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Population-Focused-NP-Competencies-2013.pdf

POPULATION-FOCUSED NURSE

PRACTITIONER COMPETENCIES

Family/Across the Lifespan

Neonatal

Pediatric Acute Care

Pediatric Primary Care

Psychiatric-Mental Health

Women’s Health/Gender-Related

2013

Population-Focused Competencies Task Force

2013

3 Population-Focused Nurse Practitioner Competencies

Population-Focused Competencies Task Force

Task Force Chair

Anne Thomas, PhD, ANP-BC, GNP, FAANP

National Organization of Nurse Practitioner Faculties

Task Force Members

Robin Bissinger, PhD, APRN, NNP-BC

National Certification Corporation

NNP Work Group

Margaret Brackley, PhD, RN, FAAN, FAANP

National Organization of Nurse Practitioner Faculties

PMHNP Work Group

Bill Buron, PhD, RN, FNP/GNP-BC

American Academy of Nursing Gero-Psych Project

FNP Work Group

Renee Davis, MSN, RN, CPNP

American Association of Colleges of Nursing

PCPNP Work Group

Kathleen R. Delaney, PhD, PMH-NP

American Association of Colleges of Nursing

PMHNP Work Group

Evelyn Duffy, DNP, G/ANP-BC, FAANP

Gerontological Advanced Practice Nurses Association

FNP Work Group

Deb Gayer, PhD, RN, CPNP-PC

Pediatric Nursing Certification Board

PCPNP Work Group

Cathy Haut, DNP, CPNP, CCRN

American Association of Colleges of Nursing

ACPNP Work Group

Caroline Hewitt, DNS(c), WHNP-BC, ANP-BC

National Certification Corporation

WHNP Work Group

Susan Hoffstetter, PhD, WHNP-BC, FAANP

National Association of Nurse Practitioners in Women’s Health

FNP Work Group

Judy Honig, EdD, DNP

National Organization of Nurse Practitioner Faculties

PCPNP Work Group

Jean Ivey, DSN, CRNP, PNP-PC

Association of Faculties of PNPs

PCPNP Work Group

Tess Judge-Ellis, DNP, ARNP

National Organization of Nurse Practitioner Faculties

FNP Work Group

Rebecca Koeniger-Donahue, PhD, APRN-BC, WHNP-BC, FAANP

American Association of Colleges of Nursing

WHNP Work Group

Judy LeFlore, PhD, RN, NNP-BC, CPNP-PC&AC, ANEF, FAAN

National Organization of Nurse Practitioner Faculties

ACPNP Work Group

4 Population-Focused Nurse Practitioner Competencies

Nancy Magnuson, DSN, CS, FNP-BC

American Association of Colleges of Nursing

FNP Work Group

Julie Marfell, DNP, FNP-BC, FAANP

National Organization of Nurse Practitioner Faculties

FNP Work Group

Kathleen McCoy, DNSc PMHNP/BC, PMHCNS-BC, FNP-BC FAANP

American Nurses Credentialing Center

PMHNP Work Group

Karen Melillo, PhD, ANP-C, FAANP, FGSA

American Academy of Nursing Gero-Psychiatric Project

WHNP Work Group

Julie Miller, MSN, APRN, PNP-BC, FNP

American Nurses Credentialing Center

PCPNP Work Group

Jamille Nagtalon-Ramos, MSN, CRNP

National Association of Nurse Practitioners in Women’s Health

WHNP Work Group

Carol Patton, DrPH, RN, FNP-BC, CRNP, CNE

American Nurses Credentialing Center

FNP Work Group

Karin Reuter-Rice, PhD, CPNP-AC, CCRN, FCCM

Pediatric Nursing Certification Board

ACPNP Work Group

Lori Baas Rubarth, PhD, APRN-NP, NNP-BC

American Association of Colleges of Nursing

NNP Work Group

Debra Sansoucie, EdD, ARNP, NNP-BC

National Association of Neonatal Nurse Practitioners

NNP Work Group

Carol Savrin, CPNP, FNP, BC, FAANP

Association of Faculties of PNPs

FNP Work Group

Margaret Scharf, DNP, PMHCNS-BC, FNP-BC

International Society of Psychiatric Nursing

PMHNP Work Group

Lorna Schumann, PhD, NP-C, ACNP, BC, ACNS, BC, CCRN-R, FAANP

American Association of Nurse Practitioners Certification Program

FNP Work Group

Diane Seibert, PhD, ARNP, FAANP

National Organization of Nurse Practitioner Faculties

WHNP Work Group

Diane Snow, PhD, RN, PMHNP-BC, CARN, FAANP

National Organization of Nurse Practitioner Faculties

PMHNP Work Group

Joan Stanley, PhD, CRNP, FAAN, FAANP

American Association of Colleges of Nursing

FNP, NNP, ACPNP, PCPNP, PMHNP, WHNP Work Groups

Judy Verger, RN, PhD

Association of Faculties of PNPs

ACPNP Work Group

Mary Weber, PhD, PMHNP-BC

American Psychiatric Nurses Association

PMHNP Work Group

5 Population-Focused Nurse Practitioner Competencies

POPULATION-FOCUSED NURSE PRACTITIONER COMPETENCIES:

Family/Across the Lifespan, Neonatal, Acute Care Pediatric, Primary Care

Pediatric, Psychiatric-Mental Health, & Women’s Health/Gender-Related

Introduction

Since the release of the 2008 APRN Consensus Model: Licensure, Accreditation, Certification, and Education, the

nurse practitioner (NP) community has been undertaking efforts to ensure congruence with the model. Within

education, NP programs have focused on changes to align educational tracks with the NP populations delineated

in the model. National organizations have supported these efforts through collaborative work on the NP

competencies that guide curriculum development. The first initiatives focused on the development of adult-

gerontology competencies (2010 and 2012). In 2011, a multi-organizational task force embarked on the challenge

to identify current competencies for the remaining NP population foci. This document presents the entry into

practice competencies for the Family/Across the Lifespan, Neonatal, Pediatric Acute Care, Pediatric Primary

Care, Psychiatric-Mental Health, and Women’s Health/Gender-Related nurse practitioners. These competencies

explicate the unique characteristics and role of each population foci and are designed to augment the NP core

competencies.

Background

The National Organization of Nurse Practitioner Faculties (NONPF) released the first set of core competencies for

all nurse practitioners in 1990 and subsequently has revised them in 1995, 2000, 2002, 2006, 2011, and 2012.

Recognizing the need to give NP programs further guidance in an area of focus, NONPF, in collaboration with the

American Association of Colleges of Nursing (AACN), facilitated the development of the first sets of population-

specific competencies. In 2002, a national panel completed the work to identify competencies in the NP primary

care areas of Adult, Family, Gerontological, Pediatric, and Women’s Health. In 2003, work groups released the

Acute Care Nurse Practitioner Competencies and the Psychiatric-Mental Health Nurse Practitioner

Competencies. The development of these population-focused competencies involved a national, consensus

process that remains in place today and was used with the 2012 population-focused competencies.

The APRN Consensus Model made a few changes to the population foci for NP educational tracks. Notably, the

adult and gerontology foci were merged, and both the adult-gerontology and pediatric foci are distinguished as

6 Population-Focused Nurse Practitioner Competencies

being primary care or acute care. In addition, the Consensus Model stipulates that the Psychiatric-Mental Health

focus crosses the lifespan. Competencies specific to these newly defined population foci did not exist. In 2011

with funding from The John A. Hartford Foundation, AACN, in collaboration with NONPF, delineated the adult-

gerontology competencies in primary care and acute care. Recognizing the need for competencies that align with

each population foci in the Model, NONPF convened a national task force in 2011 to review previous work and

delineate updated entry-level competencies for the remaining population foci.

The task force includes representatives of various organizations from nursing education and certification. The task

force formed sub-groups to identify the competencies for each population focus and also convened periodically as

a whole for discussion. The sub groups included representatives from the stakeholder organizations that

corresponded with the focus area. The task force invited review of the competencies in an external validation

process, and the final competencies reflect the feedback obtained in this step.

The APRN Core

The APRN Consensus Model stipulates that an APRN education program must include at a minimum three

separate comprehensive graduate-level courses known as the APRN core. The APRN core consists of: advanced

physiology/pathophysiology, including general principles that apply across the lifespan; advanced health

assessment, which includes assessment of all human systems, advanced assessment techniques, concepts and

approaches; and advanced pharmacology, which includes pharmacodynamics, pharmacokinetics and

pharmacotherapeutics of all broad categories of agents. In addition to the broad-based content described above,

the work groups chose to suggest content within the population-focused competencies related to the three core

courses as it pertained to the specific population. This was done to illustrate the differences in application of the

broad-based core courses as it related to therapeutic management of the various populations.

The Relationship of the NP Core and Population-Focused Competencies

Each entry-level NP is expected to meet both the NP core competencies and the population-focused

competencies in the area of educational preparation. Accordingly, NP educational programs use both NP core

competencies and population-focused competencies to guide curriculum development.

At the time the task force began its work, NONPF had just released a new set of core competencies for NPs. This

new set represented NONPF’s endorsement of the transition of NP education to the doctoral level and an

integration of previous Master’s-level core competencies with the practice doctorate NP competencies released

7 Population-Focused Nurse Practitioner Competencies

by NONPF in 2006. The NONPF Board had charged a task force to integrate the two documents with the goal of

having one set of NP core competencies to guide educational programs preparing NPs to implement the full

scope of practice as a licensed independent practitioner.

The new core competencies moved away from the previous 7 domains as a framework and instead used nine

core competency areas that delineate the essential behaviors of all NPs. These are demonstrated upon

graduation regardless of the population focus of the program. The competencies are necessary for NPs to meet

the complex challenges of translating rapidly expanding knowledge into practice and function in a changing health

care environment. The new, nine competency areas also provide the framework for the population-focused

competencies.

Other Resource Material for NP Programs

During the development of the population-focused competencies, the task force recognized that other national

documents are critical to NP curriculum development. The task force felt it very important to delineate the

following as critical resources for refinement of specific skill sets necessary to provide evidence-based, patient-

centered care across all settings:

 The Future of Nursing: Leading Change, Advancing Health (IOM, 2011)

 Core Competencies for Interprofessional Collaborative Practice (2011)

 Quality and Safety Education for Nurses (QSEN) Graduate Competency KSAs (2012)

 Essential Genetic and Genomic Competencies for Nurses with Graduate Degrees (2012)

 The Essentials of Master’s Education in Nursing (AACN, 2011)

 The Essentials of Doctoral Education for Advanced Practice Nursing (AACN, 2006)

 Oral Health Core Clinical Competencies for non-Dental Providers (to be released 2013)

How to Use This Document

The following pages include five sets of population-focused competencies. Each set is presented in a table format

to emphasize the relationship of the population-focused competencies with the NP core competencies. The

expectation is that an educational program will prepare the student to meet both sets of competencies.

In the development of the competencies, the 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

8 Population-Focused Nurse Practitioner Competencies

of how to support curriculum development for addressing a competency. The final column in each table presents

the competency work group’s ideas of relevant content. This list is not intended to be required content, nor is

the content list comprehensive for all that a program would cover with the core competencies. The

content column reflects only suggestions for content from the specific perspective of this population

focus. Content specific to the core might be highlighted here only because of particular relevance to the

population focus.

A Glossary of Terms appears after the competencies. Any population-specific terms have been added to this

glossary. The task force hopes that this glossary will facilitate common understanding of key terms.

Each set of competencies includes a brief preamble to describe the population focus. The preamble is

intentionally brief and not intended to be a full description of the NP. Definitions of the NP are found in the APRN

Consensus Model (2008).

Future Work

To supplement the tables presented herein and give further guidance to NP educational programs, an addendum

will soon be available to show the content supporting the core competencies that crosses all the population foci.

NONPF will maintain a commitment to reconvene organizational representatives for periodic re-evaluation and

updating of the population-focused competencies.

9 Population-Focused Nurse Practitioner Competencies

Family / Across the Lifespan NP Competencies

These are entry-level competencies for the family nurse practitioners (FNP) and supplement the core

competencies for all nurse practitioners.

The graduate of an FNP program is prepared to care for individuals and families across the lifespan. The FNP

role includes preventative healthcare, as well as the assessment, diagnosis and treatment of acute and chronic

illness and preventative health care for individuals and families. Family nurse practitioners demonstrate a

commitment to family –centered care and understand the relevance of the family’s identified community in the

delivery of family- centered care.

See the “Introduction” for how to use this document and to identify other critical resources to supplement these

competencies.

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and

evidence for improving advanced

nursing practice.

2. Integrates knowledge from the

humanities and sciences within the

context of nursing science.

3. Translates research and other

forms of knowledge to improve

practice processes and outcomes.

4. Develops new practice

approaches based on the

integration of research, theory,

and practice knowledge.

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and

1. Works with individuals of other professions to

maintain a climate of mutual respect and

Roles of the Family/Lifespan NP: health care

provider, coordinator, consultant, educator,

10 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

guide change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to

improve health care...

3. Demonstrates leadership that uses

critical and reflective thinking.

4. Advocates for improved access,

quality and cost effective health

care.

5. Advances practice through the

development and implementation

of innovations incorporating

principles of change.

6. Communicates practice

knowledge effectively, both orally

and in writing.

shared values.

2. Engages diverse health care professionals

who complement one's own professional

expertise, as well as associated resources, to

develop strategies to meet specific patient

care needs.

