Competencies
Quad Council PHN Competencies
Finalized 4/3/03The Quad Council of Public Health Nursing Organizations is an alliance of the four national nursing organizations that address public health nursing issues: the Association of Community Health Nurse Educators (ACHNE), the American Nurses Association's Congress on Nursing Practice and Economics (ANA), the American Public Health Association-Public Health Nursing Section (APHA), and the Association of State and Territorial Directors of Nursing (ASTDN.) In 2000, prompted in part by work on educating the public health workforce being done under the leadership of the Centers for Disease Control (CDC), the Quad Council began work on drafting a set of national public health nursing competencies.
The approach utilized by the Quad Council was to start with the Council on Linkages between Academia and Public Health Practice (COL) "Core Competencies for Public Health Professionals" and to determine their application to two levels of public health nursing practice: the staff nurse/generalist role and the manager/specialist/consultant role. It was the Quad Council's intent to examine these COL competencies for their fit with public health nursing and to continue to identify and refine unique competencies for public health nursing. By selecting the COL competencies as the framework, the Quad Council felt that the competencies could provide a guide for agencies that employ public health nurses and academic settings to facilitate education, orientation, training and lifelong learning using an interdisciplinary model where appropriate.
The COL list of core competencies "represents ten years of work on this subject" by the fifteen member organizations whose missions include improving public health education and practice. Over 1,000 public health professionals reviewed the list during a public comment period. "The Council utilized several mechanisms to receive feedback from reviewers, including e-mail, focus groups, sessions at various conferences and the competencies web site. The comments from public health professionals in a broad array of disciplines and practice settings led to this consensus set of core competencies for guiding public health workforce development efforts.The core competencies represent a set of skills, knowledge, and attitudes necessary for the broad practice of public health. They transcend the boundaries of the specific disciplines within public health and help to unify the profession" (www.trainingfinder.org/competencies.) The actual competency statements are the "property" of the COL and could not be modified by public health nursing or the Quad Council during the process of looking at applicability to public health nursing practice. The Quad Council's focus was on how public health nurses apply those competencies and the expected level of performance for each competency statement.
Nursing specific application of the competencies is necessary for specialized roles within public health nursing and the COL's competencies have been used as the framework to develop them. However, because the COL's list captures only the crosscutting competencies for all public health professionals, it does not contain competencies that are specific to public health nursing. Note again: since the COL's competencies are for all public health professionals, even this public health nursing specific draft does not include nursing competencies that are broader than public health (i.e., apply to many or all nurses.)
The "Quad Council PHN Competencies" document is designed for use with others documents. It complements the "Definition of Public Health Nursing" adopted by the APHA's Public Health Nursing Section in 1996 and the Scope and Standards of Public Health Nursing (Quad Council, 1999). Differentiating PHN competencies at the generalist and specialist levels will help to clarify the PHN specialty for both the discipline of nursing and the profession of public health. In addition, the ability to identify PHN competencies should facilitate collaboration among public health nurses and other public health professionals in education, practice and research in order to improve the public's health.
In developing the competencies the Quad Council members concurred that the generalist level would reflect preparation at the baccalaureate level. While recognizing that in many states much of the public health nursing workforce is not baccalaureate-prepared, the Quad Council believes that those nurses may require job descriptions that reflect a different level of practice and/or may require extensive orientation and education to achieve the competencies identified herein. Further, the specialist level competencies described in this document reflect preparation at the master's level in community/public health nursing and/or public health. Again, while recognizing that there may be other public health nurses who are promoted or appointed to managerial or consultant positions that require specialist competencies, master's level education prepares public health nurses for the specialist level competencies identified in this document. At both levels, it is expected that a major focus of on the job training and continuing education for nurses hired for these positions who have less than a baccalaureate or master's degree (as appropriate to the level) will be on assuring that these competencies are attained.
The Quad Council determined that, although the Council on Linkages competencies were developed with the understanding that public health practice is population-focused and public health nursing is also population-focused, one of the unique contributions of public health nurses is the ability to apply these principles at the individual and family level within the context of population-focused practice. Therefore, many of the competency statements indicate a level of awareness, knowledge or proficiency at the individual/family level. Because of their population or system-focused language however, it was decided that several specific competency statements and three entire domains would not include application at the individual/family level: "Domain 5 - community dimensions of practice," "Domain 7 - financial planning and management skills," and "Domain 8 - leadership and systems thinking skills." Finally, it was recognized that "groups" are entities which can be addressed at the individual/family level and at the population/system level. Therefore, when PHNs use the group format primarily to convey information targeted to individual or family approaches to health issues (e.g., a group format is used to teach newly diagnosed diabetics about the importance of diet and exercise, but the information targets individuals), this represents an application at the individual/family level.
