A Competency-Based Approach to Public Health Nursing ... · A Competency-Based Approach to Public Health Nursing Performance Appraisal ... Managing the Core Functions.

SPECIAL FEATURES: PRACTICE CONCEPTS

A Competency-Based Approach to PublicHealth Nursing Performance AppraisalKate BracyKalb,NancyM.Cherry, Jayne Kauzloric, Annette Brender, KathyGreen, LeaAnnMiyagawa,and Anne Shinoda-Mettler

ABSTRACT Objectives: To integrate public health nursing (PHN) competencies into a comprehensiveperformance review instrument for nurses at multiple practice levels in an urban public health department.Design: Based on thorough review of PHN competency literature, the tool evaluates performance for 5nursing practice classifications (Staff RN, Public Health Nurse, Nurse Practitioner, Clinical Nurse Specialist,Nursing Supervisor) in eight PHN domains (assessment, policy development/program planning, evaluation,communication, cultural competency, partnership/collaboration, disease prevention/health promotion,leadership/systems thinking). Sample: Tool was piloted with over 50 nurses from PHN workforce (n4400)of Public Health-Seattle & King County (Washington). Method: Pilot testing includes all components of theperformance appraisal system: Public Health Competency Grid, statement of general workplace expectations,Nursing Performance Appraisal Tool, and supporting documents defining performance elements by jobclassification. Results: Supervisors find the tool easy to use and report that it provides opportunity for realcommunication between employee and supervisor. Nurses at all practice levels report that it effectivelydescribes/evaluates their practice. Conclusions: This tool is an efficient performance appraisal instrumentproviding meaningful feedback to nursing employees within a framework of PHN competencies. Adopting suchtools in PHN practice can help nurses to better understand their role in population-based public health efforts.

Key words: clinical competence, competencies, performance appraisal, public health nursing,supervision.

Essential public health nursing competencies havebeen well described in the public health literature. Inthe everyday world of nursing activities, however,it is something of a leap from merely understanding

the competencies to seeing them form the frameworkof actual day-to-day practice. Public Health—Seattle &King County (PHSKC), located in WashingtonState, has a long history of strong, effective publichealth nursing practice. Recent changes in countynursing classifications provided an opportunity to up-date and improve the performance tool that had beenused for over a decade to evaluate King County publichealth nurses.

The earlier appraisal tool had been designed as aninstrument to offer acknowledgment and encourage-ment for nursing performance. Supervisors felt that itlacked opportunity for meaningful feedback, and thatit did not address the nursing practice as populationbased. As nurses in the department were clearlypracticing from a population-based framework, thisseemed the opportunity to develop a nursing per-formance appraisal tool that would more accuratelyreflect the current role of nursing, as well as theopportunity to define the practice explicitly usingpopulation-based competencies. Supervisors requesteda tool that would show staff growth and wouldprovide meaningful feedback on performance. At the

Kate BracyKalb,M.S., A.R.N.P., isNursing Sta¡ Develop-ment Specialist, Public HealthçSeattle & King County,Seattle, Washington. Nancy M. Cherry, R.N., M.S.N., isChief of Nursing Services (Retd.), Public HealthçSeattle& King County, Seattle, Washington. Jayne Kauzloric,R.N., M.N., is Site Manager, Public HealthçSeattle &King County, Seattle, Washington. Annette Brender,R.N., B.S.N., is Personal Health Services Supervisor, Pub-lic HealthçSeattle & King County, Seattle,Washington.Kathy Green, R.N., B.S.N., M.H.A., is Health Services Ad-ministrator, Public HealthçSeattle & King County,Seattle,Washington. LeaAnnMiyagawaR.N., M.N., is Ad-vanced PracticeNurse Specialist, Public HealthçSeattle& King County, Seattle,Washington. Anne Shinoda-Met-tler, R.N., B.S.N., is SiteManager, Public HealthçSeattle& King County, Seattle,Washington.Correspondence to:Kate Bracy Kalb, 999 Third Ave., Ste. 900, Seattle,WA98104-4039. E-mail: [email protected]

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Public Health Nursing Vol. 23 No. 2, pp. 115–1380737-1209/r 2006, The AuthorsJournal Compilationr 2006, Blackwell Publishing, Inc.

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116 Public Health Nursing Volume 23 Number 2 March/April 2006

same time, there was overwhelming support for mak-ing the tool practical, easy to use, and helpful in super-vising nurses to maximize their public health practice.

Conceptual basisPublic Health Nursing Competencies have been de-fined and clarified over the past decade. Beginning in1994, when the National Association of City andCounty Health Officials (NACCHO) and the Centersfor Disease Control and Prevention (CDC) describedthe ‘‘Ten Essential Services’’ of public health (NAC-CHO, 1994) based on three core public health func-tions (IOM, 1988) (see Fig. 1), the world of publichealth began to describe itself in terms of the popula-tion-based practice. These essential services, as theyrelated specifically to public health nurses, were fur-ther described by the Minnesota Department ofHealth (1997) in Public Health Interventions: Exam-ples from Public Health Nursing in October of 1997.This was a detailed description of the customary workof public health nurses, and framed in terms of itsrelationship with a population-based practice (seeFig. 1). That same year, the Quad Council of PublicHealth Nursing Organizations articulated ‘‘Eight Ten-ets of Public Health Nursing’’ (Quad Council, 1999)(see Fig. 1). These tenets form the underlying set ofexpectations for nurses practicing in a population-based practice. In 1998, the American Nurses Associ-ation (ANA) described ‘‘Six Standards of NursingCare’’ and ‘‘Eight Standards of Professional Perfor-mance’’ (ANA, 1998) (see Fig. 1). Although not specificto public health nursing, these standards gave morestructure to the discipline of nursing as it is currentlypracticed in this country. The National Association ofCounty and City Health Officials (NACCHO) pub-lished The Public Health Competency Handbook:Optimizing Individual and Organizational Perfor-mance for the Public’s Health in 2001 (Nelson &Eissen, 2001). The handbook includes a chapter enti-tled ‘‘Where the Rubber Meets the Road: An Overviewof Competency Based Performance Management.’’This chapter describes a process for measuring and‘‘optimizing individual and organizational perfor-mance for the public’s health.’’ It details both organ-izational and individual competencies for each ofseven organizational ‘‘competency areas.’’ The role ofpublic health nursing within a population-basedframework and the leadership necessary to managethat transition were described in 2001 by Berkowitz etal. in Public Health Nursing Leadership: A Guide to

Managing the Core Functions. In the same year,nursing competencies per se were explicitly describedby the Quad Council with their adaptation of the‘‘Core Competencies of Public Health Professionals’’(Council on Linkages Between Academia and PublicHealth Practice [COL], 2001) to public health nursingpractice (see Fig. 1). This work, finalized in 2003, listseight ‘‘domains’’ for nursing practice and describesthe expected activities and skills for each domain, aswell as the expected skill level in each domain for stafflevel nurses versus management/specialist/executivenurses (Quad Council, 2004).

With this substantial groundwork conducted, itremained to find an actual appraisal tool based on allthese well-considered documents. At the time of tooldevelopment, authors were unable to find such a tool.The Minnesota Department of Health Web site hadlisted ‘‘Entry Level Population-Based Public HealthNursing Competencies’’ (Henry Street Consortium,2003). These were useful particularly for new and in-experienced nurses, and defined 11 basic competen-cies for nurses going into a public health practice, butdid not allow for conventional performance review.South Carolina had performed a ‘‘Public HealthWorkforce Development Survey’’ in which they askedemployees to describe their skill levels in each of 68activities within the ‘‘Core Competencies of PublicHealth Professionals’’ (State of South Carolina, un-dated). The Kentucky Board of Nursing and KentuckyDepartment of Public Health had conducted someexcellent work in a ‘‘Registered Nurse Initial Employ-ment Competency Validation’’ (Kentucky Board ofNursing, 2002) checklist for newly hired public healthnurses. The checklist was based on the Quad Council’seight domains of public health nursing practice, andlists specific sub-competencies under each domainthat must be verified for each public health nurse.While each of these pieces of work was valuable for itsintended purpose, none was an appraisal tool per se,nor were any designed to address general feedback toemployees or intended to serve as performance reviewtools with goal-setting and scoring features.

Tool Development

Developing and launching a new performance ap-praisal tool for nurses is not a small undertaking in alarge county bureaucracy such as PHSKC. The HealthDepartment has 10 major clinical sites and over 400nurses in its employ. Although ‘‘population-based

Kalb et al.: Competency-Based Performance Appraisal 117

practice’’ is supported and understood by leadershipwithin the department, it has not been the basis forany official position descriptions.

