Future Nurse: Standards Of Proficiency For Registered Nurses

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Future nurse:Standards ofproficiency forregistered nursesPublished 17 May 2018www.nmc.org.ukStandards of proficiency for registered nurses1

ContentsIntroduction3The role of the nurse in the 21st century3How the proficiencies have been structured6Platform 1Being an accountable professional7Platform 2Promoting health and preventing ill health10Platform 3Assessing needs and planning care13Platform 4Providing and evaluating care16Platform 5Leading and managing nursing care and working in teams19Platform 6Improving safety and quality of care21Platform 7Coordinating care24Annexe A: Communication and relationship management skills27Annexe B: Nursing procedures31Glossary38www.nmc.org.ukStandards of proficiency for registered nurses2

Future nurse:Standards ofproficiency forregistered nursesIntroductionThe Nursing and Midwifery Council has a duty to review thestandards of proficiency it sets for the professions it registerson a regular basis to ensure that standards remain contemporaryand fit for purpose in order to protect the public. In reviewing thestandards, we have taken into account the changes that are takingplace in society and health care, and the implications these have forregistered nurses of the future in terms of their role, knowledgeand skill requirements.The proficiencies in this document therefore specify the knowledgeand skills that registered nurses must demonstrate when caringfor people of all ages and across all care settings. They reflectwhat the public can expect nurses to know and be able to do inorder to deliver safe, compassionate and effective nursing care.They also provide a benchmark for nurses from the EuropeanEconomic Area (EEA), European Union (EU) and overseas wishingto join the UK register, as well as for those who plan to return topractice after a period of absence.The role of the nurse in the 21st centuryRegistered nurses play a vital role in providing, leading andcoordinating care that is compassionate, evidence-based, andperson-centred. They are accountable for their own actions andmust be able to work autonomously, or as an equal partner witha range of other professionals, and in interdisciplinary teams.In order to respond to the impact and demands of professionalnursing practice, they must be emotionally intelligent and resilientindividuals, who are able to manage their own personal health andwellbeing, and know when and how to access support.Registered nurses make an important contribution to thepromotion of health, health protection and the prevention ofill health. They do this by empowering people, communities andpopulations to exercise choice, take control of their own healthdecisions and behaviours, and by supporting people to manage theirown care where possible.Registered nurses provide leadership in the delivery of care forpeople of all ages and from different backgrounds, cultures andbeliefs. They provide nursing care for people who have complexmental, physical, cognitive and behavioural care needs, those livingwith dementia, the elderly, and for people at the end of their life.They must be able to care for people in their own home, in thecommunity or hospital or in any health care settings where theirneeds are supported and managed. They work in the context ofcontinual change, challenging environments, different models ofcare delivery, shifting demographics, innovation, and rapidly evolvingtechnologies. Increasing integration of health and social careservices will require registered nurses to negotiate boundariesand play a proactive role in interdisciplinary teams. The confidenceand ability to think critically, apply knowledge and skills, and provideexpert, evidence-based, direct nursing care therefore lies at thecentre of all registered nursing practice.www.nmc.org.ukStandards of proficiency for registered nurses3

About these standardsThese standards of proficiency apply to all NMC registered nurses.They should be read with Realising professionalism: Standards foreducation and training which set out our expectationsregarding delivery of all pre-registration and post-registrationNMC approved nursing and midwifery education programmes.These standards apply to all approved education providers and areset out in three parts: Part 1: Standards framework for nursingand midwifery education; Part 2: Standards for student supervisionand assessment; and Part 3: Programme standards, which are theStandardsframeworkfor nursingand midwiferyeducationTogether these standards aim to provide approved educationinstitutions (AEIs) and their practice learning partners with theflexibility to develop innovative approaches to education for nurses,midwives and nursing associates, while being accountable for thelocal delivery and management of approved programmes in line withour standards.Standardsfor studentsupervisionand assessmentProgrammestandardsStandardsof proficiencyfor nursingand midwiferyprofessionsPrePostStandardsfor educationand trainingstandards specific for each pre-registration or post-registrationprogramme. Education institutions must comply with our standardsto be approved to run any NMC approved programmes.www.nmc.org.ukStandards of proficiency for registered nurses4

Legislative frameworkArticle 15(1) of the Nursing and Midwifery Order 2001(‘the Order’) requires the Council to establish standards foreducation and training which are necessary to achieve thestandards of proficiency for admission to the register, as requiredby Article 5(2) of the Order. The standards for nursing andmidwifery education providers are established under the provisionof Article 15(1) of the Order.Article 5(2) of the Nursing and Midwifery Order 2001 requiresthe NMC to establish standards of proficiency necessary to beadmitted to each part of the register and for safe and effectivepractice under that part of the register. The standards ofproficiency have been established under this provision.www.nmc.org.ukStandards of proficiency for registered nurses5

