UNCG S.O.N. Nurse Practitioner Competency Metrics

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1 Yes Module on Clinical Prevention in Long-Term Care that students complete Assessment of Health Status: Obtains a relevant health history, which may be comprehensive or focused. Post test on Clinical prevention based on Clinical evaluation form reflects preventitive measures Test questions for exam and final reflet inclusion of content SOAP notes are reviewed for relevant health history information

2 Yes OSCE is designed to include evalution measures for subjective and objective data DXR case assigned is on older patient with complex medical problems Assessment of Health Status: Evaluates signs and symptoms noting pertinent positives and negatives. SOAP notes are reviewed for review of systems and physical examination based on OSCE is critiqued for student's data collection of pertinent symptoms and signs Dxr Case is accurately completed

3 Yes Students are expected to conduct required monthly visits with patients Students assess patients for acute problems in LTC Assessment of Health Status: Performs and accurately documents a pertinent, comprehensive, and focused physical examination, demonstrating knowledge about developmental, age related, and gender specific variations. based on Clinical evaluation form reflects preventitive measures Completed DxR case: questions on health history

4 Assessment of Health Status: Assesses health promotion needs, social support and physical and mental health status using age, gender, and culturally appropriate standardized assessment instruments or processes in relationship to: a. Activity level b. Mobility c. Cognition d. Decision-making capacity e. Pain f. Skin integrity g. Nutrition h. Sexuality i. Immunization status j. Neglect and abuse k. Substance use and abuse l. Quality of life m. Genetic risks n. Health risk behaviors o. Safety p. Advance care planning preferences based on Yes Require students to complete a designated set of geriatric assessment tools SPICE evaluation competed each week in LTC Lecturer on Advanced Care Planning Completed assessments are presented to preceptor, faculty COCA patients are assessed using specific forms DxR case completed accurately

5 SOAP notes Yes OSCE documentation of the Subjective and Objective Data Assessment of Health Status: Documents accurately a relevant health history which may be comprehensive or focused. Weekly SOAP note review demonstates understanding of relevant history taking based on Students's OSCE notes are graded

6 MDS assignment Yes Community Resource Assessment Module Care giver burden scale to be completed in a relevant case Assessment of Health Status: Assesses the impact of family, community, and environment, including economic, work, institutional, school, and living environments on an individual s health status. based on Completed MDS assignment Accurately recognized caregiver burden using scale

7 Lecture on psychiatric conditions in LTC Yes Assessment of Health Status: Screens for acute and chronic mental health problems and disorders. Completed Geriatric Depression Scales as relevant based on Completed Mini Cog as relevant Test questions for exam and final reflet inclusion of content Delirium scale c ompleted as relevant

8 MDS assignment Yes Review of Nursing Home resource assignment/medicare assignment Lecture on Advanced Care Planning/MOST form Assessment of Health Status: Obtains health information from collateral sources as needed, e.g., with cognitively impaired, sensory impaired, or non-self-disclosing patients, observing ethical and legal standards of care. based on Test questions for exam and final reflet inclusion of content Passing score on MDS assignment Passing score on Medicare Assignment

9 Modules and lectures on clinical topics Assessment of Health Status: Differentiates between normal and abnormal changes associated with development and aging. Passing grades on post test quizzes and tests based on DXR case completed accurately on older patient Clinical evaluation reflects knowledge of aging versus pathology

10 Yes Assessment of Health Status: Assesses individuals with complex health issues and co-morbidities, including the interaction with acute and chronic physical and mental health problems. based on

11 Assessment of Health Status: Analyzes the relationship among development, normal physiology, and specific system alterations that can be produced by aging and/or disease processes. based on

12 Assessment of Health Status: Assesses the individual s and family s ability to cope with and manage developmental (life stage) transitions. based on

13 Assessment of Health Status: Determines the extent of the individual s ability to participate in work, school, physical, and social activities. based on

