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Nurse Practitioner Core Competencies ContentA delineation of suggested content specific to the NP core competencies2014Updated May 2017*NP Core Competencies Content Work GroupAnne Thomas (Chair), PhD, ANP-BC, GNP, FAANPM. Katherine Crabtree, DNSc, APN-BC, FAANKathleen Delaney, PhD, PMH-NP, FAANMary Anne Dumas, PhD, RN, FNP-BC, GNP-BC, FAANP, FAANRuth Kleinpell, PhD, RN, FAAN, FCCMJulie Marfell, DNP, APRN, FNP-BC, FAANPDonna Nativio, PhD, CRNP, FAAN, FAANPKimberly Udlis, PhD, FNP-BC, APNPAndrea Wolf, DNP, CRNPAcknowledgments: NONPF also wishes to recognize members of the Curricular Leadership Committee who provided review and comment onthe draft document. The comments from the following people shaped the final document: Susan Buchholz, Holly Dileo, Kathy Dontje, JudithHaber, Ann Marie Hart, Kathleen Reeve, Susan Ruppert, Susan Schaffer, and Courtney Young.* The updates made to the 2014 Nurse Practitioner Core Competencies Content publication updates the competencies to align with the 2016Adult-Gerontology Acute Care And Primary Care NP Competencies.
Nurse Practitioner Core Competencieswith Suggested Curriculum ContentIn the development of the nurse practitioner (NP) population-focused competencies, a task force had extensive discussions of competencies vs.content. The task force concluded that it would be beneficial to programs if some content could be included as exemplars of how to supportcurriculum development for addressing a competency. Within the 2013 edition of the NP population-focused competencies, the final column ineach population’s competency table presents the respective competency work group’s ideas of relevant content.In 2014, NONPF convened a work group to identify the suggested curriculum content for the NP Core Competencies. This work group consistedof members of the task force that prepared the 2011 edition of the NP Core Competencies, as well as additional representation from the NONPFBoard and Curricular Leadership Committee. A sub-group of the NONPF Curricular Leadership Committee completed a review of the draftcontent, and the work group incorporated the review feedback into the final document presented herein. Please see the cover page for a list ofwork group members and an acknowledgment of the reviewers.In 2016 the Adult-Gerontology Acute Care And Primary Care NP Competencies document was completed. This document was updated in May2017 to align with the 2016 Adult-Gerontology Acute Care And Primary Care NP Competencies.The table that follows includes the NP Core Competencies and a list of suggested curriculum content. NONPF does not intend for the requirementof all of this content, nor is the content list comprehensive for all that a program would cover with population-focused competencies. The contentcolumn reflects only suggestions for content relative to the core competencies. This document should be used in combination with the populationfocused petenciesNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies1.Critically analyzes data and evidence for improvingadvanced nursing practice.2.Integrates knowledge from the humanities and scienceswithin the context of nursing science.Comparison of patient data sets with evidence-based standards toimprove careNONPF - 1
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies3.Translates research and other forms of knowledge toimprove practice processes and outcomes.4.Develops new practice approaches based on the integrationof research, theory, and practice knowledge.Scientific foundations to practice, including, but not limited to,knowledge of advanced pathophysiology, pharmacology, physiology,genetics, and communication skillsScience from other disciplines relevant to health careTheories/conceptual frameworks/principles for practice: Translational research that guides practiceCritical evaluation of research findingsMid-range nursing theories and concepts to guide nursingpracticeEvidence-based havior changePopulation healthCritical thinking development: Evidence appraisalFormulating a practice problemUse of science-based theories and concepts to assess,enhance, and ameliorate health care delivery phenomenaUse of PICO questions to initiate research and qualityimprovement projectsQualitative and quantitative research and quality improvementmethodsEthical and legal protection of human subjectsNONPF - 2
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesInquiry processes and practices related to health literacy, vulnerablepopulations, and cultureMonitoring of health outcomesLeadershipCompetencies1.Assumes complex and advanced leadership roles to initiateand guide change.2.Provides leadership to foster collaboration with multiplestakeholders (e.g. patients, community, integrated healthcare teams, and policy makers) to improve health care.3.Demonstrates leadership that uses critical and reflectivethinking.Content related to: Crisis management and leadershipStress management (for staff and patient/family)Teams and teamwork, including team leadership, buildingeffective teams, and nurturing teamLeadership, change, and management theories with application topracticePolitical processes, political decision making processes, and healthcare advocacy4.Advocates for improved access, quality and cost effectivehealth care.5.Advances practice through the development andimplementation of innovations incorporating principles ofchange.6.Communicates practice knowledge effectively, both orallyand in writing.7.Participates in professional organizations and activities thatinfluence advanced practice nursing and/or healthoutcomes of a population focus.Problem solving: Influencing and negotiationConflict managementStrategic thinkingManaging changeBusiness development: High reliability organization principlesBuilding and maintaining effective teamsProject management conceptsPrinciples of effective decision makingPrinciples of change managementCivilityPrinciples of innovationCommunications: Scholarly writing, manuscript, and abstract preparationStructuring and presenting persuasive argumentsNONPF - 3