Future nurse:Standards ofproficiency forregistered nursesThe platforms are:How the proficiencies have been structured7.The proficiencies are grouped under seven platforms, followedby two annexes. Together, these reflect what we expect a newlyregistered nurse to know and be capable of doing safely andproficiently at the start of their career.The outcome statements for each platform have been designedto apply across all four fields of nursing practice (adult, children,learning disabilities, mental health) and all care settings. This isbecause registered nurses must be able to meet the personcentred, holistic care needs of the people they encounter in theirpractice who may be at any stage of life and who may have a rangeof mental, physical, cognitive or behavioural health challenges.They must also be able to demonstrate a greater depth ofknowledge and the additional more advanced skills required tomeet the specific care needs of people in their chosen fields ofnursing practice.Key components of the roles, responsibilities and accountabilitiesof registered nurses are described under each of the sevenplatforms. We believe that this approach provides clarity to thepublic and the professions about the core knowledge and skills thatthey can expect every registered nurse to demonstrate.These proficiencies will provide new graduates into the professionwith the knowledge and skills they need at the point of registrationwhich they will build upon as they gain experience in practice andfulfil their professional responsibility to continuously updatetheir knowledge and skills. For example, after they register withus registered nurses will already be equipped to progress to thecompletion of a prescribing qualification.1. Being an accountable professional2. Promoting health and preventing ill health3. Assessing needs and planning care4. Providing and evaluating care5. Leading and managing nursing care and working in teams6. Improving safety and quality of careCoordinating careThe annexes to these standards of proficiency are presented intwo sections. The annexes provide a description of what registerednurses should be able to demonstrate they can do at the point ofregistration in order to provide safe nursing care.Annexe A specifies the communication and relationship managementskills required, and Annexe B specifies the nursing proceduresthat registered nurses must demonstrate that they are able toperform safely. As with the knowledge proficiencies, the annexesalso identify where more advanced skills are required by registerednurses, working in a particular field of nursing practice.www.nmc.org.ukStandards of proficiency for registered nurses6

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing proceduresPlatform 1Being an accountableprofessionalRegistered nurses act in the best interests of people,putting them first and providing nursing care that isperson-centred, safe and compassionate. They actprofessionally at all times and use their knowledgeand experience to make evidence-based decisionsabout care. They communicate effectively, are rolemodels for others, and are accountable for theiractions. Registered nurses continually reflect ontheir practice and keep abreast of new and emergingdevelopments in nursing, health and care.www.nmc.org.ukStandards of proficiency for registered nurses7

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing procedures1. Outcomes:The outcomes set out below reflect the proficiencies foraccountable professional practice that must be applied across thestandards of proficiency for registered nurses, as described inplatforms 2-7, in all care settings and areas of practice.1.5understand the demands of professional practice anddemonstrate how to recognise signs of vulnerability inthemselves or their colleagues and the action required tominimise risks to healthAt the point of registration, the registered nurse will be able to:1.6understand the professional responsibility to adopt ahealthy lifestyle to maintain the level of personal fitnessand wellbeing required to meet people’s needs for mentaland physical care1.7demonstrate an understanding of research methods,ethics and governance in order to critically analyse,safely use, share and apply research findings to promoteand inform best nursing practice1.8demonstrate the knowledge, skills and ability to thinkcritically when applying evidence and drawing onexperience to make evidence informed decisions inall situations1.9understand the need to base all decisions regarding careand interventions on people’s needs and preferences,recognising and addressing any personal and externalfactors that may unduly influence their decisions1.11.21.31.4understand and act in accordance with the Code:Professional standards of practice and behaviourfor nurses, midwives and nursing associates, and fulfil allregistration requirementsunderstand and apply relevant legal, regulatoryand governance requirements, policies, and ethicalframeworks, including any mandatory reporting duties, toall areas of practice, differentiating where appropriatebetween the devolved legislatures of the United Kingdomunderstand and apply the principles of courage,transparency and the professional duty of candour,recognising and reporting any situations, behaviours orerrors that could result in poor care outcomesdemonstrate an understanding of, and the ability tochallenge, discriminatory behaviourwww.nmc.org.ukStandards of proficiency for registered nurses8

