COMPETENCIES FOR THE NEW COMPETENCIES FOR THE NEW SAUDI NURSE GRADUATESAUDI NURSE GRADUATE

Dr Thelma D. van der Merwe

KFSH & RC (Riyadh)KFSH & RC (Riyadh)March 2004March 2004

GUIDING QUESTION

What should the competencies of the new Saudi Nurse Graduate be and

Can it be implemented in a Performance Appraisal instrument?

OBJECTIVESOBJECTIVES

To define competence

To briefly analyse the relationship between regulation and competence

To analyse the International Council for Nurses (ICN) framework

To give a brief overview of the competencies required of a new graduate nurse (RN Association of British Columbia)

Analyse the performance appraisal instrument according to the above

DEFINITIONDEFINITION

ICN, 1997….. a level of performance

demonstrating

the effective application of

knowledge, skill and judgement.

PROFESSIONAL REGULATIONPROFESSIONAL REGULATION

Regulation: protect publicUnqualified workers: * not member of Nursing Board or * nurse without current/relevant knowledgeFor licensure nurse to be competent Competence = a comprehensive approach/structure

ICN FRAMEWORK FOR ICN FRAMEWORK FOR COMPETENCIESCOMPETENCIES

1. Professional, ethical, legal practice

2. Care provision and management

3. Professional development

ICN FRAMEWORK- ICN FRAMEWORK- 1. Professional, Ethical, Legal 1. Professional, Ethical, Legal

PracticePractice

1.1 ProfessionalAccountability:

Five levels* self, patient, employer, legal systems & * Professional Nursing BoardPre-conditions* ability/competence – knowledge, skills, values

attitudes* responsibility* authority ……… accountability

ICN FRAMEWORK –ICN FRAMEWORK –1.2 Ethical Practice1.2 Ethical Practice

Code of Ethics

Ethical decision making general/ specific conditions (war, disasters, violence)

Advocacy: human rights

Confidentiality: written/verbal

Patient’s rights

Unsafe practice and acts

Culturally sensitive care

Own value system

ICN FRAMEWORK –ICN FRAMEWORK –1.3 Legal Practice1.3 Legal Practice

Relevant legislation

Local & national policies and procedures

Acts upon violations of law and ethics

ICN FRAMEWORK – ICN FRAMEWORK – 2. Care provision & Management2. Care provision & Management

Key principles

Care provision

Care management

ICN FRAMEWORK- ICN FRAMEWORK- 2.1 Key Principles: Care Provision & 2.1 Key Principles: Care Provision &

ManagementManagement

Knowledge and skillsResearch findings & evidence Critical thinking & problem solving skillsPrioritise workloadObjective/subjective dataAdvocateRationale for nursingResource personDisaster planning

ICN FRAMEWORK- ICN FRAMEWORK- 2.2 Care Provision:Promotion of Health2.2 Care Provision:Promotion of Health

National health & social policiesCollaborationHolistic Health promotion & illness preventionEmpowerRelevant health informationTraditional healingHealth education & evaluation

ICN FRAMEWORK- ICN FRAMEWORK- 2.2 Care Provision: Plan of Care2.2 Care Provision: Plan of Care

Assessment

Planning

Implementation

Evaluation

ICN FRAMEWORK- ICN FRAMEWORK- Care Provision:Care Provision:Communication & Interpersonal RelationshipsCommunication & Interpersonal Relationships

Develops & ends therapeutic relationships

Communicates verbal, written, electronic

Responds appropriately to questions/ problems

Empower all

Uses information technology

ICN FRAMEWORK- ICN FRAMEWORK- 2.3 Care Management2.3 Care Management

Safe environment

Interproffessional health care

Delegation & supervision

ICN FRAMEWORK-ICN FRAMEWORK-3. Professional Development3. Professional Development

Professional enhancement

Quality improvement

Continuing education

RNABC’s GENERIC ENTRY-LEVEL RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES COMPETENCIES

Provides competent, professional care Professional & ethical framework Self development Research Role models

Serves the public & nursing profession Regulation Nursing Association/Organisation Population health needs

RNABC’s GENERIC ENTRY-LEVEL RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont…COMPETENCIES cont…

Performs & refines client assessments Standardised tools Consults Comprehensive & holistic approach Collaborates Anticipates potential problems

• Develops client-focused plans of care Clinical judgements Stable/unstable patients Appropriate technology Develop plans of care

RNABC’s GENERIC ENTRY-RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont…LEVEL COMPETENCIES cont…