To develop a tool specific to the county’s publichealth nursing practice, all of the previously men-tioned documents and publications were reviewed forcontent and form. Additionally, the current job spec-ifications were reviewed for nursing classifications atall levels. Various competencies from the availableframeworks were summarized and combined, and‘‘Eight Nursing Competencies for Public Health—Seattle & King County’’ were described for all nursesworking in public health. These competencies werethen broken into specific performance elements foreach competency, at each level of nursing practice. Forexample, ‘‘Assessment’’ was the first competencynamed in the appraisal tool. Assessment performanceelements were then described in detail for each of theclassifications of nursing practice: registered nurse,public health nurse, nurse practitioner, clinical nursespecialist, and nursing supervisor. (For detailed per-formance elements, see Appendix A, ‘‘Nursing PublicHealth Competency Grid of Performance Elements.’’)Performance elements were described for all eightcompetencies, and for each of five nursing classifica-tions. These elements were reviewed by a committeeof nurses from several of the classifications.

In order to design a tool based on these perfor-mance elements and derived from public health nurs-ing competencies, there needed to be philosophicalagreement among leadership players that it was ap-propriate to use these competencies as the basis of ourpractice. To accomplish this, first the performanceelements were developed in great detail as describedpreviously (see Appendix A). Once these elementswere detailed, the document, a ‘‘Public Health Com-petency Grid for Nurses,’’ was introduced to a reviewcommittee of six nursing supervisors and sitemanagers for their analysis and discussion. This gridoutlined numerous performance elements for eachcompetency at five levels of nursing practice (seeAppendix A). The group was offered the opportunityto comment on the grid, discuss its applicability to theKing County practice, and determine whether theycould support this model as a performance framework.The committee did support this conceptual framework,and the grid was then presented to a departmentleadership group. The leadership group reviewed theperformance elements and approved the continuingdevelopment of an appropriate appraisal tool.

One of the major goals of the review committeewas to develop an appraisal tool that not only reflecteda population-based practice, but that would also givemeaningful performance feedback and address com-mon performance concerns. With input from nursingsupervisors, it was decided to develop a ‘‘GeneralWorkplace Expectations’’ document (see Appendix B,‘‘General Workplace Expectations Document’’) to aug-ment the competency list, which would outline de-partment expectations for nurses in areas such ascommunication, reliability, appearance, and conduct.This document made it unnecessary to address theseelements separately on the appraisal tool, but providedan opportunity for feedback on any areas of concernwhen appropriate.

Next, a tool format was adopted that allowed forevaluation of general expectations as well as weightedevaluation of eight public health nursing competen-cies. The tool included scoring and goal setting. Thetool itself was identical for each level of nursingpractice, but specific evaluation content was based onthe respective performance elements for each nursingclassification, as listed in the ‘‘Nursing Public HealthCompetency Grid’’ (Appendix A). It was available inelectronic format, so that evaluators could personalizeit to each employee and develop unique and specificcomments and goals. The following componentscomprised the packet that was made available tosupervisors: (a) ‘‘General Workplace Expectationsfor Nursing Personnel’’ document (Appendix B); (b)‘‘Nursing Public Health Competency Grid,’’ whichdescribes all performance elements for all levels ofnursing (Appendix A); (c) the ‘‘Nursing PerformanceAppraisal Tool’’; and (d) separate ‘‘PerformanceElements’’ documents for respective nursing classi-fications, making it possible to share specificcompetencies and performance elements with eachnurse, using only those performance elements forthat nurse’s classification. For example, a nursepractitioner would be given a document with thecompetencies and performance elements for a nursepractitioner only, not the grid with all elements forall classifications.

Pilot implementationInitially the tool was piloted by the members of thecommittee. Ten performance appraisals were com-pleted over a period of 4 weeks. The committee re-convened to discuss their experiences and to decideon changes that might be necessary before a wider


pilot within the department. Evaluations were per-formed on nurses at varying levels of practice, includ-ing a staff RN, a nurse practitioner, a public healthnurse, and a nursing supervisor.

At the follow-up meeting to discuss the pilot,evaluators were very enthusiastic about the experi-ence. All evaluators found the new tool to be shorterand less redundant than the previous tool. Severalnoted that it gave them an opportunity to reinforcewith field nurses the concept of population-basedpractice, and that the nurses themselves appreciatedunderstanding the role they play in a population-based framework. Both supervisors and employeesfound the goal-setting portion of the tool to be practi-cal as well as comfortable to use. The electronic for-mat was user friendly, and there were no complaintsabout the actual completion of the form.

When discussing improvements to the tool, it wasagreed that there needed to be more clarity regarding‘‘weight’’ for each competency. Evaluators felt thatweights for each classification of nursing should bestandardized, reflecting the King County nursing prac-tice and its priorities. To do otherwise might be per-ceived as arbitrary, and would leave supervisors’weightings open to dispute. Another requested im-provement was to add the concept of ‘‘productivity’’ tothe tool in some explicit form. As PHSKC still providesdirect services to the community, there are productiv-ity standards that must be a part of performance eval-uation. This is consistent with the seventh tenet ofPublic Health Nursing, which states that ‘‘stewardshipand allocation of available resources support themaximum population health benefit gain’’ (QuadCouncil, 1997). Although it was agreed that pro-ductivity was implicit in many of the performanceelements, the committee suggested that having anexplicit reference to it would be helpful in supervisingthis aspect of the practice. This was added under the‘‘Leadership/Systems Thinking’’ competency area.

Operational issuesOnce the tool was piloted and introduced to nursingsupervisors, there were a number of operational fac-tors to consider. PHSKC has a unionized nursingpractice, and by contract the union was allowed re-view of such tools before a full implementation. Addi-tionally, County and Department Human Resourceswould appropriately need to be involved, with boththe competency framework and the ‘‘General Work-place Expectations for Nurses’’ document, as subse-

quent performance appraisals might involve humanresource staff to deal with individual employee oppo-sition to the new tool.

With this in mind, copies of the tool and the com-petency grid were sent to union representatives con-sistent with the contract agreement. The competencyframework was presented to a team of human re-sources staff, and the ‘‘General Workplace Expecta-tions Document’’ (Appendix B) was provided for theirreview. It was determined that the ‘‘Expectations’’document needed some revision in order to reflectcounty policies explicitly. These revisions were made.

Implementation strategyThe tool was presented at a nursing supervisors meet-ing, with the results of the initial pilot. The tool, thecompetency grid, the workplace expectations, and therationale for a new appraisal tool were all reviewedwith the group. The supervisors wholeheartedly sup-ported a broader pilot of the new tool, many of themvolunteering to use it at their respective sites. It wasdecided that there would be a 3-month pilot of thetool, with subsequent feedback from all participatingsites. Following this period, any necessary revisionswould be made and implementation throughout thedepartment would begin in July of 2005.

Because this tool delineates eight broad catego-ries of competency and specific performance elementsunder each of these categories, department leadershave already requested a review to determine how toadapt it to other disciplines within public health. Ithas been suggested that such a framework would haveappropriate applications to dentists, nutritionists,social workers, site managers, physicians, and othersworking within a population-based practice.

Discussion

The competency-based nursing performance apprais-al described in this paper is currently being piloted. ByJuly of 2005, preliminary pilot data were collectedand necessary changes were made before department-wide implementation. Used for approximately 50 ap-praisals at the time of this writing, the tool is meetingwith strong support. Use of such a tool reinforces pop-ulation-based practice and translates into under-standable terms the role of each level of nursingin the health improvement of a population. Althoughthe work of the Minnesota Department of Healthwas extremely useful in demonstrating nursing


contributions to population health, using a perfor-mance tool brings the point home in an individual andpersonal way. Reading about nursing competenciesinforms nurses regarding their respective roles inpopulation-based practice, but knowing further thatone’s performance is based on these competencieshelps a nurse integrate them into her understandingas no journal article can. Suddenly ‘‘Assessment,’’‘‘Policy Development,’’ ‘‘Health Promotion,’’ and ‘‘Sys-tems Thinking’’ have relevant and personal meaningfor the nurse’s everyday practice. The benefit tothe organization, and to nursing supervisors, is theavailability of a tool that is easy to use, provides mean-ingful performance feedback, and is an aid to commu-nication of performance expectations. The use ofperformance tools reflecting these nursing competen-cies will enable nurses to understand and redefinetheir practice, thus contributing to the ability of publichealth to meet the challenges of improving the healthstatus of increasingly complex populations.

Acknowledgments

A special thanks to Willma Elmore, Director of Nurs-ing, Public Health—Seattle & King County, for offer-ing the support of the Nursing Office in thedevelopment of the performance appraisal tool andthe creation of this manuscript.

