PAPUA NEW GUINEA
NURSING COMPETENCY STANDARDS
Nursing Council of Papua New Guinea
PO BOX 841
Port Moresby NCD
1ST Edition
September 2002
PAPUA NEW GUINEA NURSING COMPETENCY STANDARDS
Introduction
Nurses in Papua New Guinea are accountable to the community to provide safe and effective care. The law governing nursing practice is in the Medical Registration Act passed by National Parliament. The Nursing Council for Papua New Guinea is a statutory (legal) body that registers nurses and controls their practice.
In March 2002 a workshop in Port Moresby convened by the Nursing Council for Papua New Guinea and funded by World Health Organization developed the first draft of PNG Nursing Competency Standards1 . The workshop also produce draft Code of Ethics2 and Code for Professional Conduct3 for nurses. Participants represented Nursing Council for PNG, community and hospital health services, urban health clinics, nurse administrators and nurse teachers in certificate and diploma programs, Training and Curriculum Unit, Human Resource Management Branch, Department of Health and PNG Nurses Association.
Professional Nursing Practice Standards
Professional nursing practice standards describe the actions of nurses in providing safe and effective practice. The aim is to make a positive contribution to health outcomes for the people our country.
Standards for professional nursing practice integrate three components:
· Nursing Competency Standards
· Code of Ethics
· Code of Professional Conduct
Taken together, Nursing Competency Standards, Code of Ethics and Code of Professional Conduct describe the generic functions of the first level Registered Nurse.
PNG Nursing Competency Standards
The Nursing Competency Standards for Papua New Guinea are set out in seven areas of nursing practice under ‘domains’. These are: professional and ethical practice, critical thinking and analysis, communication, management and leadership, management of client care, public health and health promotion, and partnership with community and services. Under each domain the standards for practice are separated into 15 Competency Units. Each competency unit is divided again into smaller parts called elements. The performance criteria of each element are used to evaluate whether or not the standard has been reach.
The Code of Ethics identifies the morals and ideals of the profession and provides nurses with a basis for self reflection as a professional and a guide to ethical practice. The Code of Professional Conduct identifies the minimum requirements for nursing practice and clarifies professional and unprofessional conduct. Legal and statutory authorities use the Codes as a basis of decision making when the conduct of professional nurses is in question. The Codes are printed in separate documents.
The Nursing Competency Standards together with the Code of Ethics and Code of Professional Conduct provide a framework for professional nursing practice and education in this country.
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1 Adapted from Australian Nursing Council Inc. (ANCI) National Competency Standards for the Registered Nurse 3rd Ed. 2000 and Nursing Council of New Zealand Guidelines for Competence-based Practising for the Registered Nurses May 2000
2 Adapted from Philosophy and Code of Ethics for Nurses in PNG 1988 and Australian Nursing Council Inc. (ANCI) Code of Ethics for Nurses in Australia, 1999
3 Adapted from Australian Nursing Council Inc. (ANCI) Code of Professional Conduct March 1999 and New Zealand Nursing Council of New Zealand Code of Conduct for Nurses and Midwives RP September 1999.
The functions of professional nursing practice standards are:
· To inform the community of the standards of practice, values and conduct expected of nurses;
· To communicate professional nursing standards to others providing health and related services;
· To identify the knowledge, skills and attitudes required by nurses and the complex nature of nursing activities.
· For nurses’ self-assessment in daily practice;
· For ongoing appraisal of staff and workplace performance;
· For planning continuing education, staff development and in service courses;
· For rationalizing the workforce;
· To assess continuing fitness to practice;
· To assess nurses who wish to return to work after being away from the workforce for a defined period;
· To assess nurses who completed nursing courses outside Papua New Guinea;
· To provide the basis for developing competencies for specialty nursing areas;
· For nursing curriculum development and academic assessment;
· To ensure that graduates from accredited programs in various institutions can demonstrate nursing competency standards to become registered as nurses.
Development of Professional Nursing Standards in PNG
The first drafts of PNG Nursing Competency Standards, Code of Ethics and Code of Professional Conduct were circulated to PNG nurses and legal and medical personnel for their comments and additions. The comments and suggestions received were incorporated in second drafts and a small group met to finalise the documents for the first edition of Papua New Guinea Nursing Competency Standards.