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesPeer review: ip development: Skills to influence decision-making bodies at the system,state, or national levelInterprofessional leadershipAssuming leadership positions in professional, political, orregulatory organizationsStructure and functions of editorial/board rolesEthical and critical decision making, effective workingrelationships, and a systems-perspectiveConcepts of strategic planning processLeadership stylesHow to lead change in practice, manage practice changes Monitoring implementation and fidelityAdaptation of change to patients, providers andorganizational needs and resourcesInterim feedback on achievements and efficienciesInterpretation of data and articulating evidenceSelf-reflection of leadership style e.g., personal leadership strengthsand weaknesses; working with diverse skills sets and diverse teamsQualityCompetencies1.Uses best available evidence to continuously improvequality of clinical practice.Quality Safety Education in Nursing (QSEN) principles and contentEvaluation of outcomes of care such as quality improvement projectswith an evaluation componentNONPF - 4
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies2.3.Evaluates the relationships among access, cost, quality, andsafety and their influence on health care.Evaluates how organizational structure, care processes,financing, marketing, and policy decisions impact thequality of health care.4.Applies skills in peer review to promote a culture ofexcellence.5.Anticipates variations in practice and is proactive inimplementing interventions to ensure qualityReflective practiceCulture of safetyQuality improvement processes and practicesKnowledge of quality improvement methods such as: Plan-Do-Study Act Six SigmaCost benefit analysisPeer review process Reviewer RevieweeCollaborative team processes and practicesLeadership skills for leading change for quality clinical practiceMethods and measures of quality assurance during transitions ofcareLaws and rules to enhance quality such as Meaningful use Federal, state, and local quality data sources and indicatorsPractice InquiryCompetencies1.Provides leadership in the translation of new knowledgeinto practice.2.Generates knowledge from clinical practice to improvepractice and patient outcomes.3.Applies clinical investigative skills to improve healthoutcomes.4.Leads practice inquiry, individually or in partnership withLeadership for role in practice improvementClinical investigation strategies: Identifying clinical practice problemsAppraising evidence for application to practice (e.g., design,methods, tools, analysis)Literature search methods, including, but not limited to, thePICO Model to define a clinical questions and search for thebest clinical evidenceNONPF - 5
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesothers.Use of electronic databases, such as electronic health records:5.6.Disseminates evidence from inquiry to diverse audiencesusing multiple modalities.Analyzes clinical guidelines for individualized application intopractice Assessing clinical practiceReviewing patient technologyExploring behaviors and risk factorsUsing data to support evidence based changes in clinicalmanagementTemplate developmentPatient management, including, but not limited to, discerning gaps incare and barriers to care needing resolution during patientencountersProject development and management: Synthesis and translation/extrapolation of research toselected populationsFrameworks to guide projectsQuality improvement methodsAssessment of resources needed and available for projectsCompeting priorities of patients, payers, providers, andsuppliersData-based, needs assessment for projectProcesses used in conducting projects based on currentand best evidence, including evaluation of the application ofevidence or inquiry to the population of concernEvaluation of outcomes (for health status of patient andpopulation as well as system outcomes)Evaluation of why expected results were or were notattained and lessons learnedMaking recommendations for further workAddressing issues of sustainability of project findingsNONPF - 6
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesDissemination of work and findings: Abstract and manuscript writing to support thedissemination of project/research outcomesDiscussion of clinically meaningful results that may or maynot be statistically significantPresentation skill development with modification for differentaudiencesIntegration of findings: Results, methods, and tools, as appropriate, into caredeliveryIdentification of best practicesOpportunities for multidisciplinary team/inter-professionalcollaboration for patient careDevelopment and use of clinical guidelinesUse of clinical judgment to improve practiceApplication of evidence to validate or change policyEvaluation of alternative care delivery models and treatments,including costs, cost benefits, and return on investmentInstitutional review board policies and processesInterprofessional research and scholarship exemplars andopportunitiesTechnology andInformationLiteracyCompetencies1.Integrates appropriate technologies for knowledgemanagement to improve health care.2.Translates technical and scientificappropriate for various users’ needs.health informationTechnology available in clinical practice: Electronic resources that identify current evidenced-basedcare Electronic resources that enhance patient safety Technological care delivery systems Telehealth Information databases used by health care systems Electronic communication with other professionals andpatients Encrypted and unencrypted technologyNONPF - 7
