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Developing nursing core competencies.

Developing meaningful competency requirements for registered muses continues to confound con·found  
tr.v. con·found·ed, con·found·ing, con·founds
1. To cause to become confused or perplexed. See Synonyms at puzzle.

 the sing profession. The challenge it presents for healthcare regulators is learning how to objectively measure competencies across various settings, specialties, yeas of experience and geographic regions. According to according to
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

 Oppewal et al. (2006), core competencies have been developed in different specialty areas, but even nurses' awareness and implementation of such standards vary. The National Council of State Boards state boards Examinations administered by a US state board of medical examiners to license a physician in a particular state; these examinations play an ever-decreasing role in state medical licensure, as these bodies now rely on standardized national examinations  of Nursing (NCSBN NCSBN National Council of State Boards of Nursing ) has worked, through their committees of Research and Practice, Regulation, and Education, to develop a program to transition graduate nurses into the profession; this program has been a culmination of research and defines the needs of new nurses. Spector and Li (2007) discuss this ongoing research that is being completed to assess the design of this program.

At the Center for American Noses LEAD Summit 2008, Dr. May Arm Alexander, Chief Offices of Nursing Regulation for the NCSBN, will present current research and findings about past, present and future issues related to continued nursing competence. Dr. Alexander also serves on the Steering Committee steer·ing committee
A committee that sets agendas and schedules of business, as for a legislative body or other assemblage.

steering committee
 for the National Coordinating Council for Medication Error medication error Malpractice An error in the type of medication administered or dosage. See Adverse effect, Error.  Reporting and Prevention, which promotes open communication between healthcare providers, reporting of errors and improvement and dissemination of strategies to maximize safe medication use.

In a recent interview with Dr. Alexander, the Center discussed her role and previewed what attendees at LEAD Summit 2008 will lean about naming core competencies.

Center: Could you provide an overview of your role at the NCSBN?

Dr. Alexander: NCSBN is a nonprofit organization Nonprofit Organization

An association that is given tax-free status. Donations to a non-profit organization are often tax deductible as well.

Examples of non-profit organizations are charities, hospitals and schools.
 whose mission is to provide leadership to advance regulatory excellence. The organization serves 59 state boards of nursing from across the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area.  and its territories. There are two divisions in our organization: Regulator, Programs and Business Operations Business operations are those activities involved in the running of a business for the purpose of producing value for the stakeholders. Compare business processes. The outcome of business operations is the harvesting of value from assets . I oversee the Department of Regulatory Programs. Within this division me NCSBN's programs in nursing education, practice and credentialing, research, and licensure and discipline. Numerous national meetings, projects, policies and initiatives emerge from this department in response to the regulatory needs and trends of nursing in the United States Nurses in the United States can practice nursing in a wide variety of specialties. Education
Registered nurses generally receive their basic preparation through one of three basic avenues:
 and territories.

As the Chief Offices of Nursing Regulation, my first and foremost responsibility is to ensure the development of quality programs and the dissemination of timely and useful information, resources and services to meet the needs of our member boards. I am responsible for ensuing en·sue  
intr.v. en·sued, en·su·ing, en·sues
1. To follow as a consequence or result. See Synonyms at follow.

2. To take place subsequently.
 that all of our programs, projects, policies and initiatives fulfill the mission of the organization. The staff and I constantly work to evaluate nursing trends, examine opportunities and address regulatory challenges.

I, along with our CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. , Kathy Apple, and the directors within Regulatory Programs, share the responsibility of representing NCSBN at national meetings. I sit on national advisory panels, attend policy meetings and give presentations at national/international conferences. Along with other embers em·ber  
1. A small, glowing piece of coal or wood, as in a dying fire.

2. embers The smoldering coal or ash of a dying fire.
 of our leadership team, I periodically visit the state boards to assess their needs and update them on our projects and activities. We share the responsibility for building and maintaining relationships with our member boards as well as with nursing leadership organizations and other stakeholders Stakeholders

All parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government.