The first edition will be evaluated in a year’s time after nurses in various areas of practice, teaching and administration have had the opportunity to apply the standards.
Adaptation of Professional Nursing Practice Standards
The PNG Nursing Competency Standards, Code of Ethics and Code of Professional Conduct are based on the work of our nurse counterparts in Australia and New Zealand. Their professional nursing standards were adapted for PNG, and other competency standards developed for health service delivery unique to this country. Without access to the professional nursing standards of the two countries, PNG nurses would not have achieved the big task of producing professional nursing standards in a relatively short time.
Acknowledgements
The Nursing Council for Papua New Guinea acknowledges the work of the many nurses in Australia and New Zealand who have produced and refined their professional competency standards over many years. These standards became the foundation for the development of professional nursing practice standards in Papua New Guinea. The Council wishes to thank them for their contribution to the advancement of the practice of nursing in this country.
Rita Konilio
Registrar Nursing Council for Papua New Guinea
September 2002
The Philosophy
The nurse registering authorities in Papua New Guinea assert that:
· Nursing is a service which is authorized and valued by society.
· The focus of nursing care is health. Nurses are concerned with enabling people to remain healthy, return to a state of optimum function, behaviour or state of mind, and with assisting the dying to achieve a dignified death.
· Nursing addresses the complexity and uniqueness of the whole person in the environmental context.
· Nurses provide care, simultaneously attending to the biological, psychological, social and spiritual needs of the person, and by being aware of the interrelationships between these needs.
· The effect of nursing care should be positive and should result in benefit, physically, emotionally and/or spiritually, to an individual or group.
· In circumstances of ill health, nurses focus on the response of individuals and groups to health problems, and their ability to contend with these responses.
· Nursing is an art and a science. The essence of nursing lies in a unique interplay of knowledge, intuitive and logical thought and compassion for others. The interaction of cognitive, affective and psychomotor skill is essential for nursing practice.
· Nursing knowledge is derived from qualitative and quantitative research and from the experience of nurses.
Statement Pertaining To The Registered Nurse
The Registered Nurse is the first level nurse who is licensed to practise nursing in the field/s in which he/she is registered without supervision, and who assumes accountability and responsibility for his/her own actions. This nurse is also referred to as the professional nurse.
Pre-registration nursing courses are designed to prepare a beginning practioner to provide safe competent and responsible nursing care in a variety of health care settings.
The major aim of educational programs leading to registration is the development of knowledge and skill in providing nursing care for individuals and groups. This includes provision of care and comfort, support in activities of daily living, and meeting of basic human needs. The program aims to develop skills in assessment of health care needs, identification of goals; skills in problem identification and clinical decision making; and in the planning, implementation and evaluation of the care provided to individuals or groups.
The role of the registered nurse includes the following integrated components: clinician; care coordinator, counselor; health teacher; client advocate; change agent; clinical teacher/supervisor. The role of the registered nurse includes the responsibility to examine nursing practice critically and to incorporate the results of personal action research or the research findings of others.
Registering authorities expect that on initial registration, a beginning practioner will have access to more experienced nurses. Registering authorities would not expect the beginning practioner to take in-charge positions or function alone in areas where clinical decisions involve unpredictable outcomes or where the patient/client presents with multiple problems.
The nurse practices independently and inter dependently in accordance with professional standards, and employs a problem solving approach in practice.
Competencies For The Registered Nurse In Recommended Domains
PAPUA NEW GUINEA
NURSING COMPETENCY STANDARDS
T A B L E O F C O N T E N T S
PNG Nursing Competency Standards Page
Introduction ii
Domain; Professional and Ethical Practice 5
Competency Unit 1 5
Competency Unit 2 6
Competency Unit 3 6
Domain: Critical Thinking and Analysis 7
Competency Unit 4 7
Competency Unit 5 7
Domain: Communication 8
Competency Unit 6 8
Domain: Management and Leadership 9
Competency Unit 7 9
Domain: Management of Care 9
Competency Unit 8 9
Competency Unit 9 10
Competency Unit 10 10
Competency Unit 11 10
Competency Unit 12 11
Competency Unit 13 11
Domain: Public Health and Health Promotion 12
Competency Unit 14 12
Domain: Partnership with Community and Services 12
Competency Unit 15 12
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PAPUA NEW GUINEA
NURSING COMPETENCY STANDARDS
1st Edition, September 2002
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DOMAIN: PROFESSIONAL AND ETHICAL PRACTICE
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COMPETENCY UNIT 1 Practices nursing in accord with relevant legislation, common and
customary law
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Elements
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Performance Criteria
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1. Recognizes common and customary laws and is mindful of the legal implications of nursing practice.