Finally, the Quad Council based this document on the following additional assumptions:
· public health nurses must first possess the competencies common to all baccalaureate-prepared nurses (not addressed in this competency list) and then demonstrate these additional competencies specific to their roles in public health;
· the progression from awareness to knowledge to proficiency is a continuum, there are no discrete boundaries between those levels of competence (note that definitions of each of these three levels appear at the bottom of each page of the competencies list);
· both levels reflect competencies for a reasonably prudent PHN who has experience in the role (i.e., not a "novice" and not in a specialized or limited focus role);
· these competencies are intended to reflect the standard for public health nursing practice, not necessarily what is occurring in practice today; and
· in any practice setting the job descriptions may reflect components from each level, depending on the agency's structure, size, leadership and services.
In preparing this document, the Quad Council sought feedback on a draft of these competencies from nurses across the country who are members of one or more of its member organizations; more than 220 nurses, most of whom are directly involved in public health practice, provided specific comments on the draft. The Quad Council is grateful to all those public health nurses who took the time to review the draft and provide thoughtful comments. Their feedback was carefully considered in developing this final document.
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #1: Analytic Assessment Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Defines a problem
Proficiency
Knowledge
Proficiency
Proficiency
2.
Determines appropriate uses and limitations of both quantitative and qualitative data
Knowledge
Awareness
Proficiency
Proficiency
3.
Selects and defines variables relevant to defined public health problems
Knowledge
Knowledge
Proficiency
Proficiency
4.
Identifies relevant and appropriate data and information sources
Proficiency
Knowledge
Proficiency
Proficiency
5.
Evaluates the integrity and comparability of data and identifies gaps in data sources
Knowledge
Awareness
Proficiency
Proficiency
6.
Applies ethical principles to the collection, maintenance, use, and dissemination of data and information
Proficiency
Knowledge
Proficiency
Proficiency
7.
Partners with communities to attach meaning to collected quantitative and qualitative data
N/A
(see Note 1)
Knowledge
N/A
(see Note 1)
Proficiency
8.
Makes relevant inferences from quantitative and qualitative data
Knowledge
Awareness
Proficiency
Proficiency
9.
Obtains and interprets information regarding risks and benefits to the community
Knowledge
Knowledge
Proficiency
Proficiency
10.
Applies data collection processes, information technology applications, and computer systems storage/retrieval strategies
Knowledge
Awareness
Proficiency
Proficiency
11.
Recognizes how the data illuminates ethical, political, scientific, economic, and overall public health issues
Knowledge
Awareness
Proficiency
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #2: Policy Development/Program Planning Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Collects, summarizes, and interprets information relevant to an issue
Knowledge
Awareness
Proficiency
Proficiency
2.
States policy options and writes clear and concise policy statements
Awareness
Awareness
Proficiency
Proficiency
3.
Identifies, interprets, and implements public health laws, regulations, and policies related to specific programs
Knowledge
Knowledge
Proficiency
Proficiency
4.
Articulates the health, fiscal, administrative, legal, social, and political implications of each policy option
Awareness
Awareness
Proficiency
Proficiency
5.
States the feasibility and expected outcomes of each policy option
Awareness
Awareness
Proficiency
Proficiency
6.
Utilizes current techniques in decision analysis and health planning
Knowledge
Awareness
Proficiency
Proficiency
7.
Decides on the appropriate course of action
Knowledge
Awareness
Proficiency
Proficiency
8.
Develops a plan to implement policy, including goals, outcome and process objectives, and implementation steps
Knowledge
Awareness
Proficiency
Proficiency
9.
Translates policy into organizational plans, structures, and programs
N/A
(see Note 1)
Awareness
N/A
(see Note 1)
Proficiency
10.
Prepares and implements emergency response plans
Knowledge
Knowledge
Proficiency
Proficiency
11.
Develops mechanisms to monitor and evaluate programs for their effectiveness and quality
Knowledge
Knowledge
Proficiency
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #3: Communication Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Communicates effectively both in writing and orally, or in other ways
Proficiency
Knowledge
Proficiency
Proficiency
2.
Solicits input from individuals and organizations
Proficiency
Knowledge
Proficiency
Proficiency
3.
Advocates for public health programs and resources
Proficiency
Knowledge
Proficiency
Proficiency
4.
Leads and participates in groups to address specific issues
Proficiency
Knowledge
Proficiency
Proficiency
5.
Uses the media, advanced technologies, and community networks to communicate information
Knowledge
Awareness
Knowledge*
Knowledge*
* reflects ability to determine need for and to utilize experts in these areas
6.
Effectively presents accurate demographic, statistical, programmatic, and scientific information for professional and lay audiences
Knowledge
Knowledge
Proficiency
Proficiency
7.
Attitudes: Listens to others in an unbiased manner, respects points of view of others, and promotes the expression of diverse opinions and perspectives
Proficiency
Proficiency
Proficiency
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #4: Cultural Competency Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Utilizes appropriate methods for interacting sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, racial, ethnic and professional backgrounds, and persons of all ages and lifestyle preferences
Proficiency
Proficiency
Proficiency
Proficiency
2.