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Council on Linkages Between Academia and PublicHealth Practice. (2001). Council on LinkageCompetencies Project. Core Competencies withSkill Levels. Retrieved March 14, 2006 fromhttp://www.trainingfinder.org.competencies/list_levels.htm

Henry Street Consortium. (2003). Entry level pop-ulation-based public health nursing com-petencies for the new graduate or novicepublic health nurse. Retrieved March 14, 2006from http://www.health.state.mn.us/divs/chs/phn/HenryStreetProject.htm

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assessmen

tsthat

include

healthhistory;physical

assessmen

t;grow

thmon

itoring;

develop

men

tal

assessmen

t;psych

o-social

assessmen

t;assessmen

tof

familyfunctioning;

assessmen

tforsubstance

abuse

ordom

esticviolen

ceissues;an

dassessmen

tof

basicneedssuch

asfood

,hou

sing,

income,

resources

andsupports,

andaccess

tohealthcare

�Assessesneedfor

patientreferral

basedon

inform

ationga

thered

�Documen

tsassessmen

tusingestablished

med

ical

record

form

san

ddocumen

tation

practices

�Participates

incommunityassessmen

t;candistingu

ishbe

tween

quan

titative

and

qualitativecommunity

assessmen

tdata;

understan

dsinciden

cean

dprevalence

data;

know

show

toaccess

basiccommunity

epidem

iological

data

�Perform

scomprehen

sive

med

ical

assessmen

tsthat

include

healthhistory;physical

assessmen

t;ch

artreview

,develop

men

tal

assessmen

t;psych

o-social

assessmen

t;assessmen

tof

familyfunctioning

�Assessesforsubstance

abuse

ordom

esticviolen

ceissues;an

dassesses

basic

needssuch

asfood

,hou

sing,

income,

resources

andsupports,

access

tohealthcare

�Assessespresenting

illnessan

drisk

factors

�Assessesneedfor

patientreferral

basedon

inform

ationga

thered

�Documen

tsassessmen

tusingestablished

med

ical

record

form

san

ddocumen

tation

practices

�Effectively

useshealth

inform

ationretrieval

system

s,data-collection

processes,a

ndtech

nolog

yap

plication

s�

Relates

environmen

tal

andpop

ulation

surveillan

cedatato

pop

ulation

san

dindividualsserved

�Assessesspecific

dep

artm

entneedsfor

inform

ation,training,

and

program

adap

tation

s�

Collects,an

alyzes,a

nd

interprets

dataan

dpresents

inform

ationin

contextual

form

atsthat

clarifysign

ifican

ceof

the

datato

avarietyof

audiences

�Assesseshealthstatus

ofspecificpop

ulation

susingep

idem

iological

inform

ationan

dcu

rren

ttren

ddata

�Iden

tifies

anddefi

nes

healthproblem

sba

sedon

healthstatusindicators,

determinan

tsof

health,

andother

contributing

factors

�Effectively

useshealth

inform

ationretrieval

system

s,data-collection

processes,a

ndtech

nolog

yap

plications

�Relates

environmen

tal

andpop

ulation

surveillan

cedatato

pop

ulation

san

dindividualsserved

�Determines

approp

riateusesan

dlimitationsof

both

�Assessesclinican

dfieldrequ

irem

ents

for

proper

staffingan

dresourceallocation

toad

dress

healthneedsof

pop

ulation

�Assesseson

going

effectiven

essof

care

provided

byclinican

d/or

fieldstaff,an

dad

justs

staffingan

dresources

accordingly

�Participates

incommunityassessmen

t;candistingu

ishbe

tween

quan

titative

and

qualitativecommunity

assessmen

tdata;

understan

dsinciden

cean

dprevalence

data;

know

show

toaccess

basiccommunity

epidem

iologicald

ata

�Relates

environmen

tal

andpop

ulation

surveillan

cedatato

pop

ulation

san

dindividualsserved

�Effectively

useshealth

inform

ationretrieval

system

s,data-collection

processes,a

ndtech

nolog

yap

plication

s


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Effectively

useshealth

inform

ationretrieval

system

s,data-collection

processes,a

ndtech

nolog

yap

plication

s�

Relates

environmen

tal

andpop

ulation

surveillan

cedatato

pop

ulation

san

dindividualsserved

quan

titative

and

qualitativedata

�Iden

tifies

relevantan

dap

prop

riatedataan

dinform

ationsources

�Obtainsan

dinterprets

inform

ationrega

rding

risksan

dbe

nefi

tsto

the

community

�Mak

esrelevant

inferencesfrom

quan

titative

and

qualitativedata

�Dem

onstratesa

recogn

itionof

how

the

datailluminateethical,

political,scien

tific,

econ

omic,a

ndov

erall

publichealthissues

�Mon

itorsan

dassures

complian

cewithcontracts

invo

lvinghealthdistricts

andcommunityag

encies

2.Policy

develop

men

t/program

planning

�Iden

tifies,interprets,

implemen

tspublichealth

laws,regu

lation

san

dpoliciesrelatedto

patient

care�

Con

tributes

sugg

estion

sto

policyan

dprogram

chan

gean

dim

provemen

tba

sedon

clinical

experience

�Participates

indevelop

men

tofe

mergency

respon

seplan

�Participates

inQI

activities

asrequ

ired

toim

prove

patientcare

�Provides

case

man

agem

ent,care

coordination,referral,an

dfollow

-upto

individuals

andfamilieswhoare

mem

bers

ofavu

lnerab

lepop

ulation

and/orhigh-

risk

grou

p�

Usesep

idem

iological

surveillan

cemethod

sin

communityou

treach

,screen

ing,an

dcase

finding

ofcommunicab

lean

dinfectiousdiseasesthat

threaten

thehealthof

the

community

�Develop

sdifferential

diagn

osisan

drisk

iden

tification

through

assessmen

tan

dinterpretation

ofdata

�Dem

onstrates

prioritizationof

problem

san

dissues

basedon

assessmen

tdataan

dthe

individual/fam

ily

perceived

prioritiesan

dneeds

�Integrates

know

ledge

ofclients’n

eedsan

dmed

ical

interven

tion

sto

designcare

plansan

dtake

�Provides

supportfor

colleagu

esin

analyzing

dataforplanning

program

s�

Prepares

and

disseminates

inform

ation

toillustrate

ethical,

political,scien

tific,

econ

omic,a

ndgeneral

publichealthissues,

includingdisease

tren

ds

andcu

rren

tpractice

stan

dardsthat

impact

communityhealth

�Designsprogram

guidelines,a

ctivities,an

d

�Iden

tifies,interprets,

andim

plemen

tspublic

healthlaws,regu

lation

s,an

dpoliciesrelatedto

patientcare

�Usesep

idem

iological

surveillan

cemethod

sin

communityou

treach

,screen

ing,an

dcase

finding

ofcommunicab

lean


threaten

thehealthof

the

community

�Usesep

idem

iological

surveillan

cemethod

sin

communityou

treach

,


�Integrates

know

ledge

ofclients’n

eedsan

dnursinginterven

tion

sto

designcare

plansan

dtake

action

sthat

areconsisten

twiththestan

dardsof

practice,licensinglaws,

andestablished

policies

andprocedures

�Iden

tifies,interprets,

andim

plemen

tspublic

healthlaws,regu

lation

s,an

dpoliciesrelatedto

publichealthservices

�Recog

nizes

how

policiesan

dprocedures

aredevelop

edan

drevised

through

research

/eviden

ce-based

practice

�Dem

onstrates

prioritizationof

problem

san

dissues

basedon

assessmen

tdataan

dthe

family/community-

perceived

prioritiesan

dneeds

�Participates

inim

plemen

tation

ofem

ergency

respon

seplans

�Utilizescu

rren

ttech

niques

indecision

analysisan

dhealth

planning

action

sthat

areconsisten

twiththestan

dardsof


andestablished

policies

andprocedures

�Iden

tifies,interprets,

andim

plemen

tspublic

healthlaws,regu

lation

s,an

dpoliciesrelatedto

med

ical

care

�Utilizescu

rren

ttech

niques

indecision

analysisan

dhealth

planning

�Provides

man

aged

patientcare

bydevelop

ing

andim

plemen

ting

individual

treatm

entplan:

prescribing/dispen

sing

med

ications;providing

appropriatereferrals;

