Identify potential for impaired professional performance in oneself and colleagues and take action to mitigate in order to ensure a culture of safety. Know the effects of fever, pain, electrolyte disturbances, hypoxia, and hypotension on hemodynamics, cardiac rhythm, and perfusion in patients with or at risk of cardiovascular disease. The table does not necessarily reflect relationships with industry at the time of publication. Know causes of angina pectoris not related to coronary artery disease. Know the pharmacological effects, risks, and benefits of vasoactive and inotropic agents. Know the indications, contraindications, and risks for P2Y. Available at: https://www.nihcr.org/analysis/improving-care-delivery/prevention-improving-health/pcp-workforce-nps/. Skill to refine the therapeutic plan of care of patients with valvular heart disease based on laboratory and diagnostic test results. Know factors that may affect accuracy of blood pressure measurement. Solicit and incorporate feedback from patients, colleagues, and healthcare professionals to improve clinical performance. Skills to assess and manage patients in refractory heart failure requiring intravenous inotropic support. / Practice and CNS Role / CNS Competencies / Adult/Gero Competencies. endobj Know the pharmacological agents that may interfere with blood pressure control (e.g., nonsteroidal anti-inflammatory drugs). Skill to use an evidence-based, shared decision-making tool to counsel patients at risk for sudden cardiac death who are undergoing primary prevention implantable cardioverter-defibrillator implantation. Know basic lipoprotein biochemistry and metabolism. Skill to utilize concepts of behavioral change models and lifestyle interventions to assist patients with cardiovascular disease. Select two Massachusetts Nurse of the Future Nursing Core Competencies that you believe will have the most impact on your future professional nursing practice. Skills to initiate management of patients with suspected acute aortic syndromes and coordinate care to ensure medical stability. Attain and maintain nurse practitioner and/or physician assistant certification per respective credentialing organizations. Although no members participated in a formal representational role from other professional societies, the writing committee is composed of authors who are engaged in NP, PA, and cardiovascular specialty organizations. STEP 1: NEW/UPDATED DOCUMENT REVIEW Review the following documents as they become available on … This article describes the development of nurse practitioner (NP) competencies for advance care planning. Know the arrhythmias common in adults with simple congenital heart disease and referral indications to electrophysiologists with expertise in congenital heart disease. Skills to evaluate and coordinate management of patients with peripheral and visceral artery aneurysms and refer candidates for surgical or endovascular intervention. Know the symptoms, physical findings, ECG patterns, and biomarker findings in patients with STEMI. Know ECG features associated with myocardial ischemia and baseline ECG abnormalities that may impact exercise ECG interpretation. The writing committee convened by conference call and e-mail to finalize the document outline, develop the initial draft, revise the draft based on committee feedback, and ultimately approve the document for external peer review. Know the pathophysiology, differential diagnosis, clinical signs, and symptoms in patients with shock, systemic inflammatory response syndrome, and acute respiratory distress syndrome. NLN Core Competencies Note: The task statements that accompany each competency can be found in NLN Core Competencies for Nurse Educators: A Decade of Influence (2019) and The Scope of Practice for Academic Nurse Educators & Academic Clinical Nurse Educators (2020). Know the impact of pregnancy in women with simple congenital heart disease. The steering committee convened to plan the writing effort, determine the document framework, and initiate preliminary competency table development and project plans. Skills to recognize and medically manage specific supraventricular arrhythmias (e.g., atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia). Know the treatment of hypertension in special populations (e.g., patients with ischemic heart disease, heart failure, diabetes, chronic kidney disease, cerebral vascular disease; minorities, elderly). Know the advantages and disadvantages of various transcatheter and surgical options for patients with valvular heart disease, including replacement with mechanical or biological prostheses and valve repair. The NACNS CNS Statement for Clinical Nurse Specialist Practice and Education (3 rd ed.) Know the psychosocial factors that contribute to cardiovascular disease and principles of management. ACHD = adult congenital heart disease; BACH = Boston Adult Congenital Heart; UPMC = University of Pittsburgh Medical Center. Accessed