POPULATION-FOCUSED NURSE PRACTITIONER 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 exemplarsof how to support curriculum development for addressing a competency. The final column in each table presentsthe competency work group’s ideas of relevant content. This list is not intended to be required content, nor isthe content list comprehensive for all that a program would cover with the core competencies. Thecontent column reflects only suggestions for content from the specific perspective of this populationfocus. Content specific to the core might be highlighted here only because of particular relevance to thepopulation focus.A Glossary of Terms appears after the competencies. Any population-specific terms have been added to thisglossary. 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 isintentionally brief and not intended to be a full description of the NP. Definitions of the NP are found in the APRNConsensus Model (2008).Future WorkTo supplement the tables presented herein and give further guidance to NP educational programs, an addendumwill 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 andupdating of the population-focused competencies.

Family / Across the Lifespan NP CompetenciesThese are entry-level competencies for the family nurse practitioners (FNP) and supplement the corecompetencies for all nurse practitioners.The graduate of an FNP program is prepared to care for individuals and families across the lifespan. The FNProle includes preventative healthcare, as well as the assessment, diagnosis and treatment of acute and chronicillness and preventative health care for individuals and families. Family nurse practitioners demonstrate acommitment to family –centered care and understand the relevance of the family’s identified community in thedelivery of family- centered care.See the “Introduction” for how to use this document and to identify other critical resources to supplement thesecompetencies.Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the ally analyzes data andevidence for improving advancednursing practice.Integrates knowledge from thehumanities and sciences within thecontext of nursing science.Translates research and otherforms of knowledge to improvepractice processes and outcomes.Develops new practiceapproaches based on theintegration of research, theory,and practice knowledge.2.3.4.LeadershipCompetencies1.Assumes complex andadvanced leadership roles toinitiate and guide change.1.Works with individuals of other professions Roles of the Family/Lifespan NP: health careto maintain a climate of mutual respect and provider, coordinator, consultant, educator,shared values.coach, advocate, administrator, researcher,

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the population2.3.4.5.6.7.2.Provides leadership to fostercollaboration with multiplestakeholders (e.g. patients,community, integrated health careteams, and policy makers) to3.improve health care.Demonstrates leadership that usescritical and reflective thinking.4.Advocates for improved access,quality and cost effective healthcare.Advances practice through thedevelopment and implementationof innovations incorporatingprinciples of change.Communicates practiceknowledge effectively, both orallyand in writing.Participates in professionalorganizations and activities thatinfluence advanced practicenursing and/or health outcomes ofa population focus.Engages diverse health care professionalswho complement one's own professionalexpertise, as well as associated resources, todevelop strategies to meet specific patientcare needs.Engages in continuous professional andinterprofessional development to enhanceteam performance.Assumes leadership in interprofessionalgroups to facilitate the development,implementation and evaluation of careprovided in complex systems.and leader.Building and maintaining a therapeutic team toprovide optimum therapy.Skills for interpretation and marketingstrategies of the family/lifespan nursepractitioner role for the public, legislators,policy-makers, and other health careprofessions.Advocacy for the role of the advanced practicenurse in the health care system.Importance of participation in professionalorganizations.Acceptance and embracement of culturaldiversity and individual differences thatcharacterize patients, populations, and thehealth care team and embrace the culturaldiversity and individual differences thatcharacterize patients, populations, and thehealth care team.Recognition and respect for the uniquecultures, values, roles/responsibilities andexpertise of other health care team members.Importance of honesty and integrity inrelationships with patients, families and otherteam members .Importance of knowledge and opinions to teammembers involved in patient care withconfidence, clarity, and respect and work to

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the populationensure common understanding of information,treatment and care decisions.QualityCompetencies1.2.3.4.5.Uses best available evidence tocontinuously improve quality ofclinical practice.Evaluates the relationships amongaccess, cost, quality, and safetyand their influence on health care.Evaluates how organizationalstructure, care processes,financing, marketing and policydecisions impact the quality ofhealth care.Applies skills in peer review topromote a culture of excellence.Anticipates variations in practiceand is proactive in implementinginterventions to ensure quality.Interpretation of professional strengths, role,and scope of ability for peers, patients, andcolleagues.Accountability for practice.Highest standards of practice.Self-evaluation concerning practice.Use of self-evaluative information, includingpeer review, to improve care and practice.Professional development and themaintenance of professional competence andcredentials.Monitoring of quality of own practice .Continuous quality improvement based onprofessional practice standards and relevantstatutes and regulation.Research to improve quality care.Practice InquiryCompetencies1.2.3.4.Provides leadership in thetranslation of new knowledge intopractice.Generates knowledge from clinicalpractice to improve practice andpatient outcomes.Applies clinical investigative skillsto improve health outcomes.Leads practice inquiry, individuallyTranslation and application of research that isclient or patient centered and contributes topositive change in the health of or thehealthcare delivery.Use of an evidence-based approach to patientmanagement that critically evaluates andapplies research findings pertinent to patientcare management and outcomes.

