• 11 SEP 18
    • 0



    Definition: Recognize the patient or designee as the source of control and full partner in providing

    compassionate and coordinated care based on respect for patient’s preferences, values, and needs.

    Knowledge Skills Attitudes

    Integrate understanding of multiple

    dimensions of patient centered


     patient/family/community

    preferences, values

     coordination and integration of care

     information, communication, and


     physical comfort and emotional


     involvement of family and friends

     transition and continuity

    Describe how diverse cultural,

    ethnic and social backgrounds

    function as sources of patient,

    family, and community values

    Elicit patient values,

    preferences and expressed

    needs as part

    of clinicalinterview,

    implementation of care

    planand evaluation of care

    Communicate patient values,

    preferences and expressed

    needs to other members

    of health care team

    Provide patient-centered care

    with sensitivity and respect

    for the diversity of human


    Value seeing health care

    situations “through patients’


    Respect and encourage

    individual expression of patient

    values, preferences and

    expressed needs

    Value the patient’s expertise

    with own health and symptoms

    Seek learning opportunities

    with patients who represent all

    aspects of human diversity

    Recognize personally held

    attitudes about working with

    patients from different ethnic,

    cultural and social


    Willingly support patient-

    centered care for individuals

    and groups whose values differ

    from own

    Demonstrate comprehensive

    understanding of the concepts

    of pain and suffering, including

    physiologic models of pain and


    Assess presence and extent

    of pain and suffering

    Assess levels of physical and

    emotional comfort

    Elicit expectations of patient

    & family forrelief of pain,

    discomfort, or suffering

    Recognize personally

    held values and beliefs about

    the management of pain or


    Appreciate the role of the nurse

    in relief of all types and

    sources of pain or suffering

    Initiate effective treatments to

    relieve pain and suffering in

    light of patient values,

    preferences and expressed


    Recognize that patient

    expectations influence

    outcomes in management of

    pain or suffering

    Examine how the safety, quality

    and cost effectiveness of health

    care can be improved through the

    active involvement of patients and


    Examine common barriers to

    active involvement of patients in

    their own health care processes

    Describe strategies to empower

    patients or families in all aspects

    of the health care process

    Remove barriers to presence

    of families and other

    designated surrogates based

    on patient preferences

    Assess level of patient’s

    decisional conflict and

    provide access to resources

    Engage patients or

    designated surrogates in

    active partnerships that

    promote health, safety and

    well-being, and self-care


    Value active partnership with

    patients or designated

    surrogates in planning,

    implementation, and evaluation

    of care

    Respect patient preferences for

    degree of active engagement

    in care process

    Respect patient’s right to

    access to personal health


    Explore ethical and legal

    implications of patient-centered


    Describe the limits and

    boundaries of therapeutic patient-

    centered care

    Recognize the boundaries of

    therapeutic relationships

    Facilitate informed patient

    consent for care

    Acknowledge the tension that

    may exist between patient

    rights and the organizational

    responsibility for professional,

    ethical care

    Appreciate shared decision-

    making with empowered

    patients and families, even

    when conflicts occur

    Discuss principles of effective


    Describe basic principles of

    consensus building and conflict


    Assess own level of

    communication skill in

    encounters with patients and


    Participate in building

    consensus or resolving

    Value continuous improvement

    of own communication and

    conflict resolution skills

    Examine nursing roles in assuring

    coordination, integration, and

    continuity of care

    conflict in the context of

    patient care

    Communicate care provided

    and needed at each

    transition in care


    Definition: Function effectively within nursing and inter-professional teams, fostering open

    communication, mutual respect, and shared decision-making to achieve quality patient care.