3. Engages in continuous professional and

interprofessional development to enhance

team performance.

4. Assumes leadership in interprofessional

groups to facilitate the development,

implementation and evaluation of care

provided in complex systems.

coach, advocate, administrator, researcher,

and leader.

Building and maintaining a therapeutic team to

provide optimum therapy.

Skills for interpretation and marketing

strategies of the family/lifespan nurse

practitioner role for the public, legislators,

policy-makers, and other health care

professions.

Advocacy for the role of the advanced practice

nurse in the health care system.

Importance of participation in professional

organizations.

Acceptance and embracement of cultural

diversity and individual differences that

characterize patients, populations, and the

health care team and embrace the cultural

diversity and individual differences that

characterize patients, populations, and the

health care team.

Recognition and respect for the unique

cultures, values, roles/responsibilities and

expertise of other health care team members.

Importance of honesty and integrity in

relationships with patients, families and other

team members .

Importance of knowledge and opinions to team

members involved in patient care with

11 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

confidence, clarity, and respect and work to

ensure common understanding of information,

treatment and care decisions.

Quality

Competencies

1. Uses best available evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety

and their influence on health care.

3. Evaluates how organizational

structure, care processes,

financing, marketing and policy

decisions impact the quality of

health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Interpretation of professional strengths, role,

and scope of ability for peers, patients, and

colleagues.

Accountability for practice.

Highest standards of practice.

Self-evaluation concerning practice.

Use of self-evaluative information, including

peer review, to improve care and practice.

Professional development and the

maintenance of professional competence and

credentials.

Monitoring of quality of own practice.

Continuous quality improvement based on

professional practice standards and relevant

statutes and regulation.

Research to improve quality care.

Practice Inquiry

Competencies

1. Provides leadership in the

translation of new knowledge into

practice.

2. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

3. Applies clinical investigative skills

to improve health outcomes.

Translation and application of research that is

client or patient centered and contributes to

positive change in the health of or the

healthcare delivery.

Use of an evidence-based approach to patient

management that critically evaluates and

applies research findings pertinent to patient

12 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

4. Leads practice inquiry, individually

or in partnership with others.

5. Disseminates evidence from

inquiry to diverse audiences using

multiple modalities.

care management and outcomes.

Technology and

Information Literacy

Competencies

1. Integrates appropriate

technologies for knowledge

management to improve health

care.

2. Translates technical and scientific

health information appropriate for

various users’ needs.

1.a Assesses the patient’s and

caregiver’s educational needs

to provide effective,

personalized health care.

1.b Coaches the patient and

caregiver for positive

behavioral change.

3. Demonstrates information literacy

skills in complex decision making.

4. Contributes to the design of

clinical information systems that

promote safe, quality and cost

effective care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

Use of available technology that enhances

safety and monitors health status and

outcomes.

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

Strategies to influence legislation to promote

health and improve care delivery models

through collaborative and/or individual efforts.

13 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

2. Advocates for ethical policies that

promote access, equity, quality,

and cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

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 policy

development.

The relationship between community/public

health issues and social problems (poverty,

literacy, violence, etc.) as they impact the

health care of patients.

Health Delivery

System

Competencies

1. Applies knowledge of

organizational practices and

complex systems to improve

health care delivery.

2. Effects health care change using

broad based skills including

negotiating, consensus-building,

and partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of

health care systems that address

the needs of culturally diverse

populations, providers, and other

stakeholders.

5. Evaluates the impact of health

care delivery on patients,

providers, other stakeholders, and

Relationship- building values and the

principles of team dynamics to perform

effectively in different team roles to plan and

deliver patient/population-centered care that is

safe, timely, efficient, effective and equitable.

Planning, development, and implementation of

public and community health programs.

Policies that reduce environmental health

risks.

Cost, safety, effectiveness, and alternatives

when proposing changes in care and practice.

Organizational decision making.

Interpreting variations in outcomes.

Uses of data from information systems to

improve practice.

14 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

the environment.

6. Analyzes organizational structure,

functions and resources to

improve the delivery of care.

Business principles that affect long-term

financial viability of a practice, the efficient use

of resources, and quality of care.

Relevant legal regulations for nurse

practitioner practice, including,reimbursement

of services.

Skills needed to assist individuals, their

families, and caregivers to navigate transitions

and negotiate care across healthcare delivery

system(s).

Process of design, implementation, and

evaluation of evidence-based, age-appropriate

professional standards and guidelines for care.

Ethics

Competencies

1. Integrates ethical principles in

decision making.

2. Evaluates the ethical

consequences of decisions.

3. Applies ethically sound solutions

to complex issues related to

individuals, populations and

systems of care.

Ethical dilemmas specific to interprofessional

patient/population-centered care situations.

Ethics to meet the needs of patients.

Ethical implications of scientific advances and

practices accordingly.

Independent

Practice

Competencies

1. Functions as a licensed

independent practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

1. Obtains and accurately documents a relevant

health history for patients of all ages and in

all phases of the individual and family life

cycle using collateral information, as needed.

2. Performs and accurately documents

appropriate comprehensive or symptom-

focused physical examinations on patients of

all ages (including developmental and

The influence of the family or psychosocial

factors on patient illness.

Conditions related to developmental delays

and learning disabilities in all ages.

Women’s and men’s reproductive health,

including, but not limited to, sexual health,

pregnancy, and postpartum care.

15 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

3.a Provides the full spectrum of

health care services to include

health promotion, disease

prevention, health protection,

anticipatory guidance,

counseling, disease

management, palliative, and

end-of-life care.

3.b Uses advanced health

assessment skills to

differentiate between normal,

variations of normal and

abnormal findings.

3.c Employs screening and

diagnostic strategies in the

development of diagnoses.

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness

status of patients and families

over time.

4. Provides patient-centered care

recognizing cultural diversity and

the patient or designee as a full

partner in decision-making.

4.a Works to establish a

relationship with the patient

characterized by mutual

respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

behavioral screening, physical exam and

mental health evaluations).

3. Identifies health and psychosocial risk factors

of patients of all ages and families in all

stages of the family life cycle.

4. Identifies and plans interventions to promote

health with families at risk.

5. Assesses the impact of an acute and/or

chronic illness or common injuries on the

family as a whole.

6. Distinguishes between normal and abnormal

change across the lifespan.

7. Assesses decision-making ability and

consults and refers, appropriately.

8. Synthesizes data from a variety of sources to

make clinical decisions regarding appropriate

management, consultation, or referral.

9. Plans diagnostic strategies and makes

appropriate use of diagnostic tools for

screening and prevention, with consideration

of the costs, risks, and benefits to individuals.

10. Formulates comprehensive differential

diagnoses.

11. Manages common acute and chronic

physical and mental illnesses, including

acute exacerbations and injuries across the

lifespan to minimize the development of

complications, and promote function and

quality of living.

12. Prescribes medications with knowledge of

altered pharmacodynamics and

Problems of substance abuse and violence, e.

mental health, f. cultural factors, g. genetics, h.

dental health, i. families at risk, j. cultural

health, k. spiritual, and l. sexual, M. academic

functioning Family assessment.

Functional assessment of family members

(e.g., elderly, disabled).

Signs and symptoms indicative of change in

mental status, e.g. agitation, anxiety,

depression, substance use, delirium, and

dementia.

Comprehensive assessment that includes the

differentiation of normal age changes from

acute and chronic medical and

psychiatric/substance use disease processes,

with attention to commonly occurring atypical

presentations and co-occurring health

problems including cognitive impairment.

Assessment processes for persons with

cognitive impairment and

psychiatric/substance use disorders.

Evidence-based screening tools for

assessment of:

a. ADHD

b. Anxiety disorders

c. Mood disorders

d. Developmental variations to include

physical differences, behavior and

function

16 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

confidentiality, privacy,

comfort, emotional support,

mutual trust, and respect.

4.c Incorporates the patient’s

cultural and spiritual

preferences, values, and

beliefs into health care.

4.d Preserves the patient’s control

over decision making by

negotiating a mutually

acceptable plan of care.

pharmacokinetics with special populations,

such as infants and children, pregnant and

lactating women, and older adults.

13. Prescribes therapeutic devices.

14. Adapts interventions to meet the complex

needs of individuals and families arising from

aging, developmental/life transitions, co-

morbities, psychosocial, and financial issues.

15. Assesses and promotes self-care in patients

with disabilities.

16. Plans and orders palliative care and end-of-

life care, as appropriate.

17. Performs primary care procedures.

18. Uses knowledge of family theories and

development stages to individualize care

provided to individuals and families.

19. Facilitates family decision-making about

health.

20. Analyzes the impact of aging and age-and

disease-related changes in

sensory/perceptual function, cognition,

confidence with technology, and health

literacy and numeracy on the ability and

readiness to learn and tailor interventions

accordingly.

21. Demonstrates knowledge of the similarities

and differences in roles of various health

professionals proving mental health services,

e.g., psychotherapists, psychologist,

psychiatric social worker, psychiatrist, and

advanced practice psychiatric nurse.

22. Evaluates the impact of life transitions on the

e. Autistic Spectrum disorders

f. Substance disorders

g. Suicidal ideation and self-injurious

behavior

Risks to health related to:

a. Bullying and victimization

b. Environmental factors

c. Risk-taking behaviors

Signs and symptoms of acute physical and

mental illnesses, and atypical presentations

across the life span.

Resiliency and healthy coping.

Pharmacologic assessment addressing

polypharmacy; drug interactions and other

adverse events; over-the-counter;

complementary alternatives; and the ability to

obtain, purchase, self-administer, and store

medications safely and correctly.

Epidemiology, environmental and community

characteristics, cultural, and life stage

development, including the presentation seen

with increasing age, family, and behavioral risk

factors.

Assessment of families and individuals in the

development of coping systems and lifestyle

adaptations.

Referrals to other health care professionals

and community resources for individuals and

families, for example, coordination of care

17 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

health/illness status of patients and the

impact of health and illness on patients

(individuals, families, and communities).

23. Applies principles of self-

efficacy/empowerment in promoting behavior

change.

24. Develops patient-appropriate educational

materials that address the language and

cultural beliefs of the patient.

25. Monitors specialized care coordination to

enhance effectiveness of outcomes for

individuals and families

transitions within and between health care

systems.

Women’s reproductive health, including sexual

health, prenatal, and postpartum care and pre

and post-menopausal care.

Performance of common office procedures

which may include, but are not limited to,

suturing, lesion removal, incision and

drainage, casting/splinting, microscopy, and

gynecology procedures.

Comprehensive plan of care:

Assistive devices which may include but not

limited to nebulizers, walkers, CPAP.

Appropriate referral for physical therapy,

occupational therapy, speech therapy, home

health, hospice and nutritional therapy.

Establishment of sustainable partnership with

individuals and families

Ethical issues related to balancing differing

needs, age-related transitions, illness, or

health among family members.

Culturally appropriate communication skills

adapted to the individual’s cognitive,

developmental, physical, mental and

behavioral health status.

Discussion techniques for sensitive issues

such as:

a. suicide prevention, self-injury

18 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

b. sexually-related issues

c. substance use/abuse

d. risk-taking behavior

e. driving safety

f. independence

g. finances

h. violence, abuse, and mistreatment

i. prognosis

Assessment of decisional capacity (including

the balance between autonomy and safety),

guardianship, financial management and

durable and healthcare powers of attorney to

the treatment of older adults.

Intervention/crisis management and

appropriate referrals to mental health care

professionals and community agencies with

resources

Cognitive, sensory, and perceptual problems

with special attention to temperature

sensation, hearing and vision

Relationship development with patients,

families, and other caregivers to address

sensitive issues, such as driving, independent

living, potential for abuse, end-of-life issues,

advanced directives, and finances.

Education on preventive health care and end-

of-life choices.

Resources for payment of services related to

fixed income (retired), entitlements (Medicaid

19 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

and Medicare), and available resources

Provider communication skills which include

validating and verifying findings, and the

acknowledgement of patients strengths in

meeting needs.

Patient comfort and support.

Importance of “being present” during

communication with others.

Self-reflection

Evaluation of therapeutic interaction

Termination of nurse practitioner patient

relationship and issue related to transition to

another health care provider.

Patient and or caregiver support and

resources.

Respect for the inherent dignity of every

human being, whatever their age, gender,

religion, socioeconomic class, sexual

orientation, and ethnicity.

Rights of individuals to choose their care

provider, participate in care, and refuse care.

Influence of cultural variations on child health

practices, including child rearing.

Spiritual needs in the context of health and

illness experiences, including referral for

pastoral services.

Assessment of the influence of patient’s

20 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Family/Across the Lifespan

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

spirituality on his/her health care behaviors

and practices.

Appropriate incorporation of spiritual beliefs

into the plan of care.

Collaboration with patients and families to

discuss their wishes for end of life decision-

making and care.

Learning style assessment for the patients

Patient education about self-management of

acute/chronic illness with sensitivity to the

patient’s learning ability and cultural/ethnic

background.

How to adapt teaching-learning approaches

based on physiological and psychological

changes, age, developmental stage, readiness

to learn, health literacy, the environment, and

resources.

21 Population-Focused Nurse Practitioner Competencies

Neonatal NP Competencies

These are entry-level competencies for the neonatal nurse practitioner (NNP) and supplement the core

competencies for all nurse practitioners.