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies2.a Assesses the patient’s and caregiver’s educationalneeds to provide effective, personalized health care.2.b Coaches the patient and caregiver for positivebehavioral change.3.Demonstrates information literacy skills in complex decisionmaking.4.Contributes to the design of clinical information systemsthat promote safe, quality and cost effective care.5.Uses technology systems that capture data on variablesfor the evaluation of nursing care. Electronic resources to support differential diagnosis,algorithmic thinking, and medical record reviewTemplates for documentation in nursing careUse of electronic datasets to evaluate practice and improvequality, cost, and efficiency of careTechnology available to support education: Standardized patient encounters Electronic/computer based learning modules based oncharacteristics such as cultural literacy, educational level,and home assessment Coaching/teaching resources adapted to population, healthliteracy, and age of patient learning styles, Age-appropriate concepts and development of educationaltools Use of applications for references at point of careUsing telehealth to provide care for the adult population, consideringbenefits, methods, differences, and regulatory issues.IT resources such as: Informatics competencies from Technology InformaticsGuiding Education Reform (TIGER) initiative American Medical Informatics Association (AMIA)Use of electronic communication methods, including social media,with healthcare professionals, patients, families, and caregiversCompliance issues related to patient privacy with use of technologyPopulation-appropriate clinical indicators for incorporation intoinformation systems, such as electronic health recordsUse of technologies to monitor and evaluate clinical problems, e.g. Blood pressure Vital signs Glucose WeightNONPF - 8
CompetencyAreaPolicyCompetenciesNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies1.Demonstrates an understanding of the interdependence ofpolicy and practice.2.Advocates for ethical policies that promote access, equity,quality, and cost.3.Analyzes ethical, legal, and social factors influencing policydevelopment.4.Contributes in the development of health policy.5.Analyzes the implications of health policy across disciplines.6.Evaluates the impact of globalization on health care policydevelopment.7.Advocates for policies for safe and healthy practiceenvironments.Policy analysis process: Political environmentPolitical feasibilityEconomic feasibilityImplementation strategy and planningOutcomes evaluation at local, state, national, andinternational levelsSpecific NP role for influencing health care agenda andpatient advocacyHealth policy and health care reform: Federal budgetNational health prioritiesMethods for appropriation of fundingVulnerable populations and needsThe relationship between the USPSTF guidelines andAffordable Care Act implementationLegislative and regulatory processes: Origin of lawsRegulatory processHow to influence/impact passage of laws and theirtranslation into regulationHealth care financing and third party reimbursementPopulation health model and its impact on policy planningIntroduction of global issues: ss to health careNONPF - 9
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesEthical issues in health care planning: FairnessEquity and health disparitiesAccess and resource allocationHealth behaviorSocial determinants of healthComparative health systemsProactive and responsive use of mediaBarriers to NP practiceLegislative process and resources, e.g., Congress.govPolicy theoriesExamples of policy making at multiple levels and individual andcollective contributions to shape policyHealth DeliverySystemCompetencies1.Applies knowledge of organizational practices andcomplex systems to improve health care delivery.2.Effects health care change using broad based skillsincluding negotiating, consensus-building, and partnering.3.Minimizes risk to patients and providers at the individualand systems level.4.Facilitates the development of health care systems thataddress the needs of culturally diverse populations,providers, and other stakeholders.5.Evaluates the impact of health care delivery on patients,Organizational practices: Organizational structure, tables of organizationOrganizational decision makingOrganizational theoryPrinciples of managementInterprofessional collaborative partnershipsInformatics/information systems: Interpreting variations in outcomesUse of data to improve practiceUse of collateral informationOrganizational delivery subsystems, (e.g. electronicprescription writing-pharmacy software)NONPF - 10
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesproviders, other stakeholders, and the environment.6.Analyzes organizational structure, functions and resourcesto improve the delivery of care.7.Collaborates in planning for transitions across thecontinuum of care.Needs assessment of populations served: Socioeconomic and cultural factorsUnique population needsSystem resources to meet population needs (e.g. useinterpreters to facilitate communication)Community resources/system outreach to communityDiversity among providersFinancial issues: Financial business principlesHealth care system financingReimbursement systemsResource managementBilling and coding principlesInterprofessional/team competencies: Communication (theory)CollaborationConflict resolutionConsultations/referralsTeam buildingValues and ethicsRoles and responsibilitiesSafety and quality: Cost-effective careLegal/ethical issuesResearch and quality improvementContinuous quality improvementQuality and Safety Education in NursingTransitional care:NONPF - 11
