" (ANA, 2000, p.11). Inservice education is required when changes, such as equipment or policies, occur within the organization that affect the staff's work processes. Teaching staff about the use of a new electronic health record is an example of inservice education.Continuing Education"Continuing education refers to those systematic professional learning experiences designed to augment the knowledge, skills, and attitudes of nurses, and therefore enrich the nurses' contributions to quality health care and their pursuit of professional career goals" (ANA, 2000, p. 10). What differentiates continuing education from inservice education is the transferability of the knowledge to another employer. In the previous example, the education on use of a particular electronic health record is typically not transferable to another employer. However, education on the legal aspects of documentation is applicable regardless of employer and, therefore, may be considered continuing education rather than inservice education.Career Development/Role TransitionCareer development is the "identification and development of strategies that meet the career goals, tasks, and challenges in different stages throughout a nurse's career" (Chang, Chou, & Cheng, 2006, as cited in NNSDO & ANA, 2010, p. 6). Career development involves more than climbing the hierarchal ladder. For example, a nurse may have a goal of obtaining a graduate degree in nursing. The NPD specialist may help this nurse identify accessible programs that qualify for organizational tuition reimbursement. In another case, the NPD specialist may assist with the development of an educational plan for someone a manager has identified as his or her successor. In each of these cases, the NPD specialist is in a prime position to assist these individuals with their growth needs.Research and ScholarshipThe new model of NPD specialist practice recognizes that not all NPD specialists are prepared to conduct research. But all NPD specialists have a role in research and scholarship. Research involves systematic inquiry and is usually conducted by nurses with advanced degrees. Scholarship involves evaluation of what works and sharing of results. Scholarship may be in the form of a quality improvement project or program evaluation. The key is sharing results. This may occur through oral or poster presentations. Results may also be shared through the NNDSO Web site in the "Best Practices Exchange" or submitted to a journal, such as the Journal for Nurses in Staff Development, for publication.Academic PartnershipsAcademic partnerships are reciprocal relationships between academic nursing education programs and service organizations. Typically, these partnerships involve a contractual relationship whereby nursing students are allowed to have clinical rotations in the facility. Varying partnership models are evolving as the shortage of clinical faculty and clinical sites grows. In some partnerships, staff serve as coaches or preceptors for nursing students. In others, academic faculty may work with staff to conduct research at the bedside. The NPD specialist is usually the liaison with the nursing program and may take an active role in scheduling, teaching, and coordinating to ensure the sustainability and growth of the partnership.OUTPUTSThe overall outcome of the NPD model has not changed from the former model. Ultimately, the practice of NPD should result in the "acquisition of knowledge, skills and attitudes that support safety and contribute to the protection of the public and provision of quality care" (NNSDO & ANA, 2010, p. 7).LearningLearning is "the acquisition of knowledge, skills, abilities and attitudes upon which to base practice" (NNSDO & ANA, 2010, p. 7). In the VAP example described previously, to decrease the VAP rate through staff implementing the guidelines for prevention of VAP, staff must know about the guidelines.ChangeChange is "a movement to a desired state" that is "reflected by adoption of new behaviors and/or processes" (Sullivan & Decker, 2009, as cited in NNSDO & ANA, 2010, p. 7). This change is the basis of program evaluation. Did the program have the desired effect? In the VAP example, did the staff implement the practices to prevent VAP? Did the rate of VAP decline?Professional Role Competence and GrowthAll nurses should progress through increasing levels of competence, from novice to expert (Benner, 1984), in their specialty area. In some cases, progress can be captured as advancement in the organizational structure. A more direct example might be the number of nurses sitting for and passing a certification examination after attending a preparation course.FEEDBACKThe feedback loop in the NPD model depicts the influence of learning, change and professional role competence, and growth on both the inputs and throughputs of the system through the use of validated outcomes and data. Influence is defined as "the process of affecting change, behaviors and decisions of others" (NNSDO & ANA, 2010, p. 8). As a result of this feedback, the system of NPD continually changes and evolves.SUMMARYThe new model of NPD reflects the complexities of the current practice of NPD in a variety of settings but allows for further evolution as the healthcare environment changes.Mary Harper, PhD, RN-BCAcademic MentorClinical FacultyWestern Governors UniversitySalt Lake City, UtahReferencesAmerican Nurses Association. (2000). Scope and standards of practice for nursing professional development. Washington, DC: American Nurses Publishing.American Nurses Association. (2008). Professional role competence [Position statement]. Washington, DC: Author.National Nursing Staff Development Organization and American Nurses Association. (2010). Nursing Professional development (NPD) scope and standards of practice. Silver Spring, MD: Nurses books.org.Benner, P. A. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley.So, how do you operationalize the model? First, identify gaps between your work environment and the model. Let's say that as a "department of one," you only have the resources to do orientation and inservice classes. By ensuring that the inservice and orientation programs you plan and implement are based on evidence-based practice and or practice-based evidence strategies, you are operationalizing the model. Would it be feasible for you to be responsible for establishing a research program for the facility? This would take your operationalizing the model to another, more advanced level. If you are part of a larger department, with more resources available, you might consider categorizing educational programming using the model. In another example, you might change the name of your department to the "Nursing Professional Development Department." In addition, as you define the scope of the department, you would address how you support the career development and role transitions of nurse employees, how you implement academic partnerships, and how you operationalize other processes in the model.We all need to begin to develop the skills and knowledge to measure and document the results of our practice in terms of change, learning, and professional role competence, as well as linkages to quality. It is through these efforts that we will be able to establish credibility and become influential leaders in shaping the learning and practice environment in each of our settings.Scope and StandardsDepartments:Scope and Standards626