Neonatal nurse practitioners provide health care to neonates, infants, and children up to 2 years of age. Practice

as a NNP requires specialized knowledge and skills if safe, high-quality care is to be delivered to patients.

Competencies are identified by the professional organization, along with an established set of standards that

protect the public, ensuring patients’ access to safe, high-quality care. The National Association of Neonatal

Nurse Practitioners (NANNP, 2010) had established competencies for the neonatal population focus that built

upon the Domains and Core Competencies of Nurse Practitioner Practice developed by the National Organization

of Nurse Practitioner Faculties (NONPF, 2006). The NNP competencies presented here build on that previous

work and relate to the more recent Nurse Practitioner Core Competencies published by NONPF in 2012. The core

competencies, which are demonstrated upon graduation regardless of population focus, are necessary for NPs to

meet the complex challenges of translating rapidly expanding knowledge into practice and function in a changing

health care environment.

See the “Introduction” for how to use this document and to identify other critical resources to supplement these

competencies.

Competency Area

NP Core Competencies Neonatal NP Competencies Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and

evidence for improving advanced

nursing practice.

2. Integrates knowledge from the

humanities and sciences within

the context of nursing science.

3. Translates research and other

forms of knowledge to improve

practice processes and outcomes.

Advanced Neonatal Pathophysiology

Advanced Neonatal Pharmacology

Advanced Neonatal Assessment

Research and Quality Improvement

 Research process and methods

 Information databases

 Critical evaluation of research findings

 Translational research

 Research on vulnerable populations

22 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Neonatal NP Competencies Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

4. Develops new practice

approaches based on the

integration of research, theory,

and practice knowledge

 Funding for research

 Research dissemination

 Institutional review boards

 Safety

 Continuous Quality Improvement

Professional Role

 Nursing Theories

 Evidence based practice

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and

guide change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to

improve health care.

3. Demonstrates leadership that

uses critical and reflective

thinking.

4. Advocates for improved access,

quality and cost effective health

care.

5. Advances practice through the

development and implementation

of innovations incorporating

principles of change.

6. Communicates practice

knowledge effectively both orally

and in writing.

7. Participates in professional

Interprets the role of the neonatal nurse

practitioner (NNP) to the infant’s family, other

healthcare professionals, and the community.

Professional Role

 Professional leadership

 Professional accountability

 Evidence-based practice

 Role theory

 Advanced practice role

 Role of the NNP

 Scope of practice of the NNP

 Standards of practice

 Professional regulation and licensure

 Credentialing and certification

 Clinical decision making and problem

solving

 Professional scholarship

Teaching and Education

 Theories—motivational, change,

education, communication

 Program planning and evaluation

 Instructional technology

 Cultural sensitivity

 Communication

23 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Neonatal NP Competencies Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

organizations and activities that

influence advanced practice

nursing and/or health outcomes of

a population focus.

 Communication theory

 Collaboration

 Conflict resolution

 Assertiveness

 Collaborative practice models

 Informatics

 Consultation

Quality

Competencies

1. Uses best available evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety

and their influence on health care.

3. Evaluates how organizational

structure, care processes,

financing, marketing and policy

decisions impact the quality of

health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Healthcare Policy and Advocacy

 Economics of health care

Research and Quality Improvement

 Information databases

 Critical evaluation of research findings

 Translational research

 Research dissemination

 Institutional review boards

 Safety

 Continuous Quality Improvement

 Finance and Value added care

Practice Inquiry

Competencies

1. Provides leadership in the

translation of new knowledge into

practice.

2. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

3. Applies clinical investigative skills

to improve health outcomes.

Research and Quality Improvement

 Research process and methods

 Information databases

 Critical evaluation of research findings

 Translational research

 Research on vulnerable populations

 Research dissemination

24 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Neonatal NP Competencies Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

4. Leads practice inquiry, individually

or in partnership with others.

5. Disseminates evidence from

inquiry to diverse audiences using

multiple modalities.

6. Analyze clinical guidelines for

individualized application into

practice

 Institutional review boards

 Safety

 Continuous Quality Improvement

Technology and

Information Literacy

Competencies

1. Integrates appropriate

technologies for knowledge

management to improve health

care.

2. Translates technical and scientific

health information appropriate for

various users’ needs.

2.a Assesses the patient’s and

caregiver’s educational needs

to provide effective,

personalized health care.

2.b Coaches the patient and

caregiver for positive

behavioral change.

3. Demonstrates information literacy

skills in complex decision making.

4. Contributes to the design of

clinical information systems that

promote safe, quality and cost

effective care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

Communication

 Communication theory

 Collaboration

 Conflict resolution

 Assertiveness

 Collaborative practice models

 Informatics

 Information data bases/technology

 Consultation

Professional Role

 Information technology

Teaching and Education

 Theories—motivational, change,

education, communication

 Program planning and evaluation

 Instructional technology

 Cultural sensitivity

25 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Neonatal NP Competencies Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

2. Advocates for ethical policies that

promote access, equity, quality,

and cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

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 policy

development.

Healthcare Policy and Advocacy

 Process of healthcare legislation

 Maternal and child health legislation

 Implications of healthcare policy

 Economics of health care

 Third-party reimbursement

 Legislation and regulations concerning

advanced practice

 Advocacy

Ethical and Legal Issues

 Ethical decision making

 Ethical issues—reproductive, prenatal,

neonatal, and infancy

 Ethical use of information

 Patient advocacy

 Resource allocation

 Legal issues affecting patient care and

professional practice

 Cultural sensitivity

Global Health Care

Communication

 Communication theory

 Collaboration

 Conflict resolution

 Assertiveness

 Collaborative practice models

 Informatics

 Consultation

26 Population-Focused Nurse Practitioner Competencies

Health Delivery

System

Competencies

1. Applies knowledge of

organizational practices and

complex systems to improve

health care delivery.

2. Effects health care change using

broad based skills including

negotiating, consensus-building,

and partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of

health care systems that address

the needs of culturally diverse

populations, providers, and other

stakeholders.

5. Evaluates the impact of health

care delivery on patients,

providers, other stakeholders, and

the environment.

6. Analyzes organizational structure,

functions and resources to

improve the delivery of care.

7. Collaborates in planning for

transitions across the continuum

of care.

Management and Organization

 Organizational theory

 Principles of management

 Models of planned change

 Collaborative practice

 Healthcare system financing

 Reimbursement systems

 Standards of practice

 Cost, quality, outcome measures

 Resource management

 Evaluation models

 Peer review

Communication

 Communication theory

 Collaboration

 Conflict resolution

 Assertiveness

 Collaborative practice models

 Informatics

 Consultation

Healthcare Policy and Advocacy

 Process of healthcare legislation

 Maternal and child health legislation

 Implications of healthcare policy

 Economics of health care

 Third-party reimbursement

 Legislation and regulations concerning

advanced practice

 Advocacy

Research and Quality Improvement

 Safety

 Continuous Quality Improvement

27 Population-Focused Nurse Practitioner Competencies

Ethics

Competencies

1. Integrates ethical principles in

decision making.

2. Evaluates the ethical

consequences of decisions.

3. Applies ethically sound solutions

to complex issues related to

individuals, populations and

systems of care.

Conforms to the national Code of Ethics of the

National Association of Neonatal Nurses.

Ethical and Legal Issues

 Ethical decision making

 Ethical issues—reproductive, prenatal,

neonatal, and infancy

 Ethical use of information

 Patient advocacy

 Bioethics committees

 Clinical research

 Resource allocation

 Genetic counseling

 Legal issues affecting patient care and

professional practice

 Informed consent

 Cultural sensitivity

Independent

Practice

Competencies

1. Functions as a licensed

independent practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

3.a Provides the full spectrum of

health care services to

include health promotion,

disease prevention, health

protection, anticipatory

guidance, counseling, disease

management, palliative, and

end of life care.

3.b Uses advanced health

assessment skills to

1. Obtains a thorough health history to include

maternal medical, antepartum, intrapartum,

and newborn history.

2. Performs a complete, systems-focused

examination to include physical, behavioral,

and developmental assessments.

3. Develops a comprehensive database that

includes pertinent history, diagnostic tests,

and physical assessment.

4. Demonstrates critical thinking and diagnostic

reasoning skills in clinical decision-making.

5. Establishes priorities of care.

6. Initiates therapeutic interventions according

to established standards of care.

7. Demonstrates competency in the technical

skills considered essential for NNP practice

according to the standards set forth by

national, professional.

Advanced Neonatal Pathophysiology

Advanced Neonatal Pharmacology

Advanced Neonatal Assessment

Perinatal Issues

A. Perinatal physiology

 Maternal physiology (physiologic

adaptation to pregnancy, pathologic

changes or disease in pregnancy,

effects of pre-existing disease)

 Fetal physiology

 Transitional changes

 Neonatal physiology

B. Pharmacology

 Principles of pharmacology and

pharmacotherapeutics, including those

at the cellular response level

28 Population-Focused Nurse Practitioner Competencies

differentiate between normal,

variations of normal and

abnormal findings.

3.c Employs screening and

diagnostic strategies in the

development of diagnoses.

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness

status of patients and families

over time.

4. Provides patient-centered care

recognizing cultural diversity and

the patient or designee as a full

partner in decision-making.

4.a Works to establish a

relationship with the patient

characterized by mutual

respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

confidentiality, privacy,

comfort, emotional support,

mutual trust, and respect.

4.c Incorporates the patient’s

cultural and spiritual

preferences, values, and

beliefs into health care.

4.d Preserves the patient’s

control over decision making

by negotiating a mutually

acceptable plan of care.

8. Intervenes according to established

standards of care to resuscitate and stabilize

compromised newborns and infants.

9. Implements developmentally appropriate

care.

10. Ensures that principles of pain management

are applied to all aspects of neonatal care.

11. Documents assessment, plan, interventions,

and outcomes of care.

12. Considers community and family resources

and strengths, when planning patient care

and follow up needs across the continuum of

care.

13. Communicates with family members and

caregivers regarding the newborn and

infant’s healthcare status and needs.

14. Applies principles of crisis management to

assist family members in coping with their

infant’s illness.

15. Participates in the learning needs of students

and other healthcare professionals.

16. Participates as a member of an

interdisciplinary team through the

development of collaborative and innovative

practices.

17. Identify strategies to deliver culturally

sensitive, high quality care free of personal

biases.

 Principles of pharmacokinetics and

pharmacodynamics of broad categories

of drugs

 Common categories of drugs used in

the newborn and infant

 Effects of drugs during pregnancy and

lactation

C. Genetics

 Principles of human genetics

 Genetic testing and screening

 Genetic abnormalities

 Human Genome Project

 Gene therapy

 Genetic Counseling

General Assessment

 Perinatal history

 Antepartum conditions

 Prenatal diagnostic testing

 Intrapartum conditions

 Influence of altered environment on the

newborn and infant

 Gestational age assessment

 Neonatal physical exam

 Behavioral assessment

 Developmental assessment

 Pain assessment

 Assessment of family adaptation, coping

skills, and resources

Sociocultural Assessment

A. Family assessment

 Family function

1. roles

2. interactions

3. effect of childbearing

29 Population-Focused Nurse Practitioner Competencies

 Social, cultural, and spiritual variations

 Support systems

B. Families in crisis

 Crisis theory

 Principles of intervention

 Crises of childbearing

1. sick or premature infant

2. chronically ill or malformed infant

3. death of an infant

 Grief

1. stages

2. factors influencing grieving

process

3. pathologic grief

4. sibling reactions

C. Principles of family-centered care

Clinical and Diagnostic Laboratory

Assessments

Clinical laboratory tests

 Microbiologic

 Biochemical

 Hematologic

 Serologic

 Metabolic and endocrine

 Immunologic

 Routine newborn screening

 Other

Diagnostic tests (types and techniques)

 Ultrasound

 Computed tomography (CT)

 Magnetic resonance imaging (MRI),

magnetic resonance angiogram (MRA),

magnetic resonance spectroscopy (MRS)

 X-ray

30 Population-Focused Nurse Practitioner Competencies

 Electrocardiogram (EKG)

 Electroencephalogram (EEG)

 Echocardiogram

 Cardiac catheterization

Selection of diagnostic tests

 Indications

 Reliability

 Advantages and disadvantages

 Cost-effectiveness

 Interpretation of results

 Performance of procedures for neonates,

including, but not limited to:

 Lumbar puncture

 Umbilical vessel catheterization

 Percutaneous arterial and venous

catheters

 Arterial puncture

 Venipuncture

 Capillary heel-stick blood sampling

 Suprapubic bladder aspiration

 Bladder catheterization

 Endotracheal intubation

 Laryngeal airway placement

 Intraosseous (to be alike)

 Assisted ventilation

 Resuscitation and stabilization

 Needle aspiration of pneumothorax

 Chest-tube insertion and removal

 Exchange transfusion

General Management

A. Thermoregulation

 Factors affecting heat loss and

production

 Mechanisms of heat loss and gain

31 Population-Focused Nurse Practitioner Competencies

 Temperature assessment techniques

 Hypothermia, hyperthermia

 Management techniques to minimize

heat loss or maintain body temperature

B. Resuscitation and stabilization

 Assessment of risk factors

 Physiology of asphyxia

 Indications for intubation, ventilation,

and cardiac compressions (see also

section on neonatal procedures)