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the population5.6.Technology andInformation LiteracyCompetencies1.2.3.4.5.or in partnership with others.Disseminates evidence frominquiry to diverse audiences usingmultiple modalities.Analyzes clinical guidelines forindividualized application intopractice.Integrates appropriatetechnologies for knowledgemanagement to improve healthcare.Translates technical and scientifichealth information appropriate forvarious users’ needs.1.a Assesses the patient’s andcaregiver’s educational needsto provide effective,personalized health care.1.b Coaches the patient andcaregiver for positivebehavioral change.Demonstrates information literacyskills in complex decision making.Contributes to the design ofclinical information systems thatpromote safe, quality and costeffective care.Uses technology systems thatcapture data on variables for theevaluation of nursing care.Use of available technology that enhancessafety and monitors health status andoutcomes.

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the populationPolicyCompetencies1.2.3.4.5.6.Health DeliverySystemCompetencies1.2.3.4.Demonstrates an understanding ofthe interdependence of policy andpractice.Advocates for ethical policies thatpromote access, equity, quality,and cost.Analyzes ethical, legal, and socialfactors influencing policydevelopment.Contributes in the development ofhealth policy.Analyzes the implications of healthpolicy across disciplines.Evaluates the impact ofglobalization on health care policydevelopment.Applies knowledge oforganizational practices andcomplex systems to improvehealth care delivery.Effects health care change usingbroad based skills includingnegotiating, consensus-building,and partnering.Minimizes risk to patients andproviders at the individual andsystems level.Facilitates the development ofhealth care systems that addressthe needs of culturally diversepopulations, providers, and otherstakeholders.Strategies to influence legislation to promotehealth and improve care delivery modelsthrough collaborative and/or individual efforts.The relationship between community/publichealth issues and social problems (poverty,literacy, violence, etc.) as they impact thehealth care of patients.Relationship- building values and theprinciples of team dynamics to performeffectively in different team roles to plan anddeliver patient/population-centered care that issafe, timely, efficient, effective and equitable.Planning, development, and implementation ofpublic and community health programs.Policies that reduce environmental healthrisks.Cost, safety, effectiveness, and alternativeswhen proposing changes in care and practice.Organizational decision making.Interpreting variations in outcomes.

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the population5.6.7.Evaluates the impact of healthcare delivery on patients,providers, other stakeholders, andthe environment.Analyzes organizational structure,functions and resources toimprove the delivery of care.Collaborates in planning fortransitions across the continuum ofcare.Uses of data from information systems toimprove practice.Business principles that affect long-termfinancial viability of a practice, the efficient useof resources, and quality of care.Relevant legal regulations for nursepractitioner practice, including reimbursementof services.Skills needed to assist individuals, theirfamilies, and caregivers to navigate transitionsand negotiate care across healthcare deliverysystem(s).Process of design, implementation, andevaluation of evidence-based, age-appropriateprofessional standards and guidelines for mpetencies1.2.3.Integrates ethical principles indecision making.Evaluates the ethicalconsequences of decisions.Applies ethically sound solutionsto complex issues related toindividuals, populations andsystems of care.Functions as a licensed1.independent practitioner.Demonstrates the highest level ofaccountability for professionalpractice.2.Practices independently managingEthical dilemmas specific to interprofessionalpatient/population-centered care situations.Ethics to meet the needs of patients.Ethical implications of scientific advances andpractices accordingly.Obtains and accurately documents a relevanthealth history for patients of all ages and inall phases of the individual and family lifecycle using collateral information, as needed.Performs and accurately documentsappropriate comprehensive or symptom-The influence of the family or psychosocialfactors on patient illness.Conditions related to developmental delaysand learning disabilities in all ages.