    Knowledge Skills Attitudes

    Describe own strengths,

    limitations, and values in

    functioning as a member of a


    Demonstrate awareness of own

    strengths and limitations as a

    team member

    Initiate plan for self-development

    as a team member

    Act with integrity, consistency and

    respect for differing views

    Acknowledge own potential to

    contribute to effective team


    Appreciate importance of

    intra- and inter-professional


    Describe scopes of practice

    and roles of health care team


    Describe strategies for

    identifying and managing

    overlaps in team member roles

    and accountabilities

    Recognize contributions of

    other individuals and groups in

    helping patient/family achieve

    health goals

    Function competently within own

    scope of practice as a member of

    the health care team

    Assume role of team member or

    leader based on the situation

    Initiate requests for help when

    appropriate to situation

    Clarify roles and accountabilities

    under conditions of potential

    overlap in team member


    Integrate the contributions of

    others who play a role in helping

    patient/family achieve health


    Value the perspectives and

    expertise of all health team


    Respect the centrality of the

    patient/family as core

    members of any health care


    Respect the unique attributes

    that members bring to a team,

    including variations in

    professional orientations and


    Analyze differences in

    communication style

    preferences among patients

    and families, nurses and other

    members of the health team

    Describe impact of own

    communication style on others

    Discuss effective strategies for

    communicating and resolving


    Communicate with team

    members, adapting own style of

    communicating to needs of the

    team and situation

    Demonstrate commitment to

    team goals

    Solicit input from other team

    members to improve individual,

    as well as team, performance

    Initiate actions to resolve conflict

    Value teamwork and the

    relationships upon which it is


    Value different styles of

    communication used by

    patients, families and health

    care providers

    Contribute to resolution of

    conflict and disagreement

    Describe examples of the

    impact of team functioning on

    safety and quality of care

    Explain how authority

    gradients influence teamwork

    and patient safety

    Follow communication practices

    that minimize risks associated

    with handoffs among providers

    and across transitions in care

    Assert own position/perspective

    in discussions about patient care

    Choose communication styles

    that diminish the risks associated

    with authority gradients among

    team members

    Appreciate the risks

    associated with handoffs

    among providers and across

    transitions in care

    Identify system barriers and

    facilitators of effective team


    Examine strategies for

    improving systems to support

    team functioning

    Participate in designing systems

    that support effective teamwork

    Value the influence of system

    solutions in achieving effective

    team functioning


    Definition: Integrate best current evidence with clinical expertise and patient/family preferences and

    values for delivery of optimal health care.

    Knowledge Skills Attitudes

    Demonstrate knowledge of basic

    scientific methods and processes

    Describe EBP to include the

    components of research

    evidence, clinical expertise and

    patient/family values.

    Participate effectively in

    appropriate data collection

    and other research activities

    Adhere to Institutional

    Review Board (IRB)


    Base individualized care

    plan on patient values,

    clinical expertise and


    Appreciate strengths and

    weaknesses of scientific bases

    for practice

    Value the need for ethical

    conduct of research and quality


    Value the concept of EBP as

    integral to determining best

    clinical practice

    Differentiate clinical opinion from

    research and evidence


    Describe reliable sources for

    locating evidence reports and

    clinical practice guidelines

    Read original research and

    evidence reports related to

    area of practice

    Locate evidence reports

    related to clinical practice

    topics and guidelines

    Appreciate the importance of

    regularly reading relevant

    professional journals

    Explain the role of evidence in

    determining best clinical practice

    Describe how the strength and

    relevance of available evidence

    influences the choice of

    interventions in provision of

    patient-centered care

    Participate in structuring the

    work environment to

    facilitate integration of new

    evidence into standards of


    Question rationale for

    routine approaches to care

    that result in less-than-

    desired outcomes or

    adverse events

    Value the need for continuous

    improvement in clinical practice

    based on new knowledge

    Discriminate between valid and

    invalid reasons for modifying

    evidence-based clinical practice

    based on clinical expertise or

    patient/family preferences

    Consult with clinical experts

    before deciding to deviate

    from evidence-based


    Acknowledge own limitations in

    knowledge and clinical expertise

    before determining when to

    deviate from evidence-based

    best practices


    Definition: Use data to monitor the outcomes of care processes and use improvement methods to

    design and test changes to continuously improve the quality and safety of health care systems.