14 Assessment of Health Status: Assesses the effect of illness, disability, and/or injury on the individual s: a. Functional status b. Independence c. Physical and mental status d. Social roles and relationships e. Sexual function and well-being f. Economic or financial status based on

15 Assessment of Health Status: Conducts a pharmacologic assessment addressing polypharmacy; drug interactions and other adverse events; over-thecounter; complementary alternatives; and the ability to obtain, purchase, self administer, and store medications safely and correctly. based on

16 Assessment of Health Status: Distinguishes cultural, spiritual, ethnic, gender, and age cohort differences in presentation, progression, and treatment response of common acute and chronic health problems. based on

17 Assessment of Health Status: Assesses for syndromes and constellations of symptoms that may be manifestations of other common health problems e.g., risk-taking behaviors, self-injury, stress, incontinence, falls, delirium or depression. based on

18 Assessment of Health Status: Determines the need for transition to a different level or type of care based on an assessment of an individual s acuity, stability, resources, and need for assistance. based on

19 Assessment of Health Status: Assesses the adequacy of and/or need to establish an advance care plan. based on

20 Assessment of Health Status: Assesses the appropriateness of implementing the advance care plan. based on

21 Assessment of Health Status: Assesses genetic risks and heath risk behaviors. based on

22 Diagnosis of Health Status: Identifies both typical and atypical presentations of health problems. based on

23 Diagnosis of Health Status: Develops differential diagnoses for new or recurring health problems. based on

24 Diagnosis of Health Status: Recognizes the presence of comorbidities, their impact on presenting health problems, and the risk for iatrogenesis. based on

25 Diagnosis of Health Status: Diagnoses acute and chronic physical and mental illnesses, disease progression, and associated complications. based on

26 Diagnosis of Health Status: Plans diagnostic strategies and makes appropriate use of diagnostic tools for screening and prevention, with consideration of the costs, risks, and benefits to individuals. based on

27 Diagnosis of Health Status: Orders, performs, and supervises laboratory diagnostic testing, and clinical procedures, and interprets results in relation to the individual s age, gender, and health status. based on

28 Diagnosis of Health Status: Synthesizes data from a variety of sources to make clinical decisions regarding appropriate management, consultation, or referral. based on

29 Diagnosis of Health Status: Prioritizes diagnoses based on reevaluation of data and changing health status. based on

30 Diagnosis of Health Status: Determines decision making capacity. based on

31 Plan of Care and Implentation of Treatment: Develops, implements, and evaluates age-appropriate health screening and health promotion programs. based on

32 Plan of Care and Implentation of Treatment: Designs health maintenance and disease prevention interventions that are age, gender, and health status appropriate. based on

33 Plan of Care and Implentation of Treatment: Provides anticipatory guidance and counseling to individuals and their families based on identified health promotion needs, social support and health status. based on

34 Plan of Care and Implentation of Treatment: Plans therapeutic interventions to restore or maintain optimal level of physical and psychosocial health. based on

35 Plan of Care and Implentation of Treatment: Treats and manages acute and chronic physical and mental health problems. based on

36 Plan of Care and Implentation of Treatment: Treats and manages geriatric syndromes such as falls, loss of functional abilities, dehydration, delirium, depression, dementia, malnutrition, incontinence, and constipation. based on

37 Plan of Care and Implentation of Treatment: Adapts interventions to meet the complex needs of individuals and families arising from aging, developmental/life transitions, multiple system problems, psychosocial, and financial issues. based on

38 Plan of Care and Implentation of Treatment: Plans and orders palliative care and end of life care as appropriate. based on

39 Plan of Care and Implentation of Treatment: Prescribes medications with particular attention to high potential for adverse drug outcomes and polypharmacy in vulnerable populations, including women of childbearing age, adults with comorbidities, and older adults. based on

40 Plan of Care and Implentation of Treatment: Prescribes therapeutic devices. based on

41 Plan of Care and Implentation of Treatment: Monitors and evaluates the safety and effectiveness of pharmacologic, behavioral, and other therapeutic interventions. based on

