Guidelines Knowledge and Expertise
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- Charla Williamson
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1 1 Knowledge and Expertise Consult the Glossary of terms for definitions of words identified with an *. (See Page 7 of Job Analysis Questionnaire) This factor considers the minimum current knowledge and expertise required for the position. This may come from several sources, including general education, experience, work-related qualifications and life skills. In many positions, experience can substitute for education/training and vice versa. The precise means of achieving knowledge is not important; it is the total amount of knowledge required by the position that is important. This factor considers both the breadth and depth of knowledge. Some positions require highly specialized knowledge within one area of nursing while others require less depth across a broader range of nursing areas. This factor recognizes both types of requirement to the advantage of both. It is important to note that each response refers to minimum current requirements for a position. There may be individuals with *substantially more experience or qualifications than the minimum requirement. The responsibility for on-going self-education exists for every nurse and is inherent in the knowledge and expertise at every level. It is the nurses professional responsibility to orientate, preceptor or buddy other nurses. This may include helping to familiarize other nurses with clinical practice, the layout of the facility, equipment, policies/procedures specific to the service. Knowledge may be clinical, technical and/or organizational. Specific areas of nursing may refer to maternal child health, psychiatry, gerontology, critical care, palliative care, home care, etc. Response A Refers to positions requiring basic nursing education where additional knowledge is accumulated over time. This includes the transfer of nursing function to other health care workers. Response B Depth is the specific detailed understanding of one area of nursing. Breadth is an overall understanding of a number of areas of nursing. This response refers to a level of additional in-depth knowledge with respect to *theoretical or clinical nursing practice which may be accumulated over time or acquired through additional education. Response C Additional knowledge is required as part of an *assigned formal role, which accounts for a *substantial portion of the position duties. Does not apply to positions which act as a resource unless 25 time or greater is spent doing staff education. Page 1
2 1 Knowledge and Expertise Response D This position requires the application of knowledge and skills required for implementing independent assessment, diagnoses, treatment and the authority to prescribe, normally found in a Nurse Practitioner role, but may be found elsewhere. Page 2
3 2 for Communication Skills (See Page 8 of Job Analysis Questionnaire) This factor measures the communication skills required to deliver or *facilitate *client/patient/resident care. This includes oral and written communication skills. This section measures the importance and frequency of different types of communication with other people. Different forms of communication may be simultaneous. Nursing positions may come in contact with a variety of people to deliver or *facilitate nursing care. Examples may include families, staff, visitors, volunteers, physicians, employees and managers of other departments, colleagues, health and social service agencies, community based services, committees, or vendors. Each of these contacts are an important part of the nursing role. Since the expression of compassion and sensitivity are recognized as being synonymous with the profession of nursing, this communication skill is not measured. Space is provided to give comments/examples to validate the response you have chosen for each type of communication. for 7.5 Hour Shift Hours for Hour Shift Hours Page 3
4 3 for Decision Making (See Page10 of Job Analysis Questionnaire) PLEASE READ THESE GUIDELINES BEFORE COMPLETING FACTOR INFORMATION This factor measures the skill to apply knowledge, professional judgment, expertise and interpretation to make decisions that are routine to innovative. This factor does not measure duties that are compensated by in-charge and relief premiums as found within the collective agreement with the exception of those individuals who are *assigned in-charge duties all of the time. *Unit, *Area, *Program and *Services see glossary for definitions and examples. In this factor, the decision making responses identified in each level will be applied as a MINIMUM requirement to receive a rating at that level. This includes the day-to-day clinical decisions relating to *client/patient/resident care and staffing. Response B This position is *assigned an ongoing continuous requirement for decision-making respecting coordination within a *unit or *area. Response C This position is *assigned the authority to change/develop policies and standards within an entire program or service. In addition, this level applies to RNs who coordinate staffing and/or patient care for more than one *unit or *area. Page 4
5 4 for Responsibility for Client/Patient/Resident Care (See Page 11 of Job Analysis Questionnaire) This factor measures the responsibility for *client/patient/resident care in your job. The provision of promotive, preventative, curative and/or rehabilitative care is indirect or direct responsibility of most nursing jobs. Response A Indirect care is assessed when hands-on or direct care provided is only a secondary part of a nurse s daily duties. It also refers to nurses who direct/coordinate a program and/or staff. Response B Direct care is defined as direct contact (verbal or physical) with the *client/patient/resident. Page 5
