Professional Development Framework for Nurses: Behaviors

NURSING PROCESS

Assessment

Performs assessment & identifies appropriate nursing diagnosis and/or patient care standard with assistance.

Independently and completely performs focused assessment to provide most effective patient care for a given patient population.

Independently and consistently performs goal-focused and individualized assessment when caring for all patients, including those with complex pathophysiological and psychosocial needs.

Exhibits highly developed assessment abilities that exemplify a comprehensive understanding of the total patient/family situation.

Recognizes specialty data.

Nursing Diagnosis

Recognizes data and identifies obvious nursing diagnoses.

Prioritizes key nursing diagnoses to address physical and psychosocial/emotional areas.

Individualizes nursing diagnoses based on assessment data.

Individualizes nursing diagnoses based on assessment data and integrates that with the diagnoses & priorities of other disciplines in order to provide holistic care.

Planning/Implementation/Evaluation

Practice is guided primarily by policies, procedures, and standards.

Practice is driven by theory and experience.

Practice relies on previous experience for focused analysis of problems and solutions with individual patient modification in order to meet outcomes.

Practice is driven by an intuitive base and is self-directed, flexible, and innovative.

Identifies expected outcomes and nursing interventions to meet identified diagnoses and maintain standards of clinical practice.

Independently develops, implements, and evaluates plan of care that recognizes subtle changes in patient’s condition and adapts plan as needed.

Accommodates unplanned events and evaluates/ responds appropriately with speed, efficiency, flexibility, and confidence.

Is consistently effective in providing holistic care that ensures positive change even in the most challenging patient care situations.

Evaluates patients based on basic standards.

DOMAIN: Clinical Skills and Knowledge (continued)

Technology

Utilizes standard unit technology and with assistance uses advanced technology as appropriate.

Utilizes standard unit technology and uses advanced technology as appropriate.

Becomes expert and resource for use of standard unit technology and advanced technology as appropriate.

Takes a leadership role in evaluating technology and its potential for use.

Utilizes computer correctly for basic functions, including: - GroupWise - CareWeb- labs and radiology results reporting - Omnicell - Mandatory Program / Competencies - Policies and procedures.

Utilizes computer for basic functions as well as reference on patient conditions and treatment.

Becomes resource for use of computer.

Able to conduct literature search through library functions— CINAHL, Cochrane, Medline, PubMed.

Patient/Family Education

With assistance, identifies basic patient/family learning needs.

Accurately assesses patient/family’s readiness to learn, organizes and executes individualized teaching plan, evaluates patient’s understanding and modifies approach as necessary.

Identifies learning needs of designated populations.

Anticipates patient/family learning needs and utilizes a variety of teaching strategies appropriate to the patient’s needs.

Initiates teaching using patient teaching protocols, patient care standards and critical paths.

Seeks out additional patient education resources beyond unit.

Works collaboratively to develop strategies to meet these learning needs.

Serves as expert resource and facilitates other staff in improving patient education.

Utilizes patient education resources on the unit.

Seeks out challenging patient/family education opportunities.

Collaborates with other disciplines to develop and/or implement patient/family teaching programs.

Revises and develops patient education materials.

Policy/Procedure/Protocols

Identifies location of and utilizes hospital policies and unit procedures and protocols.

Demonstrates ease in application of hospital policies and unit procedures and protocols.

Teaches and functions as a resources in the application of hospital policies, and unit procedures and protocols.

*** Researches, revises, and develops hospital policies and unit procedures and protocols utilizing appropriate channels and resources.

DOMAIN: Clinical Skills and Knowledge (continued)

Promoting Culture of Safety

Adheres to hospital policies related to medication safety: - Order writing conventions - Correct administration considerations - Double checks and other established policies and practices.

Identifies and intervenes when there are concerns related to medication safety, providing feedback to staff members involved.

Unit expert and resource on medications applicable to their unit/clinical setting.

*** Advocates for culture of safety through knowledge, problem solving, and system changes.

Familiar with and follows standards related to patient and staff safety.

Anticipates and intervenes related to patient and staff safety.

Facilitates others related to patient and staff safety; actively works toward prevention of potential injury.

Documentation

Admission assessment, flow sheets, MARs, and other applicable documentation forms are completed in a timely manner according to policy with minimal guidance.

Consults documentation to identify trends in patient status and enhance continuity of assessment and ongoing nursing care.

Involved in ongoing quality monitoring of documentation of nursing care and patient outcome.