ensuringed

ucation

,counseling,

andcase

man

agem

entfollow

-up

withother

professional

andcommunityag

encies

�Participates

inpolicy

develop

men

t,care

guidelines,a

ndprogram

chan

gesusingcu

rren

tscientificinform

ationan

dclinical

experience

�Participates

inim

plemen

tation

ofem

ergency

respon

seplans

�Usesresultsof

quality

ofcare

activities

toinitiate

chan

gesthrough

outthe

healthcare

system

proceduresthat

maxim

ize

availability,a

ccessibility,

acceptability,a

ndqu

ality

ofpublichealthservices

�Iden

tifies

program

and

policyop

tion

san

dwrites

clearan

dconcise

policy

statem

ents

�States

thefeasibility

andexpectedou

tcom

esof

policiesan

dprogram

option

s�

Develop

splansto

implemen

tpoliciesan

dprogram

s,includinggo

als,

outcom

ean

dprocess

objectives,a

nd

implemen

tation

step

s�

Translates

policyinto

organizational

plans,

structures,an

dprogram

s�

Develop

smechan

isms

tomon

itor

andevaluate

program

sfortheir

effectiven

essan

dqu

ality

�Works

with

dep

artm

entan

dexternal

plannersto

develop

policiesan

dprogram

sreflectingcu

rren

tpublic

healthpriorities

�Con

tributesto

planningeffortswithin

the

dep

artm

entaccordingto

area(s)of

expertise

screen

ing,an

dcase

finding

ofcommunicab

lean


threaten

thehealthof

the

communityconsisten

twiththestan

dardsof


andestablished

policies

andprocedures

�Iden

tifies

program

and

policyop

tion

san

dwrites

clearan

dconcise

policy

statem

ents

�States

thefeasibility

andexpectedou

tcom

esof

policiesan

dprogram

option

s�

Designsprogram

guidelines,a

ctivities,an

dproceduresthat

max

imize

availability,a

ccessibility,

acceptability,a

ndqu

ality


�Integrates

know

ledge

ofpop

ulation

needsan

dnursinginterven

tion

sto

designsystem

san

dtake

action

sthat

areconsisten

twiththestan

dardsof


andestablished

policies

andprocedures

�Recog

nizes

how

policiesan

dprocedures

aredevelop

edan

drevised

through

research

/eviden

ce-based

practice

�Dem

onstrates

prioritizationof

problem

san

dissues

basedon

assessmen

tdataan

dthe

family/community-

perceived

prioritiesan

dneeds


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Participates

inim

plemen

tation

ofem

ergency

respon

seplans

�Utilizescu

rren

ttech

niques

indecision

analysisan

dhealth

planning

�Participates

inpolicy

develop

men

t,care

guidelines,a

ndprogram

chan

gesusingcu

rren

tscientificinform

ationan

dclinical

experience

�Usesresultsof

quality

ofcare

activities

toinitiate

chan

gesthrough

outthe

healthcare

system

�Develop

sstrategies

for

determiningbu

dget

priorities

�Negotiatesan

ddevelop

scontracts

and

other

documen

tsforthe

provision

ofpop

ulation

-ba

sedservices

�Man

ages

program

swithin

budgetconstraints

�Analyzes

dataan

dinform

ationto

iden

tify

opportunitiesfor

improvingservices

using

appropriateinternal

and

external

data

�Factors

inmag

nitude,

duration

,andtren

dsof

healthproblem

s/im

provemen

tsin

program

planning

3.Evaluation

�Evaluates

interven

tion

sfor

effectiven

essan

d

�Evaluates

individual

andfamilyou

tcom

esfor

effectiven

essof

plan,a

nd

�Evaluates

individual

andfamilyou

tcom

esfor

effectiven

essof

plan,a

nd

�Con

ductsprogram

evaluationas

needed

todeterminewhether

�Con

ductsprogram

evaluationas

needed

todeterminewhether


documen

tsthesameusing

established

med

ical

record

form

san

ddocumen

tation

practices

mak

esch

angesas

necessary

onmicro

and

macro

levels

�Works

with

man

agem

entan

dstaffto

evaluateindividual

and

team

perform

ance

andto

develop

plansto

improve

perform

ance

asap

propriate

mak

esch

angesas

necessary

onmicro

and

macro

levels

�Works

with

man

agem

entan

dstaffto

evaluateindividual

and

team

perform

ance

andto

develop

plansto

improve

perform

ance

asap

propriate

program

goalsan

dob

jectives

havebe

enmet

�Works

with

man

agem

entan

dstaffto

evaluateindividual

and

team

perform

ance

andto

develop

plansto

improve

perform

ance

asap

prop

riate

�Evaluates

theintegrity

andcomparab

ilityof

data

andiden

tifies

gapsin

data

sources

program

goalsan

dob

jectives

havebe

enmet

�Works

with

man

agem

entan

dstaffto

evaluateindividual

and

team

perform

ance

andto

develop

plansto

improve

perform

ance

asap

propriate

�Evaluates

theintegrity

andcomparab

ilityof

data

andiden

tifies

gapsin

data

sources

�Iden

tifies

keyqu

ality

indicatorsformon

itoring

andevaluatingservices

�Evaluates

staff

perform

ance

inan

objectivean

deq

uitab

lefashion

4.C

ommunication�

Dem

onstrates

communicationskillsthat

areclear;effective;

facilitate

patientcare

and

team

functioning;

andare

respectfulo

fdifferences

�Listensrespectfully

andpromotes

the

expressionof

diverse

opinionsan

dperspectives

�Translates

client’s

expressionof

needsinto

cleardescription

sof

health

needs

�Creates

acommunication

environmen

twhere

patients

andcolleagu

esfeel

free

toaskqu

estion

san

dmak

esugg

estion

s�

Com

municates

facts,

ideas,an

dskillsthat

chan

gekn

owledge,

attitudes,v

alues,b

eliefs,

behaviors,a

ndpractices

ofindividualsan

dfamilies

�Dem

onstrates


areclear;effective;

facilitate

patientcare

and

team

functioning;

andare

respectfulo

fdifferences


andpromotes

the

expressionof

diverse

opinionsan

dperspectives

�Maintainsclient

confiden

tialityan

dfollow

spublichealthmed

ical

recordspoliciesan

dproceduresan

dstatean

dfederal

lawsthat

govern

releaseof

healthcare

inform

ation

�Applies

ethical

principlesto

thecollection

,maintenan

ce,u

se,a

nd

disseminationof

dataan

dinform

ation

�Com

municates

facts,

ideas,an

dskillsthat

chan

gekn

owledge,

�Dem

onstrates


areclear;effective;

facilitate

patientcare

and

team

functioning;

andare

respectfulo

fdifferences


andpromotes

the

expressionof

diverse

opinionsan

dperspectives

�Maintainsclient

confiden

tialityan

dfollow

spublichealthmed

ical

recordspoliciesan

dproceduresan

dstatean

dFed

eral

lawsthat

govern

releaseof

healthcare

inform

ation

�Applies

ethical

principlesto

thecollection

,maintenan

ce,u

se,a

nd

disseminationof

dataan

dinform

ation

�Com

municates

facts,

ideas,an

dskillsthat

chan

gekn

owledge,

�Dem

onstrates


areclear;effective;

facilitate

patientcare

and

team

functioning;

andare

respectfulo

fdifferences


andpromotes

the

expressionof

diverse

opinionsan

dperspectives

�Maintainsclient

confiden

tialityan

dfollow

spublichealthmed

ical

recordspoliciesan

dproceduresan

dstatean

dFed

eral

lawsthat

govern

releaseof

healthcare

inform

ation

�Applies

ethical

principlesto

thecollection

,maintenan

ce,u

se,a

nd

disseminationof

dataan

dinform

ation

�Com

municates

effectivelyorally

andin

writing,

including

�Dem

onstrates


areclear;effective;

facilitate

patientcare

and

team

functioning;