I am also responsible fu the direct development of several initiatives and projects. I oversee our Center for Regulatory Excellence Grant Program, which will award 2.5 nation dollars in grants this yea; I am exploring research related to patient safety and examining potential regulatory interventions; and I an currently the lead staff for our continuing competence initiative.

Center: In your research, have you found that there is agreement on competency requirements for registered nurses?

Dr. Alexander: Yes. NCSBN conducted a post-entry RN practice analysis, which was the first of its kind to scientifically determine whether core competencies existed across all areas of nursing. Scientific data emerged from a survey administered to a random sampling of nurses in the profession. Over 4,700 RNs participated. The geographic distribution, gender, ethnicity and work settings of the survey respondents in this shady were extremely comparable to the sample of nurses described in the Health Resources and Services Administration's (HRSA HRSA Health Resources & Services Administration (US)
HRSA Historical Radio Society of Australia
HRSA Hamilton Rating Scale for Anxiety
HRSA Hotel and Restaurant Suppliers Association (Canada) 
) study, The Registered Nurse Population: National Sample Survey of Registered Nurses (HRSA 2004). The results from our practice analysis determined core competencies for RNs existed regardless of nursing specialty or practice selling. For example, the competencies that were identified according to frequency and importance most often by survey participants included: patient-centered care, working with the interdisciplinary team interdisciplinary team,
n a group that consists of specialists from several fields combining skills and resources to present guidance and information.
 and communication. These were not only identified by nurses across the country that participated in our study as being essential for competent practice, but they were also identified by the Institute of Medicine (IOM IOM

See: Index and Option Market
) and the Quality and Safety Education for Nurses (QSEN) faculty. In fact all of the competencies outlined by the IOM and QSEN were identified in our practice analysis.

In addition, while the purpose of our shady was to identify the competencies that are essential for nurses in the United States, it is interesting to note that, when we presented the post-entry practice analysis at a conference in Toronto with regulators from around the world in attendance, individuals commented that what we had identified were universal competencies that should be core to nursing practice around the world

Center: What is your vision for the future related to the regulation of nursing practice?

Dr. Alexander: Together with leaders from across all areas of nursing, we will continue to develop ways to ensure competency of nurses and safer systems for patient care. There will be even more collaboration of educators, practitioners and regulators to advance sing and improve outcomes for patients. NCSBN's vision is to build regulatory expertise worldwide. It is my vision that our regulatory programs will be a center for knowledge, not only for regulators in the United States, but on a global scale as well.

Center: What will nurses attending your session at the LEAD Summit learn?

Dr. Alexander: Nurses will learn past, present and future issues related to continued competence. The presentation will include:

1) A discussion about the significance of continued competence, its purpose and why this issue has come to the forefront of nursing

2) An examination of the history of the continued competence movement from a national and global perspective

3) The current status of continued competence in nursing across the United States

4) The future of continued competence, including data for and against various methodologies

5) Research done by NCSBN identifying RN core competencies

For more information about the LEAD Summit, please visit

Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency within the United States Department of Health and Human Services whose goal is to improve access to health care for those without insurance. : Bureau of Health Professions. 2006. The registered nurse population: Findings from the March 2004 national sample survey of registered nurses. Rockville: U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979
Health and Human Services, HHS

Oppewal, S., Lamanna, B., and Glenn, L. 2006. Comparison of the dissemination and implementation of standardized public health nursing competencies in academic and practice settings. Public Health Nursing, 23(2):99-107.

Spector, N., and Li, S. 2007. A regulatory model on transitioning nurses from education to practice. Journal of Nursing Administration: Healthcare Law, Ethics and Regulation 9(1):19-22.
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Author:Scott, Diane E.
Publication:STAT Bulletin
Geographic Code:1USA
Date:Apr 1, 2008
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