*** Participates in the development of documentation tools, standards, and/or policy.

DOMAIN: Therapeutic Relationships: An intentional interactive relationship with patients and families that is caring, clear, boundaried, positive and professional. It encompasses the philosophy of the institution, empowerment of the care givers and empowerment of the patient/family.

Therapeutic Communication

Recognizes how the nurse: patient/family relationship impacts the patient experience.

Possesses clarity on ones own values and how they effect interactions, relationships and boundary setting.

Consistently role models individualized therapeutic communication based on patient and family needs.

Intuitively uses expert therapeutic communication with patient/family.

Introduces self as a Registered Nurse and describes role.

Individualizes communication based on assessment of the patients and families.

Initiates consultation / leadership with the healthcare team to share and promote collaborative approach to patient and family care.

Shares and promotes collaborative approach to patient and family care.

Consistently wears identification.

Establishes open communication.

Empowerment—Nurse, Patient, Family

Recognizes the need for patient and family to participate in care.

Incorporates patient/family in planning and implementing care.

Invites patients and families to actively participate in plan of care to foster growth and competence.

Maximizes patient/family participation in decision-making and goal setting along the continuum of care.

Seeks help as appropriate to assess readiness for participation in care.

DOMAIN: Therapeutic Relationships (continued): An intentional interactive relationship with patients and families that is caring, clear, boundaried, positive and professional. It encompasses the philosophy of the institution, empowerment of the care givers and empowerment of the patient/family.

Compassion

Actively listens to patient/family concerns in a respectful manner.

Demonstrates empathy in interactions with patients/families.

Plans and provides nursing care that promotes intentional caring.

Intuitive understanding of patient/family experience and is proactive in providing creative approaches to optimize comfort and support.

Shows kindness and caring with patient/families.

Advocacy and Ethics

Recognizes, respects, and supports patient/family rights and maintains confidentiality.

Mobilizes appropriate resources in response to situations that have the potential to negatively impact patient/ family outcomes.

Challenges situations and/or decisions that obstruct positive patient outcomes and works to reduce barriers.

*** Challenges and adapts systems to maximize the benefits for patient care.

Aware of UMHS patient rights and responsibility.

Recognizes ethical issues and seeks assistance in addressing them.

Anticipates patient/family needs.

Valuing of Diversity with Patients and Family

Aware of and values the diversity in patient and families.

Seeks to learn about and optimize the unique contribution inherent in the diversity and culture of each individual.

Demonstrates actions that incorporate the rich traditions, beliefs, and values of patients and families.

Embraces visible and invisible diversity; seeks out perspectives from those of different backgrounds and cultures.

Begins to incorporate diversity considerations in patient care.

Integrates understandings of populations into patient care.

DOMAIN: Professional Relationships: An intentional interactive relationship with the health care team that is marked by mutual regard, trust, and active engagement.

Collaboration with the Health Care Team

Recognizes role of each member of the health care team.

Initiates, recognizes and values professional collaborative communication and the positive effect on patient outcomes.

Is sought out by members of the multi-disciplinary health care team.

Through shared values and a clear professional identity, demonstrates and role models an interdisciplinary collaborative approach to patient care.

Aware of importance of team collaboration and with guidance begins to initiate collaborative communication.

Identifies and utilizes collaborative resources.

Frequently initiates consults with health care team.

Participates and/or leads team care conference.

Initiates referrals.

Monitors referrals.

Actively collaborates with other health professionals in delivering care.

Recognizes the impact of one’s behavior on others.

Recognizes need and calls for team conference.

Acts as resource to nursing and health care team.

DOMAIN: Professional Relationships (continued): An intentional interactive relationship with the health care team that is marked by mutual regard, trust, and active engagement.

Valuing Teams/Teamwork

Identifies self as member of nursing and health care teams.

Functions as an independent and supportive team member.

Fosters mutual regard, respect, and trust.

Demonstrates team values that orient people to care about performance and success of others.

Begins to generate trust, respect, and compassion within the workgroup.

Provides assistance to others.

Demonstrates flexibility.

Recognizes value of conflict in individual and organization learning and growth.

Takes responsibility for developing beginning team relationships.

Demonstrates empathy and compassion in interactions with team members.

Creates conditions and relationships that promote creative, innovative, and positive processes and outcomes.

Seeks assistance with resolving conflict.

Approaches conflict situations in a constructive manner.

Role models behaviors that demonstrate compassion and caring.

Meets professional commitments consistently.

Fosters other's development of conflict resolution skills.

Asks for and accepts help when needed.

Demonstrates active engagement to enhance patient care and promote a positive workplace.

Valuing of Diversity in Team

Aware of and values diversity in all members of the health care team.