Intervenes put theory into practice Evidence-based knowledge Theory based Interventions for stable/unstable patients – simple,

complex, specialised Creative, innovative interventions Multiple interventions, negotiates with patient, makes

formal referrals, includes family Relationships, cognitive behaviour, support groups Comprehensive approach Technology – safe & effective Potentially unsafe situations & provides support Changing situations

RNABC’s GENERIC ENTRY-LEVEL RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont…COMPETENCIES cont…

Intervenes: Communicates Social & professional interaction Holistic caring environment Partnerships with stable/unstable patients families Variety of communication methods Information, respecting patient confidentiality

• Intervenes: Teaches, verifies learning General health related information Individualizes information Appropriate media & learning strategies Assesses patients needs

RNABC’s GENERIC ENTRY-LEVEL RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont…COMPETENCIES cont…

Evaluates client progress Status of stable/unstable patients Evaluates & verifies findings Modifies & individualises learning plan

• Organises care delivery for self & team Organisational culture Workload – effective time management Basic computer skills Record keeping, physical resources, QA & QI Workloads to & of others Actions in emergency situations Accountability for delegated decisions Unsafe situations for team members

RNABC’s GENERIC ENTRY-LEVEL RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont…COMPETENCIES cont…

Practices collaboratively in health system Interdisciplinary team Partnerships, supports other team members Own values/ norms Impact of change Team problem solving/ decision making/ collaboration in

nursing practice Conflict resolution Nursing knowledge Constructive feedback Established communication protocols Community related health care sectors

PERFORMANCE APPRAISAL PERFORMANCE APPRAISAL CRITERIA/INDICATORS FOR SAUDI CRITERIA/INDICATORS FOR SAUDI

NEW GRADUATESNEW GRADUATES

Definition: New Graduate a Saudi Nurse with New Graduate a Saudi Nurse with less than 2 years clinical experienceless than 2 years clinical experience10 standards from RNABC (2000)

Criteria adapted for Saudi needsAll criteria to a 5 rating:

3 rating = can perform basic nursing 4 rating = 3 rating & some added nursing

actions 5 rating = 3 & 4 rating & some added

nursing actions

CHRONOLOGICAL PRIORITIES OF 10 CHRONOLOGICAL PRIORITIES OF 10 STANDARDSSTANDARDS

RNABCRNABC SAUDI NEW GRAD SAUDI NEW GRAD1. Competent, professional 1. Performs/refines patient

care assessments

2. Serves public & nursing 2. Develops patient care professionplans

3. Performs/refines assess- 3. Intervenes: uses theory ments for decision making

4. Develops client care plans 4. Intervenes: Patient Communication

5. Theory into action 5. Intervenes: Patient teaching

CHRONOLOGICAL PRIORITIES OF 10 CHRONOLOGICAL PRIORITIES OF 10 STANDARDS cont…STANDARDS cont…

RNABCRNABC SAUDI NEW GRAD SAUDI NEW GRAD6. Intervenes: Patient 6. Evaluates patient progress

Communication

7. Intervenes: Patient 7. Organises care for self and teaching participates in others

8. Evaluates client progress 8. Collaborative practice

9. Organises care for self and 9. Functions in ethical, legal participates in others system

10. Collaborative practice 10. Serves public & Nursing Profession

IMPLEMENTATION OF PERFORMANCE IMPLEMENTATION OF PERFORMANCE APPRAISAL INSTRUMENTAPPRAISAL INSTRUMENT

Validation: ICN (2003) Framework RNABC (2000) Competencies Sent out to Head Nurses – minimal to no changes

• ReliabilityPilot study done on 3 New Graduates

• Recommendations Test it out on a bigger numberActive education with implementation

SUMMARYSUMMARY

Social agreement to the publicEssential for new graduate nurses to become competent Proactive framework is proposed by the ICNBasic competencies have been identified according to RNABC (2000) and adjusted for the Saudi New Graduate Should be tested in other health care organisations in Saudi Arabia

Shukran!!

ACKNOWLEDGEMENTACKNOWLEDGEMENT

The organising committee of the Saudi German The organising committee of the Saudi German Hospital for inviting me and accepting my paperHospital for inviting me and accepting my paper

The Saudi Nurse Graduates who inspired me to do this The Saudi Nurse Graduates who inspired me to do this work so that one day they can take over from us and work so that one day they can take over from us and role model our workrole model our work

The Task Force at KFSH&RC who believed I can do the The Task Force at KFSH&RC who believed I can do the job on my ownjob on my own

Mollie Butler for providing me with the RNABC Mollie Butler for providing me with the RNABC informationinformation Shukran!!!