42 Plan of Care and Implentation of Treatment: Prescribes and monitors the effect of therapies such as physical therapy, occupational therapy, speech therapy, home health, hospice, and nutritional therapy. based on

43 Plan of Care and Implentation of Treatment: Provides leadership to facilitate planning and delivery of care by the healthcare team. based on

44 Plan of Care and Implentation of Treatment: Formulates and implements a plan of care related to sexual and reproductive health and functioning across the adult age spectrum. based on

45 Plan of Care and Implentation of Treatment: Develops a plan for long-term management of healthcare problems with the individual, family, and healthcare team. based on

46 Plan of Care and Implentation of Treatment: Treats and manages complications of chronic and/or multi-system health problems. based on

47 Plan of Care and Implentation of Treatment: Evaluates anticipated and unanticipated risks and adverse treatment outcomes, non recognition of treatable illness, and under/overtreatment. based on

48 Plan of Care and Implentation of Treatment: Evaluates effectiveness of individual s and/or caregiver s support systems. based on

49 Plan of Care and Implentation of Treatment: Performs procedures common to clinical practice:* a. for primary care practice this includes but is not limited to wound debridement, suturing, microscopy, biopsies, Pap smears, and joint aspiration and injection. b. for acute care practice this includes but is not limited to: suturing, line/tube insertion, lumbar puncture, wound debridement. based on

50 Plan of Care and Implentation of Treatment: Manages the individual s transition between health care settings. based on

51 Plan of Care and Implentation of Treatment: Promotes safety and risk reduction through the use of interventions such as: a. devices to promote mobility and prevent falls b. cognitive and sensory enhancements c. restraint-free care d. reduced urinary catheter use based on

52 Plan of Care and Implentation of Treatment: Designs and implements interventions to prevent or reduce risk factors that contribute to: a. decline in physical or mental function b. impaired quality of life c. social isolation based on d. excess disability

53 Plan of Care and Implentation of Treatment: Modifies plan of care and treatment as needed based on evaluation. based on

54 NURSE PRACTITIONER-PATIENT RELATIONSHIP Provides support through effective communication and therapeutic relationships with individuals, families, and caregivers facing complex physical and/or psychosocial challenges. based on

55 NURSE PRACTITIONER-PATIENT RELATIONSHIP Assists individuals, families and caregivers to support or enhance the individual s sense of safety, autonomy, worth and dignity. based on

56 NURSE PRACTITIONER-PATIENT RELATIONSHIP Uses culturally appropriate communication skills adapted to the individual s cognitive, developmental, physical, mental and behavioral health status. based on

57 NURSE PRACTITIONER-PATIENT RELATIONSHIP Advocates for the individual s and family s rights regarding health care decision making such as emancipation, guardianship, durable power of attorney, health care proxy, advance directives and informed consent, taking into account ethical and legal standards. based on

58 NURSE PRACTITIONER-PATIENT RELATIONSHIP Fosters a trusting relationship that facilitates discussion of sensitive issues with the individual, family and other caregivers such as: a. suicide prevention, self injury b. sexually-related issues c. substance use/abuse d. risk-taking behavior e. driving safety f. independence g. finances h. violence, abuse, and mistreatment based on i. prognosis

59 Teaching-Coaching Function Collaborates with the individual, family, and caregivers in the development of appropriate interventions. based on

60 Teaching-Coaching Function Educates individuals, families, caregivers, and groups regarding strategies to manage the interaction among normal development, aging, and mental and physical disorders. based on

61 Teaching-Coaching Function Adapts teaching-learning approaches based on physiological and psychological changes, age, developmental stage, readiness to learn, health literacy, the environment, and resources. based on

62 Teaching-Coaching Function Provides educational experiences for caregivers and health professionals based on

63 Professional Role Directs and collaborates with both formal and informal caregivers and professional staff to achieve optimal care outcomes. based on