Seeks to learn about and optimize the unique contribution inherent in the diversity and culture of each individual on the health care team.

Role models and helps to establish group norms that promote valuing of all health care team members.

Depends on diversity of workforce to enrich and build great places to work.

Recognizes own biases and begins to demonstrate empathy as a member of the health care team.

DOMAIN: Professional Development: Committed to the professional development of self and others.

Delegation

Functions as part of nursing team; able to describe and begin to use 5 Rights of Delegation when delegating to UAP:

Readily able to delegate to UAP according to the 5 Rights of Delegation.

Recognizes and values interdependent relationships.

Adaptable, flexible, and consistently effective in delegation.

- Right task - Right circumstances - Right person - Right communication - Right supervision and evaluation

Facilitates continuity of care and nursing work flow through nurse to nurse delegation.

Recognizes strengths of other team members that would benefit the patient and the team—aligns skill sets of individual nurses/UAP to specific patients.

Demonstrates foresight in anticipating and planning to meet patient and family concerns.

Recognizes value of nurse-to-nurse delegation.

Successfully organizes and coordinates multiple activities, requests, and needs.

Develops work process that maximize team work.

Self

Engages in self assessment related to orientation and ongoing learning needs and seeks out unit resources to assist in meeting needs.

Sets goals for knowledge/skill enhancement within the practice setting.

*** Sets goals for knowledge/skill enhancement within and beyond the practice setting.

*** Sets goals in self directed manner and actively seeks out opportunities for knowledge/skill enhancement within and beyond the practice setting.

Completes mandatory / competency requirements during orientation and annually.

Seeks out additional learning experiences within practice area - Unit specific certifications - Consultation with experts - Inservices / rounds - Collaborating with multidisciplinary team

*** Attends inservice(s)/CE’s within and beyond practice area.

*** Evidence of advancing professional identity (at least one): - Certification in specialty (ACCN, ANCC Specialty Areas) - Active participation in professional organization - i.e.: Clinical specialty organizations, UMPNC, MNA, ANA, UAN - Active membership / leadership role in institutional groups r/t nursing.

DOMAIN: Professional Development: (Continued) Committed to the professional development of self and others.

Contributions to Others

Provides respectful feedback to preceptors, peers, and Manager related to orientation and initial learning experience.

Participates in peer feedback.

Shares in/contributes to others knowledge/skill development in practice setting, examples include: - Conducts inservices - Develops staff education tools - Acts as interdisciplinary clinical resource and informal mentor.

Works to create and sustain a culture that is supportive and rewards and recognizes professionalism.

Attends formal Peer Feedback training.

Expands knowledge of the feedback process: - Authentic, accountable, respectful, relevant to clinical performance - Identifiable / attributable (not anonymous)

Takes a leadership role in building and maintaining an environment where all team members thrive.

Mentors nurse colleagues in achievement of Professional Development Framework progression.

Contributes to others knowledge and skill development in practice setting.

Recognizes professional strengths in others and builds upon them.

*** Acts as a clinical resource/liaison beyond the unit setting - Specialty resource - Other units

May act as preceptor of new and present staff when applicable.

Utilizes own knowledge/skills to improve professional development environment on the unit.

DOMAIN: Advancing Practice through Innovation and Research: Demonstrates ongoing innovation by reviewing, critiquing and applying existing evidence to practice. Continually improves practice by applying performance improvement methodologies.

Innovation (creative solutions to everyday problems)

Has knowledge of and supports established nursing improvement projects / endeavors in practice setting.

Identifies areas for creative improvement in practice setting and seeks out resources and avenues to address them (unit practice council, content experts, etc.).

Takes on leadership role in relation to innovations/ improvements in practice setting.

Independently seeks out opportunities to share information and influence evidence based nursing practice.

Evaluates effectiveness of innovation/practice changes.

Research

Reads clinical articles.

Demonstrates an awareness of current literature in area of practice, including journal club, inservices, etc.

Reads evidence based articles related to area of practice.

Implements change in practice for a population of patients based on the application of current research findings and evaluates effectiveness of practice changes.

Participates in unit/area based Continuous Quality Improvement projects.

Identifies individual patient problems which require investigation.

*** Participates in unit/area based/institutional Continuous Quality Improvement projects.

Makes recommendations for changes in practice based on findings.

Participates in unit/area based research, as appropriate.

Presents at unit based educational forums.

*** Shares findings of Continuous Quality Improvement projects, such as: - Unit presentation - Rounds - Poster - Publishing

Applies current literature/ research to problems in practice area.