nunurrsising core cong core commpetpetency iency in n

Nursing Core Competency in Nursing Core Competency in HA 2001 HA 2001

Core Competency

for RN 1997

Core Competency

for EN

1998

3 3…………… …………… 4 4…………… ……………

1 1……… ……… 2 2………… …………

2. Care management 2. Care management

3 3………… ………… 4 4…………… ……………

1 1……… ……… 2 2……… ………

1.Therapeutic and caring 1.Therapeutic and caring relationship relationship

CCANP CCANP CCRN CCRN

Who are APN in HK

Who are APN in HK

context

context？

？ How

is the e

xisting

How is t

he exist

ing

Ranking

fit in th

e APN co

ncept

Ranking

fit in th

e APN co

ncept？？

Should

we defin

e APN

Should

we defin

e APN

as that in

oversea

countri

es

as that in

oversea

countri

es？？

1999

Definition of term of the CC ANP Definition of term of the CC ANP Project 1999 Project 1999

‘The nurses at the advanced level’ in this project is defined as a group of nurses who develop to the higher level of competencies that goes beyond the entry /generic level goes beyond the entry /generic level of registered nurses of registered nurses in HA regardless of ranking practice is focus on direct patient direct patient service service

1997 CCRN

Data generation Modified ACS

Rounds of Validation

1999 CCANP

Endorsement Rounds of Validation

Consultation Survey Competency Requirement Forecasting interview

Focus Group

HRPG & HRC 2001 HRPG & HRC 2001

Reframing & Refining (2000) Reframing & Refining (2000)

Communication on Home page

Repertory Grid Analysis

About 10

00 data in

put

Competency Requirement Competency Requirement Forecasting interview Forecasting interview

on on SEM(N) SEM(N)

2000 2000

Critical Competency Critical Competency RN APN RN APN • • Effective patient care Effective patient care delivery delivery

• • Patient centered Patient centered assessment assessment

• • Quality conscious Quality conscious • • Meet with standard Meet with standard • • Caring aptitude Caring aptitude • • Accountable practice Accountable practice • • Effective teamwork Effective teamwork

• • Leader, mentor Leader, mentor • • Improve care delivery Improve care delivery through system through system

• • Advance practice Advance practice through evidence through evidence

• • Service development Service development • • Collaborative practice Collaborative practice • • Consultancy Consultancy • • Dissemination of Dissemination of knowledge knowledge

• • Nurse led practice Nurse led practice

Things to be done differently Things to be done differently RN APN RN APN • • Independent & Independent & accountable accountable

• • More active and assertive More active and assertive • • Emphases on caring & Emphases on caring & partnership partnership

• • Thorough primary nursing Thorough primary nursing • • Strengthen predischarge Strengthen predischarge program program

• • More teaching role More teaching role • • Delegation & Supervising Delegation & Supervising

• • Shift from supervising to Shift from supervising to facilitating facilitating

• • Refocus on client care Refocus on client care • • Backup for peers Backup for peers • • Equal multi Equal multi disciplinary disciplinary team member team member

• • Practice in wider context Practice in wider context • • Grade reform to facilitate Grade reform to facilitate the change the change

Critical Appraisal Critical Appraisal • • SEM(N) puts higher expectation on RN SEM(N) puts higher expectation on RN as practitioner & supervisors & mentor as practitioner & supervisors & mentor

• • SEM(N) more emphases on caring, SEM(N) more emphases on caring, partnership, sensitivity of RN partnership, sensitivity of RN

• • Scope of practice of ANP in in wider Scope of practice of ANP in in wider context context

• • ANP should be free from repetitive ANP should be free from repetitive supervisory job supervisory job

• • ANP more on innovative practice & ANP more on innovative practice & evidence evidence

Functional Functional Competency Competency

Personal

Organizational People & Team

Framework of Framework of Competency Competency

Prevention

Helping

Support

Promotion

Empowerment

F F U U N N C C T T I I O O N N

Death Recovery Healing

Format of the CC Framework Format of the CC Framework 2001 2001


1.Therapeutic and caring relationship 1.Therapeutic and caring relationship

6 6……………… ……………… 7 7……………… ………………. .

4 4………………… ………………….. .. 5 5…………… …………….. ..

6 6……………… ……………… 7 7……………… ………………. .

4 4………………… ………………….. .. 5 5…………… …………….. ..

CCANP CCANP CCRN CCRN

Competency Based SDR for Competency Based SDR for Enrolled Nurses in HA Enrolled Nurses in HA

20022004

Format of the CC Framework Format of the CC Framework

6 6……………… ……………… 7 7……………… ………………. .

4 4………………… …………………. . 5 5…………… …………….. ..

1 1………………… ………………… 2 2…………… …………….. .. 3 3…………… ……………. .


6 6……………… ……………… 7 7……………… ………………. .

4 4………………… …………………. . 5 5…………… …………….. ..