 Resuscitation equipment

 Pharmacotherapeutics

 Stabilization

 Neonatal transport

 Neonatal Resuscitation Program (NRP)

provider

C. Pain management

 Physiology of pain

 Pain management

1. Nonpharmacologic

2. Pharmacologic

D. Palliative and end-of-life care

 Ethical considerations

 Pain management at end of life

 Hospice care

 Bereavement

Clinical Management

A. Cardiovascular system

 Embryology

 Physiology

 Fetal, transitional, neonatal circulation

 Rhythm disturbances/EKG

interpretation

32 Population-Focused Nurse Practitioner Competencies

 Myocardial dysfunction

 Shock, hypotension, hypertension

 Congenital heart disease

(pathophysiology, clinical presentation,

differential diagnosis, medical

management, pre- and postoperative

management)

 Cardiovascular radiology and

echocardiogram interpretation

 Cardiovascular pharmacology

B. Pulmonary system

 Embryology

 Physiology (oxygenation and

ventilation, gas exchange, acid-base

balance)

 Asphyxia

 Pulmonary diseases (pathophysiology,

etiology, clinical presentation,

differential diagnosis, treatment)

 Pulmonary radiology

 Respiratory therapy

1. Physiologic principles

2. Physiologic monitoring

3. Continuous distending pressure

4. Ventilation strategies

5. Extracorporeal membrane

oxygenation (ECMO)

 Respiratory pharmacology

C. Gastrointestinal (GI) system

 Embryology

 Anatomy and physiology of the GI tract

1. Structure and function

2. Hormonal influence

3. Motility

4. Digestion and absorption

33 Population-Focused Nurse Practitioner Competencies

 Digestive and absorptive disorders

1. Disorders of sucking and

swallowing

2. Motility

3. Gastroesophageal (GE) reflux

4. Malabsorption

5. Diarrhea or short gut

 Anomalies and obstruction

 Necrotizing enterocolitis

D. Nutrition

 Effects of maturational changes on

management of nutritional requirements

and feeding

 Caloric and nutritional requirements

 Feeding methods

1. Breast

2. Bottle

3. Gavage

4. Gastrostomy

5. Transpyloric

6. Trophic

 Breast milk versus formula

1. Composition

2. Benefits

3. Preterm infants

 Parenteral nutrition

1. Composition

2. Indications

3. Benefits

4. Complications

5. Monitoring

 Dietary supplementation for term and

preterm infants

 Dietary adjustments in special

circumstances

1. Cholestasis

34 Population-Focused Nurse Practitioner Competencies

2. Short gut syndrome

3. Osteopenia

4. Inborn errors of metabolism

E. Renal and genitourinary

 Embryology and anatomy

 Renal physiology

 Evaluation of renal function

 Urinary tract infections

 Congenital anomalies

 Functional abnormalities of the renal

system

 Renal failure

1. Predisposing factors and etiologies

2. Pathophysiology

3. Management

a. Fluid and electrolytes

b. Nutritional modification

c. Drug modification

d. Hemofiltration

e. Dialysis

f. Transplant

F. Fluid and electrolytes

 Physiology

1. Electrolyte homeostasis

2. Body composition in fetal and

neonatal periods

3. Transitional changes

4. Insensible water loss

5. Endocrine control,

(mineralocorticoids, antidiuretic

hormone (ADH),

calcitonin/parathyroid hormone

(PTH)

6. Renal function, physiology

 Calcium and phosphorus homeostasis

35 Population-Focused Nurse Practitioner Competencies

 Principles of fluid therapy

1. Assessment of hydration

2. Maintenance requirements

3. Factors affecting total fluid

requirements

 Disorders of fluids and electrolytes

 Immune and nonimmune hydrops

G. Endocrine and metabolic system

 Neuroendocrine regulation

 Carbohydrate metabolism

 Infant of a diabetic mother

 Adrenal disorders

 Thyroid disorders

 Inborn errors of metabolism

 Newborn screening

 Ambiguous genitalia, intersex disorders

H. Hematologic system and malignancies

 Development of the hematopoietic

system

 Anemia

 Polycythemia and hyperviscosity

 Bilirubin

1. Physiology of bilirubin production,

metabolism, and excretion

2. Hyperbilirubinemia

3. Breast milk jaundice

4. Encephalopathy

 Hepatic disorders

 Coagulation and platelets

1. Physiology

2. Disorders of coagulation and

platelets

 Disorders of leukocytes

 Blood transfusions and blood products

 Malignancies, neoplasms

36 Population-Focused Nurse Practitioner Competencies

I. Immunologic system

 Development of the immune system

 Function of the immune system

 Allo- and auto-immune disorders

 Infectious diseases

 Evaluation of the infant

1. History

2. Physical examination

3. Laboratory data

4. Other diagnostic tests

 Treatment

1. Antimicrobial

2. Adjunctive therapy

 Infection with specific microorganisms

J. Musculoskeletal system

 Embryology

 Congenital abnormalities

 Birth injuries

 Metabolic bone disease

K. Neurobehavioral system

 Development of the nervous system

1. 1.Embryology

2. Anatomy

3. Cerebral circulation

4. Maturation

 Birth injuries

 Anomalies and defects of central

nervous system (CNS) and spine

 Ischemic brain injury

 Seizures

 Intracranial hemorrhage

 Disorders of movement and tone

 Growth and development

 Developmentally supportive care

37 Population-Focused Nurse Practitioner Competencies

 Developmental follow-up of infants

L. Eyes, ears, nose, and throat

 Embryology and anatomy

 Abnormalities of the airway

1. Congenital

2. Acquired

 Auditory system

1. Physiology of hearing and speech

2. Speech and language alterations

3. Hearing screening methods

4. Abnormalities

 Visual system

1. Physiology of vision and visual

development

2. Visual acuity

3. Visual screening

4. Pharmacotherapy

5. Abnormalities

6. Retinopathy of prematurity (ROP)

M. Integumentary system

 Embryology

 Anatomy and physiology

 Terminology

 Common variations

 Skin disorders

 Pharmacology

N. Intrauterine drug exposure

 Screening for maternal substance use

 Laboratory tests

 Ethical considerations

 Physiologic effects

 Clinical management

1. Pharmacologic

2. Nonpharmacologic

38 Population-Focused Nurse Practitioner Competencies

Health Promotion and Disease Prevention

A. Discharge planning

 Discharge planning process

 Technologically dependent infants

 Parent education

1. infant cue recognition

2. emergency measures

3. medical equipment

4. disease-specific instructions

5. well-child care (normal growth and

development, nutrition, dental

health)

 Community resources

 Home care and follow-up

B. Primary care up to 2 years

 Physical assessment

 Immunization

 Hearing screening

 Eye exams

 Neurologic follow-up

 Developmental screening

 Safety issues

39 Population-Focused Nurse Practitioner Competencies

Acute Care Pediatric Nurse Practitioner Competencies

These are entry-level competencies for the acute care pediatric nurse practitioner (ACPNP) and supplement the

core competencies for all nurse practitioners.

The graduate of an ACPNP program is prepared to care for children with complex acute, critical and chronic

illness across the entire pediatric age spectrum, from birth to young adulthood. Circumstances may exist in which

a patient, by virtue of age, could fall outside the traditionally defined ACPNP population but by virtue of special

need, the patient is best served by the ACPNP. The ACPNP implements the full scope of the role through

assessment, diagnosis and management with interventions for patients and their families. The ACPNP

implements the full scope of the role through assessment, diagnosis and management with interventions for

patients and their families. The ACPNP provides care to patients who are characterized as “physiologically

unstable, technologically dependent, and/or are highly vulnerable to complications” (AACN Scope and Standards,

2006, p 9), and a continuum of care ranging from disease prevention to critical care in order to “stabilize the

patient’s condition, prevent complications, restore maximum health and/or provide palliative care” (AACN p. 10).

Patients may be encountered across the continuum of care settings and require ongoing monitoring and

intervention.

See the “Introduction” for how to use this document and to identify other critical resources to supplement these

competencies.

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and

evidence for improving advanced

nursing practice.

2. Integrates knowledge from the

humanities and sciences within

the context of nursing science.

3. Translates research and other

forms of knowledge to improve

1. Contributes to knowledge development for

improved child and family-centered care.

2. Participates in child and family focused

quality improvement, program evaluation,

translation, and dissemination of evidence

into practice.

3. Delivers of evidence-based practice for

pediatric patients.

The following curriculum considers advanced

pathophysiology; advanced physical

examination findings; and advanced

pharmacology (kinetics, dynamics, genomics)

that pertains to the unique aspects of the

infant, child, and adolescent.

40 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

practice processes and outcomes.

4. Develops new practice

approaches based on the

integration of research, theory,

and practice knowledge

Scientific Foundations

 Clinical practice guidelines

 Evidence based care

 Translational research

 Vulnerable and diverse populations and

cultures

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and

guide change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to

improve health care.

3. Demonstrates leadership that

uses critical and reflective

thinking.

4. Advocates for improved access,

quality and cost effective health

care.

5. Advances practice through the

development and implementation

of innovations incorporating

principles of change.

6. Communicates practice

knowledge effectively both orally

and in writing.

7. Participates in professional

organizations and activities that

influence advanced practice

1. Advances the knowledge of the

interprofessional team to improve pediatric

healthcare delivery and patient outcomes.

2. Participates actively in pediatric focused

professional organizations that promote

optimal health care for children and their

families.

3. Advocates within health care agencies for

unrestricted access to all health care

providers that provide quality, cost effective

care to children and families.

Professional Role

 Professional accountability

 Role theory

 Role of the ACPNP

 Scope & standards of practice of the

ACPNP

 Professional regulation and licensure

 Credentialing and certification

 Clinical decision making and problem

solving

 Professional scholarship

 Engagement in Professional organizations

 Advocacy

 Self-evaluation and peer review

Teaching and Education

 Theories - change, education,

communication, family

 Cultural sensitivity

Communication

 Communication theory

 Collaboration

 Conflict resolution

 Collaborative practice models

41 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

nursing and/or health outcomes of

a population focus.

 Simulation with role-playing for learning

skills such as history taking as well as for

more complex communication techniques

such as sharing bad news or potential poor

outcomes with patients and families.

Clinical practicum

 Incorporation into interprofessional team

member.

 Quality improvement initiatives

 Safety

Continuous Quality Improvement

Replication of clinical scenarios with a focus

on team training for the purpose of learning

leadership, followership, and team concepts.

Quality

Competencies

1. Uses best availablye evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety

and their influence on health care.

3. Evaluates how organizational

structure, care processes,

financing, marketing and policy

decisions impact the quality of

health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Articulates the importance of collaborating with

local, state and national child organizations to

foster best practices and child safety.

Healthcare Policy and Advocacy

 Economics of health care

 Safety (local, state, national)

Quality Improvement Process in measuring

outcomes

42 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Practice Inquiry

Competencies

1. Provides leadership in the

translation of new knowledge into

practice.

2. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

3. Applies clinical investigative skills

to improve health outcomes.

4. Leads practice inquiry, individually

or in partnership with others.

5. Disseminates evidence from

inquiry to diverse audiences using

multiple modalities.

6. Analyze clinical guidelines for

individualized application into

practice

Ensures pediatric assent and consent, and/or

parental permission when conducting clinical

inquiry.

Aspects of conducting research with children.

Application of research and EBP findings

pertinent to pediatric patients and their families

to improve outcomes.

Technology and

Information Literacy

Competencies

1. Integrates appropriate

technologies for knowledge

management to improve health

care.

2. Translates technical and scientific

health information appropriate for

various users’ needs.

2.a Assesses the patient’s and

caregiver’s educational needs

to provide effective,

personalized health care.

2.b Coaches the patient and

caregiver for positive

behavioral change.

3. Demonstrates information literacy

skills in complex decision making.

1. Considers developmental level of child and

the family when translating health information

to support positive health outcomes.

2. Uses pediatric focused simulation based

learning to improve practice.

3. Evaluates information systems to assure the

inclusion of data appropriate for pediatric

patients.

Educational initiatives that translate health

information to children and families.

Integration of hospital information systems and

evaluation appropriateness for pediatric

patients.

Distance linked services.

Use of electronic information to enhance

patient care and outcomes.

Technology that enhances safety, such as with

information databases.

43 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

4. Contributes to the design of

clinical information systems that

promote safe, quality and cost

effective care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

2. Advocates for ethical policies that

promote access, equity, quality,

and cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

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 policy

development.

1. Demonstrates an understanding of pediatric

and acute care advocacy/ legislation and

policy statements.

2. Uses relevant policy specific to children to

direct appropriate patient care.

3. Advocates for unrestricted financial and

legislative access for children and families to

quality, cost effective healthcare.

Healthcare Policy and Advocacy

 Process of healthcare legislation

 Child and family health legislation

 Implications of healthcare policy

 Third-party reimbursement

 Legislation and regulations concerning

advanced practice

 Resource allocation

Health Delivery

System

Competencies

1. Applies knowledge of

organizational practices and

complex systems to improve

health care delivery.

2. Effects health care change using

broad based skills including

negotiating, consensus-building,

1. Serves as an advocate for the needs of

children and their families within the health

care system including facilitating transitions

across settings.

2. Applies knowledge of family, child

development, healthy work environment

standards, and organizational theories and

Management and Organization

 Organizational theory

 Models of planned change

 Healthcare system financing

 Reimbursement systems

 Resource management

44 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

and partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of

health care systems that address

the needs of culturally diverse

populations, providers, and other

stakeholders.