andare

respectfulo

fdifferences


andpromotes

the

expressionof

diverse

opinionsan

dperspectives

�Maintainsclient

confiden

tialityan

dfollow

spublichealthmed

ical

recordspoliciesan

dproceduresan

dstatean

dFed

eral

lawsthat

govern

releaseof

healthcare

inform

ation

�Applies

ethical

principlesto

thecollection

,maintenan

ce,u

se,a

nd

disseminationof

dataan

dinform

ation

�Maintainsstaff

confiden

tialityas

professionally

appropriate


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Fullyrespon

dsto

client

andcolleagu

equ

estion

s�

Com

municates

effectivelyorally

andin

writing,

including

documen

tation

,record

keep

ing,

and

correspon

den

ce�

Maintainsclient

confiden

tialityan

dfollow

spublichealthmed

ical

recordspoliciesan

dproceduresan

dstatean

dfederal

lawsthat

govern

releaseof

healthcare

inform

ation

�Applies

ethical

principlesto

thecollection

,maintenan

ce,u

se,a

nd

disseminationof

dataan

dinform

ation

�Estab

lishes

and

maintainseffective

communicationwith

mem

bers

ofthehealth

care

team

attitudes,v

alues,b

eliefs,

behaviors,a

ndpractices

ofindividualsan

dfamilies

�Com

municates

effectivelyorally

andin

writing,

including

documen

tation

,record

keep

ing,

and

correspon

den

ce�

Documen

tspatient

assessmen

tan

dinterven

tion

datain

med

ical

record

using

established

med

ical

record

form

san

ddocumen

tation

practices

�Provides

training,

orientation

,anded

ucation

tostaff,studen

ts,a

nd

other

healthan

dhuman

serviceprofessionals

inthecommunity

rega

rdingpublichealth

practices

�Estab

lishes

and

maintainseffective

communicationwith

individuals,families,

mem

bers

ofthehealth

care

team

,andmem

bers

ofthecommunity

�So

licits

inputfrom

individuals,families,an

dorga

nizationsthrough

out

thedecision-m

aking

process

�Leadsan

dparticipates

ingrou

psto

address

specificissues

attitudes,v

alues,b

eliefs,

behaviors,a

ndpractices

ofindividualsan

dfamilies

�Com

municates

effectivelyorally

andin

writing,

including

documen

tation

,record

keep

ing,

and

correspon

den

ce�

Documen

tspatient

assessmen

tan

dinterven

tion

datain

med

ical

record

using

established

med

ical

record

form

san

ddocumen

tation

practices

�Provides

training,

orientation

,anded

ucation

tostaff,studen

ts,a

nd

other

healthan

dhuman

serviceprofessionalsin

the

communityrega

rding

publichealthpractices

�Estab

lishes

and

maintainseffective

communicationwith

individuals,families,

mem

bers

ofthehealth

care

team

,andmem

bers

ofthecommunity

documen

tation

,record

keep

ing,

and

correspon

den

ce�

Provides

training,

orientation

,anded

ucation

tostaff,studen

ts,a

nd

other

healthan

dhuman

serviceprofessionalsin

the

communityrega

rding

publichealthpractices

�Estab

lishes

and

maintainseffective

communicationwith

individuals,mem

bers

ofthehealthcare

team

,mem

bers

ofthe

community,mem

bers

ofprofessional

organizations,an

dother

pertinen

tconstituen

cies

�Advo

catesforpublic

healthprogram

san

dresources

�So

licits

inputfrom

approp

riateindividuals

andconstituen

cies

toaid

indecisionmak

ingan

dprogram

planning

�Usesthemed

ia,

advancedtech

nolog

ies,

andcommunitynetworks

tocommunicate

inform

ation

�Maintainsop

encommunicationacross

dep

artm

ents

and

disciplines

�Maintainsop

encommunicationwith

communitystak

eholders

�Com

municates

effectivelyorally

andin

writing,

including

documen

tation

,record

keep

ing,

and

correspon

den

ce�

Provides

training,

orientation

,anded

ucation

tostaff,studen

ts,a

nd

other

healthan

dhuman

serviceprofessionals

inthecommunity

rega

rdingpublichealth

practices

�Estab

lishes

and

maintainseffective

communicationwith

individuals,mem

bers

ofthehealthcare

team

,mem

bers

ofthe

community,

mem

bers

ofprofessional

orga

nizations,an

dother

pertinen

tconstituen

cies

�Advo

catesforpublic

healthprogram

san

dresources

�So

licits

inputfrom

appropriateindividuals

andconstituen

cies

toaid

indecisionmak

ingan

dprogram

planning

�Usesthemed

ia,

advancedtech

nolog

ies,

andcommunitynetworks

tocommunicate

inform

ation

�Maintainsop

encommunicationwithstaff

andsubo

rdinates


�Respon

dsto

individual,supervisory,

andcommunityinqu

iries

inatimelyman

ner

�Inform

sap

propriate

communitystak

eholders

ofprogram

opportunities

andbe

nefi

ts�

Strivesforconsisten

cyin

articu

latingthemission

�Maintainsop

encommunicationacross

dep

artm

ents

and

disciplines

�Maintainsop

encommunicationwith

communitystak

eholders

�Inform

sap

propriate

communitystak

eholders

ofprogram

opportunities

andbe

nefi

ts�

Strivesforconsisten

cyin

articu

latingthemission

�Creates

aclim

ateof

mutual

respectan

dunderstan

ding

�Com

municates

thorou

ghly,p

romptly,

and

respectfullywithstaff

rega

rdingperform

ance

issues

�Perform

sperform

ance

appraisalswithan

attitude

ofprofessional

respectan

dwithago

alof

max

imizing

staffeffectiven

essan

dsuccess

5.Cultural

competen

cy�

Utilizesap

propriate

method

sforinteracting

sensitively,effectively,a

nd

professionally

with

personsfrom

diverse

cultural,socioe

conom

iced

ucation

al,racial,ethnic,

andprofessional

backgrou

nds,an

dpersons

ofalla

gesan

dlifestyle

preferences

�Iden

tifies

therole

ofcu

ltural,social,a

nd

behavioralfactors

indeterminingthedelivery

ofpatientcare

�Utilizesap

propriate

method

sforinteracting


nd

professionally

with

personsfrom

diverse

cultural,socioe

conom

iced

ucation

al,racial,ethnic,

andprofessional

backgrou

nds,an

dpersons

ofalla

gesan

dlifestyle

preferences

�Iden

tifies

therole

ofcu

ltural,social,a

nd

behavioralfactors



�Utilizesap

propriate

method

sforinteracting


nd

professionally

with

personsfrom

diverse

cultural,socioe

conom

ic,

education

al,racial,ethnic,

andprofessional

backgrou

nds,an

dpersons

ofalla

gesan

dlifestyle

preferences

�Iden

tifies

therole

ofcu

ltural,social,a

nd

behavioralfactors


ofmed

ical

care

�Utilizesap

propriate

method

sforinteracting


nd

professionally

with

personsfrom

diverse

cultural,socioe

conom

ic,

education

al,racial,ethnic,

andprofessional

backgrou

nds,an

dpersons

ofalla

gesan

dlifestyle

preferences

�Iden

tifies

therole

ofcu

ltural,social,a

nd

behavioralfactors



�Utilizesap

propriate

method

sforinteracting


nd

professionally

with

personsfrom

diverse

cultural,socioe

conom

ic,

education

al,racial,ethnic,

andprofessional

backgrou

nds,an

dpersons

ofalla

gesan

dlifestyle

preferences

�Iden

tifies

therole

ofcu

ltural,social,a

nd

behavioralfactors




Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Develop

san

dad

apts

approaches

toproblem

sthat

take

into

account

culturald

ifferences

�Mak

esap

propriateuse

ofinterpretation

services

�Develop

san

dad

apts

approaches

toproblem

sthat

take

into

account

culturald

ifferences

�Dem

onstratesan

understan

dingof

the

dyn

amicforces

contributingto

cultural

diversity

andtheim

pactof

thoseforces

onpublic

healthissues

�Provides

education

and

counselingto

individuals,

families,an

dcommunity

grou

psthat

isad

aptedto

theiruniqueneeds,

lifestyle,an

dcu

lturala

nd

socioe

conom

icsituations

�Develop

san

dad

apts

approaches

toproblem

sthat

take

into

account

culturald

ifferences

�Dem

onstratesan

understan

dingof

the

dyn

amicforces

contributingto

cultural

diversity

andtheim

pactof

thoseforces

onhealthcare

issues

�Provides

education

and

counselingto

individuals,

families,an

dcommunity

grou

psthat

isad

aptedto

theiruniqueneeds,

lifestyle,an

dcu

lturala

nd

socioe

conom

icsituations

�Develop

san

dad

apts

approa

ches

toproblem

sthat

take

into

account

culturald

ifferences

�Dem

onstratesan

understan

dingof

the

dyn

amicforces

contributingto

cultural

diversity

andtheim

pactof

thoseforces

onpublic

healthissues

�Includes

mem

bers

ofcu

lturala

nd/orethnic

communitiesin

planning

andevaluatingprogram

sim

pactingthose

communities

�Develop

san

dad

apts

approaches

toproblem

sthat

take

into

account

culturald

ifferences

�Dem

onstratesan

understan

dingof

the

dyn

amicforces

contributingto

cultural

diversity

andtheim

pactof

thoseforces

onpublic

healthissues

�Includes

mem

bers

ofcu

lturala

nd/orethnic

communitiesin

planning

andevaluatingprogram

sim

pactingthose

communities

�Dem

onstratesan

understan

dingof

the

importance

ofadiverse

publichealthworkforce

�Tak

esinto

account

culturala

ndlangu

age

factorswhen

workingwith

stafffrom

variou

scu

ltural

grou

ps

�Com

municates

program

andpublichealth

issues

clearlyto

all

pertinen

tstaff

6.P

artnership

and

collab

oration

(includes

community

dim

ension

s)