July 18, 2019. Skill to counsel adults with congenital heart disease on exercise modalities. Vascular Medicine Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2509, Author Relationships with Industry and Other Entities (Relevant) 2512. Skills to interpret cardiovascular imaging reports and apply results to clinical decision making. Know the clinical presentation and diagnostic findings of statin-induced myopathies. Know the indications for and contraindications to computed tomographic angiography, magnetic resonance angiography, and invasive angiography in patients with known or suspected venous and arterial disease. Know the entrance testing requirements for a cardiac rehabilitation phase II program and methods for developing a management plan. Skills to recognize and initiate evaluation of secondary causes of hypertension. A comprehensive list of healthcare-related disclosures for each reviewer can be found online. Clinical competencies for NPs and PAs are designed to promote a framework for educational initiatives and practice performance. 4. Know the psychosocial impact of cardiac device therapies. Know the indications for cardiac catheterization for adults with simple congenital heart disease. Provide emotional support to patients, families, and caregivers. Know the indications for endocarditis prophylaxis in adults with congenital heart disease. Skill to determine a noninvasive versus invasive treatment strategy for patients with acute coronary syndromes. Skills to utilize and titrate medical therapy for patients with heart failure in both the hospital and outpatient care settings. Cardiovascular Disease Prevention Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2498, Table 9. Cochrane Database Syst Rev2018; 7:Cd001271. Skill to recognize symptoms and ECG changes suggestive of ischemic heart disease and variant angina. The competencies for cardiovascular NPs and PAs are organized using the 6 domains promulgated by Accreditation Council for Graduate Medical Education/American Board of Medical Specialties and endorsed by American Board of Internal Medicine (see Table 2) to align with ACC’s physician-based competencies. Skill to assist with or remove central venous or arterial catheters and hemodynamic monitoring systems. Approved March 20, 2020 ACNM Core Competencies for Basic Midwifery Practice The Core Competencies for Basic Midwifery Practice include the fundamental knowledge, skills, and abilities expected of new midwives certified by the American Midwifery Certification Board (AMCB). Silver Spring, MD: Nursesbooks, 2015. "Cardiovascular nursing: scope and standards for practice" Skill to manage perioperative patients following surgical and percutaneous valvular heart disease procedures. Skill to utilize noninvasive imaging reports for diagnosis and follow-up care of patients with vascular disease. The basic assumption of CBE is that the student will demonstrate acquisition of the identified essential knowledge, skills, and attitudes expected for the designated educational process before leaving the learning environment. Know the indications for performing home blood pressure monitoring. Disclosure information for the ACC Competency Management Committee is available online, online, as is the ACC disclosure policy for document development. Know the diagnostic testing and clinical evaluation indicated prior to surgical or transcatheter intervention for valvular heart disease. A modified Delphi method was used to engage NPs in achieving consensus for advance care planning competencies. Know the risks, benefits, indications, and timing for diagnostic coronary angiography. "ACC 2015 core cardiovascular training statement (COCATS 4) (revision of COCATS 3) " . Know the pharmacology of commonly used cardiovascular medications in diverse patient populations. Cardiovascular NP and PA Competencies 2487, Table 1. American Academy of PAs Research Department. This document is considered current until the ACC Competency Management Committee revises or withdraws it from publication. Know the indications for, contraindications to, and pharmacology of vasoactive and inotropic medications used to treat patients with heart failure, hypotension, or shock. Retrieved October 22, 2020, from Wittmann-Price, R. A., Godshall, M., & Wilson, L. (2017). Know the indications for and potential complications of pericardiocentesis. Skill to manage patients with chronic ischemic heart disease and associated risk factors. Skill to initially evaluate patients with extracranial carotid and vertebral artery disease. Utilize clinical practice guidelines, appropriate use criteria, and point-of-care tools to improve clinical decision-making. To ensure transparency, comprehensive healthcare-related disclosure information, for authors and peer reviewers has been posted online. Skill to provide age appropriate, culturally-sensitive education regarding lifestyle modification to patients with cardiovascular disease and