Please reflect on the End of Program Competencies and discuss which competency(s

Question

Please reflect on the End of Program Competencies and discuss which competency(s) you feel most confident about with your current experience and abilities and which competency(s) you feel you will need to work on.

How do you see caring science and complexity science guiding your professional practice?

How do you think you will integrate change theory as a Clinical Nurse Leader? Have you seen some changes implemented in practice that would have benefited from the use of change theory to guide or sustain the change?

Compose an Elevator Speech on the role of the Clinical Nurse Leader. This is the speech you will use when someone asks you, so "What's a Clinical Nurse Leader?"

AACN End-of-Program Competencies & Required Clinical Experiences
for the Clinical Nurse Leadersm –
May 2006
This document delineates the competencies expected of every graduate of a CNLsm master’s education program. A minimum set of clinical experiences required to attain the end-of–program competencies also is included.
Graduate Level
Curriculum
Elements
CNLsm Role Functions
CNLsm Role Expectations
End of Program Competencies
Required Clinical Experiences
Nursing Leadership
Advocate
• Keeps clients well informed
• Includes clients in care planning
• Advocates for the profession
• Works with interdisciplinary team
• Strives to achieve social justice within the microsystem
Effects change through advocacy for the profession, interdisciplinary health care team and the client.
Communicates effectively to achieve quality client outcomes and lateral integration of care for a cohort of clients.
Identify clinical and cost outcomes that improve safety, effectiveness, timeliness, efficiency, quality and client-centered care.
Communicate within a conflict milieu with nurses and other health care professionals who provide care to the same clients in that setting and in other settings.
Review and evaluate patient care guidelines/protocols and implement a guideline to address an identified patient care issue like pain management or readiness for discharge; follow-up to evaluate the impact on the issue.
Discover, disseminate and apply evidence for practice and for changing practice.
Participate in development of or change in policy within the health care organization.
Identify potential equity and justice issues within the health care setting related to client care.
Present to appointed/elected officials regarding a health care issue with a proposal for change.
AACN CNL End-of-Program Competencies & Required Clinical Experiences May 2006 1
Nursing Leadership
Advocate
Analyze the care of a patient cohort and the care environment in light of ANA Nursing Standards of Care and the Code of Ethics.
Analyze interdisciplinary patterns of communication and chain of command both internal and external to the unit that impact care.
Member of a Profession
• Effects change in health care practice
• Effects change in health outcomes
• Effects change in the profession
Actively pursues new knowledge and skills as the CNL role, needs of clients, and the health care system evolve.
Develop a life long learning plan for self.
Speak at a public engagement to a public forum
Participate in a professional organization/or agency wide committee
Care Environment Management
Team Manager
• Properly delegates and manages
• Uses team resources effectively
• Serves as leader/partner on interdisciplinary team
Properly delegates and utilizes the nursing team resources (human and fiscal) and serves as a leader and partner in the interdisciplinary health care team.
Identifies clinical and cost outcomes that improve safety, effectiveness, timeliness, efficiency, quality, and the degree to which they are client-centered.
Design, coordinate, & evaluate plans of care for a cohort of patients incorporating patient/family input and team member input.
Monitor/delegate care in the patient care setting.
Present to the multidisciplinary team a cost saving idea that improves patient care outcomes and improves efficiency
Conduct a multidisciplinary team meeting; incorporate client and/or family as part of the team meeting
Information Manager
• Uses information systems/
technologies
• Improves health care outcomes
Uses information systems and technology at the point of care to improve health care outcomes.
Using patient information system data, design and implement a plan of care for a cohort of patients.
Use aggregate data sets to prepare reports and justify needs for select care improvements.
Evaluate the impact of new technologies on nursing staff, patients and families. AACN CNL End-of-Program Competencies & Required Clinical Experiences May 2006 2
Systems Analyst/Risk Anticipator
• Participates in system reviews
• Evaluates/anticipates client risks to improve patient
safety
Participates in systems review to critically evaluate and anticipate risks to client safety to improve quality of client care delivery.
Participate in establishing and reviewing interdisciplinary patient care plans with team.
Apply evidence-based practice as basis for client care decisions
Conduct a microsystem analysis by:
•Identifying a clinical issue with a focus on a population.
•Conducting a trend analysis of incident reports
•Evaluating a sentinel event and conducting a root cause analysis (RCA)
• Incorporating analysis of outcome data
•Analyzing barriers and facilitators within the organization related to the identified issue
•Writing an action plan related to the analysis
•Presenting/disseminating to appropriate audience.
Work with quality improvement team and engage in designing and implementing a process for improving patient safety.
Clinical Outcomes Management
Clinician
• Designs/coordinates/evaluates care
• Delivers care in a timely, cost effective manner
• Emphasizes health promotion/risk reduction
Assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting recognizing the influence of the meso- and macrosystems on the microsystem.
Assimilates and applies research-based information to design, implement and evaluate client plans of care.
Plan and delegate care for clients with multiple chronic health problems, identify nursing interventions to impact outcomes of care.
Using an existing database, evaluate aggregate care outcomes for a designated microsystem with focus on specific nursing interventions
Contribute to interdisciplary plans of care based on best practice guidelines and evidence-based practice.
AACN CNL End-of-Program Competencies & Required Clinical Experiences May 2006 3
Clinical Outcomes Management
Outcomes Manager
• Uses data to change practice and improve outcomes.
• Achieves optimal client outcomes
Synthesizes data, information and knowledge to evaluate and achieve optimal client and care environment outcomes.
Coordinate care for a group of patients based on desired outcomes consistent with evidence-based guidelines and quality care standards.
Revise patient care based on analysis of outcomes and evidence-based knowledge.
Analyze unit resources and set priorities for maximizing outcomes
Conduct a patient care team research review seminar
Clinical Outcomes Management
Educator
• Uses teaching/learning principles/strategies
• Uses current information/ materials/techniques
• Facilitates clients learning, anticipating their health trajectory needs.
• Facilitates client care using evidence-based resources.
• Facilitates group & other health professions’ learning and professional development
Uses appropriate teaching/learning principles and strategies as well as current information, materials and technologies to facilitate the learning of clients, groups and other health care professionals.
Present a seminar or case study at a grand rounds or team meeting.
Conduct health education of individual patient or cohort based on risk profile.
Create or review an education module directed at patients and staff; develop a self-management guide for patients and families.
Develop and implement a professional development session for other professional nursing and ancillary staff.
Develop a health education plan for a unit-specific issue common to multiple clients.
Implement & evaluate the health education plan, evaluating the role of the team, the teaching learning methods used, the client interactions, the expected & actual outcomes, including health status changes.
AACN CNL End-of-Program Competencies & Required Clinical Experiences May 2006 4