�Estab

lishes

aninterpersonal

relation

ship

withindividualsor

familiesthat

increases

oren

han

cestheir

capacityforself-carean

dcoping

�Estab

lishes

effective

professional

relation

ships

withotherson

thehealth

care

team

�Estab

lishes

aninterpersonal

relation

ship

withindividualsor

familiesthat

increasesor

enhan

cestheircapacityfor

self-carean

dcoping

�Estab

lishes

effective

professional

relation

ships

withotherson

thehealth

care

team

andin

the

community

�Estab

lishes

aninterpersonal

relation

ship

withindividualsor

familiesthat

increases

oren

han

cestheir

capacityforself-care

andcoping

�Su

pports

individual/

familyou

treach

approaches

inap

propriate

program

s

�Estab

lishes

effective

professional

relation

ships

withotherson

thehealth

care

team

,man

agem

ent

team

,andin

the

community

�Se

eksinform

ationan

dgenerates

option

alsolution

sto

perceived

problem

sthrough

interactiveproblem

�Estab

lishes

effective

professional

relation

ships

withotherson

thehealth

care

team

,man

agem

ent

team

,andin

the

community

�Se

eksinform

ationan

dgenerates

option

alsolution

sto

perceived

problem

sthrough

interactiveproblem


�Acknow

ledges

colleagu

es’con

tribution

sto

team

work

�Se

eksinform

ationan

dgenerates

option

alsolution

sto

perceived

problem

sthrough

interactiveproblem

solvingwithindividuals

�Creates

andmaintains

effectiveworking

relation

shipswithexternal

resources

relatedto

patientcare

�Su

pports

individual/

familyou

treach

approaches

inap

propriate

program

s

�Se

eksinform

ationan

dgenerates

option

alsolution

sto

perceived

problem

sthrough

interactiveproblem


�Creates

andmaintains

effectiveworking

relation

shipswithexternal

resources

relatedto

public

healthservices

�Dem

onstrates

awaren

essof

existing

resources

that

have

poten

tial

forim

proving

communityhealthstatus

�Su

pports

individual/

familyou

treach

approaches

inap

propriate

program

s�

Utilizeslead

ership,

team

building,

negotiation

,andconflict-

resolution

skillsto

build

communitypartnerships

�Collabo

rateswith

communitypartnersto

promotethehealthof

the

pop

ulation

�Iden

tifies

community

assets

andavailable

resources

�Con

tributesto

anen

vironmen

tthat

isconducive

totheclinical

education

ofnursing

studen

ts,o

ther

healthcare

studen

ts,a

ndother

employees

asap

propriate

�Collabo

rateswiththe

physician,clien

t,family,

other

healthcare

practitioners,an

dpayers

inform

ulatingov

erall

goalsan

dtheplanof

care

�Estab

lishes

effective

professional

relation

ships

withotherson

thehealth

care

team

andin

the

community

�Se

eksinform

ationan

dgenerates

option

alsolution

sto

perceived

problem

sthrough

interactiveproblem


�Creates

andmaintains

effectiveworking

relation

shipswithexternal

resources

relatedto

public

healthservices

�Dem

onstrates

awaren

essof

existing

resources

that

have

poten

tial

forim

proving

healthstatus

�Collabo

rateswith

communitypartners

topromotehealth

care

access

�Iden

tifies

community

assets

andavailable

resources

�Dem

onstratesan

understan

dingof

therole

ofgo

vernmen

tin

the

deliveryof

med

ical

care

�Con

tributesto

anen

vironmen

tthat

isconducive

totheclinical

education

ofnursing

studen

ts,o

ther

healthcare

studen

ts,a

ndother

employees

asap

propriate

�Collabo

rateswiththe

physician,clien

t,family,

other

healthcare

practitioners,an

dpayers

inform

ulatingov

erall

goalsan

dtheplanof

care


�Creates

andmaintains

effectiveworking

relation

shipswithexternal

resources

relatedto

public

healthservices

�Dem

onstrates

awaren

essof

existing

resources

that

have

poten

tial

forim

proving

healthstatusof

target

pop

ulation

s�

Collabo

rateswith

communitypartnersto

promotehealthcare

access

�Iden

tifies

community

assets

andavailable

resources

�Dem

onstratesan

understan

dingof

therole

ofgo

vernmen

tin

the

deliveryof

publichealth

services

�Con

tributesto

anen

vironmen

tthat

isconducive

totheed

ucation

ofnursingstuden

ts,o

ther

healthcare

studen

ts,a

nd

other

employees

asap

prop

riate

�Participates

oninterdisciplinaryteam

sto

achieve

designated

public

healthou

tcom

es�

Acknow

ledges

colleagu

es’con

tribution

sto

team

work

�Develop

scollegial

relation

shipsan

dcollab

orates

with

communitypartnersto

promotethehealthof

the

pop

ulation

�Coo

perates

withother

organizationsspon

soring


�Creates

andmaintains

effectiveworking

relation

shipswithexternal

resources

relatedto

public

healthservices

�Dem

onstrates

awaren

essof

existing

resources

that

have

poten

tial

forim

proving

healthstatusof

target

pop

ulation

s�

Collabo

rateswith

communitypartnersto

promotehealthcare

access

�Iden

tifies

community

assets

andavailable

resources

�Dem

onstratesan

understan

dingof

therole

ofgo

vernmen

tin

the

deliveryof

publichealth

services

�Con

tributesto

anen

vironmen

tthat

isconducive

totheed

ucation

ofnursingstuden

ts,o

ther

healthcare

studen

ts,a

nd

other

employees

asap

propriate

�Participates


sto

achieve

designated

public

healthou

tcom

es�

Acknow

ledges

colleagu

es’con

tribution

sto

team

work

�Develop

scollegial

relation

shipsan

dcollab

orates

with

communitypartnersto

promotethehealthof

the

pop

ulation

�Coo

perates

withother

orga

nizationsspon

soring


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Initiatesreferrals,

includingprovision

sfor

continuityof

care,a

sneeded

�Participates

ininterdisciplinaryteam

sto

achieve

designated

client

outcom

es�

Coo

rdinates

resources

forpatientcare

�Dem

onstratesan

understan

dingof

therole

ofgo

vernmen

tin

the

deliveryof

community

healthservices

�Initiatesreferrals,

includingprovision

sfor

continuityof

care,a

sneeded

�Participates


sto

achieve

designated

client

outcom

es�

Coo

rdinates

resources

forpatientcare

�Acknow

ledges

colleagu

es’con

tribution

sto

team

work

�Develop

scollegial

relation

shipsan

dcollab

orates

with

communitypartnersto

promotethehealthof

the

pop

ulation

�Coo

perates

withother

orga

nizationsspon

soring

complemen

tary

health

initiativesin

the

community

�Works

with

man

agem

enton

areasof

clinical

practicethat

contribute

totheov

erall

effectiven

essof

theclinic

complemen

tary

health

initiativesin

the

community

�Works

with

man

agem

entwithin

areas

ofexpertise

inorder

tocontribute

totheov

erall

effectiven

essof

public

healthdelivery

�Collabo

rateswith,

provides

lead

ership

to,

andotherwiseinvo

lves

stak

eholdersan

daffected

pop

ulation

sin

assessing

healthneedsof

specific

pop

ulation

sor

geog

raphic

areas,an

din

develop

ing

strategies

andspecific

program

sto

address

publichealthissues

and

communityneeds

�Utilizeslead

ership,

team

building,

negotiation

andconflictresolution

skillsto

buildcommunity

partnerships

�Iden

tifies

how

public

andprivate

orga

nizations

operatewithin

acommunity

�Develop

s,im

plemen

ts,

andevaluates

community

publichealthassessmen

ts

complemen

tary

health

initiativesin

the

community

�Works

withstaffan

dorga

nizationwithin

areas

ofexpertise

inorder

tocontribute

totheov

erall

effectiven

essof

public

healthdelivery

�Collabo

rateswith,

provides

lead

ership

to,

andotherwiseinvo

lves

stak

eholdersan

daffected

pop

ulation

sin

assessing

healthneedsof

specific

pop

ulation

sor

geog

raphic

areas,an

din

develop

ing

strategies

andspecific

program

sto

address

publichealthissues

and

communityneeds

�Utilizeslead

ership,

team

building,

negotiation

,andconflict-

resolution

skillsto

build

communitypartnerships

�Iden

tifies

how

public

andprivate

orga

nizations

operatewithin

acommunity

�Works

withstaffon

areasof

clinical

practice

that

contribute

tothe

overalle

ffectivenessof

servicedelivery

�Collabo

rateswith

nursingstaffan

dother

disciplines

atalllevelsin

thedevelop

men

t,im

plemen

tation

,and


evaluationof

program

san

dservices

�Collabo

rateswith

administrativepeers

indeterminingthe

acqu

isition,a

llocation,

andutilization

oforga

nizational

fiscal

and

human

resources

�Collabo

rateswiththe

human

resources

staffto

develop

andim

plemen

trecruitmen

tan

dretention

program

sforstaff

�Collabo

rateswithother

providersof

nursing/

patientcare

within

the

deliverysystem

for

deliveryof

seam

less

services

�Provides

supportfor

colleagu

esin

analyzing,

planning,

andevaluating

program

s�

Buildsin

representation

ofdiverse

internal

stak

eholdersin

grou

pprocesses

�Assuresrepresentation

from

appropriate

communitystak

eholders

forhealthserviceplanning

efforts

�Facilitates

implemen

tation

ofthe

orga

nizationvision

through

collab

orative

lead

ership

7.Disease

prevention

/health

promotion(basic

publichealth

science)