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the population4.previously diagnosed andundiagnosed patients.3.a Provides the full spectrum ofhealth care services to includehealth promotion, diseaseprevention, health protection,anticipatory guidance,counseling, diseasemanagement, palliative, andend-of-life care.3.b Uses advanced healthassessment skills todifferentiate between normal,variations of normal andabnormal findings.3.c Employs screening anddiagnostic strategies in thedevelopment of diagnoses.3.d Prescribes medications withinscope of practice.3.e Manages the health/illnessstatus of patients and familiesover time.Provides patient-centered carerecognizing cultural diversity andthe patient or designee as a fullpartner in decision-making.4.a Works to establish arelationship with the patientcharacterized by mutualrespect, empathy, andcollaboration.focused physical examinations on patients ofall ages (including developmental andbehavioral screening, physical exam andmental health evaluations).3.Identifies health and psychosocial risk factorsof patients of all ages and families in allstages of the family life cycle.4. Identifies and plans interventions to promotehealth with families at risk.5. Assesses the impact of an acute and/orchronic illness or common injuries on thefamily as a whole.6. Distinguishes between normal and abnormalchange across the lifespan.7. Assesses decision-making ability andconsults and refers, appropriately.8. Synthesizes data from a variety of sources tomake clinical decisions regarding appropriatemanagement, consultation, or referral.9. Plans diagnostic strategies and makesappropriate use of diagnostic tools forscreening and prevention, with considerationof the costs, risks, and benefits to individuals.10. Formulates comprehensive differentialdiagnoses.11. Manages common acute and chronicphysical and mental illnesses, includingacute exacerbations and injuries across thelifespan to minimize the development ofcomplications, and promote function andquality of living.Women’s and men’s reproductive health,including, but not limited to, sexual health,pregnancy, and postpartum care.Problems of substance abuse and violence, e.mental health, f. cultural factors, g. genetics, h.dental health, i. families at risk, j. culturalhealth, k. spiritual, and l. sexual, M. academicfunctioning Family assessment.Functional assessment of family members(e.g., elderly, disabled).Signs and symptoms indicative of change inmental status, e.g. agitation, anxiety,depression, substance use, delirium, anddementia.Comprehensive assessment that includes thedifferentiation of normal age changes fromacute and chronic medical andpsychiatric/substance use disease processes,with attention to commonly occurring atypicalpresentations and co-occurring healthproblems including cognitive impairment.Assessment processes for persons withcognitive impairment andpsychiatric/substance use disorders.Evidence-based screening tools forassessment of:a. ADHDb. Anxiety disordersc. Mood disorders

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the population4.b Creates a climate of patientcentered care to includeconfidentiality, privacy,comfort, emotional support,mutual trust, and respect.4.c Incorporates the patient’scultural and spiritualpreferences, values, andbeliefs into health care.4.d Preserves the patient’s controlover decision making bynegotiating a mutuallyacceptable plan of care.12. Prescribes medications with knowledge ofaltered pharmacodynamics andpharmacokinetics with special populations,such as infants and children, pregnant andlactating women, and older adults.13. Prescribes therapeutic devices.14. Adapts interventions to meet the complexneeds of individuals and families arising fromaging, developmental/life transitions, comorbities, psychosocial, and financial issues.15. Assesses and promotes self-care in patientswith disabilities.16. Plans and orders palliative care and end-oflife care, as appropriate.17. Performs primary care procedures.18. Uses knowledge of family theories anddevelopment stages to individualize careprovided to individuals and families.19. Facilitates family decision-making abouthealth.20. Analyzes the impact of aging and age-anddisease-related changes insensory/perceptual function, cognition,confidence with technology, and healthliteracy and numeracy on the ability andreadiness to learn and tailor interventionsaccordingly.21. Demonstrates knowledge of the similaritiesand differences in roles of various healthprofessionals proving mental health services,e.g., psychotherapists, psychologist,psychiatric social worker, psychiatrist, andd.e.f.g.Developmental variations to includephysical differences, behavior andfunctionAutistic Spectrum disordersSubstance disordersSuicidal ideation and self-injuriousbehaviorRisks to health related to:a. Bullying and victimizationb. Environmental factorsc. Risk-taking behaviorsSigns and symptoms of acute physical andmental illnesses, and atypical presentationsacross the life span.Resiliency and healthy coping.Pharmacologic assessment addressingpolypharmacy; drug interactions and otheradverse events; over-the-counter;complementary alternatives; and the ability toobtain, purchase, self-administer, and storemedications safely and correctly.Epidemiology, environmental and communitycharacteristics, cultural, and life stagedevelopment, including the presentation seenwith increasing age, family, and behavioral riskfactors.Assessment of families and individuals in thedevelopment of coping systems and lifestyleadaptations.

Competency AreaNP Core CompetenciesFamily/Across the LifespanNP CompetenciesCurriculum Content to SupportCompetenciesNeither required nor comprehensive, this list reflects onlysuggested content specific to the populationadvanced practice psychiatric nurse.22. Evaluates the impact of life transitions on thehealth/illness status of patients and theimpact of health and illness on patients(individuals, families,

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 .