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· Identifies relevant common and customary laws.
· Identifies legislation governing nursing practice.
· Manages and administers medications according to legal requirements.
· Plans and provides nursing care within legal parameters.
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2. Upholds law relating to management of care, appropriate to circumstances and resources.
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· Identifies and maintains practices that are required by law e.g. client’s rights to accept or refuse treatment; free and informed consent; confidentiality; freedom of movement; and duty of care.
· Reports breaches of law to appropriate authorities.
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3. Provides duty of care.
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· Performs adequate and accurate assessment as the basis for all nursing interventions.
· Performs nursing interventions according to recognized standards of practice.
· Clarifies aspects of care with other members of health team.
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4. Observes the obligations, policies, rules and regulations of the employing agency/institution.
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· Documents accurately and communicates nursing interventions and observations immediately after performance.
· Documentation conforms to legal requirements and institutional guidelines.
· Adheres to the rules and policies of employing agency/institution.
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5. Recognises unsafe practice and prevents its recurrence.
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· Identifies safe practice.
· Takes action to prevent unsafe practice.
· Reports unsafe practices to the appropriate authority.
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5
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COMPETENCY UNIT 2 Provides nursing service in accord with ethical standards and practice
codes of the nursing profession.
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Elements
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Performance Criteria
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1. Values and respect all people regardless of place of origin, race, politics, status, role, gender, culture, belief system and/or behaviour.
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· Recognises own beliefs, values and prejudice that may compromise the provision of health care.
· Delivers care that is sensitive to the individuality, rights and social bias of the client.
· Responds to the spiritual and cultural beliefs of the client.
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2. Recognises the spiritual needs of client/group related to the delivery of care.
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· Responds to spiritual needs with compassion, kindness, patience and tolerance.
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3. Creates, maintains and strengthens good relationships with others in the health team.
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· Seeks opportunities to discuss professional matters with other health workers.
· Acknowledges the contribution of each member of the health team.
· Shares own knowledge and experience with others in the health team.
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4. Develops attitudes and behaviours that foster own integrity and promotes the nursing profession.
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· Acts responsibly and with honesty to maintain personal and professional integrity.
· Maintains consistent quality nursing standards of practice in all settings.
· Meets professional and institutional dress codes.
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5. Maintains confidentiality of professional colleagues except where required by law to give evidence.
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· Respects the rights of privacy and confidentiality relating to colleagues.
· Discusses professional conduct of peers in a constructive manner when required.
· Stores sensitive and confidential documents securely.
· Seeks approval from appropriate authority to release confidential information when required by law.
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6. Participates in the resolution of ethical issues.
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· Identifies ethical issues in aspects of nursing practice.
· Participates in group discussions to find appropriate solutions in ethical issues.
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COMPETENCY UNIT 3 Practises client advocacy in all settings.
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Elements
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Performance Criteria
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1. Maintains client confidentiality.
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· Limits the discussion of client health team members.
· Maintains client confidentiality in teaching/learning situations.
· Maintains confidentiality of client records, personal information and interactions.
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2. Upholds the rights of clients/groups to optimal health.
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· Identifies policies and practices that are detrimental to the health status of clients/groups.
· Supports changes that address detrimental health policies and practices.
· Promotes lifestyle practices that lead to optimal health.
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3. Ensures that clients are adequately informed regarding the expected outcomes and possible adverse effects of all interventions.
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· Provides appropriate information within the nurse’s scope of practice to assist the client in decision making.
· Confirms that the client has been adequately informed prior to signing a consent form.
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4. Protects the client’s right to decide and facilitates the decision-making process.