5. Evaluates the impact of health

care delivery on patients,

providers, other stakeholders, and

the environment.

6. Analyzes organizational structure,

functions and resources to

improve the delivery of care.

7. Collaborates in planning for

transitions across the continuum

of care.

systems to support safe, high quality, and

cost effective care within health care delivery

systems.

 Informatics

Collaboration and planning for transition to

adult health care.

Integration of palliative and end-of-health care.

Ethics

Competencies

1. Integrates ethical principles in

decision making.

2. Evaluates the ethical

consequences of decisions.

3. Applies ethically sound solutions

to complex issues related to

individuals, populations and

systems of care.

Ethical and Legal Issues

 Ethical decision making

 Ethical use of information

 Bioethics committees

 Clinical research, including informed

consent/assent

 Clinical trials for therapeutic management

 Legal issues affecting patient care and

professional practice

 Cultural sensitivity

 Strategies for connecting the student to the

45 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

local, national and international

community.

Independent

Practice

Competencies

1. Functions as a licensed

independent practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

3.a Provides the full spectrum of

health care services to

include health promotion,

disease prevention, health

protection, anticipatory

guidance, counseling, disease

management, palliative, and

end of life care.

3.b Uses advanced health

assessment skills to

differentiate between normal,

variations of normal and

abnormal findings.

3.c Employs screening and

diagnostic strategies in the

development of diagnoses.

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness

status of patients and families

over time.

4. Provides patient-centered care

1. Recognizes the importance of

interprofessional team practice in providing

safe, comprehensive clinical care.

2. Obtains relevant comprehensive problem

focused health histories for children with

complex acute, critical, and chronic

conditions.

3. Applies advanced assessment skills to

determine appropriate management in the

care of children with single and/or multi

system organ dysfunction.

4. Integrates knowledge of pathophysiology to

anticipate and identify rapidly changing

physiologic conditions and organ system

failure in children.

5. Responds to children with complex acute,

critical, and chronic problems to address

rapidly changing conditions, including the

recognition and management of emerging

health crises, and organ dysfunction using

both physiologically and technology derived

data.

6. Prioritizes data recognizing the dynamic

nature of a child with a complex acute,

critical, and chronic condition.

7. Interprets age, developmental and situational

appropriate screening and diagnostic studies

essential in the diagnosis and management

of the child with a complex acute, critical, or

chronic health condition.

Consider the unique aspects of the infant,

child, and adolescent as they pertain to:

 Advanced Pathophysiology

 Advanced Physical Assessment

 Advanced Pharmacology (kinetics,

dynamics, genomics)

Genetics

 Principles of human genetics

 Genetic testing and screening

 Genetic abnormalities

 Human Genome Project

 Gene therapy

 Genetic Counseling

Foundational concepts of the child & family

 Health and family assessment with

emphasis on normal and abnormal growth

and development

 Behavioral assessment

 Health promotion and disease prevention

 Common acute and chronic conditions

 Assessment of family adaptation, coping

skills, and resources

Sociocultural Assessment

 Family assessment

 Family function

1. roles

2. interactions

46 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

recognizing cultural diversity and

the patient or designee as a full

partner in decision-making.

4.a Works to establish a

relationship with the patient

characterized by mutual

respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

confidentiality, privacy,

comfort, emotional support,

mutual trust, and respect.

4.c Incorporates the patient’s

cultural and spiritual

preferences, values, and

beliefs into health care.

4.d Preserves the patient’s

control over decision making

by negotiating a mutually

acceptable plan of care.

8. Develops appropriate differential diagnosis

with an understanding of new or

exacerbation of complex acute, critical, and

chronic conditions.

9. Provides ongoing monitoring of children with

single or multi-system organ dysfunction.

10. Seeks and integrates the perspectives of

interprofessional team members in

developing and implementing the plan of

care.

11. Performs specific diagnostic maneuvers

and/or technical skills to monitor and sustain

physiological function.

12. Appropriately orders and performs

interventions to monitor, sustain and restore

stability in children with deteriorating

conditions.

13. Understands the complexity and interaction

of prescribing pharmacologic and non-

pharmacologic therapies required in the care

of children with complex acute, critical, and

chronic conditions.

14. Prescribes medications and complex medical

regimes monitoring for adverse outcomes

specific to the child with high risk complex

acute, critical, and chronic conditions.

15. Manages the medically fragile technology

dependent child who presents with complex

acute, critical, and chronic illness and injury

16. Stabilizes children in emergent and life

threatening situations.

17. Performs consultations in a variety of

settings for children with complex acute,

 Social, cultural, and spiritual variations

 Support systems

Families in crisis

 Crisis theory

 Principles of intervention

 Grief

1. stages

2. factors influencing grieving process

3. pathologic grief

4. sibling reactions

 Principles of family-centered care

Foundational concepts of the acutely ill

child

 Responding to rapidly changing clinical

conditions, including the recognition and

management of emerging crises and organ

dysfunction and failure. Complex

monitoring and ongoing management of

intensive therapies in a variety of settings,

including but not limited to:

 inpatient and outpatient hospital

settings

 specialty services

 emergency departments

 home care settings

 Essential knowledge of unique challenges

and management of the chronically ill child

and their family.

 Assessment of clinical laboratory and

diagnostic imaging; including but not

limited to:

47 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

critical and chronic conditions based on

knowledge and expertise.

18. Initiates and facilitates the child’s transition

within and outside of the health care setting

and across all levels of care including

admission, transfer and discharge.

 Microbiologic, biochemical,

hematologic, and other relevant test.

 Diagnostic imaging studies

 Indications

 Reliability

 Advantages and disadvantages

 Cost-effectiveness

 Interpretation of results

 Screening tests, such as:

 Auditory, visual, and others as

indicated.

 Indication for and principles of

procedures, including but not limited to:

 Lumbar puncture

 Percutaneous arterial and venous

catheters

 Arterial puncture

 Endotracheal intubation

 Laryngeal mask airway placement

 Assisted ventilation

 Intraosseous

 Needle aspiration of pneumothorax

 Chest-tube insertion and removal

 Fluid and electrolytes:

 Physiology

1. Electrolyte homeostasis

2. Body

3. Transitional changes

4. Insensible water loss

5. Endocrine control

 Renal function, physiology

48 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Calcium and phosphorus homeostasis

 Principles of fluid therapy

1. Assessment of hydration

2. Maintenance requirements

3. Factors affecting total fluid

requirements

 Disorders of fluids and electrolytes

 Nutrition

 Caloric and nutritional requirements

 Feeding methods

1. Human milk

2. Bottle

3. Gavage

4. Gastrostomy

5. Transpyloric

6. Trophic

 Human milk, common formulas,

specialty formulas

1. Composition

2. Benefits

3. Indication/contraindications

 Parenteral nutrition

1. Composition

2. Indications

3. Benefits

4. Complications

5. Monitoring

 Dietary supplementation

 Dietary adjustments in special

circumstances

 Discharge planning

 Discharge planning process

49 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Technologically dependent children

 Parent education

 Community resources

 Home care and follow-up

Assessment, diagnosis, and management

of the following system specific problems:

Cardiology:

 Arrhythmias

 Cardiomyopathy

 Cardiogenic Shock

 Congenital heart lesions

 Congestive heart failure

 Postpericardiotomy syndrome

 Pulmonary hypertension

 Rheumatic fever

 Syncope

 Transplantation

Gastroenterology:

 Abdominal injuries

 Appendicitis

 Esophageal disorders

 Foreign Body

 Gastroenteritis

 Gastrointestinal bleeding

 Hepatitis

 Hyperbilirubinemia in the neonate

 Ingestions

 Inflammatory bowel disease

50 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Intestinal obstructions

 Hepatic insufficiency/failure

 Pancreatitis

 Superior mesenteric artery syndrome

Genito-urinary/ Nephrology:

 Dialysis

 Female genitorurinary disorders (e.g.

pelvic inflammatory disease, ovarian

torsion)

 Hematuria

 Hypertension

 Renal Insufficiency/failure

 Male genitorurinary disorders (e.g.

testicular torsion)

 Nephrotic syndrome

 Pylenonephritis/nephritis

 Renal tubular acidosis

 Transplantation

 Urosepsis

Infectious Diseases:

 Bacterial infections (e.g. apparent life-

threatening events, bacteremia, epiglottitis,

tracheitis)

 Health care associated infections

 Fever

 Fungal infections

 Multiple organ dysfunction syndrome

 Opportunistic infections

 Parapneumonic infections

 Resistant organisms

51 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Septic shock

 Systemic inflammatory response

syndrome

 Travel Associated Infection

 Tuberculosis

 Viral infections (e.g. CMV, EBV, H1N1,

RSV)

Neurology:

 Arteriovenous malformation

 Brain death

 Cerebral palsy

 Cerebral vascular accidents

 Encephalopathy

 Hydrocephalus

 Hypotonia

 Meningitis

 Muscular dystrophies

 Neuropathy

 Spinal Cord Injury

 Status Epilepticus

 Submersion injuries

 Traumatic Brain Injury

Pulmonary:

 Acute respiratory distress syndrome

 Air leak syndromes

 Airway obstructive/failure disorders

 Bronchiolitis

 Chronic lung disease

 Congenital central hypoventilation

syndrome

52 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Cystic fibrosis

 Obstructive sleep apnea

 Pertussis

 Pneumonia

 Pulmonary edema

 Smoke inhalation

 Status asthmaticus

 Transplantation

 Congenital central hypoventilation

syndrome

 Obstructive sleep apnea

 Pulmonary edema

 Smoke inhalation

 Status asthmatic

 Transplantation

Oncology:

 Blood cell tumors

 Graft versus host disease

 Long-term effects of cancer therapy

 Solid tumors

 Transplant

 Tumor lysis syndrome

Endocrine and Metabolic

 Adrenal disorders

 Cerebral salt wasting syndrome

 Diabetes I & II

 Diabetic ketoacidosis

 Diabetes insipidus

 Inborn errors of metabolism

 Metabolic syndromes

53 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Syndrome of inappropriate antidiuretic

hormone

 Thyroid/parathyroid disorders

Hematology:

 Anemias (e.g. aplastic, sickle cell)

 Coagulation disorders (e.g. disseminated

intravascular coagulation, hemophilia,

Henoch Schönlein purpura, heparin

induced thrombocytopenia, idiopathic

thrombocytopenia purpura)

 Thrombotic disorders (e.g. deep vein

thrombosis)

Inflammatory:

 Anaphylaxis

 Immunodeficiencies

 Juvenile Idiopathic Arthritis,

 Systemic Lupus Erythematosus

 Vasculitis

Otolaryngology:

 Laryngomalacia

 Mastoiditis

 Orbital/periorbital cellulitis

 Retropharyngeal abscess

 Vocal cord paralysis

 Musculoskeletal:

 Compartment syndrome

 Legg-Calvé-Perthes disease

 Myositis

 Osteomyelitis

 Rhabdomyolisis

54 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Acute Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Septic arthritis

 Spinal fusion

Pain management:

 Physiology of pain

 Pain management

1. Nonpharmacologic

2. Pharmacologic

 Palliative and end-of-life care:

 Ethical considerations

 Pain management at end of life

 Hospice care

 Bereavement

55 Population-Focused Nurse Practitioner Competencies

Primary Care Pediatric Nurse Practitioner Competencies

The following are entry-level competencies for the primary care pediatric nurse practitioner. These pediatric

population-focused competencies expand upon the core competencies set forth for all nurse practitioners. The

role of the primary care pediatric nurse practitioner is to provide care to children from birth through young adult

with an in-depth knowledge and experience in pediatric primary health care including well child care and

prevention/management of common pediatric acute illnesses and chronic conditions. This care is provided to

support optimal health of children within the context of their family, community, and environmental setting.

Although primary care pediatric nurse practitioners practice primarily in private practices and ambulatory clinics,

their scope of practice may also extend into the inpatient setting and is based upon the needs of the patient.

Upon entry into practice, the pediatric nurse practitioner should demonstrate competence in the categories as

described. See the “Introduction” for how to use this document and to identify other critical resources to

supplement these competencies.

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and

evidence for imprsoving advanced

nursing practice.

2. Integrates knowledge from the

humanities and sciences within the

context of nursing science.

3. Translates research and other

forms of knowledge to improve

practice processes and outcomes.

4. Develops new practice approaches

based on the integration of

research, theory, and practice

knowledge

1. Contributes to knowledge development for

improved child and family centered care.

2. Participates in child and family focused

quality improvement, program evaluation,

translation and dissemination of evidence

into practice.

3. Delivers evidence-based practice for

pediatric patients.

Genetic disorders

Genetic risks, human inheritance, molecular

genetics, human genome, genetic variation,

and pharmacogenetics

56 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and

guide change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to

improve health care.

3. Demonstrates leadership that uses

critical and reflective thinking.

4. Advocates for improved access,

quality and cost effective health

care.

5. Advances practice through the

development and implementation

of innovations incorporating

principles of change.

6. Communicates practice knowledge

effectively both orally and in

writing.

7. Participates in professional

organizations and activities that

influence advanced practice

nursing and/or health outcomes of

a population focus.

Advocates for unrestricted access to quality cost

effective care within health care agencies for

children and families.

Vulnerable children in nontraditional settings

such as:

 Incarcerated youth

 Infants and children of incarcerated

parents

 Children in foster care

 Homeless children

 Children of migrant workers

 International adoptees

Global pediatric health issues

Quality

Competencies

1. Uses best available evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety

and their influence on health care.