their family members. "ACC 2015 core cardiovascular training statement (COCATS 4) (revision of COCATS 3)" Know the common complications of cardiac surgery and procedures. In 2017, NONPF has released the most current, nationally validated set of core competencies for nurse practitioners. The writing committee met the College’s disclosure requirements for RWI as described in the Preamble. Researchers Advance Understanding of Nurse Practitioner (NP) Quality of Care November 12, 2020; AANP Honors the Nation’s Veterans, Proud to Provide Care During COVID-19 November 11, 2020 Skills to obtain a clinical history and perform a physical examination of the peripheral circulation. Skills to perform zero referencing and troubleshoot hemodynamic monitoring systems. Skills to identify and refer patients with pericardial disease who are candidates for intervention. Skills to interpret exercise and pharmacological stress test reports with or without imaging and apply results to clinical decision making. Skill to manage patients following catheter ablation of atrial fibrillation and atrial flutter, supraventricular tachycardias, and ventricular arrhythmias. Know the methods to assess preoperative risk for patients with known or suspected cardiovascular disease undergoing noncardiac surgery. Know the risks, benefits, and importance of timing of an invasive versus noninvasive strategy for the management of patients with NSTE-ACS. Advocate for quality patient care and assist patients and families in dealing with system complexities and limited resources. Since the 1995 publication of its Core Cardiovascular Training Statement (COCATS) (1), the American College of Cardiology (ACC) has played a central role in defining the knowledge, experiences, skills, and behaviors expected of all clinical cardiologists upon completion of training. ACC = American College of Cardiology; ACPC = adult congenital/pediatric cardiology; APP = advanced practice provider; CEO = chief executive officer; CHI = Catholic Health Initiatives; CV = cardiovascular; EP = electrophysiology; FIT = fellow in training; HF&T = heart failure and transplant; MCS = mechanical circulatory support; NE = northeast; NP = nurse practitioner; PA = physician assistant; UCONN = University of Connecticut. Renew your Annual Practising Certificate read more. ∗ Mr. Drajpuch was employed by the Children’s Hospital of Philadelphia as a Nurse Practitioner during most of this writing effort. Skill to manage patients with valvular heart disease with complex comorbid conditions. Skills to order and assess laboratory testing at various stages of lipid management. Know the principles of and indications for palliative care in patients with heart disease. Skill to recognize ECG changes suggestive of myocardial ischemia and/or infarction. Skill to recognize signs and symptoms of ventricular systolic and diastolic dysfunction. Skill to identify needs of patients when current management goals are no longer effective (e.g., long-term needs such as palliative care and termination of device therapy). Relationships in this table are modest unless otherwise noted. Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American College of Cardiology. Also noted was the lack of formal postgraduate training programs for NPs and PAs such that most cardiovascular knowledge and skills are learned through practice experience from more experienced and tenured clinicians on the team. Objective evaluation of clinical competence in the practice setting can be challenging and sometimes overlooked. Continuing education for NPs and PAs is important for ensuring high-quality care, fostering practice collaboration, sharing best practices, and providing an opportunity for self-assessment and reflection. Skill to perform a physical assessment and examination for patients with lipid disorders. J Am Coll Cardiol 2020;75:2483–2517. Know the effects of heart failure on perfusion, organ function, nutrition, and energy metabolism. Know the indications for extubation from mechanical ventilation. Know the differential diagnosis, clinical presentation, ECG changes, and imaging and biomarker features for diagnosis and risk stratification of patients with NSTE-ACS and other nonischemic causes of myocardial injury. Know the indications for genetic screening of premature atherosclerotic disease. Know advanced therapies for pericardial disease. 