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Standards of Professional Performance
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Introduction
Standards of professional performance describe a competent level of behavior in the
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professional role, including activities related to ethics, education, evidence-based practice and research,
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quality of practice, communication, leadership, collaboration, professional practice evaluation, resource
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utilization, and environmental health, The competency statements describe how the standards are met
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and are not ordered in particular level of importance.
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Standard I: Quality of Practice
The nurse caring for the acutely and critically ill patient contributes to quality and effectiveness of
nursing practice.
Competencies:
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Participates in clinical inquiry through quality improvement activities.
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Consults to initiate changes in nursing practice and the healthcare delivery system.
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Ensures that quality improvement activities incorporate appropriate patient and family beliefs,
values and preferences.
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Evaluates practice in an ongoing process, based on best evidence.
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Identifies barriers to quality care and patient outcomes..
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Participates in the development, implementation, evaluation and revision of policies,
procedures, and/or guidelines to improve the quality and effectiveness of nursing practice..
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Uses creativity and innovation to enhance quality nursing care.
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Demonstrates quality by documenting the application of the nursing process in a responsible,
accountable and ethical manner and a clear and retrievable format.
Standard II: Professional Practice Evaluation
The nurse caring for the acutely and critically ill patient evaluates his/her own nursing practice in
relation to professional practice standards, organizational guidelines, relevant statutes, rules, and
regulations.
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Competencies:
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Engages in a self-evaluation of practice on a regular basis, identifying areas of strength as well as
areas where professional growth would be beneficial.
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Takes action to achieve goals identified in the evaluation process.
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Obtains feedback regarding his/her own practice from patients, families, peers and professional
colleagues.
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Provides peers with formal or informal constructive feedback regarding their practice or role
performance.
Standard III: Education
The nurse acquires and maintains current knowledge and competence in the care of acutely and
critically ill patients.
Competencies:
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Participates in on-going learning experiences and activities to develop and maintain clinical and
professional skills and knowledge.
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Seeks learning opportunities that reflect current and evidence-based practice.
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Shares educational findings, experiences and ideas with peers.
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Contributes to a work environment conducive to the education of healthcare professionals.
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Maintains a professional records or portfolio that provides evidence of competence and life-long
learning.
Standard IV: Communication
The nurse caring for the acutely and critically ill patient uses skilled communication in a variety of
formats.
Competencies:
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Assesses communication format preferences of acute and critically ill patients and the
interprofessional team.
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Assesses personal communication skills.
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.Solicits feedback to continuously improve her or his own communication and conflict resolution
skills.
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Conveys accurate information to acutely and critically ill patients and the interprofessional team
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Questions the rationale supporting care processes and decisions with all members of the
interprofessional team.
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Discloses observations or concerns related to safety, hazards, and errors in care or the practice
environment to the appropriate level.
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Maintains communication with other providers to minimize risks associated with patient
handoffs, transfers and transitions in care.
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Contributes her or his own professional perspective in discussions with the interprofessional
team.
Standard V: Ethics
The nurse’s decisions and actions are carried out in an ethical manner in all areas of practice.
Competencies:
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Practice is guided by the ANA Code of Ethics for Nurses with Interpretive Statements,1 the AACN
Core Values and ethical principles.
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Promotes ethical accountability and integrity in relationships, organizational decisions and
stewardship of resources.
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Protects patient confidentiality within legal and regulatory parameters.
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Advocates for the concerns of patients, their families and the community.
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Delivers care in a nonjudgmental and nondiscriminatory manner that meets the diverse needs,
of the patient
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Maintains patient autonomy, dignity, values, beliefs and rights at all times
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Uses available resources in formulating ethical decisions.
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Demonstrates a commitment to self-care and self-advocacy.
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Reports unethical, illegal, incompetent, or impaired practices.
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Assists patient and family in self-determination and informed decision making
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Maintains a therapeutic and professional nurse/patient relationship within appropriate role
boundaries.
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Contributes to resolving ethical issues involving the patient, family and interprofessional team.