Recognizes the importance of collaborating with

local, state and national child organizations to

foster best practices and child safety.

Child safety policies

57 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

3. Evaluates how organizational

structure, care processes,

financing, marketing and policy

decisions impact the quality of

health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Practice Inquiry

Competencies

1. Provides leadership in the

translation of new knowledge into

practice.

2. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

3. Applies clinical investigative skills

to improve health outcomes.

4. Leads practice inquiry, individually

or in partnership with others.

5. Disseminates evidence from

inquiry to diverse audiences using

multiple modalities.

6. Analyze clinical guidelines for

individualized application into

practice

1. Ensures pediatric assent and consent,

and/or parental permission when conducting

clinical inquiry.

2. Promotes research that is child-centered and

contributes to positive change in the health

of or the health care delivered to children.

Quality research for children.

Product design and development with pediatric

user/consumer in mind.

Barriers to quality research in the pediatric

population.

Technology and

Information

Literacy

1. Integrates appropriate technologies

for knowledge management to

improve health care.

1. Promotes development of information

systems to assure inclusion of data

appropriate to pediatric patients, including

Tailoring information to the child’s

developmental and cognitive level.

58 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Competencies

2. Translates technical and scientific

health information appropriate for

various users’ needs.

2.a Assesses the patient’s and

caregiver’s educational needs

to provide effective,

personalized health care.

2.b Coaches the patient and

caregiver for positive

behavioral change.

3. Demonstrates information literacy

skills in complex decision making.

4. Contributes to the design of clinical

information systems that promote

safe, quality and cost effective

care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

developmental and physiologic norms.

2. Considers developmental level of child and

the family when translating health

information to support positive health

outcomes.

3. Uses pediatric focused simulation based

learning to improve practice.

Design and implementation of the electronic

health/medical record for compatibility with

health and illness of the child.

Information systems to assure inclusion of data

appropriate to pediatric clients, including

developmental and physiologic norms.

Advising and counseling families whose

members may have a genetic disorder.

Age appropriate concepts and the

development of education tools for the

pediatric patient and family.

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

2. Advocates for ethical policies that

promote access, equity, quality,

and cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

4. Contributes in the development of

health policy.

5. Analyzes the implications of health

1. Advocates for local, state, and national

policies to address the unique needs of

children and families.

2. Uses relevant policy specific to children to

direct appropriate patient care, and to

advocate against financial and legislative

restrictions that limit access or opportunity.

Child safety policies

Poverty initiatives

59 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

policy across disciplines.

6. Evaluates the impact of

globalization on health care policy

development.

Health Delivery

System

Competencies

1. Applies knowledge of

organizational practices and

complex systems to improve health

care delivery.

2. Effects health care change using

broad based skills including

negotiating, consensus-building,

and partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of

health care systems that address

the needs of culturally diverse

populations, providers, and other

stakeholders.

5. Evaluates the impact of health care

delivery on patients, providers,

other stakeholders, and the

environment.

6. Analyzes organizational structure,

functions and resources to improve

the delivery of care.

7. Collaborates in planning for

transitions across the continuum of

care.

1. Optimizes outcomes for children and their

families by facilitating access to other health

care services (e.g. mental health) or to

community and educational settings.

2. Facilitates parent-child shared management

and transition to adult care as

developmentally appropriate.

3. Applies knowledge of family, child

development, healthy work environment

standards and organizational theories and

systems to support safe, high quality, and

cost effective care within health care delivery

systems.

4. Facilitates transitions across settings

including health care, mental health,

community and educational services to

optimize outcomes.

Transitions and linkages across health and

mental service, community, and educational

settings to optimize outcomes

Early intervention programs and committee

special education.

Advocacy for effective models of health care

delivery for alternative families.

Development of systems of care across health

and mental services, social and educational

institutions.

Integration of mental health into primary care

for children.

Navigation and promotion of health care

access for children and adolescents.

Collaboration in planning for transition to adult

health care.

Collaboration in palliative and end of life care.

60 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Ethics

Competencies

5. Integrates ethical principles in

decision making.

6. Evaluates the ethical

consequences of decisions.

7. 3. Applies ethically sound solutions

to complex issues related to

individuals, populations and

systems of care.

Knowledge of the unique challenge and

process with ethical dilemmas concerning

children and families.

Long term outcomes of ethical decisions

(chemo).

Principles of legal and ethical decision making.

Independent

Practice

Competencies

1. Functions as a licensed

independent practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

3.a Provides the full spectrum of

health care services to include

health promotion, disease

prevention, health protection,

anticipatory guidance,

counseling, disease

management, palliative, and

end of life care.

3.b Uses advanced health

assessment skills to

differentiate between normal,

variations of normal and

abnormal findings.

3.c Employs screening and

diagnostic strategies in the

development of diagnoses.

1. Conducts age appropriate comprehensive

advanced physical, mental and

developmental assessment across pediatric

life span.

2. Assesses growth, development and

mental/behavioral health status across the

pediatric life span.

3. Assesses for evidence of physical, emotional

or verbal abuse, neglect and the effects of

violence on the child and adolescent.

4. Analyzes the family system (i.e. family

structure, cultural influences etc.) to identify

contributing factors that might influence the

health of the child/adolescent and/or family

5. Assesses patient’s, family’s or caregiver’s

knowledge and behavior regarding age-

appropriate health indicators and health

risks.

6. Performs age appropriate comprehensive

and problem-focused physical exams.

7. Performs a systematic review of normal and

abnormal findings resulting in a differential

diagnoses encompassing anatomical,

physiological, motor, cognitive,

Refer to resource list for most up to date

guidelines:

 Bright Futures

 AAP well child visits

 ACIP Immunization schedule

Pediatric health risks and health indicators

Genetic (3 generational), developmental,

behavioral, psychosocial, cognitive screening

and family history.

Age-appropriate and condition specific

screening tools, tests, laboratory test, and

diagnostic procedures .

Age appropriate anticipatory guidance.

Etiology, natural history, developmental

considerations, pathogenesis, and clinical

manifestations of common disease processes

in children.

Principles of health education and counseling

for growth and development, health promotion,

health status, illnesses, illness management.

61 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness

status of patients and families

over time.

4. Provides patient-centered care

recognizing cultural diversity and

the patient or designee as a full

partner in decision-making.

4.a Works to establish a

relationship with the patient

characterized by mutual

respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

confidentiality, privacy,

comfort, emotional support,

mutual trust, and respect.

4.c Incorporates the patient’s

cultural and spiritual

preferences, values, and

beliefs into health care.

4.d Preserves the patient’s control

over decision making by

negotiating a mutually

acceptable plan of care.

developmental, psychological, and social

behavior across the pediatric lifespan.

8. Identifies nutritional conditions and

behavioral feeding issues and implements

appropriate educational, dietary or medical

treatments/interventions.

9. Interprets age-appropriate, developmental

and condition-specific screening and

diagnostic studies to diagnosis and manage

the well, minor acute, or chronic conditions in

the pediatric scope of practice.

10. Promotes healthy nutritional and physical

activity practices.

11. Provides health maintenance and health

promotion services across the pediatric

lifespan.

12. Activates child protection services, and

recommends/incorporates other resources

on behalf of children or families at risk.

13. Partners with families to coordinate family

centered community and health care

services as needed for specialty care and

family support.

14. Incorporates health objectives and

recommendations for accommodations, as

appropriate, into educational plans (IEP)

15. Assists the parent/child in coping with

developmental behaviors and facilitates the

child’s developmental potential.

16. Recognizes and integrates the perspectives

of intradisciplinary collaboration in

developing and implementing the plan of

care.

Anticipatory guidance

Breast feeding promotion and management.

Nutritional programs, and nutritional intake

considering food preferences and avoidance of

food sensitivities.

Coordination of care .with Early Intervention

and special education

Newborn screening and appropriate follow up.

Exposure to and knowledgeable about the

following procedures:

 Fluorescein staining

 Removal of foreign body from eye-cotton

tip applicator

 Ear foreign body and cerumen removal-

curette and irrigation method

 Nasal foreign body removal

 Nasal packing for epistaxis

 Tooth evulsion- stabilization

 Pulse oximetry

 CPR

 Nasogastric tube insertion

 Urethral catheterization

 Removal of vaginal foreign body

 Skin scraping

 Wound immigration and drainage

 Wound closure- suture insertion; staple

insertion; butterfly/steri-strip, tissue

adhesive

 Splinting

62 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Primary Care Pediatric

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

17. Understands the complexity and interaction

of nonpharmacologic and pharmacologic

therapies required in the care of children.

 Reduction of radial head subluxation

 Spirometry

 Nebulizer treatment

 Spacers devices

 Incheck dial for assessing inhaler

technique

 Pelvic exams with collection of cultures

 Diagnostic testing

 Proper strep test

 RSV collection of specimen

 Influenza A/B collection

63 Population-Focused Nurse Practitioner Competencies

Psychiatric-Mental Health Nurse Practitioner Competencies

These are entry-level competencies for the psychiatric-mental health nurse practitioner (PMHNP) and supplement

the core competencies for all nurse practitioners.

The PMHNP focuses on individuals across the lifespan (infancy through old age), families, and populations

across the lifespan at risk for developing and/or having a diagnosis of psychiatric disorders or mental health

problems. The PHMNP provides primary mental health care to patients seeking mental health services in a wide

range of settings. Primary mental health care provided by the PMHNP involves relationship-based, continuous

and comprehensive services, necessary for the promotion of optimal mental health, prevention, and treatment of

psychiatric disorders and health maintenance. This includes assessment, diagnosis, and management of mental

health and psychiatric disorders across the lifespan.

See the “Introduction” for how to use this document and to identify other critical resources to supplement these

competencies.

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and

evidence for improving advanced

nursing practice.

2. Integrates knowledge from the

humanities and sciences within

the context of nursing science.

3. Translates research and other

forms of knowledge to improve

practice processes and outcomes.

4. Develops new practice

approaches based on the

integration of research, theory,

Neurobiology

Advanced Pathophysiology, Advanced

Pharmacotherapeutics, Advanced Health

Assessment

Psychotherapy theories

Genomics

Developmental neuroscience

Interpersonal neurobiology

Recovery and resiliency

64 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

and practice knowledge

Trauma informed care

Toxic stress

Adverse Childhood Events Studies (ACES)

Studies

Allopathic stress

Advanced Practice and Interprofessional

psychiatric theoretical frameworks

Theories of change in individuals, systems

Stigma issues

Role of the PMHNP in changing policies

Aging Science

Caregiver stress

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and

guide change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to

improve health care.

3. Demonstrates leadership that

uses critical and reflective

thinking.

4. Advocates for improved access,

quality and cost effective health

care.

1. Participates in community and population-

focused programs that promote mental

health and prevent or reduce risk of mental

health problems and psychiatric disorders.

2. Advocates for complex patient and family

medicolegal rights and issues.

3. Collaborates with interprofessional

colleagues about advocacy and policy issues

at the local, state, and national related to

reducing health disparities and improving

clinical outcomes for populations with mental

health problems and psychiatric disorders.

Interprofessional practice competencies

65 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

5. Advances practice through the

development and implementation

of innovations incorporating

principles of change.

6. Communicates practice

knowledge effectively both orally

and in writing.

7. Participates in professional

organizations and activities that

influence advanced practice

nursing and/or health outcomes of

a population focus.

Quality

Competencies

1. Uses best available evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety

and their influence on health care.

3. Evaluates how organizational

structure, care processes,

financing, marketing and policy

decisions impact the quality of

health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Evaluates the appropriate uses of seclusion and

restraints in care processes.

QSEN competencies

Reflective Practice

Self-awareness and self-care

QI process in measuring outcomes of care

66 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Practice Inquiry

Competencies

6. Provides leadership in the

translation of new knowledge into

practice.

7. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

8. Applies clinical investigative skills

to improve health outcomes.

9. Leads practice inquiry, individually

or in partnership with others.

10. Disseminates evidence from

inquiry to diverse audiences using

multiple modalities.

11. Analyze clinical guidelines for

individualized application into

practice

Research knowledge of:

 Research utilization

 Research process

Skill in use of EBP:

 Evaluating outcomes


 Integrating results into practice

Technology and

Information Literacy

Competencies

1. Integrates appropriate

technologies for knowledge

management to improve health

care.

2. Translates technical and scientific

health information appropriate for

various users’ needs.

2.a Assesses the patient’s and

caregiver’s educational needs

to provide effective,

personalized health care.

2.b Coaches the patient and

caregiver for positive

behavioral change.

3. Demonstrates information literacy

Electronic medical records

Electronic prescriptions

Virtual patient care

Distance linked services

(Telemedicine/Telepsychiatry)

Social networking

Laws for technology

Cultural and Linguistic literacy

Data banks and quality assurance findings

matched by evidence based best practices in

Web-based, tele-, written, oral and electronic

67 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

skills in complex decision making.

4. Contributes to the design of

clinical information systems that

promote safe, quality and cost

effective care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

communications to enhance care.

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

2. Advocates for ethical policies that

promote access, equity, quality,

and cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

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 policy

development.

Employs opportunities to influence health policy

to reduce the impact of stigma on services for

prevention and treatment of mental health

problems and psychiatric disorders.