2 0 obj Skills to interrogate, troubleshoot, program, and monitor performance of implanted cardiac devices. Former Competency Management Committee chair, chair during this writing effort. Competencies in the Context of Entry-level Registered Nurse Practice in British Columbia | 35 pages | 250 KB | Entry-Level Competencies for Registered Nurses (in effect Dec. 31, 2020) | … ONE Award Submissions ; Outstanding Orthopaedic Nurse Practice Award; Online Store; Online Store. Pericardial Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2505, Table 12. Skill to risk stratify patients for potential bleeding risk on anticoagulation. Know the normal and abnormal findings in patients with heart failure with preserved and reduced ejection fraction who undergo hemodynamic catheterization. Competency is a topic of great interest to educators and administrators in practice disciplines, particularly health care disciplines such as nursing. CNS Competencies CNS Competencies. Cardiac Arrhythmias and Electrophysiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2496, Table 8. This competency document identifies the knowledge and skills important for NPs and PAs working in general cardiovascular medicine and cardiac subspecialty areas, thereby assisting NPs and PAs in identifying learning needs and opportunities for professional growth. Know the pathophysiology and risks of thrombosis and thromboembolism in adults with congenital heart disease. Know the epidemiology of cardiovascular disease. Skills to evaluate and manage patients with venous insufficiency. These minimum general competencies were endorsed by the ACGME in February 1999 ( www.acgme.org) and all Residency Review Committees and Institutional Review Committees were to include this minimum language in their respective Program and Institutional Requirements by June 2001. Adult/Gero Competencies. Know the risk reduction strategies for populations at increased risk for cardiovascular disease. Laurant M., van der Biezen M., Wijers N., "Nurses as substitutes for doctors in primary care", "Expanding the role of advanced nurse practitioners—risks and rewards", "Practice information by state: what you need to know about NP practice in your state", "Cardiovascular nursing: scope and standards for practice". Know general concepts and modes of mechanical ventilation (e.g., tidal volume, fraction of inspired oxygen, positive end-expiratory pressure). Know the indications for, contraindications to, pharmacology, and adverse effects of drugs used to treat patients with heart failure. Skills to recognize and mitigate factors associated with nonadherence rates in cardiac rehabilitation. Know the postprocedure complications of catheter ablation in patients with atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. . Know management strategies for patients with arterial compression devices and arterial sheaths. Skills to clinically evaluate and manage patients with acute and relapsing pericarditis. Skill to participate in the insertion of implantable loop recorders. Please refer to http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with-industry-policy for definitions of disclosure categories or additional information about the ACC Disclosure Policy for Writing Committees. Skill to develop a plan of care for patients with heart failure. The task force behind the 2012 update included various nurse practitioner organization and certification boards, and they created sub-groups of experts for each population focus. Skill to participate in pericardiocentesis. Know the prognostic factors used to assess patients with acute coronary syndromes and advanced heart failure. Know the arrhythmias common in complex congenital heart disease and indications for referral to electrophysiologists with expertise in congenital heart disease. Know the indications, contraindications, complications, and components of invasive and hemodynamic monitoring. 7. Know the indications and contraindications for advanced cardiac imaging in patients with heart failure. Know the strategies for promoting behavioral change and treatment adherence in primary prevention of atherosclerosis. Collaborate in screening patients for investigational therapies and clinical trials, as applicable. Know the typical and atypical presentations of angina, including disorders that can simulate or mask acute coronary syndromes. Please be sure to address all 10 competencies and give specific examples. Know the indications for wearable devices. Know the diagnostic studies recommended for monitoring during titration of antihypertensive medications. Know the inherited arrhythmia syndromes and indications for genetic testing and counseling for patients and family members. There are two steps to the self-assessment. Skill to manage patients with heart failure with implantable hemodynamic monitoring (e.g., pulmonary artery pressure monitoring systems), including changes in volume status. This competency framework addresses the common core competencies and the wider range of skills, knowledge and behaviours a nurse needs, to be a fully proficient General Practice Nurse (GPN). These competencies are unique to each of the clinical areas identified in Table 1. Skill to participate in invasive electrophysiology procedures, including catheter ablation. Know the structure of normal arteries and basic vascular biology of atherosclerosis. Skills to evaluate and manage patients with arterial access complications, including arteriovenous fistula and arterial pseudoaneurysm. Skill to participate in the