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing procedures1.10demonstrate resilience and emotional intelligence andbe capable of explaining the rationale that influencestheir judgments and decisions in routine, complex andchallenging situations1.15demonstrate the numeracy, literacy, digital andtechnological skills required to meet the needs ofpeople in their care to ensure safe and effectivenursing practice1.11communicate effectively using a range of skills andstrategies with colleagues and people at all stages oflife and with a range of mental, physical, cognitive andbehavioural health challenges1.16demonstrate the ability to keep complete, clear, accurateand timely records1.17demonstrate the skills and abilities required to supportpeople at all stages of life who are emotionally orphysically vulnerabletake responsibility for continuous self-reflection, seekingand responding to support and feedback to develop theirprofessional knowledge and skills1.18demonstrate the skills and abilities required to develop,manage and maintain appropriate relationships withpeople, their families, carers and colleaguesdemonstrate the knowledge and confidenceto contribute effectively and proactively in aninterdisciplinary team1.19act as an ambassador, upholding the reputation of theirprofession and promoting public confidence in nursing,health and care services, and1.121.131.14provide and promote non-discriminatory, personcentred and sensitive care at all times, reflecting onpeople’s values and beliefs, diverse backgrounds, culturalcharacteristics, language requirements, needs andpreferences, taking account of any need for adjustments1.20 safely demonstrate evidence-based practice in all skillsand procedures stated in Annexes A and B.www.nmc.org.ukStandards of proficiency for registered nurses9

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing proceduresPlatform 2Promoting health andpreventing ill healthRegistered nurses play a key role in improving andmaintaining the mental, physical and behavioural healthand well-being of people, families, communities andpopulations. They support and enable people at allstages of life and in all care settings to make informedchoices about how to manage health challenges inorder to maximise their quality of life and improvehealth outcomes. They are actively involved in theprevention of and protection against disease andill health and engage in public health, communitydevelopment and global health agendas, and in thereduction of health inequalities.www.nmc.org.ukStandards of proficiency for registered nurses10

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing procedures2. Outcomes:The proficiencies identified below will equip the newly registerednurse with the underpinning knowledge and skills required for theirrole in health promotion and protection and prevention of ill health.At the point of registration, the registered nurse will be able to:2.1understand and apply the aims and principles of healthpromotion, protection and improvement and the prevention ofill health when engaging with people2.2demonstrate knowledge of epidemiology, demography,genomics and the wider determinants of health, illness andwellbeing and apply this to an understanding of global patternsof health and wellbeing outcomes2.3understand the factors that may lead to inequalities inhealth outcomes2.4identify and use all appropriate opportunities, makingreasonable adjustments when required, to discuss the impactof smoking, substance and alcohol use, sexual behaviours, dietand exercise on mental, physical and behavioural health andwellbeing, in the context of people’s individual circumstanceswww.nmc.org.ukStandards of proficiency for registered nurses11

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skills2.5promote and improve mental, physical, behavioural and otherhealth related outcomes by understanding and explainingthe principles, practice and evidence-base for healthscreening programmes2.11 promote health and prevent ill health by understandingand explaining to people the principles of pathogenesis,immunology and the evidence-base for immunisation,vaccination and herd immunity, and2.6understand the importance of early years and childhoodexperiences and the possible impact on life choices, mental,physical and behavioural health and wellbeing2.12 protect health through understanding and applying theprinciples of infection prevention and control, includingcommunicable disease surveillance and antimicrobialstewardship and resistance.2.7understand and explain the contribution of social influences,health literacy, individual circumstances, behaviours andlifestyle choices to mental, physical and behaviouralhealth outcomes2.8explain and demonstrate the use of up to date approaches tobehaviour change to enable people to use their strengths andexpertise and make informed choices when managing their ownhealth and making lifestyle adjustments2.9use appropriate communication skills and strength basedapproaches to support and enable people to make informedchoices about their care to manage health challenges in orderto have satisfying and fulfilling lives within the limitationscaused by reduced capability, ill health and disabilityAnnexe B:Nursing procedures2.10 provide information in accessible ways to help peopleunderstand and make decisions about their health, life choices,illness and carewww.nmc.org.ukStandards of proficiency for registered nurses12

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing proceduresPlatform 3Assessing needs andplanning careRegistered nurses prioritise the needs of peoplewhen assessing and reviewing their mental, physical,cognitive, behavioural, social and spiritual needs.They use information obtained during assessmentsto identify the priorities and requirements forperson-centred and evidence-based nursinginterventions and support. They work in partnershipwith people to develop person-centred care plans thattake into account their circumstances, characteristicsand preferences.www.nmc.org.ukStandards of proficiency for registered nurses13

Being anaccountableprofessionalPromotinghealth and preventingill healthAssessingneeds andplanning careProviding andevaluating careLeading and managingnursing careand working in teamsImprovingsafety andquality of careCoordinatingcareAnnexe A:Communicationand relationshipmanagement skillsAnnexe B:Nursing procedures3. Outcomes:The proficiencies identified below will equip the newly registerednurse with the underpinning knowledge and skills required for theirrole in assessing and initiating person-centred plans of care.3.4understand and apply a person-centred approach to nursingcare, demonstrating shared assessment, planning, decisionmaking and goal setting when working with people, th

www.nmc.org.uk Standards of proficiency for registered nurses 6 Future nurse: Standards of proficiency for registered nurses How the proficiencies have been structured The proficiencies are grouped under seven platforms, followed by two annexes. Together, these reflect what we expect a newly registered nurse to know and be capable of doing safely and proficiently at the start of their career .

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