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‘Questions healthcare practice when necessary for safety and quality improvement.
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Collaborates with the interprofessional team to promote palliative or end-of-life discussions and
care.
Standard VI: Collaboration
The nurse caring for the acutely and critically ill patient collaborates with the patient, family and
interprofessional team.
Competencies:
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Partners with others to effect change and produce positive outcomes through knowledge
sharing
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Adheres to standards that govern behavior among the interprofessional team to create a
healthy work environment that promotes cooperation, respect and trust.
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Collaborates with the patient, family and interprofessional team to promote effective and safe
transition across care settings
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Engages in teamwork and conflict resolution.
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Contributes to creating a interprofessional plan of care.
Standard VII: Evidence-based Practice/Research/Clinical Inquiry3
The nurse caring for the acute and critically ill patient uses clinical inquiry and integrates best evidence
into practice.
Competencies:
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Questions clinical practices for the purpose of improving the quality of care
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Describes clinical problems using evidence generated within a clinical setting, such as patient
assessment data, outcomes management, and quality improvement data
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Formulates clinical questions.
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Participates in evaluating evidence to determine applicability to practice.
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Assists with integrating evidence into policy, procedure, and practice.
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Implements practice changes based on evidence, clinical expertise, and patient preferences to
improve care processes and patient outcomes.
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Evaluates outcomes of evidence-based decisions and practice changes for individuals, groups,
and populations to determine best practices.
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Disseminates best practices supported by evidence to improve quality of care and patient
outcomes.
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Participates in activities and strategies to sustain an evidence-based practice culture.
Standard VIII: Resource Utilization
The nurse caring for the acute and critically ill patient uses appropriate resources to plan and provide
services that are safe, effective and financially responsible.
Competencies:
 Assesses the individual patient needs and available resources to achieve desired outcomes.
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Delegates elements of care (as defined by regulatory agencies) to the appropriate individual
based upon assessed needs and condition of the patient, potential for harm, patient stability,
predictability of the outcomes, competence of the individual, and resources available.
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Assists the patient and family in identifying and securing appropriate services to address healthrelated needs according to resource availability.
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Informs the patient and family regarding the options, alternatives, risks, benefits, for nursing
interventions.
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Advocates for additional resources that enhance nursing practice and quality of care.
Standard IX: Leadership
The nurse caring for the acutely and critically ill patient provides leadership in the professional practice
setting as well as the profession.
Competencies:
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Contributes to the creation and maintenance of healthy work environments
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Supports peers and colleagues through mentoring and other strategies.
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Demonstrates flexibility and the ability to remain patient-focused in a rapidly changing
environment.
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Directs the coordination of care among caregivers, including oversight of licensed and
unlicensed personnel in any assigned or delegated tasks.
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Participates on committees, councils, and interprofessional teams.
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Promotes advancement of the profession through participation in professional organizations.
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Develops a culture of safety for patients, families, and interprofessional team..
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Promotes communication of information and advancement of the profession through writing,
publishing, and presentations for professional or lay audiences.
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Promotes development and implementation of innovative solutions.
Standard X: Environmental Health
The nurse caring for the acutely and critically ill patient maintains a safe and healthy environment.
Competencies:
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Minimizes environmental risk factors that may cause physical harm or injury to patients,
families, and the interprofessional team.
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Implements strategies to reduce the impact of environmental factors that jeopardize health,
such as sound, odor, noise, and light.
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Communicates environmental health risks and exposure reduction strategies to patients,
families and colleagues.
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Uses reliable resources to determine if a product or treatment is an environmental threat.
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Participates in strategies and activities to promote healthy communities.
1
American Nurses Association. Code of Ethics for Nurses with Interpretive Statements. Washington, DC:
American Nurses Association; 2001.
2
American Association of Critical Care Nurses. AACN Core Values.
http://www.aacn.org/wd/aacninfo/content/mission-vision-values-ethics.pcms?menu=aboutus.
Accessed October 10, 2014.
3
Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). 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. Worldviews on Evidence-Based Nursing, 11(1), 5-15.