6 5 for Responsibility for Standards of Care/Projects (See Page 12 of Job Analysis Questionnaire) This factor measures the responsibility for standards of care/projects. This includes identifying needs/problems, gathering and researching information, developing or modifying, implementing and evaluating standards of care /projects. This responsibility may require collaboration with *clients and/or service providers. Examples of projects include clinical studies, surveys, utilization audits, educational programs, etc. Response A This refers to the responsibility for information gathered being utilized to provide nursing care to individuals. Response B This refers to positions, which are accountable for gathering/researching information or data to be submitted for analysis by someone else. Response C This refers to positions, which are accountable for writing and developing/modifying standards of care/projects based on information analyzed. Response D This refers to positions, which are accountable for assessing the effectiveness of and making required changes to the standards of care/projects. This accountability usually rests with one individual and cannot be delegated to another. Evaluating overall effectiveness refers to assessing standard of care, or project as a whole. Page 6
7 6 for Responsibility for Education Delivery (See Page 13 of Job Analysis Questionnaire) This factor measures the responsibility for educating others, including *clients/patients/residents, external groups (e.g., school groups, parents), and other caregivers. The level of responsibility increases with the complexity of assessment, range of education techniques employed and program development or preparation required. Response A An example of education at this level is providing discharge *teaching to a *client/patient/resident. This response also refers to the orientation of other nurses which includes helping to familiarize them with the layout of the facility, equipment, policies/procedures and clinical skills/expertise specific to the *unit/*area. Response B Examples of formal education programs are diabetic education, prenatal education programs. Response C This response refers to situations where the development and delivery of formal programs require *consultation and education of multiple stakeholders. Examples of situations with multiple stakeholders are the development of a program for school education requiring *consultation with parents, teachers, local school board, etc.; the development of an education program for renal patients requiring *consultation with the Nurses Association of New Brunswick (NANB), Canadian Nurses Association (CNA), College of Physicians and Surgeons, Kidney Foundation, etc. Page 7
8 7 for Responsibility for Referrals (See Page 14 of Job Analysis Questionnaire) This factor measures the responsibility in your position to make the appropriate referrals in providing *client/patient/resident care. Referrals can be internal or external to the organization, including other health professionals, community resources, community-based organizations and/or government departments/agencies. Response A This response encompasses positions with no direct *client/patient/resident care responsibilities. Response B Defined policy in this response refers to well-defined rules that govern the assessment and reporting requirements when particular situations are identified. Normally refers to the responsibility for referrals which require authorization by physicians. Response C Refers to the positions responsible for independent initiation of the referral, including documentation of relevant past medical history, current assessment, and rationale for the referral to the appropriate health professional or external agencies. Interagency transfers and documentation of same also apply when the position has the responsibility for the independent initiation of the transfer. Response D Follow up and continued contact (case management) in this response refers to the responsibility for continual assessment of the patient s progress with respect to the referral and to maintaining ongoing communication with the referral personnel/agency and the client, followed by revision of the care plan as necessary. In this level, the RN is the hub of care for a patient, *client or resident. Page 8
9 8 for Responsibility for Resources (See Page 15 of Job Analysis Questionnaire) The factor considers responsibility for resources. Resources include supplies, equipment, and financial resources (money or budgets). Responsibility for resources includes working with finances, maintenance and procurement of resources. This factor does not consider responsibility for people resources, which is measured in the Supervision factor. This factor does not measure duties that are compensated by in-charge and relief premiums as found within the collective agreement with the exception of those individuals who are *assigned in-charge duties all of the time. Equipment/materials is defined as physical assets or materials, including machinery, vehicles, materials and/or supplies used while performing duties. Response A, B and C: Includes one or more of the following under working with finances OR, maintenance OR procurement. Response D - Must include working with finances OR maintenance and procurement of equipment for the area of responsibility. Working with finances Maintenance Procurement A. Prudent Use. This response refers to the routine use of equipment, office materials, medical equipment and supplies in the most efficient manner and with minimal waste. A. nil A. nil B. Prudent Use (example gas cards, procurement cards, ordering or reordering regularly used supplies) Petty cash, Input into (wish list) C. Know your budget, Monitor it, Project budget Financial responsibility in this response is for an allocated budget amount and discretionary spending within that budget. B. Standard procedures - i.e. calibrating equipment such as glucometers, audiometers, dialysis machines, cardiac monitors) C. Responsible for coordinating maintenance for an area of responsibility. This response includes those positions with *assigned responsibility for all maintenance and up keep of employer vehicle. B. Reordering regularly used supplies, small expenditures C. Purchase of supplies other than regularly used items for the area of responsibility. Page 9