64 Professional Role Demonstrates leadership to achieve optimal care outcomes for the adultgerontology population in practice, policy, and other venues. based on

65 Professional Role Coordinates comprehensive care in and across care settings. based on

66 Professional Role Participates in community and professional organizations to: a. Influence health policy b. Promote access to care for the population(s) served c. Advocate on behalf of the population(s) served d. Promote adult-gerontology NP and advanced practice nursing roles. based on

67 Professional Role Participates in the development and use of professional standards and evidence-based care. based on

68 Professional Role Contributes to knowledge development for improved care of the adult-gerontology population. based on

69 Professional Role Describes the current and evolving adult-gerontology NP role to other healthcare providers and the public. based on

70 Professional Role Advocates for a safe and healthy practice environment. based on

71 Professional Role Engages in self reflection, performance appraisal, and peerreview to: a. Identify lifelong learning needs b. Enhance inter- and intraprofessional relationships c. Effect continuous quality improvement d. Enhance professional development based on

72 Professional Role Participates in the design, development, and evaluation of current and evolving healthcare services to optimize care and outcomes for the adult-gerontology population. based on

73 Professional Role Provides guidance and mentorship to other nursing and other health professionals. based on

74 Professional Role Provides consultation to health professionals and others. based on

75 Professional Role Advocates for implementation of the full scope of the adult-gerontology NP role. based on

76 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Assists individuals, their families, and caregivers to navigate transitions and negotiate care across healthcare delivery system(s). based on

77 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Applies knowledge of regulatory processes and principles of payer systems to the planning and delivery of healthcare services. based on

78 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Addresses challenges to optimal care created by competing priorities of patients, payers, providers and suppliers. based on

79 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Participates in the design, implementation, and evaluation of evidence-based, age-appropriate professional standards and guidelines for care. based on

80 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Considers cost, safety, effectiveness, and alternatives when proposing changes in care and practice. based on

81 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Addresses system barriers to care and provides care coordination. based on

82 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Demonstrates knowledge of the services provided by type and level of care across health care settings. based on

83 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Advises, plans, and leads the development of health promoting programs within the community. based on

84 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Advocates for access, quality, and cost-effective care within healthcare agencies and through professional organizations. based on

85 MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS Influences legislation to promote health and improve care delivery models through collaborative and/or individual efforts. based on

86 MONITORING AND ENSURING THE QUALITY OF HEALTH CARE PRACTICE Monitors and evaluates one s own practice by: a. Applying evidence-based practice principles in providing quality care. b. Evaluating evidence to address questions arising in practice and improve patient outcomes. c. Evaluating one s own practice against identified local, regional or national standards. based on

87 MONITORING AND ENSURING THE QUALITY OF HEALTH CARE PRACTICE Improves practice quality by: a. Using internal agency resources and external resources to ensure quality outcomes b. Engaging in peer review processes based on

88 MONITORING AND ENSURING THE QUALITY OF HEALTH CARE PRACTICE Improves practice outcomes within systems by: a. Contributing to the knowledge base of the discipline and healthcare community b. Contributing to health literacy of the public c. Using technology and quality improvement methods to enhance safety and monitor health outcomes d. Developing strategies to reduce the impact of ageism and sexism on healthcare policies and systems. based on e. Advocating for access to quality, costeffective health care.

89 CULTURAL AND SPIRITUAL COMPETENCE Addresses the influence of culture, ethnicity, and spirituality on the mental and physical health of the individual and family in varied healthcare settings. based on

90 CULTURAL AND SPIRITUAL COMPETENCE Recognizes one s own personal biases related to aging, development, and independence and prevents them from interfering with delivery of quality care. based on

91 CULTURAL AND SPIRITUAL COMPETENCE Addresses cultural, spiritual, and ethnic influences that potentially create conflict among individuals, families, staff and caregivers. based on

92 CULTURAL AND SPIRITUAL COMPETENCE Educates professional and lay caregivers to provide culturally and spiritually sensitive, appropriate care. based on

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