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetencies Navigating transitions across health care settingsCoordination of servicesPlanning, delivering and/or evaluating models of care: Models of planned changeProcess and evaluation design implementationEvaluation modelsProcess of proposing changes in practiceLegislative and regulatory issues: Relevant and current issues (e.g., Accountable Care Actimplementation)Process of health care legislationScope and standards of practiceCultural competenceTheories of vulnerabilitySocial determinants of healthPolicy and advocacy: EthicsCompetencies1.Integrates ethical principles in decision making.2.Evaluates the ethical consequences of decisions.3.Applies ethically sound solutions to complex issuesrelated to individuals, populations and systems ofcare.Reducing environmental health risksImplications of health policyVariations in policyEthics in decision making: Ethical considerations in decision making in clinical practice Applications of ethical principles in policy making and incare delivery Sources of information to facilitate ethical decision makingtheories of ethical decision makingethics committeegenetic counselingclinical researchlegal statutescultural sensitivityscope of practiceNONPF - 12
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesEvaluation of ethical decisions: Methods of evaluating outcomes (long-term and short-term) Debriefing and assessment of outcomes Ethical frameworks.Population-specific complex ethical issues occurring in clinical practiceSystem-specific resources to implement ethical decisions (e.g. hospicecare, palliative care)Spiritual resources for patients and families (e.g., on site and ons as a licensed independent practitioner.Clinical decision making based on evidence and patient/providerpartnership2.Demonstrates the highest level of accountability forprofessional practice.Current and emerging professional standardsPractices independently managing previously diagnosedand undiagnosed patients.Political, policy and regulatory issues regarding licensure, nationalcertification, and scope of practice.3.3.a Provides the full spectrum of health care services toinclude health promotion, disease prevention, healthprotection, anticipatory guidance, counseling, diseasemanagement, palliative, and end-of-life care.3.b Uses advanced health assessment skills to differentiatebetween normal, variations of normal and abnormalfindings.3.c Employs screening and diagnostic strategies in thedevelopment of diagnoses.3.d Prescribes medications within scope of practice.3.e Manages the health/illness status of patients andfamilies over time.4.Provides patient-centered care recognizing culturalNovice to expert continuum of clinical practiceLeadership approaches for employment contract negotiation,networking, and advancing professional standards and rolesApplication of select sciences to practice: PharmacologyPhysiologyPathophysiologySpecific areas of assessment, including but not limited to: PhysicalPsychosocialDevelopmentalFamilyPsychiatric mental healthNONPF - 13
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesdiversity and the patient or designee as a full partner indecision-making.4.a Works to establish a relationship with the patientcharacterized by mutual respect, empathy, andcollaboration.4.b Creates a climate of patient- centered care to includeconfidentiality, privacy, comfort, emotional support,mutual trust, and respect.4.c Incorporates the patient’s cultural and spiritualpreferences, values, and beliefs into health care.duplicate.4.d Preserves the patient’s control over decision makingby negotiating a mutually acceptable plan of care.4e. Develops strategies to prevent one’s own personal biasesfrom interfering with delivery of quality care. Oral healthScreeningsDiagnostics (tests, labs)Specific proceduresHealth promotion, prevention, and disease managementPharmacology and complementary alternative therapiesProvider-patient relationship: Role of culture in patient-centered careContracting a management plan with patient and/or familyCulture of trust in interpersonal relationship w/patient and/orfamiliesBusiness of practice:4f. Addresses cultural, spiritual, and ethnic influences thatpotentially create conflict among individuals, families, staff andcaregivers.5. Educates professional and lay caregivers to provide culturallyand spiritually sensitive, appropriate care6. Collaborates with both professional and other caregivers toachieve optimal care outcomes. Legal, business, and ethical issuesHow to set up, finance and evaluate a practice ,Writing a business planCultural issuesConcepts of life-long learning7. Coordinates transitional care services in and across caresettings.8. Participates in the development, use, and evaluation ofprofessional standards and evidence-based care.NONPF - 14
CompetencyAreaNP Core CompetenciesCurriculum Content to Support CompetenciesNeither required nor comprehensive, this list reflectsonly suggested content specific to the corecompetenciesNONPF - 15
May 16, 2017 · Nurse Practitioner Core Competencies Content A delineation of suggested content specific to the NP core competencies 2014 Updated May 2017* NP Core Competencies Content Work Group Anne Thomas (Chair), PhD, ANP-BC, GNP, FAANP M. Katherine Crabtre