    Knowledge Skills Attitudes

    Describe strategies for learning

    about the outcomes of care in the

    setting in which one is engaged in

    clinical practice

    Seek information about

    outcomes of care for

    populations served in care


    Seek information about

    quality improvement projects

    in the care setting

    Appreciate that continuous

    quality improvement is an

    essential part of the daily

    work of all health


    Recognize that nursing and other

    health professions students are

    parts of systems of care and care

    processes that affect outcomes for

    patients and families

    Give examples of the tension

    between professional autonomy and

    system functioning

    Use tools (such as flow

    charts, cause-effect

    diagrams) to make processes

    of care explicit

    Participate in a root cause

    analysis of a sentinel event

    Value own and others’

    contributions to outcomes of

    care in local care settings

    Explain the importance of variation

    and measurement in assessing

    quality of care

    Use quality measures to

    understand performance

    Use tools (such as control

    charts and run charts) that

    are helpful for understanding


    Identify gaps between local

    and best practice

    Appreciate how unwanted

    variation affects care

    Value measurement and its

    role in good patient care

    Describe approaches for changing

    processes of care

    Design a small test of change

    in daily work (using an

    experiential learning method

    such as Plan-Do-Study-Act)

    Practice aligning the aims,

    measures and changes

    involved in improving care

    Value local change (in

    individual practice or team

    practice on a unit) and its

    role in creating joy in work

    Appreciate the value of what

    individuals and teams can to

    do to improve care

    Use measures to evaluate

    the effect of change


    Definition: Minimizes risk of harm to patients and providers through both system effectiveness and

    individual performance.

    Knowledge Skills Attitudes

    Examine human factors and

    other basic safety design

    principles as well as commonly

    used unsafe practices (such as,

    work-arounds and dangerous


    Describe the benefits and

    limitations of selected safety-

    enhancing technologies (such

    as, barcodes, Computer

    Provider Order Entry, medication

    pumps, and automatic


    Discuss effective strategies to

    reduce reliance on memory

    Demonstrate effective

    use of technology and

    standardized practices

    that support safety and


    Demonstrate effective

    use of strategies to

    reduce risk of harm to

    self or others

    Use appropriate

    strategies to reduce

    reliance on memory

    (such as, forcing

    functions, checklists)

    Value the contributions of

    standardization/reliability to safety

    Appreciate the cognitive and

    physical limits of human


    Delineate general categories of

    errors and hazards in care

    Describe factors that create a

    culture of safety (such as, open

    communication strategies and

    organizational error reporting



    observations or concerns

    related to hazards and

    errors to patients,

    families and the health

    care team

    Use organizational error

    reporting systems for

    near miss and error


    Value own role in preventing errors

    Describe processes used in

    understanding causes of error

    and allocation of responsibility

    and accountability (such as, root

    cause analysis and failure mode

    effects analysis)

    Participate appropriately

    in analyzing errors and

    designing system


    Engage in root cause

    analysis rather than

    blaming when errors or

    near misses occur

    Value vigilance and monitoring (even

    of own performance of care

    activities) by patients, families, and

    other members of the health care


    Discuss potential and actual

    impact of national patient safety

    resources, initiatives and


    Use national patient

    safety resources for own


    development and to

    focus attention on safety

    in care settings

    Value relationship between national

    safety campaigns and

    implementation in local practices and

    practice settings


    Definition: Use information and technology to communicate, manage knowledge, mitigate error, and

    support decision making.

    Knowledge Skills Attitudes

    Explain why information and

    technology skills are essential for

    safe patient care

    Seek education about

    how information is

    managed in care settings

    before providing care

    Apply technology and

    information management

    tools to support safe

    processes of care

    Appreciate the necessity for all

    health professionals to seek

    lifelong, continuous learning of

    information technology skills

    Identify essential information that

    must be available in a common

    database to support patient care

    Contrast benefits and limitations of

    different communication

    Navigate the electronic

    health record

    Document and plan

    patient care in an

    electronic health record

    Value technologies that support

    clinical decision-making, error

    prevention, and care


    technologies and their impact on

    safety and quality

    Employ communication

    technologies to coordinate

    care for patients

    Protect confidentiality of

    protected health information in

    electronic health records

    Describe examples of how

    technology and information

    management are related to the

    quality and safety of patient care

    Recognize the time, effort, and skill

    required for computers, databases

    and other technologies to become

    reliable and effective tools for

    patient care

    Respond appropriately to

    clinical decision-making

    supports and alerts

    Use information

    management tools to

    monitor outcomes of care


    Use high quality electronic

    sources of healthcare


    Value nurses’ involvement in

    design, selection,

    implementation, and evaluation

    of information technologies to

    support patient care

    REFERENCES 1 Institute of Medicine. Health professions education: A bridge to quality. Washington DC: National

    Academies Press; 2003.

    2 Cronenwett, L., Sherwood, G., Barnsteiner J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D.,

    Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3)122-131.

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