1. COMPETENCIES FOR THE NEW SAUDI NURSE GRADUATE KFSH & RC (Riyadh) March 2004 COMPETENCIES FOR THE NEW SAUDI NURSE GRADUATE Dr Thelma D. van der Merwe KFSH & RC (Riyadh) March 2004

2. GUIDING QUESTION What should the competencies of the new Saudi Nurse Graduate be and Can it be implemented in a Performance Appraisal instrument?

3. OBJECTIVES To define competence To briefly analyse the relationship between regulation and competence To analyse the International Council for Nurses (ICN) framework To give a brief overview of the competencies required of a new graduate nurse (RN Association of British Columbia) Analyse the performance appraisal instrument according to the above

4. DEFINITION ICN, 1997 ….. a level of performance demonstrating the effective application of knowledge, skill and judgement.

5. PROFESSIONAL REGULATION Regulation: protect public Unqualified workers: * not member of Nursing Board or * nurse without current/relevant knowledge For licensure nurse to be competent Competence = a comprehensive approach/structure

6. ICN FRAMEWORK FOR COMPETENCIES 1. Professional, ethical, legal practice 2. Care provision and management 3. Professional development

7. ICN FRAMEWORK- 1. Professional, Ethical, Legal Practice 1.1 Professional Accountability: Five levels * self, patient, employer, legal systems & * Professional Nursing Board Pre-conditions * ability/competence – knowledge, skills, values attitudes * responsibility * authority ……… accountability

8. ICN FRAMEWORK – 1.2 Ethical Practice Code of Ethics Ethical decision making general/ specific conditions (war, disasters, violence) Advocacy: human rights Confidentiality: written/verbal Patient’s rights Unsafe practice and acts Culturally sensitive care Own value system

9. ICN FRAMEWORK – 1.3 Legal Practice Relevant legislation Local & national policies and procedures Acts upon violations of law and ethics

10. ICN FRAMEWORK – 2. Care provision & Management Key principles Care provision Care management

11. ICN FRAMEWORK- 2.1 Key Principles: Care Provision & Management Knowledge and skills Research findings & evidence Critical thinking & problem solving skills Prioritise workload Objective/subjective data Advocate Rationale for nursing Resource person Disaster planning

12. ICN FRAMEWORK- 2.2 Care Provision:Promotion of Health National health & social policies Collaboration Holistic Health promotion & illness prevention Empower Relevant health information Traditional healing Health education & evaluation

13. ICN FRAMEWORK- 2.2 Care Provision: Plan of Care Assessment Planning Implementation Evaluation

14. ICN FRAMEWORK- Care Provision: Communication & Interpersonal Relationships Develops & ends therapeutic relationships Communicates verbal, written, electronic Responds appropriately to questions/ problems Empower all Uses information technology

15. ICN FRAMEWORK- 2.3 Care Management Safe environment Interproffessional health care Delegation & supervision

16. ICN FRAMEWORK- 3. Professional Development Professional enhancement Quality improvement Continuing education

17. RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES Provides competent, professional care  Professional & ethical framework  Self development  Research  Role models Serves the public & nursing profession  Regulation  Nursing Association/Organisation  Population health needs

18. RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont… Performs & refines client assessments  Standardised tools  Consults  Comprehensive & holistic approach  Collaborates  Anticipates potential problems Develops client-focused plans of care  Clinical judgements  Stable/unstable patients  Appropriate technology  Develop plans of care

19. RNABC’s GENERIC ENTRY- LEVEL COMPETENCIES cont… Intervenes put theory into practice  Evidence-based knowledge  Theory based  Interventions for stable/unstable patients – simple, complex, specialised  Creative, innovative interventions  Multiple interventions, negotiates with patient, makes formal referrals, includes family  Relationships, cognitive behaviour, support groups  Comprehensive approach  Technology – safe & effective  Potentially unsafe situations & provides support  Changing situations

20. RNABC’s GENERIC ENTRY- LEVEL COMPETENCIES cont… Intervenes: Communicates  Social & professional interaction  Holistic caring environment  Partnerships with stable/unstable patients families  Variety of communication methods  Information, respecting patient confidentiality Intervenes: Teaches, verifies learning  General health related information  Individualizes information  Appropriate media & learning strategies  Assesses patients needs

21. RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont… Evaluates client progress  Status of stable/unstable patients  Evaluates & verifies findings  Modifies & individualises learning plan Organises care delivery for self & team  Organisational culture  Workload – effective time management  Basic computer skills  Record keeping, physical resources, QA & QI  Workloads to & of others  Actions in emergency situations  Accountability for delegated decisions  Unsafe situations for team members

22. RNABC’s GENERIC ENTRY-LEVEL COMPETENCIES cont… Practices collaboratively in health system  Interdisciplinary team  Partnerships, supports other team members  Own values/ norms  Impact of change  Team problem solving/ decision making/ collaboration in nursing practice  Conflict resolution  Nursing knowledge  Constructive feedback  Established communication protocols  Community related health care sectors

23. PERFORMANCE APPRAISAL CRITERIA/INDICATORS FOR SAUDI NEW GRADUATES New Graduate a Saudi Nurse with less than 2 years clinical experience Definition: New Graduate a Saudi Nurse with less than 2 years clinical experience 10 standards from RNABC (2000)  Criteria adapted for Saudi needs All criteria to a 5 rating:  3 rating = can perform basic nursing  4 rating = 3 rating & some added nursing actions  5 rating = 3 & 4 rating & some added nursing actions

24. CHRONOLOGICAL PRIORITIES OF 10 STANDARDS RNABC SAUDI NEW GRAD 1. Competent, professional 1. Performs/refines patient care assessments 2. Serves public & nursing 2. Develops patient care professionplans 3. Performs/refines assess- 3. Intervenes: uses theory ments for decision making 4. Develops client care plans 4. Intervenes: Patient Communication 5. Theory into action 5. Intervenes: Patient teaching

25. CHRONOLOGICAL PRIORITIES OF 10 STANDARDS cont… RNABC SAUDI NEW GRAD 6. Intervenes: Patient 6. Evaluates patient progress Communication 7. Intervenes: Patient 7. Organises care for self and teaching participates in others 8. Evaluates client progress 8. Collaborative practice 9. Organises care for self and 9. Functions in ethical, legal participates in others system 10. Collaborative practice 10. Serves public & Nursing Profession

26. IMPLEMENTATION OF PERFORMANCE APPRAISAL INSTRUMENT Validation:  ICN (2003) Framework  RNABC (2000) Competencies  Sent out to Head Nurses – minimal to no changes Reliability  Pilot study done on 3 New Graduates Recommendations  Test it out on a bigger number  Active education with implementation

27. SUMMARY Social agreement to the public Essential for new graduate nurses to become competent Proactive framework is proposed by the ICN Basic competencies have been identified according to RNABC (2000) and adjusted for the Saudi New Graduate Should be tested in other health care organisations in Saudi Arabia Shukran!!

28. ACKNOWLEDGEMENT The organising committee of the Saudi German Hospital for inviting me and accepting my paper The Saudi Nurse Graduates who inspired me to do this work so that one day they can take over from us and role model our work The Task Force at KFSH&RC who believed I can do the job on my own Mollie Butler for providing me with the RNABC information Mollie Butler for providing me with the RNABC information Shukran!!!