Specialized Body of Knowledge
- Has a knowledge base about the contribution of registered nurse practice to the achievement of positive client health outcomes.
- Has a knowledge base from nursing and other disciplines concerning current and emerging health care issues (e.g., the health care needs of older adults, vulnerable and/or marginalized populations, health promotion, obesity, pain prevention and pain management, end-of-life care, problematic substance use, and
- Has a knowledge base about human growth and development, and population health, including the determinants of health.
- Has a knowledge base in the health sciences, including anatomy, physiology, pathophysiology, psychopathology, pharmacology, microbiology, epidemiology, genetics, immunology, and nutrition.
- Has a knowledge base in nursing science, social sciences, humanities, and health-related research (e.g., culture, power relations, spirituality, philosophical, and ethical reasoning).
- Has a knowledge base about workplace health and safety, including ergonomics, safe work practices, prevention and management of disruptive behaviour, including horizontal violence, aggressive, or violent behaviour.
- Has theoretical and practical knowledge of relational practice and understands that relational practice is the foundation for all nursing practice.
- Has knowledge about emerging community and global health issues, population health issues and research (e.g., pandemic, mass immunizations, emergency/disaster planning, and food and water safety).
- Knows how to find evidence to support the provision of safe, competent, compassionate, and ethical nursing care, and to ensure the personal safety and safety of other health care workers.
- Understands the role of primary health care and the determinants of health in health delivery systems and its significance for population health.
- Understands nursing informatics and other information and communication technologies used in health care.
Area i) Ongoing Comprehensive Assessment: Incorporates critical inquiry and relational practice to conduct a client-focused assessment that emphasizes client input and the determinants of health.
- Uses appropriate assessment tools and techniques in consultation with clients and the health care team.
- Engages clients in an assessment of the following: physical, emotional, spiritual, cultural, cognitive, developmental, environmental, and social needs.
- Collects information on client status using assessment skills of observation, interview, history taking, interpretation of laboratory data, mental health assessment, and physical assessment, including inspection, palpation, auscultation, and percussion.
- Uses information and communication technologies to support information synthesis.
- Uses anticipatory planning to guide an ongoing assessment of client health status and health care needs (e.g., prenatal/postnatal, adolescents, older adults, and reaction to changes in health status and or/diagnosis).
- Analyzes and interprets data obtained in client assessments to draw conclusions about client health status.
- Incorporates knowledge of the origins of the health disparities and inequities of Aboriginal Peoples, Black Canadians of African descent, and French Acadians and the contributions of nursing practice to achieve positive health outcomes for these populations.
- Uses knowledge to address health disparities and inequities of vulnerable and/or marginalized populations (e.g., sexual orientation, age, poverty, persons with disabilities, ethnic diversity, homeless, racial diversity, language minorities) and the contributions of nursing practice to achieve positive health outcomes.
- Collaborates with clients and the health care team to identify actual and potential client health care needs, strengths, capacities, and goals.
- Completes assessments in a timely manner, and in accordance with evidence-informed practice, agency policies, and protocols.
Area ii) Health Care Planning: Within the context of critical inquiry and relational practice, plans nursing care appropriate for clients which integrates knowledge from nursing, health sciences and other related disciplines, as well as knowledge from practice experiences, clients’ knowledge and preferences, and factors within the health care setting.
- Uses critical inquiry to support professional judgment and reasoned decision-making to develop health care plans.
- Uses principles of primary health care in developing health care plans.
- Facilitates the appropriate involvement of clients in identifying their preferred health outcomes.
- Negotiates priorities of care and desired outcomes with clients, demonstrating cultural safety, and considering the influence of positional power relationships.
- Initiates appropriate planning for clients’ anticipated health problems or issues and their consequences (e.g., childbearing, childrearing, adolescent health, and senior well-being).
- Explores and develops a range of possible alternatives and approaches for care with clients.
- Facilitates client ownership of direction and outcomes of care developed in their health care plans.
