The following is a copy of the framework set out by: Nursing Council of New Zealand
Demonstrates safe and accountable nurse practice
PROVIDES SAFE AND ACCOUNTABLE ADVANCED PRACTICE
Competency 1: Demonstrates safe and accountable nurse practitioner practice incorporating strategies to maintain currency and competence.
1.1 Practises in accordance with legislation, professional standards and health policy relevant to mātanga tapuhi nurse practitioner practice.
1.2 Practises within safe boundaries of an area of practice (client/population group) and demonstrates timely referral and consultation when an issue is outside scope, area of practice, experience or competence.
1.3 Confidently and autonomously provides the full spectrum of healthcare services in relation to client/population group, including health promotion and protection, disease prevention, guidance and counselling, disease management, maintenance and restoration of health, rehabilitation and palliative care.
1.4 Self-monitors and critically reflects on practice including through regular professional supervision, collaborative case review and audit of practice, including prescribing.
1.5 Continually reviews and updates knowledge and skills to ensure currency and adaptability to address broad and changing population health needs and to practise safely across healthcare settings.
1.6 Integrates a broad base of nursing knowledge, human sciences (pathophysiology and psychosocial health), and clinical knowledge and skills within a framework of nurse practitioner practice.
1.7 Demonstrates accountability in considering access, cost and clinical efficacy, and applies ethical decision making when providing health services.
Conducts assessments, applies diagnostic reasoning
ASSESSES, DIAGNOSES, PLANS, IMPLEMENTS AND EVALUATES CARE
Competency 2: Conducts comprehensive assessments and applies diagnostic reasoning to identify health needs/problems and diagnoses.
2.1 Completes a comprehensive health history relevant and appropriate to the client’s presentation.
2.2 Actively explores the health consumer’s concerns, preferences, health behaviours, attitudes and priorities using a strengths-based health promotion focus and risk identification to identify healthcare needs.
2.3 Identifies the level of assessment (focused or comprehensive) required and performs a systematic review based on the client’s presenting condition and health history.
2.4 Demonstrates comprehensive skill in obtaining and interpreting data that informs clinical judgement and differential diagnosis including prior treatment outcomes, physical findings and test results.
2.5 Applies analysis, clinical reasoning and problem solving to assessment findings and synthesises clinical and human science knowledge to develop differential diagnoses.
2.6 Orders or performs diagnostic investigations using evidence to support or rule out diagnoses.
2.7 Formulates an accurate diagnosis from an informed set of differential diagnoses using clinical reasoning and best available evidence.
2.8 Demonstrates a high level of clinical proficiency in managing common and complex client situations, and acts to prevent and/or diagnose urgent, emergent or life threatening situations.
Develops, plans, implements interventions
ASSESSES, DIAGNOSES, PLANS, IMPLEMENTS AND EVALUATES CARE
Develops, plans, implements and evaluates therapeutic interventions when managing episodes of care.
3.1 Works in partnership with the health consumer to determine therapeutic goals and options.
3.2 Makes decisions about healthcare management and interventions informed by critical evaluation of research findings.
3.3 Develops an individual plan of care and communicates this to the health consumer and appropriate members of the healthcare team and relevant agencies.
3.4 Applies a comprehensive knowledge of pharmacology to make safe and appropriate risk benefit prescribing decisions, including considerations of antibiotic stewardship and drug dependency where appropriate.
3.5 Verifies the suitability of evidence-based treatment options, including medicines, in regard to commencing, maintaining/titrating or ceasing treatment/interventions.
3.6 Safely prescribes therapeutic interventions based on accurate knowledge of the characteristics and concurrent therapies of the health consumer.
3.7 Safely and effectively performs evidence-informed invasive/non-invasive interventions for the clinical management and/or prevention of illness, disease, injuries, disorders or conditions.
3.8 Makes appropriate decisions regarding admission and discharge of health consumers from healthcare services.
3.9 Monitors, critically evaluates and documents treatments/interventions in accordance with health-consumer-determined goals and healthcare outcomes.