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· Determines extent of client’s knowledge of health condition.
· Provides relevant information.
· Supports client in the decision-making process.
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5. Identifies community resources available to promote optimal well-being.
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· Provides information about resources, support groups and facilities.
· Assists client in accessing these resources.
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6
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DOMAIN: CRITICAL THINKING AND ANALYSIS
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COMPETENCY UNIT 4 Acknowledges accountability and responsibility for own actions and
outcomes and acts to enhance professional nursing practice.
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Elements
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Performance Criteria
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1. Uses professional standards of practice to assess the performance of self and others.
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· Undertakes regular self evaluation of own nursing practice.
· Seeks and considers feedback from colleagues and reflects critically on own nursing practice.
· Participates actively in performance review process.
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2. Recognises the need for and participates in own professional development.
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· Identifies own professional development needs by reflecting on own practice.
· Seeks additional knowledge/information when in unfamiliar situations.
· Seeks support from colleagues in identifying learning needs.
· Seeks opportunities to undertake ongoing professional development activities, including continuing education.
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3. Recognises the need for own care.
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· Identifies and seeks appropriate support for personal needs.
· Shares mutual experiences related to professional issues with colleagues.
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4. Contributes to the learning experiences and professional development of others.
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· Coaches and mentors junior and new colleagues to assist in their development.
· Shares knowledge and mutual experiences with colleagues.
· Role models professional behaviour.
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5. Reports errors of judgment and action immediately to appropriate authority.
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· Acknowledges own errors.
· Reports promptly to appropriate health professional.
· Prepares incident report and submits to appropriate authority.
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COMPETENCY UNIT 5 Values research in contributing to development of nursing knowledge
and improving standards of nursing practice.
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Elements
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Performance Criteria
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1. Acknowledges the importance of research in improving nursing outcomes.
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· Identifies how research could contribute to nursing practice.
· Communicates the importance and implications of research to colleagues.
· Critically reviews outcomes of nursing activities with colleagues.
· Identifies problems/issues relating to nursing practice which may be investigated using research methods.
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2. Contributes to the process of nursing research.
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· Demonstrates an understanding of own role in contributing to nursing research.
· Contributes to research projects when possible by maintaining accurate records and related documentation.
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3. Applies current nursing knowledge, skill, research and reflective practice to the provision of quality nursing.
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· Seeks opportunities to gain further knowledge and skills from research findings relevant to nursing practice and shares them with others.
· Seeks ways of improving nursing care by collecting, collating and analyzing data and applying to nursing practice.
· Seeks opportunities to adjust own practice in response to current literature, insights and processes that enhance the quality of nursing care.
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DOMAIN: COMMUNICATION
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COMPETENCY UNIT 6 Communicates effectively to support client through the health care
experience.
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Elements
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Performance Criteria
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1. Communicates effectively using formal and informal channels of communication.
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· Takes responsibility for establishing rapport and trust with the client.
· Interviews client to assess current knowledge, needs and problems.
· Respects the boundaries of a professional relationship with the client.
· Negotiates partnership that is empowering to the client and/or carer.
· Uses interpreter where necessary.
· Utilises range of effective communication techniques/methods.
· Communicates clearly and appropriately, verbally or in writing, when giving instructions about client carer to all involved.
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2. Ensures accurate, retrievable documentation.
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· Records information promptly, legibly, clearly and concisely; using accurate spelling and accepted abbreviations; includes date and time.
· Files information according to guidelines.
· Retrieve information as required.
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3. Uses lines of communication within the organization.
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· Identifies lines of communication in the organization.
· Delivers messages according to protocols and procedures.
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4. Monitors health services delivery.
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· Uses standard forms to record and collate data.
· Disseminates information appropriately.
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8
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DOMAIN: MANAGEMENT AND LEADERSHIP
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COMPETENCY UNIT 7 Manages material and human resources appropriately
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Elements
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Performance Criteria
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1. Uses information from current PNG National Health Plan and Minimum Standards to plan health services.
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· Participates in formulating annual plan based on priorities of PNG National Health Plan and Minimum Standards.
· Uses appropriate data to assist in identifying needs and priorities, setting short and long term goals and objectives and planning strategies to achieve goals.