Healthcare/public policy knowledge of:

 Laws and regulations (e.g., Health

Insurance Portability and Accountability

Act [HIPAA], Center for Medicare and

Medicaid Services [CMS], The Joint

Commission, Accreditation Healthcare

Organizations, documentation,

coding/reimbursement, American with

Disabilities Act, mental health parity),

 Principles of advocacy to influence socially

responsible policy, including consumer

focused care .

 Laws, procedures for seclusion and

restraint for hospitals/psychiatric units,

long term care (LTC is inclusive of nursing

homes)

Health Delivery

System

Competencies

1. Applies knowledge of

organizational practices and

complex systems to improve

health care delivery.

2. Effects health care change using

Interprofessional practice competencies

Scope of practice knowledge of:

 Scope and Standards of Practice

 Legal/ethical issues

68 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

broad based skills including

negotiating, consensus-building,

and partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of

health care systems that address

the needs of culturally diverse

populations, providers, and other

stakeholders.

5. Evaluates the impact of health

care delivery on patients,

providers, other stakeholders, and

the environment.

6. Analyzes organizational structure,

functions and resources to

improve the delivery of care.

7. Collaborates in planning for

transitions across the continuum

of care.

 Regulatory agencies

Coordination of services knowledge of

available resources (e.g., consultation

resources, evidence based practice,

community resources, government funded

studies/grants, school resources)

Models of integrative care skill in:

 Obtaining and utilizing appropriate

collateral information

 Providing and utilizing consultations and

referrals

 Communicating with other health care

providers

Ethics

Competencies

1. Integrates ethical principles in

decision making.

2. Evaluates the ethical

consequences of decisions.

3. 3. Applies ethically sound

solutions to complex issues

related to individuals, populations

and systems of care.

Boundaries, duty to report, duty to warn,

confidentiality, reporting abuse, seeks

consultation, knowing scope of practice,

knowing personal limits, safety

State mental health laws

State laws related to involuntary

hospitalization and commitment

Influence on policy by monitoring of policy and

69 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

active communication to appropriate parties to

affect policy for optimal healthcare.

Independent

Practice

Competencies

1. Functions as a licensed

independent practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

3.a Provides the full spectrum of

health care services to

include health promotion,

disease prevention, health

protection, anticipatory

guidance, counseling, disease

management, palliative, and

end of life care.

3.b Uses advanced health

assessment skills to

differentiate between normal,

variations of normal and

abnormal findings.

3.c Employs screening and

diagnostic strategies in the

development of diagnoses.

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness

status of patients and families

over time.

1. Develops an age-appropriate treatment plan

for mental health problems and psychiatric

disorders based on biopsychosocial theories,

evidence-based standards of care, and

practice guidelines.

2. Includes differential diagnosis for mental

health problems and psychiatric disorders.

3. Assess impact of acute and chronic medical

problems on psychiatric treatment.

4. Conducts individual and group

psychotherapy.

5. Applies supportive, psychodynamic

principles, cognitive-behavioral and other

evidence based psychotherapy/-ies to both

brief and long term individual practice.

6. Applies recovery oriented principles and

trauma focused care to individuals.

7. Demonstrates best practices of family

approaches to care.

8. Plans care to minimize the development of

complications and promote function and

quality of life.

9. Treats acute and chronic psychiatric

disorders and mental health problems.

10. Safely prescribes pharmacologic agents for

patients with mental health problems and

psychiatric disorders.

11. Ensures patient safety through the

appropriate prescription and management of

Age Specific Psychiatric Disorders for:

 Aging adult (65 years and older)

 Adult (18-64 years)

 Adolescent (13-17 years)

 Pre-Adolescent (10-12 years)

 Child (3-9 years)

 Infant (Prebirth-2 years)

Evaluation:

 History and Physical Exam

 Psychiatric Evaluation

 Mental Status Exam Concepts related to

screening instruments (e.g., specificity and

sensitivity, reliability and validity)

Type of screening instruments (e.g.,

depression screening, Mini Mental Status

Exam (MMSE), alcohol screening, ADHD

screening, anxiety screening, drug screening,

serum screening)

Clinical guidelines

Screening tools

Clinical evaluation tools

Medical co-morbidities and differentials

Theoretical foundations of individual, group

and family approaches

70 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

4. Provides patient-centered care

recognizing cultural diversity and

the patient or designee as a full

partner in decision-making.

4.a Works to establish a

relationship with the patient

characterized by mutual

respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

confidentiality, privacy,

comfort, emotional support,

mutual trust, and respect.

4.c Incorporates the patient’s

cultural and spiritual

preferences, values, and

beliefs into health care.

4.d Preserves the patient’s

control over decision making

by negotiating a mutually

acceptable plan of care.

pharmacologic and non-pharmacologic

interventions.

12. Explain the risks and benefits of treatment to

the patient and their family.

13. Identifies the role of PMHNP in risk-mitigation

strategies in the areas of opiate use and

substance abuse clients.

14. Seeks consultation when appropriate to

enhance one’s own practice.

15. Uses self-reflective practice to improve care.

16. Provides consultation to health care

providers and others to enhance quality and

cost- effective services.

17. Guides the patient in evaluating the

appropriate use of complementary and

alternative therapies.

18. Uses individualized outcome measure to

evaluate psychiatric care.

19. Manages psychiatric emergencies across all

settings.

20. Refers patient appropriately.

21. Facilitates the transition of patients across

levels of care.

22. Uses outcomes to evaluate care.

23. Attends to the patient- nurse practitioner

relationship as a vehicle for therapeutic

change.

24. Maintains a therapeutic relationship over time

with individuals, groups, and families to

promote positive clinical outcomes.

25. 25. Therapeutically concludes the nurse-

patient relationship transitioning the patient to

other levels of care, when appropriate.

Theoretical foundations of trauma-focused

care and recovery models of care

Gender differences and equality

Foster care, caregiver stress

Simulation of crisis intervention, risk

assessment, other pertinent areas

Epidemiology/risk analysis knowledge of:

 Prevalence of disorders or behaviors in

diverse populations across the life span

 Contributing risk factors and potential

barriers to health promotion and disease

prevention (e.g., 
socioeconomic,

biological, environmental, community

specific variables)

Epidemiology/risk analysis skill in:

 Risk assessment (e.g., violence, abuse,

neglect, suicide, psychopathology)

Health Promotion and Disease Prevention

Health behavior knowledge of:

 Health behavior guidelines (e.g., gender-

based recommendations, exercise,

lifestyle, familial factors that predisposes

one to disease, cultural and societal

influences/stigmas)


Health behavior skills in:

 Selecting and implementing appropriate

health behavior guidelines to specific

situations based on individual patient

71 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

26. Demonstrates ability to address

sexual/physical abuse, substance abuse,

sexuality, and spiritual conflict across the

lifespan.

27. Applies therapeutic relationship strategies

based on theories and research evidence to

reduce emotional distress, facilitate cognitive

and behavioral change, and foster personal

growth

28. Apply principles of self-efficacy/

empowerment and other self-management

theories in promoting relationship

development and behavior change.

29. Identifies and maintains professional

boundaries to preserve the integrity of the

therapeutic process.

30. Teaches patients, families and groups about

treatment options with respect to

developmental, physiological, cognitive,

cultural ability and readiness.

31. Provides psychoeducation to individuals,

families, and groups regarding mental health

problems and psychiatric disorders.

32. Modifies treatment approaches based on the

ability and readiness to learn.

33. Considers motivation and readiness to

improve self-care and healthy behavior when

teaching individuals, families and groups of

patients.

34. Demonstrates knowledge of appropriate use

of seclusion and restraints.

35. Documents appropriate use of seclusion and

restraints.

variances

Growth and development across the lifespan

knowledge of:

 Growth and development theories and

concepts (including spiritual, cultural,

cognitive, emotional, psychosexual,

physical abilities)

 Variances

Growth and development across the lifespan

skill in:

 Developmental assessment

Screening instruments (including invasive and

noninvasive screenings) skill in:

 Selecting and implementing appropriate

screening instrument(s), interpreting

results, and making recommendations and

referrals

Prevention activities knowledge of:

 Primary, Secondary and Tertiary

Prevention activities (e.g., health

promotion, immunizations, anticipatory

guidance, parenting skills, lifestyle

modifications, psychosocial rehabilitation

activities, in- home family treatments, risk

reduction, pharmacology, CAM, self-care)

 Access to care to underserved populations

Prevention activities skill in:

 Guidance, teaching, coaching,

collaborating (with patient, family, and

community)

72 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 Assessing readiness and capacity (e.g.,

change, learning, health literacy)

 Implementing early intervention activities

Assessment of Acute and Chronic Illness

Anatomy, physiology, development and

pathophysiology across the lifespan

knowledge of:

 Normal anatomy and physiology (including

genetics, normal aging)

 Pathophysiology

Comprehensive psychiatric evaluation

knowledge of:

 Psychopathology (including DSM V signs

and symptoms and neurobiology)

Comprehensive psychiatric evaluation skills in:

 Recognizing clinical signs and symptoms

of psychiatric illness

 Differentiating between pathophysiological

and psychopathological conditions

 Performing and interpreting a

comprehensive and/or interval history and

physical examination 
(including

laboratory and diagnostic studies)

 Performing and interpreting a mental

status examination

 Performing and interpreting a psychosocial

assessment and family psychiatric history

 Performing and interpreting a functional

assessment (activities of daily living,

occupational, social, 
leisure, educational,

73 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

coping skills)

Diagnostic reasoning knowledge of:

 Diagnostic reasoning process

 Diagnostic criteria (e.g., DSM V current

International Classification of Disease)

Diagnostic reasoning skill in:

 Developing and prioritizing a differential

diagnoses list

 Formulating diagnoses according to DSM

V based on assessment data

 Differentiating between normal/abnormal

age related physiological and

psychological symptoms/changes

The Nurse Practitioner and Patient

Relationship

Therapeutic communication knowledge of:

 Therapeutic communication principles,

techniques and ethics (e.g., boundaries,

phases of the therapeutic relationship,

conflict of interest, self-awareness,

negotiation and collaboration)

 Principles of family dynamics and social

support systems

 Cultural competency (e.g., language,

ethnicity, race, religious, spiritual,

biopsychosocial, urban/rural, 
homeless,

migrant, Gay-Bisexual-Lesbian-

Transgender/Transexual orientation,

corrections/forensic, uninsured and

underinsured, health disparities)

74 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Therapeutic communication skill in:

 Initiating a therapeutic relationship with

patient and family/support system (e.g.,

developing 
therapeutic alliances,

assessing literacy, health literacy, spiritual

needs, and barriers to communication)

 Maintaining a therapeutic relationship with

patient and family/support system (e.g.,

encouraging 
adherence and clinical

engagement, maintaining therapeutic

boundaries)

 Terminating a therapeutic relationship with

patient and family/support system (e.g.,

evaluating the 
effectiveness of a

therapeutic relationship, appropriate

closure and transitioning)

Legal/business/ethical issues knowledge of:

 Ethical principles and issues (e.g.,

termination, risk/benefit of disclosure,

professional boundaries, patient

autonomy, advocacy, consent/assent to

treatment, consumer focused care)

 Legal principles and issues (e.g., conflict

of interest, patient rights and

responsibilities, Health Information

Portability and Accountability Act [HIPAA],

professional obligations, duty to warn)

 Business principles and issues (e.g.,

financial agreements, contracts for

services)

75 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Clinical Management

Pharmacotherapuetic knowledge of:

 Current pharmacological concepts (e.g.,

pharmacodynamics, pharmacokinetics,

interactions, Complementary/Alternative

medicines [CAM])

 Standards of practice and clinical

guidelines, evidenced-based practice

 Safety and continuous quality

improvement

Pharmacotherapuetic skills in:

 Selecting appropriate medication plan

(e.g., risk/benefit, patient preference,

developmental 
considerations, financial,

the process of informed consent, symptom

management)

 Evaluating patient response and modify

plan as necessary

 Documenting (e.g., adverse reaction,

patient response, changes to plan of care)

Psychotherapy, psychoeducation,

complementary/alternative medicine

knowledge of:

 Theories of treatment modalities (models

and practices)

 Standards of practice and clinical

guidelines, evidenced-based practice

 Safety and continuous quality

improvement

76 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Psychotherapy, psychoeducation,

complementary/alternative medicine skill in:

 Selecting appropriate therapeutic plan

(e.g., risk/benefit, patient preferences,

developmental 
considerations, financial,

the process of informed consent)

 Implementing appropriate therapeutic plan

 Evaluating patient response and modify

plan as necessary

 Documenting (e.g., adverse reaction,

patient response, changes to plan of care)

Crisis management (e.g., chemical and

physical restraints, seclusion, reporting abuse

and neglect, involuntary hospitalization, safety

assessment, duty to warn, end of life,

institutionalization, residential treatment, foster

care, military service)
knowledge of:

 Theories and concepts associated with

crisis management (e.g., intervention risk

vs. benefit, level of risk, safety, lethality

assessment, stress adaptation, crisis

theories, disaster response)

 Standards of practice and clinical

guidelines, evidenced-based practice

 Safety, continuous quality improvement,

and patient rights

Crisis management skill in:

 Selecting appropriate intervention (e.g.,

risk/benefit, patient preference,

developmental 
considerations, the

77 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Psychiatric-Mental Health

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

process of informed consent, least

restrictive environment/invasive treatment)

 Implementing appropriate intervention

 Evaluating patient response and modify

plan as necessary

 Documenting (e.g., adverse reaction,

patient response, changes to plan of care)

 Seclusion & restraint

Neurobiology and genetics of mental illnesses

Theories and application of behavior change

78 Population-Focused Nurse Practitioner Competencies

Women’s Health/Gender-Related NP Competencies

These are entry level competencies for the women’s health/gender-related nurse practitioner and supplement the

core competencies for all nurse practitioners.