3.10 Considers a plan for appropriately ceasing and/or modifying treatment in partnership with the health consumer, and other members of the healthcare team.
Involves the health consumer for full partnership
WORKS IN PARTNERSHIP WITH HEALTH CONSUMERS
Competency 4: Consistently involves the health consumer to enable their full partnership in decision making and active participation in care.
4.1 Works to establish a relationship with the health consumer that is characterised by mutual trust and respect, empathy and collaboration.
4.2 Demonstrates respect for differences in cultural, social and developmental responses to health and illness, and incorporates health beliefs of the health consumer/community into care planning and implementation.
4.3 Supports, educates, coaches, motivates, counsels and works in partnership with the health consumer and their family/whānau where relevant regarding diagnoses, prognoses and self-management, including their personal responses to illness, injuries, risk factors and therapeutic interventions.
4.4 Advises the health consumer and their family/whānau where relevant on therapeutic interventions including benefits, potential side effects, unexpected effects, interactions, importance of compliance and recommended follow-up.
4.5 Discloses the facts of adverse events to the health consumer and other health professionals; mitigates harm and reports adverse events to appropriate authorities.
4.6 Respects the rights of the health consumer to make informed decisions whilst taking accountability to ensure access to accurate and appropriately interpreted information.
4.7 Assesses and contributes to health literacy by sharing knowledge with the health consumer to achieve an evidence-informed management plan.
4.8 Uses appropriate teaching/learning strategies and style to provide diagnostic information, health promotion and health education to meet the health consumers learning needs.
Works collaboratively to optimise health outcomes
WORKS COLLABORATIVELY WITH HEALTHCARE TEAMS
Competency 5: Works collaboratively to optimise health outcomes for health consumers /population groups
5.1 Establishes and maintains effective collegial relationships as a senior member of interprofessional teams.
5.2 Collaborates with other health professionals and agencies to ensure timely access and smooth transition to quality services for the health consumer.
5.3 Demonstrates advanced interpersonal, leadership and management skills to foster and maintain collegial relationships by communicating and engaging effectively and professionally with diverse groups and communities to improve healthcare.
5.4 Effects nursing practice and healthcare change using broad-based skills, including negotiating, consensus building and partnering.
5.5 Articulates the mātanga tapuhi nurse practitioner role and promotes nursing in clinical, political and professional contexts.
5.6 Contributes to the healthcare team by supporting, directing, educating and mentoring colleagues, students and others (adapted).
Actively supports safe care, population health
WORKS TO IMPROVE THE QUALITY AND OUTCOMES OF HEALTHCARE
Competency 6: Initiates, and participates in, activities that support safe care, community partnership and population health improvements.
6.1 Utilises systems thinking and critical inquiry skills to audit, evaluate and improve the quality of health services.
6.2 Uses relevant tools to monitor and measure the effectiveness of strategies, services and interventions to promote safe practice.
6.3 Monitors and minimises risks to health consumers and healthcare service providers at the individual and systems level.
6.4 Applies knowledge of health systems, socio-political issues, new technologies and funding/business practices to advocate, influence and manage innovative changes to healthcare services to improve access, equity of outcomes, quality and cost-effective healthcare for specific groups or populations.
6.5 Critically appraises scientific literature and shares new knowledge and research through discussions, presentations and publications, and the development of best-practice guidelines
6.6 Incorporates understanding of diversity, cultural safety and socio-economic determinants of health and uses cultural models of care when planning and providing healthcare services.
6.7 Demonstrates commitment to the Treaty of Waitangi/Tiriti o Waitangi and applies advanced knowledge of Māori health and socio-economic disparities when working in partnership with Māori health consumers and local iwi/Māori health providers to improve access to healthcare and health outcomes.
6.8 Influences and critiques health policy and nursing practice through leadership and active participation in workplace and professional organisations.