Identifies the role of cultural, social, and behavioral factors in determining the delivery of public health services
Knowledge
Knowledge
Proficiency
Proficiency
3.
Develops and adapts approaches to problems that take into account cultural differences
Proficiency
Knowledge
Proficiency
Proficiency
4.
Attitudes: Understands the dynamic forces contributing to cultural diversity
N/A
(see Note 1)
Knowledge
N/A
(see Note 1)
Proficiency
5.
Attitudes: Understands the importance of a diverse public health workforce
N/A
(see Note 1)
Knowledge
N/A
(see Note 1)
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #5: Community Dimensions of Practice Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Establishes and maintains linkages with key stakeholders
Knowledge
Proficiency
2.
Utilizes leadership, team building, negotiation, and conflict resolution skills to build community partnerships
Knowledge
Proficiency
3.
Collaborates with community partners to promote the health of the population
Knowledge
Proficiency
4.
Identifies how public and private organizations operate within a community
Knowledge
Proficiency
5.
Accomplishes effective community engagements
Knowledge
Proficiency
6.
Identifies community assets and available resources
Knowledge
Proficiency
7.
Develops, implements, and evaluates a community public health assessment
Knowledge
Proficiency
8.
Describes the role of government in the delivery of community health services
Knowledge
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #6: Basic Public Health Sciences Skills Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Identifies the individual's and organization's responsibilities within the context of the Essential Public Health Services and core functions
Knowledge Knowledge
Proficiency
Proficiency
2.
Defines, assesses, and understands the health status of populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services
Knowledge
Knowledge
Proficiency
Proficiency
3.
Understands the historical development, structure, and interaction of public health and health
Knowledge
Knowledge
Proficiency
Proficiency
4.
Identifies and applies basic research methods used in public health
Awareness
Awareness
Knowledge
Knowledge
5.
Applies the basic public health sciences including
behavioral and social sciences, biostatistics, epidemiology, environmental public health, and prevention of chronic and infectious diseases and injuries
Awareness
Awareness
Knowledge
Knowledge
6.
Identifies and retrieves current relevant scientific evidence
Knowledge
Knowledge
Proficiency
Proficiency
7.
Identifies the limitations of research and the importance of observations and interrelationships
Awareness
Awareness
Knowledge
Knowledge
8.
Attitudes: Develops a lifelong commitment to rigorous critical thinking
Proficiency
Proficiency
Proficiency
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration
Domain #7: Financial Planning and Management Skills Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Develops and presents a budget
Awareness
Proficiency
2.
Manages programs within budget constraints
Knowledge
Proficiency
3.
Applies budget processes
Awareness
Proficiency
4.
Develops strategies for determining budget priorities
Awareness
Proficiency
5.
Monitors program performance
Knowledge
Proficiency
6.
Prepares proposals for funding from external sources
Awareness
Proficiency
7.
Applies basic human relations skills to the management of organizations, motivation of personnel, and resolution of conflicts
Knowledge
Proficiency
8.
Manages information systems for collection, retrieval, and use of data for decision-making
Awareness
Proficiency
9.
Negotiates and develops contracts and other documents for the provision of population-based services
Awareness
Proficiency
10.
Conducts cost-effectiveness, cost-benefit, and cost utility analyses
Awareness
Proficiency
Definitions:
PUBLIC HEALTH NURSING COMPETENCIES – Finalized 04/03
Source of competencies: Core Competencies for Public Health Professionals A Project of the Council on Linkages Between Academia and Public Health Practice Funded by the Health Resources and Services Administration.
Domain #8: Leadership and Systems Thinking Skills
Generalist/Staff PHN
Manager/CNS/Consultant/ Program Specialist/Executive
Individuals & Families
Populations/ Systems
Individuals & Families
Populations/ Systems
1.
Creates a culture of ethical standards within organizations and communities
Knowledge
Proficiency
2.
Helps create key values and shared vision and uses these principles to guide action
Knowledge
Proficiency
3.
Identifies internal and external issues that may impact delivery of essential public health services (i.e. strategic planning)
Knowledge
Proficiency
4.
Facilitates collaboration with internal and external groups to ensure participation of key stakeholders
Knowledge
Proficiency
5.
Promotes team and organizational learning
Knowledge
Proficiency
6.
Contributes to development, implementation, and monitoring of organizational performance standards
Knowledge
Proficiency
7.
Uses the legal and political system to effect change
Knowledge
Proficiency
8.
Applies theory of organizational structures to professional practice
Awareness
Proficiency
Definitions:
Note 1: (applicable to Domains 1, 2 and 4) These competencies, because of their population or system-focused language, do not apply at the individual/family level, but are applicable to the broader context of population-focused public health services and systems.