1 1………………… ………………… 2 2…………… …………….. .. 3 3…………… ……………. .


CCA CCAPN PN (additional) (additional)

CCRN CCRN (additional) (additional)

CCEN CCEN

EN EN

RN RN

ANP ANP

Education Education Skills Skills

Experience Experience

Same scope of Same scope of practice practice

Patient care is Patient care is the focus the focus

•Practitioner with expertise •Manage overall client group with complex & multiple problems •Build culture & system •Be the resource person •Leaders & work cross sectorially •Active in EBP & service development •Supervisors & coaches of peers •Fulfill academic requirement

•Independent Practitioner •Manage acute & complicated cases •Accountable for clinical decision •Collaborate with other team liaising patients’ care •Act as coaches of learners & assistants •Contribute to innovative practice •Update & uphold standard professionally

•Associated nurse •Contribute significantly in basic nursing care and noncomplex cases •Follow protocols •Able to relate symptom to health status & take immediate action •Manage structured situation & routine •Equip self

Additional for APN Additional for RN ENCC

Focus of the Competency Focus of the Competency

Therapeutic and caring relationship Therapeutic and caring relationship Focus: Facilitate clients in the process of growth and psychological change and support nurses in the establishment of therapeutic and care relationship

Care management Care management Focus: Manage complex clinical condition and build up a care delivery system/ model.


Knowledge & Skill application Knowledge & Skill application Focus: Master specialty knowledge and refine nursing practice

Quality and Risk Management Quality and Risk Management Focus: Drive towards the effective care delivery system and upkeep the standard of care through continuous monitoring and reengineering


Personal qualities Personal qualities Focus: Influence individuals and organisation using a variety of techniques; think broadly and outside traditional boundaries Professional attribute Professional attribute Focus: Increase creditability as a professional nurse and clinical expert


Team work Team work Focus: Lead the team and build the culture.

People Development People Development Focus: Involve actively in staff development.


Service Development Service Development Focus: Facilitate changes and lead new projects

Legal and ethical practice Legal and ethical practice Focus: establish structure for ethical practice and client advocacy .

APN Projects APN Projects

Developing the CC for ANP (2001)

Study on Competency Based Study on Competency Based Performance Appraisal of Performance Appraisal of

APN ( APN (Entry Level Entry Level) in HA ) in HA

Adoption of the CC based SDR

Study on Competency Based Study on Competency Based Performance Appraisal Performance Appraisal

of APN of APN (Entry Level) in HA (Entry Level) in HA

2004 2004

Terminology to be consistent to the Pilot project on APN Terminology to be consistent to the Pilot project on APN

Study on Competency Based Study on Competency Based Performance Appraisal of Performance Appraisal of APN ( APN (Entry Level Entry Level) in HA ) in HA

Aim: Aim:

To verify the applicability of the APN CC To verify the applicability of the APN CC set in the performance appraisal for NO, set in the performance appraisal for NO, NS, WM and APN NS, WM and APN

To suggest the strategies in establishing To suggest the strategies in establishing the CC based SDR for APN the CC based SDR for APN

Target Subjects Target Subjects

In proportional

125 133 133 78 78 180 180

Supervisor Supervisor APN APN in post by 31

March 04

WM WM NS NS NO NO

Appraiser Appraisee

Distributed in 26 hospitals

Format of the CC Framework Format of the CC Framework

6 6……………… ……………… 7 7……………… ………………. .

4 4………………… …………………. . 5 5…………… …………….. ..

1 1………………… ………………… 2 2…………… …………….. .. 3 3…………… ……………. .


6 6……………… ……………… 7 7……………… ………………. .

4 4………………… …………………. . 5 5…………… …………….. ..

1 1………………… ………………… 2 2…………… …………….. .. 3 3…………… ……………. .


CCA CCAPN PN (additional) (additional)

CCRN CCRN (additional) (additional)

CCEN CCEN

Some concerns on the Some concerns on the subjects of subjects of APNs APNs entry Level entry Level Newly recruited APN Newly recruited APN – – NO NO

• • the role & responsibility of APN the role & responsibility of APN – – NO NO seems to be the combination of existing seems to be the combination of existing NO, NS & WM NO, NS & WM

• • the successful transformation of role & the successful transformation of role & responsibility of APN responsibility of APN – – NO might be NO might be influenced by internal factors influenced by internal factors eg eg adaptation to new role and external adaptation to new role and external factors factors eg eg duty balance between the new duty balance between the new and existing ranking and existing ranking

Some concerns on the Some concerns on the subjects of subjects of APNs APNs entry Level entry Level Existing NO, NS, WM Existing NO, NS, WM • • There may be discrepancy when using the There may be discrepancy when using the CC set as the SDR tool to rate the CC set as the SDR tool to rate the performance of NO, NS, WM as each performance of NO, NS, WM as each ranking has special focus in the role and ranking has special focus in the role and responsibility responsibility

nunurrsising core cong core commpetpetency iency in n

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