management of sedation and hemodynamics during procedures in the critical care setting. Know the appropriate timing to refer patients with heart failure for cardiac resynchronization therapy, invasive monitoring, invasive support, and/or transplant. Know the symptoms, physical findings, and evaluation of acute pericarditis, pericardial effusion/tamponade, and constrictive pericarditis. Practice within organization bylaws and state and federal regulations governing nurse practitioner and physician assistant practice. "Nurses as substitutes for doctors in primary care" Know the comorbidities that contribute to cardiovascular disease. Skills to evaluate and manage patients with venous thromboembolism. Know the pathophysiology and management of bicuspid aortic valve and associated aortopathy. Know the determinants of coronary blood flow and myocardial oxygen consumption. In addition to the NP and PA members of the committee, 3 cardiologists with expertise in team model care and competency development participated in the writing, review, and revision of the document. Know the differential diagnoses of chest pain, palpitations, fatigue, lightheadedness, syncope, dyspnea, and peripheral edema. Conduct literature searches, interpret findings, and apply evidence-based results to clinical care. Practitioners … Know the primary prevention application of various cardiovascular risk assessment tools (e.g., atherosclerotic cardiovascular disease risk). Acute Coronary Syndromes Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2490, Table 5. Know the indications for selection of pacemaker systems and cardiac resynchronization therapy. Knowledge should be maintained and enhanced through regular review of journals and other sources of reliable information and through participation in scholarly scientific meetings, continuing professional education activities, and professional congresses. Know the common medications that may cause QT prolongation. Registered nurses in British Columbia must meet the entry-level competencies to be eligible to practice in the province. These represent the entry into practice competencies upon graduation from a NP educational program. Skill to recognize ST-segment changes on continuous ECG monitoring suggestive of acute coronary syndromes. Laurant M., van der Biezen M., Wijers N., et al. A person is deemed to have a significant interest in a business if the interest represents ownership of ≥5% of the voting stock or share of the business entity, or ownership of ≥$5,000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person’s gross income for the previous year. Pre-Order: Core Curriculum for Orthopaedic Nursing, 8th Edition. GUIDELINES ON ADVANCED PRACTICE NURSING 2020 6 7 A scholarly approach to literature review is required to evaluate evidence, address clinical questions, and enhance outcomes. Know the risks and benefits of exercise in adults with complex congenital heart disease, including those with associated pulmonary hypertension. To fill this educational gap, the Cardiovascular Team Section Leadership Council requested that the Competency Management Committee commission a competency statement. Skill to manage patients with acute myocardial infarction and associated complications. Skills to develop, implement, manage, and evaluate a plan of care for patients with elevated blood pressure and hypertension. Nurse practitioners are well positioned to implement advance care planning with their patients; however, very few patients have an advance care plan. Know the genetic syndromes and corresponding pathophysiology associated with congenital heart disease. Nurse Practitioner Core Competencies Content A delineation of suggested content specific to the NP core competencies 2014 Updated May 2017* NP Core Competencies Content Work Group Anne Thomas (Chair), PhD, ANP-BC, GNP, FAANP M. Katherine Crabtree, DNSc, APN-BC, FAAN Kathleen Delaney, PhD, PMH-NP, FAAN Mary Anne Dumas, PhD, RN, FNP-BC, GNP-BC, FAANP, FAAN Ruth … Many hospital systems also now use the 6-domain structure as part of medical staff privileging and peer-review professional competence assessments. The document was reviewed by 4 official representatives from the ACC and 25 reviewers representing the following organizations: the Accreditation Review Commission on Education for the Physician Assistant, American Academy of Physician Assistants, American Association of Heart Failure Nurses, American Association of Nurse Practitioners, American Heart Association, American Nurses Credentialing Center, Association of Physician Assistants in Cardiology, Heart Failure Society of America, Heart Rhythm Society, National Organization of Nurse Practitioner Faculties, Physician Assistant Education Association, Preventive Cardiovascular Nurses Association, and the Society for Cardiovascular Angiography and Interventions. The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. 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