The women’s health nurse practitioner provides primary care to women across the life cycle with emphasis on

conditions unique to women from menarche through the remainder of their life cycle within the context of socio-

cultural environments – interpersonal, family, and community. In providing care, the women’s health nurse

practitioner considers the inter-relationship of gender, social class, culture, ethnicity, sexual orientation, economic

status, and socio-political power differentials.

See the “Introduction” for how to use this document and to identify other critical resources that supplement these

competencies.

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Scientific

Foundation

Competencies

1. Critically analyzes data and evidence

for improving advanced nursing

practice.

2. Integrates knowledge from the

humanities and sciences within the

context of nursing science.

3. Translates research and other forms

of knowledge to improve practice

processes and outcomes.

4. 4. Develops new practice approaches

based on the integration of research,

theory, and practice knowledge

1. Integrates research, theory, and evidence-

based practice knowledge to develop clinical

approaches that address women's responses

to physical and mental health and illness

across the lifespan.

2. Integrates best evidence into practice

incorporating client values and clinical

judgment

Hormonal therapy (contraception, HRT,

infertility/fertility treatments)

In-depth knowledge of reproductive

endocrinology

Advanced assessment of female breast and

genitourinary systems

Genomics

Advanced practice and interprofessional role

development

Gender discrimination

Sexual Assault

Gender-unique disease presentations

79 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Leadership

Competencies

1. Assumes complex and advanced

leadership roles to initiate and guide

change.

2. Provides leadership to foster

collaboration with multiple

stakeholders (e.g. patients,

community, integrated health care

teams, and policy makers) to improve

health care.

3. Demonstrates leadership that uses

critical and reflective thinking.

4. Advocates for improved access,

quality and cost effective health care.

5. Advances practice through the

development and implementation of

innovations incorporating principles of

change.

6. Communicates practice knowledge

effectively both orally and in writing.

7. 7. Participates in professional

organizations and activities that

influence advanced practice nursing

and/or health outcomes of a

population focus.

Quality

Competencies

1. Uses best available evidence to

continuously improve quality of

clinical practice.

2. Evaluates the relationships among

access, cost, quality, and safety and

their influence on health care.

3. Evaluates how organizational

structure, care processes, financing,

80 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

marketing and policy decisions impact

the quality of health care.

4. Applies skills in peer review to

promote a culture of excellence.

5. 5. Anticipates variations in practice

and is proactive in implementing

interventions to ensure quality.

Practice Inquiry

Competencies

1. Provides leadership in the translation

of new knowledge into practice.

2. Generates knowledge from clinical

practice to improve practice and

patient outcomes.

3. Applies clinical investigative skills to

improve health outcomes.

4. Leads practice inquiry, individually or

in partnership with others.

5. Disseminates evidence from inquiry

to diverse audiences using multiple

modalities.

6. Analyzes clinical guidelines for

individualized application into practice

1. Evaluates gender-specific interventions and

outcomes.

2. Integrates of gender-specific evidence into

practice

Review of literature to distinguish unique

aspects of gender-specific health for

application of appropriate findings to patient

care.

81 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

Technology and

Information

Literacy

Competencies

1. Integrates appropriate technologies

for knowledge management to

improve health care.

2. Translates technical and scientific

health information appropriate for

various users’ needs.

2.a Assesses the patient’s and

caregiver’s educational needs to

provide effective, personalized

health care.

2.b Coaches the patient and

caregiver for positive behavioral

change.

3. Demonstrates information literacy

skills in complex decision making.

4. Contributes to the design of clinical

information systems that promote

safe, quality and cost effective care.

5. Uses technology systems that

capture data on variables for the

evaluation of nursing care.

Uses health information and technology tools in

providing care for women across the lifespan to

communicate, manage knowledge, improve

access, mitigate error, and to support clinical

decision making locally and globally.

Use of electronic datasets to evaluate practice

and improve quality, cost, and efficiency

Distance-linked services

 Telewomen’s health

 Social networking

Technology laws affecting women and families

Use of electronic communications to enhance

care processes

 Use of simulation to enhance clinical skills

in the care of women

 gynececologic urologic teaching

associates (GOTA)

 task trainers (e.g., IUD insertion, Leopold

maneuvers)

 standardized patient encounters focusing

on issues more prevalent in women such

as, but not limited to, domestic violence

and prenatal counseling

Policy

Competencies

1. Demonstrates an understanding of

the interdependence of policy and

practice.

2. Advocates for ethical policies that

promote access, equity, quality, and

cost.

3. Analyzes ethical, legal, and social

factors influencing policy

development.

4. Contributes in the development of

health policy.

Advocates for health care policies and research

that support accessible, equitable, affordable, safe

and effective health care for women both locally

and globally.

Principles of advocacy to influence socially

responsible policy for women and their

families.

Promotion of gender-specific health concerns

such as, but not limited to:

 undernourishment with body dysmorphism

 obesity epidemic

 female genital cutting

82 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

5. Analyzes the implications of health

policy across disciplines.

6. Evaluates the impact of globalization

on health care policy development.

Health Delivery

System

Competencies

1. Applies knowledge of organizational

practices and complex systems to

improve health care delivery.

2. Effects health care change using

broad based skills including

negotiating, consensus-building, and

partnering.

3. Minimizes risk to patients and

providers at the individual and

systems level.

4. Facilitates the development of health

care systems that address the needs

of culturally diverse populations,

providers, and other stakeholders.

5. Evaluates the impact of health care

delivery on patients, providers, other

stakeholders, and the environment.

6. Analyzes organizational structure,

functions and resources to improve

the delivery of care.

7. Collaborates in planning for

transitions across the continuum of

care.

Demonstrates knowledge of legal/ethical issues

and regulatory agencies relevant to gender-

specific issues

Consent forms such as, but not limited to:

 minors

 tubul ligation

 IUD insertion

Variation of policies specific to women among

state and federal regulatory agencies

Ethics

Competencies

1. Integrates ethical principles in

decision making.

2. Evaluates the ethical consequences

1. Recognizes the unique ethical dilemmas in

women’s health care.

2. Recognize the global ethical challenges in

Activities that raise awareness of issues that

influence women’s health such as, but not

limited to:

83 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

of decisions.

3. Applies ethically sound solutions to

complex issues related to individuals,

populations and systems of care.

women’s health care.

3. Develops ethically sound solutions to

complex global issues related to women.

 ageism

 racism,

 sexism,

 religious beliefs

 cultural variations

 health belief systems

 violence against women

 homophobia

 gender roles

 poverty

Independent

Practice

Competencies

1. Functions as a licensed independent

practitioner.

2. Demonstrates the highest level of

accountability for professional

practice.

3. Practices independently managing

previously diagnosed and

undiagnosed patients.

3.a Provides the full spectrum of

health care services to include

health promotion, disease

prevention, health protection,

anticipatory guidance,

counseling, disease

management, palliative, and end

of life care.

3.b Uses advanced health

assessment skills to differentiate

between normal, variations of

normal and abnormal findings.

3.c Employs screening and

diagnostic strategies in the

Provides culturally appropriate reproductive and

primary care for women of all ages.

Approaches gender-specific developmental

events, such as menarche, pregnancy,

menopause and senescence, as normative

transitions not disease states.

Recognizes unique health care needs of

marginalized women, including victims of violence

and transgendered female clients.

Recognizes disease manifestations unique to

women.

Manages disease manifestations unique to

women.

Provides infertility and sexually transmitted

disease services to sexual partners of female

patients.

Supports a woman’s right to make her own

decisions regarding her health and reproductive

Age-appropriate care

 women across the lifespan

 gynecologic

 obstetric

Normal vs. abnormal

 development of the female

 obstetrics

 gynecology

 age-related changes

Male conditions related to reproductive and

urologic systems

Selection and implementation of appropriate

clinical guidelines and standards

Using clinical decision support tools

Epidemiology/risk analysis, including

knowledge of:

 Prevalence of gynecologic and obstetric

disorders in diverse populations across the

84 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

development of diagnoses.

3.d Prescribes medications within

scope of practice.

3.e Manages the health/illness status

of patients and families over

time.

4. Provides patient-centered care

recognizing cultural diversity and the

patient or designee as a full partner in

decision-making.

4.a Works to establish a relationship

with the patient characterized by

mutual respect, empathy, and

collaboration.

4.b Creates a climate of patient-

centered care to include

confidentiality, privacy, comfort,

emotional support, mutual trust,

and respect.

4.c Incorporates the patient’s cultural

and spiritual preferences, values,

and beliefs into health care.

4.d Preserves the patient’s control

over decision making by

negotiating a mutually acceptable

plan of care.

choices within the context of her belief system.

Assesses genetic, social, environmental, physical,

and mental health risks through collection of

family, social, environmental, and health data.

Provides counseling, management, and/or referral

based on identified healthcare risk factors.

life span

 Contributing risk factors and potential

barriers to health promotion and disease

prevention (e.g., socioeconomic,

biological, environmental, community-

specific variables)

Gender-based recommendations, exercise,

lifestyle, familial factors that predisposes one

to disease, cultural, and societal

influences/stigmas.

Growth and development theories and

concepts (spiritual, cultural, cognitive,

emotional, psychosexual, physical abilities) &

variances

Principles of family dynamics and social

support systems.

Cultural differences impacting health such as,

but not limited to:

 language

 ethnicity

 race

 religious

 spiritual

 biopsychosocial

 urban/rural

 homeless

 migrant

 lesbian-gay-bisexual-

transgender/transsexual (LGBT)

orientation

85 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 corrections/forensic

 uninsured and underinsured

 health disparities

 health literacy

Complementary/alternative medicine therapies

used across the lifespan in women’s health

Crisis management

 sexual assault

 violence (such as, but not limited to,

intimate partner and elder abuse)

 divorce

 caregiver burden

Female genital health, including, but not limited

to:

 vulvodynia

 vulvar vestibulitis

 chronic pelvic pain

 vulvovaginal dermatalogic conditions

Common urological disorders in women,

including, not limited to:

 urinary Incontinence

 urinary frequency

 interstitial cystitis

Skill in the procedures such as, but not limited

to:

 IUD insertion

 punch biopsies

 endometrial biopsies

 basic ultrasound

86 Population-Focused Nurse Practitioner Competencies

Competency Area

NP Core Competencies Women’s Health / Gender-Related

NP Competencies

Curriculum Content to Support

Competencies

Neither required nor comprehensive, this list reflects only

suggested content specific to the population

 pessary use

Prenatal and postpartum management,

including, but not limited to:

 supervision of high-risk pregnancy

 breastfeeding

 contraception counseling

87 Population-Focused Nurse Practitioner Competencies

Glossary of Terms

Care processes: Actions or changes that occur during the delivery of health care.

Clinical investigative skills: Those skills needed to conduct inquiry of practice questions/therapies, evaluate

discovered evidence, and then translate it into practice.

Cultural diversity: Common beliefs, values, practices and behaviors shared by multiple subgroups or individuals.

Culture of excellence: The environment developed through the internalization of core values and a shared

commitment in which the highest standards of personal integrity, professionalism, and clinical expertise are

upheld.

Developmental neuroscience: The study of the differentiation and organization of neurons into an integrated,

functioning nervous system.

Evidence-based practice: The "conscientious, explicit and judicious use of current best evidence in making

decisions about the care of individual patients. Individual clinical expertise is integrated with the best available

external evidence from systematic research.” (Modified from Sackett, 1996).

Globalization: The interrelated influence of actions, resources, cultures, and economies across nations.

Health policy: The set of decisions pertaining to health whether made at local, state, national, and global levels

that influences health resource allocation.

Independent practice: Recognizes independent licensure of nurse practitioners who provide autonomous care

and promote implementation of the full scope of practice.

Independently: Having the educational preparation and authority to make clinical decisions without the need or

requirement for supervision by others.

Information literacy: The use of digital technology, communications tools, and/or networks to access, manage,

integrate, evaluate, create, and effectively communicate information.

88 Population-Focused Nurse Practitioner Competencies

Interpersonal neurobiology: The study of developmental neuroscience with the study of human experience,

particularly to understand how the brain gives rise to mental processes and is directly shaped by interpersonal

experiences (Siegel 1999).

Interprofessional education: When two or more professions learn about, from and with each other to enable

effective collaboration and improve health outcomes.

Interprofessional practice: Occurs when multiple health workers from different professional backgrounds work

together with patients, families, and communities to deliver the highest quality of care.

Knowledge management: Strategies that identify, create, represent, distribute, and enable the efficient use of all

types of information.

Licensed independent practitioner: An individual with a recognized scientific knowledge base that is permitted

by law to provide care and services without direction or supervision.

Quality care: The degree to which health services to individuals and populations increase the desired health

outcomes consistent with professional knowledge and standards. Quality care also means avoiding underuse,

overuse, and misuse of health care services.

Patient centered care: Care based on a partnership between the patient and health care provider that is focused

on the patient’s values, preferences, and needs.

Peer review: Evaluation of the processes and/or outcomes of care by professionals with similar knowledge, skills

and abilities.