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2. Uses available resources to achieve maximum health outcomes at minimum cost.
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· Participates in implementing and monitoring the plan through providing health care and supervising other staff.
· Follows protocols and procedures.
· Uses resources wisely to contain costs.
· Participates in evaluating achievement of goals/objectives and cost containment.
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3. Provides a role model for optimal health.
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· Maintains health and fitness through adequate nutrition, hygiene, elimination, sleep, rest and exercise.
· Takes measures to prevent infections and diseases related to alcohol, betel nut, nicotine and other drugs.
· Initiates and maintains satisfactory interpersonal relationships.
· Consults and collaborates with others.
· Displays problem solving and time management skills.
· Fosters development of spiritual beliefs.
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4. Demonstrates leadership ability.
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· Takes responsibility for own actions and decisions.
· Strives for excellence in the quality of own work.
· Acknowledges others’ skills and abilities.
· Is receptive to new ideas and is willing to learn.
· Promotes advocacy.
· Suggests ways of improving health service delivery.
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DOMAIN: MANAGEMENT OF CARE
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COMPETENCY UNIT 8 Promotes environment which maximizes client
safety, independence, quality of life and health
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Elements
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Performance Criteria
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1. Promotes a safe health care environment.
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· Recognises potential physical, psychological and cultural risk to all in the health care environment.
· Takes steps to promote safety.
· Reports when equipment is not accessible, functional and/or suitable for the purpose.
· Accesses, maintains and uses emergency equipment and supplies
· Acts appropriately to protect self and others in crisis/emergency/disaster situations.
· Participates in management of emergency and disaster situations.
· Maintains a safe and supportive environment when directing, delegating or supervising other staff.
· Implements infection control policies and guidelines.
· Promotes an environment that reduces risk of cross infection.
· Participates in reviewing infection control standards.
· Notifies safety hazards in the environment.
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COMPETENCY UNIT 9 Practises nursing in a manner that respects the cultural and spiritual
values of the client.
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Elements
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Performance Criteria
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1. Supports the needs of clients/groups in relation to their cultural and spiritual values.
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· Recognises and respects the diverse cultural and spiritual values of people of PNG.
· Recognises the impact of care on the culture on clients and endeavours to support their individual beliefs/traditions/way of life.
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2. Acts to maintain the dignity, integrity and self-esteem of clients/groups.
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· Identifies situations that may threaten the dignity/integrity/self esteem of clients/groups.
· Provides information to clients/groups to enhance their control of their own health care.
· Involves clients/groups/carers in making decisions about health care.
· Affirms individual client/group differences.
· Recommends support networks to clients/groups.
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COMPETENCY UNIT 10 Carries out comprehensive and accurate nursing assessment of
clients/groups in a variety of settings.
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Elements
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Performance Criteria
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1. Uses a structured approach in the process of assessment.
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· Uses a standard framework when obtaining health history and gathering data.
· Uses a range of data gathering techniques (observation, interview, physical examination and measurement) from available sources (client; group; family; significant others; previous health records; health care team) to obtain subjective and objective data relating to physiological, psychological, spiritual, socioeconomic and cultural variables on an ongoing basis.
· Records the findings in appropriate format.
· Confirms data with clients/groups and members of the health care team.
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2. Analyses and interprets data accurately.
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· Identifies actual and potential health problems through accurate interpretation of data.
· Identifies changes in the health status of clients.
· Identifies and documents nursing diagnoses in the appropriate format.
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COMPETENCY UNIT 11 Formulates a plan of care in collaboration with clients/groups.
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Elements
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Performance Criteria
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1. Establishes priorities to address identified health needs in consultation with clients/groups.
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· Determines priorities of care and intervention, based on nursing assessment client/group needs and preferences, values and beliefs and current nursing knowledge and research.
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2. Identifies expected outcomes including a time frame for achievement in consultation with clients/groups
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· Establishes short and long term goals in collaboration with clients/groups that include conditions for achievement of outcomes.
· Writes goals/objectives/outcomes that are appropriate, measurable and achievable in the time frame.
· Identifies criteria to evaluate expected outcomes.
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3. Develops plan of care in consultation with client/carer to achieve optimal health, rehabilitation or a dignified death.