�Applies

theba

sic

publichealthsciences,

includingbe

haviorala

nd

social

sciences,

nursing,

biostatistics,

epidem

iology,

environmen

talp

ublic

�Applies

theba

sic


includingbe

haviorala

nd

social

sciences,

nursing,

biostatistics,

epidem

iology,

environmen

talp

ublic

�Applies

theba

sic


includingbe

haviorala

nd

social

sciences,

nursing,

biostatistics,

epidem

iology,

environmen

talp

ublic

�Applies

theba

sic


includingbe

haviorala

nd

social

sciences,

nursing,

biostatistics,

epidem

iology,

environmen

talp

ublic

�Applies

theba

sic


includingbe

haviorala

nd

social

sciences,

nursing,

biostatistics,

epidem

iology,

environmen

talp

ublic


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

health,a

ndprevention

ofch

ronican

dinfectious

diseasesas

they

relate

toprovision

ofindividual

care�

Execu

tesprescribe

dtreatm

ents

andmed

ical,

den

tal,an

dpsych

iatric

interven

tion

s,ad

ministers

prescribe

dmed

ications,

mon

itorsan

ddocumen

tstreatm

entprogress,an

ddocumen

tstreatm

ent

progressan

dpatient

respon

se�

Provides

patient

education

toindividuals

andgrou

psab

outhealth

maintenan

cean

dman

agem

entof

acute

and

chronicconditions

�Respon

dsto

emergency

situationswith

basiclife

supportan

dfirst

aidskills.S

ummon

sother

healthcare

providersan

dem

ergency

personnel

ina

timelyan

dap

propriate

man

ner

�Maintainsasafe

clinic

environmen

tby

adhering

tothestan

dardssetby

the

Occupational

Safety

and

HealthAdministration

andtheWashington

Industrial

Safety

and

HealthAdministration

(OSH

A/W

SHA).Assures

implemen

tation

ofthese

stan

dardsat

workby

follow

inginfectioncontrol

health,a

ndprevention

ofch

ronican

dinfectious

diseasesas

they

relate

toprovision

ofpublichealth

services

�Provides

patient

education

toindividuals

andgrou

psab

outhealth

maintenan

cean

dman

agem

entof

acute

and

chronicconditions

�Provides

patientan

dfamilycare

basedon

practicegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s�

Respon

dsto

emergency

situationswith

basiclife

supportan

dfirst

aidskills.S

ummon

sother

healthcare

providersan

dem

ergency

personnel

ina

timelyan

dap

propriate

man

ner

�Ensurescomplian

cewithstan

dards,laws,

regu

lation

s,policies,an

dproceduresrelatingto

scop

eof

practice

�Ensurescomplian

cewithpracticegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s.�

Ensuresasafe

working

environmen

tby

adhering

tothestan

dardssetby

OSH

A/W

SHA

�Dem

onstratescritical

thinkingskills

health,a

ndprevention

ofch

ronican

dinfectious

diseasesas

they

relate

toprovision

ofmed

ical

care

�Perform

sphysical

assessmen

tusing

communityclinical

stan

dards

�Ordersan

d/or

perform

sap

propriate

diagn

ostican

dscreen

ing

testsan

dcollects

additional

datafor

evaluationof

illness/

wellness

�Develop

sdifferential

diagn

osisan

drisk

iden

tification

through

assessmen

tan

dinterpretation

ofdata

�Provides

patient

education

toindividuals

andgrou

psab

outhealth

maintenan

cean

dman

agem

entof

acute

and

chronicconditions

�Respon

dsto

emergency

situationswith

basiclife

supportan

dfirst

aidskills.S

ummon

sother

healthcare

providersan

dem

ergency

personnel

ina

timelyan

dap

propriate

man

ner

�Participates

indep

artm

entem

ergency

respon

setrainings

and

drills

�Maintainshom

eprepared

ness

�Ensurescomplian

ce

health,a

ndprevention

ofch

ronican

dinfectious

diseasesas

they

relate

toprovision

ofpublichealth

services

�Respon

dsto

emergency

situationswith

basiclife

supportan

dfirst

aidskills.S

ummon

sother

healthcare

providersan

dem

ergency

personnel

ina

timelyan

dap

propriate

man

ner

�Participates

indep

artm

entem

ergency

respon

setrainings

and

drills

�Maintainshom

eprepared

ness

�Ensurescomplian

cewithpracticegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s.�

Ensuresasafe

working

environmen

tby

adhering

tothestan

dardssetby

OSH

A/W

SHA

�Iden

tifies

andutilizes

curren

trelevantscientific

healthinform

ation

�Dem

onstratescapacity

forcritical

thinking

�Maintainsprofessional

competen

ceby

pursuing

opportunitiesfor

continuou

slearning,

attendingcontinuing

education

offerings,

read

ingprofessional

literature,a

nden

gagingin

health,a

ndprevention

ofch

ronican

dinfectious

diseasesas

they

relate

toprovision

ofpublichealth

services

�Respon

dsto

emergency

situationswith

basiclife

supportan

dfirst

aidskills.S

ummon

sother

healthcare

providersan

dem

ergency

personnel

ina

timelyan

dap

propriate

man

ner

�Participates

indep

artm

entem

ergency

respon

setrainings

and

drills

�Maintainshom

eprepared

ness

�Ensurescomplian

cewithpracticegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s.�

Ensuresasafe

working

environmen

tby

adhering

tothestan

dardssetby

OSH

A/W

SHA

�Iden

tifies

andutilizes

curren

trelevantscientific

healthinform

ation

�Dem

onstratescapacity

forcritical

thinking


competen

ceby

pursuing

opportunitiesfor

continuou

slearning,

attendingcontinuing

education

offerings,

read

ingprofessional

literature,a

nden

gagingin


guidelines;using

tech

niques

ofasep

sis;