Explanation / Answer

Ques-1:

Please reflect on the End of Program Competencies and discuss which competency(s) you feel most confident about with your current experience and abilities and which competency(s) you feel you will need to work on.

How do you see caring science and complexity science guiding your professional practice?

Answer:

The End of nursing program competencies prior to graduation experience includes the acquiring of utility competencies, ethical-based practices, and leadership and managership competencies. These are transformational skills required for transcultural nursing. As a nurse, the most confident competency is leadership competency as it is possible to develop and implement interpersonal skills, communication skills for me to make a clinical decision.

The most competency skill which need a specific attention is dealing with complex, ethical & human right aspects when making & implementing a clinical decision. This is a challenging competency skill, which needs more work. There are other skills that need specific competencies such as dealing with bioterrorism, emerging infections etc.

Ques-2:

How do you see caring science and complexity science guiding your professional practice?

The complexity science of nursing professional practice is to includes nursing assessment, nursing diagnosis, planning, Nursing implementation.

The caring science includes the access to health care is late adulthood makes up the significant difference in life expectancy between developed countries and developing countries. The hospice care center and nursing home is for adults who have been suffering from illhealth in their late adulthood. In this hospice care, people or family members do provide hospice care to dying person but they may have improper psychological function during their lives till 2 years compared to the family members who have not served them.

According to Benner, professional nursing managerial theory, the RNs should acquire managerial skills such as “utility competencies”, “leadership competencies” and the ethical –based decision making skills.

For example, as a registered nurse & manager, the significant future roles to perform in a surgical unit at the end of life care for patient require a deliberate planning with clinicians, clinical competency skills and confidence and consciousness in delivering adequate efficiency.

Another example is managing other staff during palliative care for a cancer patient with chronic pain. The novice and competency, proficiency skills are essential to maintain nursing advocacy for this manager role. The principle of accountability, equity and partnership in delivering clinical skills are major Benner’s theoretical framework useful to promote nursing managers to become competent in their clinical service.  

RNs should learn education backgrounds about different communities and different cultures. They do learn about the spreading of communicable diseases in the communities. The communication skills, education and health care skills, leadership skills and utility competency skills must acquired to deliver evidence-based health care at a community setting. The nursing informatics and maintenance of electronic health care record is another crucial aspect to learn for community health care setting. These are the required skills and competencies of a RN to deliver community based- Hospice- holistic, interdisciplinary care: this is a community based care to aged people suffering from various mental ill health problems, pain and allow patient to die comfortably with dignity. This hospice care is not solely to extend the life of older adults.

Ques-3:

How do you think you will integrate change theory as a Clinical Nurse Leader? Have you seen some changes implemented in practice that would have benefited from the use of change theory to guide or sustain the change?

The change process is similar to the nursing process because “indentifying a problem” followed by collecting required clinical data & information has similar type “planning” and” implementation process as in nursing process.

Yes, it is possible to see some changes that benefited nursing pactice. The method of planning is required resources to make sufficient changes in the work force finally establishing a feedback system in order to evaluate its progress and success. This is a similar which can be seen in both nursing leadership & management aspects. According to Lewin’s motion theory, the implementation of “change process” should be done as per individual’s perceptions, personal attitudes and moral values. Similarly nursing process is going to implement their managing roles in choosing the required individuals with these values.   

The force-field model can describe a kind of both driving forces and restraining forces to make balance in the “changing process” similar in nursing process. This changing process is useful to construct an efficient clinical infrastructure for future interprofessional health care that also includes workforce data.

The Lippitt's Change Theory would describe similar changing processes of work force as in “nursing process” in seven step manner where workforce would learn communication skills with patients, rapport building finally to achieve goals in problem-solving. Roger’s theory is depicts an innovative decision –making model in clinical data collection.

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