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· Identifies strategies in development of plan of care.
· Discusses plan with client/carer and adjusts as necessary.
· Documents the plan.
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COMPETENCY UNIT 12 Implements planned nursing care to achieve identified outcomes within
scope of competence.
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Elements
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Performance Criteria
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1. Provides planned care.
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· Provides care according to plan using appropriate nursing interventions and techniques safely.
· Uses an appropriate range of strategies to facilitate clients/groups achievement of short term and long term goals/objectives/outcomes.
· Monitors responses to care and makes the necessary adjustments to plan of care.
· Utilizes resources effectively and efficiently in providing care.
· Provides support/education to develop and/or maintain independent living skills.
· Documents provision of care.
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2. Supports health team in planning for continuity of care as appropriate.
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· Supports therapeutic interventions of other health team members.
· Maintains and documents information necessary for continuity of care.
· Responds to educational needs of client and/or carer.
· Identifies appropriate community agencies to ensure continuity of care.
· Refers client to community agency with written information and supplies needed to maintain continuity of care.
· Documents plan of care.
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3. Educates clients/groups to maintain and promote health.
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· Identifies and documents specific educational requirements and requests of clients/groups/family/carers.
· Plans teaching and identifies appropriate educational resources that may include other health professionals.
· Conducts formal and informal education sessions with clients/groups.
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COMPETENCY UNIT 13 Evaluates progress towards expected outcomes, reviews and revises
plans accordingly.
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Elements
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Performance Criteria
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1. Determines the progress of clients/groups towards planned outcomes.
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· Evaluates clients/groups response to interventions.
· Assess the effectiveness of planned care in achieving outcomes
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2. Revises nursing intervention in accordance with evaluation data and determines further outcomes
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· Revises nursing interventions and priorities based on changes to client’s/group’s condition, needs or situational variation.
· Documents and communicates revised and new information to other members of the health care team as required.
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DOMAIN: PUBLIC HEALTH AND HEALTH PROMOTION
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COMPETENCY UNIT 14 Assists clients and community to achieve optimal health.
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Elements
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Performance Criteria
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1. Uses a structured approach in the process of assessment, delivery and evaluation of health promotion and health education for individuals and groups.
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· Recognises the potential for health promotion and health education in nursing interventions.
· Uses information formal methods to assess the needs of client/group.
· Identifies the problems and formulates goals/objective/outcomes and makes plan to solve them.
· Selects health promotion material/programs to meet client/group needs.
· Uses formal and informal methods of teaching appropriate to client/group.
· Evaluates client’s/group’s achievement of goals/objectives/outcomes.
· Evaluates achievements of targets in health service delivery.
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2. Participates in health promotion.
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· Ensures sufficient equipment, supplies and appropriate health teaching resources are available.
· Uses local networks to and resources for notification.
· Provides opportunities for individuals/groups to voice their concerns.
· Conducts or supervises health education/promotion program.
· Records activities on standard forms.
· Utilizes ‘Healthy Islands Approach’ concept in health program activities.
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3. Assists in management of epidemics.
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· Consults notifiable diseases list and notifies supervisor when relevant.
· Completes necessary forms to report an epidemic and its initial assessment.
· Carries out instructions in Public Health Manual to control specific diseases.
· Monitors progress of epidemic and reports to supervisor.
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DOMAIN: PARTNERSHIP WITH COMMUNITY AND SERVICES
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COMPETENCY UNIT 15 Promotes a nursing perspective to work in partnership with other
sectors in promoting health.
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Elements
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Performance Criteria
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1. Recognises the roles of each member of the team in the delivery of health care.
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· Invites the client and groups in the community such as teachers, community and church groups, to assist in achieving optimal health outcomes.
· Utilizes community resources to maximize health outcomes for clients.
· Promotes the contribution of nursing to health care.
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2. Establishes and maintains working relationships with all members of the health care team.
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· Established working relationships and collaborates with colleagues and other members of the health team and the client to achieve and maintain relationships.
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3. Participates with other members of the health care team and clients/groups in decision making.
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· Consults and collaborates with other members of the health team.
· Documents progress and continues ongoing communication and collaboration with other team members.
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