- Collaborates with the health care team to develop health care plans that promote continuity for clients as they receive conventional, complementary and alternative health care.
- Determines, with the health care team or health-related sectors, when consultation is required to assist clients in accessing available resources.
- Consults with the health care team as needed to analyze and organize complex health challenges into manageable components for health care planning.
Area iii) Providing Nursing Care: Provides client-centred care in situations related to:
- health promotion, prevention, and population health;
- maternal/child health;
- altered health status, including acute and chronic physical and mental health conditions and rehabilitative care; and
- palliative care and end-of-life care.
- Provides nursing care across the lifespan that is informed by a variety of theories relevant to health and healing (e.g., nursing; family; communication and learning; crisis intervention; loss, grief, and bereavement; systems; culture; community development; and population health theories).
- Prioritize and provide timely nursing care and consult as necessary for any client with co-morbidities, and a complex and rapidly changing health status.
- Provides nursing care to clients with chronic and persistent health challenges (e.g., mental health, problematic substance use, dementia, cardiovascular conditions, strokes, asthma, arthritis, and diabetes).
- Incorporates evidence from research, clinical practice, client perspective, client and staff safety, and other available resources to make decisions about client care.
- Supports clients through developmental stages and role transitions across the lifespan (e.g., pregnancy, infant nutrition, well-baby care, child development stages, family planning and relations).
- Recognize, seek immediate assistance, and help others in a rapidly changing client condition affecting health or patient safety (e.g., myocardial infarction, surgical complications, acute neurological event, acute respiratory event, cardiopulmonary arrest, perinatal crisis, diabetes crisis, mental health crisis, premature birth, shock, and trauma).
- Applies principles of population health to implement strategies to promote health as well as prevent illness and injury (e.g., promoting hand washing, immunization, helmet safety, and safe sex).
- Assists clients to understand how lifestyle factors impact health (e.g., physical activity and exercise, sleep, nutrition, stress management, personal and community hygiene practices, family planning, and high risk activities).
- Implements learning plans to meet identified client learning needs.
- Assists clients to identify and access health and other resources in their communities (e.g., other health disciplines, community health services, rehabilitation services, support groups, home care, relaxation therapy, meditation, and information resources).
- Applies knowledge when providing nursing care to prevent development of complications (e.g., optimal ventilation and respiration, circulation, fluid and electrolyte balance, nutrition, urinary elimination, bowel elimination, body alignment, mobility, tissue integrity, comfort, and sensory stimulation).
- Applies bio-hazard and safety principles, evidence-informed practices, infection prevention and control practices, and appropriate protective devices when providing nursing care to prevent injury to clients, self, other health care workers, and the public.
- Implements strategies related to the safe and appropriate administration and use of medication.
- Recognizes and takes initiative to support environmentally-responsible practice (e.g., observing safe waste disposal methods, using energy as efficiently as possible, and recycling plastic containers and other recyclable materials).
- Performs therapeutic interventions safely (e.g., positioning, skin and wound care, management of intravenous therapy and drainage tubes, and psychosocial interaction).
- Implements evidence-informed practices of pain prevention and pain management with clients using pharmacological and non-pharmacological measures.
- Prepares the client for diagnostic procedures and treatments; provides post-diagnostic care; performs procedures; interprets findings, and provides follow-up care as appropriate.
- Provides nursing care to meet palliative care or end-of-life care needs (e.g., pain and symptom management, psychosocial and spiritual support, and support for significant others).
Area iv) Evaluation: Monitors the effectiveness of client care to inform future care planning.
- Uses critical inquiry to monitor and evaluate client care in a timely manner.
- Collaborates with others to support involvement in research and the use of research findings in practice.
- Modifies and individualizes client care based on the emerging priorities of the health situation in collaboration with clients.
- Verifies that clients have an understanding of essential information and skills to be active participants in their own care.
- Reports and documents client care in a clear, concise, accurate, and timely manner.