10 8 for Responsibility for Resources D. Develop, allocate, monitor, administer budget in a service/program/agency D. Same as C D. New equipment: research products, the need for and cost and either purchase it or recommend purchase Page 10
11 9 for Supervision (See Page 16 of Job Analysis Questionnaire) This factor measures the responsibility for guiding, directing and supervising other employees. This factor does not measure duties that are compensated by in-charge and relief premiums as found within the collective agreement with the exception of those individuals who are *assigned in-charge duties all of the time. This factor measures the nature of the supervisory demands, not the numbers of employees supervised. This covers supervision of employees of the organization, including full-time, part-time and casual employees. This factor does not include supervision of volunteers. Other health care workers are defined as support staff such as housekeeping, maintenance, laundry, food service workers, administrative support, LPNs, aides, students, etc. Response A - Provide guidance means giving work direction in the form of providing information/demonstration on an informal basis and *orientation. Guidance which includes helping to familiarize other nurses with the layout of the facility, equipment and policies/procedures specific skills and expertise to the service/*area. Response B *Clinical supervision in this level is defined as the supervision of the clinical work of other staff that provide direct care. Response B includes a diverse group of positions that provide *clinical supervision to both unlicensed and licensed health care workers. Response C This response refers to those with *assigned supervisory responsibility and authority to direct other health care workers. Appropriate deployment of staff may mean approval of short notice time off, floating staff from one work *area to another and/or calling in staff. Page 11
12 10 for Physical Effort (See Page 17 of Job Analysis Questionnaire) This factor measures the typical effort required in the position that may result in physical or sensory fatigue. Efforts may be simultaneous. Consider the physical effort required after all safety precautions have been taken. Space is provided to give comments/examples to validate the response you have chosen for each type of effort. for 7.5 Hour Shift Hours for Hour Shift Hours Page 12
13 11 for Mental Effort (See Page 19 of Job Analysis Questionnaire) This factor measures the typical effort required in the position that may result in mental or psychological fatigue and/or distress. Efforts may be simultaneous. Indicate your answer by placing one number from the scale in the space provided rather than a check mark. Space is provided to give comments/examples to validate the response you have chosen for each type of effort. for 7.5 Hour Shift Hours for Hour Shift Hours Page 13
14 12 for Working Conditions (See Page 21 of Job Analysis Questionnaire) This factor measures the likelihood, frequency and severity of exposure to hazardous or disagreeable working conditions in your work environment after all required safety precautions have been taken. Exposure to different working conditions can be simultaneous. Space is provided to give comments/examples to validate the response you have chosen for each type of condition. Question B only applies when it is a requirement of the position e.g. overnight stays to attend educational opportunities would not apply unless it is required of the position. for 7.5 Hour Shift Hours for Hour Shift Hours Page 14
15 Area A geographical location, territory or zone. GLOSSARY Assigned Requirement of that position as designated by the employer Client person to whom you are providing a nursing service. Examples patient, resident, employee. Clinical Supervision Responsible for leading/overseeing the clinical care in a team/collaborative approach and making changes to ensure standards of care are met. Consultation - To seek advice and input into the development process. This is a participatory process to meet mutual goals, not simply an information gathering process. Counsel/Counseling - Giving advice and support to others whether they are clients, patients, residents or staff. Documentation Information provided from the factors throughout the questionnaire Facilitate/Facilitating To either lead a group discussion or initiate a group meeting and help them come up with decisions/solutions to situations. Key Work Activities Major areas of responsibility for a position. Negotiate/Negotiation/Negotiating Discussion and bargaining (give and take) between the parties that takes place to reach the end result or solution. Orientation preceptering or buddying. Program a large entity comprised of multiple services that affects the entire Zone. It is directed to all employees; it is either Zone wide or covers the entire spectrum of the Zone, all professions. Ex. Surgical program, employee health, Extra-Mural Program. Service - A very specific modality, much smaller in scope than a program and applies to a very specific client group. Ex. GI Service, Diabetes Services, Ambulatory Clinics. Substantial Being of considerable degree, amount, or extent. Teaching Transferring skills. Theoretical - Of, relating to, or based on theory. Unit A division of a program that provides services such as orthopedics (Surgical Program); Fredericton Unit (Extra-Mural Program) ; Mental Health Services, Bathurst (Community Mental Health Program); etc.
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