disposingsafely

ofbiolog

ical

andclinical

materials;an

dusing

appropriatepersonal

protectiveeq

uipmen

t�

Provides

patientcare

basedon

practice

guidelines,com

munity

stan

dardsof

care,a

nd

federal

andstatelawsan

dregu

lation

s�

Ensurescomplian

cewithstan

dards,laws,

regu

lation

s,policies,an

dproceduresrelatingto

scop

eof

practice

�Participates

indep

artm

entem

ergency

respon

setrainings

and

drills

�Maintainshom

eprepared

ness


competen

ceby

pursuing

opportunitiesfor

continuou

slearning,

attendingcontinuing

education

offerings,

read

ingprofessional

literature,a

nden

gagingin

other

activities

that

develop

new

know

ledge

andskills

�Dem

onstratesan

understan

dingof

how

pop

ulation

-based

public

healthrelatesto

individual

healthcare

practice

�Participates

indep

artm

entem

ergency

respon

setrainings

and

drills

�Maintainshom

eprepared

ness


competen

ceby

pursuing

opportunitiesfor

continuou

slearning,

attendingcontinuing

education

offerings,

read

ingprofessional

literature,a

nden

gagingin

other

activities

that

develop

new

know

ledge

andskills

�Iden

tifies

curren

trelevantscientifichealth

inform

ationan

dap

plies

itap

propriatelyto

public

healthpractice

withpracticegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s.�

Ensuresasafe

working

environmen

tby

adhering

tothestan

dardssetby

OSH

A/W

SHA

�Provides

patient

education

toindividuals

andgrou

psab

outhealth

maintenan

cean

dman

agem

entof

acute

and

chronicconditions

�Iden

tifies

andutilizes

curren

trelevantscientific

healthinform

ation

�Dem

onstratescapacity

forcritical

thinking

�Provides

patientan

dfamilycare

basedon

practicegu

idelines,

communitystan

dardsof

care,a

ndfederal

andstate

lawsan

dregu

lation

s�

Ensurescomplian

cewithstan

dards,laws,

regu

lation

s,policies,an

dprocedures

�Defi

nes,a

ssesses,an

drecogn

izes

thehealth

statusof

pop

ulation

san

dindividuals,determinan

tsof

healthan

dillness,

factorscontributingto

healthpromotionan

ddisease

prevention

,and

factorsinfluen

cingthe

deliveryof

healthcare

�Dem

onstratesan

understan

dingof

the

historicald

evelop

men

t,structure,a

ndinteraction

ofpublichealthan

dother

healthcare

system

s

other

activities

that

develop

new

know

ledge

andskills

�Iden

tifies

curren


inform

ationan

dap

plies

itap

prop

riatelyto

public

healthpractice

�Defi

nes,a

ssesses,an

drecogn

izes

thehealth

statusof

pop

ulation

san


tsof

healthan

dillness,


healthpromotionan

ddisease

prevention

,and

factorsinfluen

cingthe

deliveryof

healthcare

�Dem

onstratesan

understan

dingof

the

historicald

evelop

men

t,structure,a

ndinteraction

ofpublichealthan

dother

healthcare

system

s�

Iden

tifies

andap

plies

basicresearch

method

susedin

publichealth

�Iden

tifies

the

limitationsof

research

andtheim

portance

ofob

servationsan

dinterrelationships

�Usesresearch

findings

inthedevelop

men

tof

policies,plans,

procedures,program

s,an

dgu

idelines

forpop

ulation

care

other

activities

that

develop

new

know

ledge

andskills

�Defi

nes,a

ssesses,an

drecogn

izes

thehealth

statusof

pop

ulation

san


tsof

healthan

dillness,


healthpromotionan

ddisease

prevention

,and

factorsinfluen

cingthe

deliveryof

healthcare

�Dem

onstratesan

understan

dingof

the

historicald

evelop

men

t,structure,a

ndinteraction

ofpublichealthan

dother

healthcare

system

s�

Iden

tifies

andap

plies

basicresearch

method

susedin

publichealth

�Iden

tifies

the

limitationsof

research

and

theim

portance

ofob

servationsan

dinterrelationships

�Usesresearch

findings

inthedevelop

men

tof

policies,plans,

procedures,program

s,an

dgu

idelines

forpop

ulation

care�

Iden

tifies

the

individual’san

dorga

nization’s

respon

sibilities

within

the

context

oftheEssen

tial

Services

ofPublicHealth,

andCoreFunctions


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Iden

tifies

andap

plies

basicresearch

method

susedin

publichealth

�Iden

tifies

the

limitationsof

research

andtheim

portance

ofob

servationsan

dinterrelationships

8.L

eadership/

system

sthinking

�Develop

sindividual

care

plansto

directcare

�Iden

tifies

curren


inform

ationan

dap

plies

itap

propriatelyto

individual

care�

Delegates

care,a

sap

propriate,to

other

mem

bers

ofthehealth

care

team

inaman

ner

consisten

twiththeLaw

Relatingto

NursingCare

andRegulation

ofHealth

Professions—

Uniform

DisciplinaryAct

�Participates

inCQI

activities

toim

prove

overallcliniceffectiven

ess

�Perform

sin

aman

ner

consisten

twithsite/

orga

nizational

productivitygo

als

�Se

eksavailable

resources

inform

ulating

ethical

decisions

�Gen

erates,shares,a

nd

accepts

new

ideasan

dincorporates

them

into

owndaily

work

�Con

sidersindividual/

family,extended

family,

andcu

lturalissues

asthey

�Provides

lead

ership

andacts

asaliaisonwith

other

communityag

encies

andprofessionals,

advo

cateson

behalfof

vulnerab

leindividualsan

dpop

ulation

s,participates

inassessingan

devaluatinghealthcare

services

toen

sure

that

peo

ple

areinform

edof

availableprogram

san

dservices

andareassisted

intheutilization

ofthose

services

�Dem

onstratessupport

ofthepublichealth

mission

toprotect

and

promotethehealthof

all

residen

tsthrough

implemen

tingprimary

prevention

strategies

that

preventhealthproblem

sfrom

starting,

spread

ing,

orprogressing

�Delegates

and

supervisestasksassign

edto

parap

rofessional

staff

�Participates

indep

artm

entan

dpossibly

communityem

ergency

respon

setraining

anddrillsin

�Assumes,a

saclinical

expert,alead

ership

role

inestablishingan

dmon

itoringstan

dardsof

practiceto

improve

client

care�

Participates

inefforts

tominim

izecostsan

dunnecessary

duplication

oftestingor

other

diagn

ostic

activities

andto

facilitate

timelytreatm

entof

the

patient

�Analyzes

orga

nizational

system

sfor

barriers

andpromotes

enhan

cemen

tsthat

affect

clienthealthcare

status

�Iden

tifies

curren


inform

ationan

dap

pliesit

appropriatelyto

public

healthpractice

�Provides

lead

ership

andacts

asaliaisonwith

other

communityag

encies

andprofessionals,

advo

cateson

behalfof

vulnerab

leindividualsan

dpop

ulation

s,participates

inassessingan


services

toen

sure

that

�Assumes,a

saclinical

expert,alead

ership

role

inestablishingan

dmon

itoringstan

dardsof

practiceto

improve

client

care�

Mak

espresentation

sto

keypolicymak

ers,health

care

professionals,specific

pop

ulation

s,funding

sources,a

ndmoregeneral

audiencesin

order

toraise

awaren

essan

d/orsecu

recollab

orationan

dfunding

�Plansan

dim

plemen

tstrainingan

dprovides

tech

nical

assistan

cean

dnursingconsultationto

healthdep

artm

entstaff,

healthproviders,policy

mak

ers,an

dpersonnel

inother

communityan

dgo

vernmen

tala

gencies

andorga

nizations

�Participates

inpeer-

review

activities

asap

prop

riate

�Provides

lead

ership

andacts

asaliaisonwith

other

communityag

encies

andprofessionals,

advo

cateson

behalfof

vulnerab

leindividualsan

d

�Delegates

respon

sibilities

appropriateto

the

licensure,education

,and

experience

ofthestaff

�Designsan

dnegotiates

orga

nizational

acceptance

ofap

propriaterolesforthe

utilization

ofallstaff

�Develop

s,im

plemen

ts,

andevaluates

system

san

dprocesses

that

complemen

ttheov

erall

system

forperform

ance

improvemen

t�

Mak

espresentation

sto

keypolicymak

ers,health

care

professionals,specific

pop

ulation

s,funding

sources,a

ndmoregeneral

audiencesin

order

toraise

awaren

essan

d/orsecu

recollab

orationan

dfunding

�Plansan

dim

plemen

tstrainingan

dprovides

tech

nical

assistan

cean

dnursingconsultationto

healthdep

artm

entstaff,

healthproviders,policy

mak

ers,an

dpersonnel

inother

communityan

dgo

vernmen

tala

gencies

andorga

nizations


relate

tohealthstatusof

individual

�Balan

cesneedsof

individual

withdesignof

efficien

tservices

�Advo

catesfor,an

dassistsindividualsin

advo

catingfor,

appropriatecare

supportof

disaster

prepared

ness

�Participates

inresearch

and

dem

onstration

projects

that

seek

toim

prove

the

healthof

communitiesan

ddeterminenew

waysto

address

healthissues

�Participates

inprogram

develop

men

t,im

plemen

tation

,coordination,a

ndsupport

�Participates

inqu

ality

man

agem

entactivities

usingqu

ality

improvemen

tan

devaluationap

proaches

�Perform

sin

aman

ner

consisten

twithsite/

orga

nizational

productivitygo

als

�Assumes

respon

sibility

forow

nprofessional

develop

men

tby

pursuing

education

,participatingin

professional

committees

andworkgrou

ps,an

dcontributingto

awork

environmen

twhere

continual

improvemen

tsin

practicearepursued

�Encouragesuse

ofcommunityresources

insupportof

publichealth

practice

�Align

spracticewith

overallo

rgan

izational

goals

peo

ple

areinform

edof

availableprogram

san

dservices

andareassisted

intheutilization

ofthose

services

�Dem

onstratessupport

ofthepublichealth

mission

toprotect

and

promotethehealthof

all

residen

tsthrough

implemen

tingprimary

prevention

strategies

that


sfrom

starting,

spread

ing,

orprogressing

�Delegates

and

supervisestasksassign

edto

parap

rofessional

staff

�Participates

indep

artm

entan

dpossibly

communityem

ergency

respon

setrainingan

ddrillsin

supporto

fdisaster

prepared

ness

�Assumes

respon

sibility

forow

nprofessional

develop

men

tby

pursuing

education

,participatingin

professional

committees

andworkgrou

ps,an

dcontributingto

awork

environmen

twhere

continual

improvemen

tsin

practicearepursued

�Se

eksprofessional

certification

inthearea

ofexpertise

when

available

�Participates

inresearch

and

dem

onstration

projects

that

seek

toim

prove

the

healthof

individualsan

dpop

ulation

s,an

ddeterminenew

waysto

address

healthissues

pop

ulation

s,participates

inassessingan


services

toen

sure

that

peo

ple

areinform

edof

availableprogram

san

dservices

andareassisted

intheutilization

ofthose

services

�Dem

onstratessupport

ofthepublichealth

mission

toprotect

and

promotethehealthof

all

residen

tsthrough

implemen

tingprimary

prevention

strategies

that


sfrom

starting,

spread

ing,

orprogressing

�Participates

indep

artm

entan

dpossibly

communityem

ergency

respon

setrainingan

ddrillsin

supporto

fdisaster

prepared

ness

�Assumes

respon

sibility

forow

nprofessional

develop

men

tby

pursuing

education

,participatingin

professional

committees

andworkgrou

ps,an

dcontributingto

awork

environmen

twhere

continual

improvemen

tsin

practicearepursued

�Se

eksprofessional

certification

inthe

area

ofexpertise

when

available

�Participates

inresearch

and

dem

onstration

projects

that

seek

toim

prove

the

healthof

individualsan

dpop

ulation

s,an

d

�Provides

lead

ership

andacts

asaliaisonwith

other

communityag

encies

andprofessionals,

advo

cateson

behalfof

vulnerab

leindividualsan

dpop

ulation

s,participates

inassessingan


services

toen

sure

that

peo

ple

areinform

edof

availableprogram

san

dservices

andareassisted

intheutilization

ofthose

services

�Dem

onstratessupport

ofthepublichealth

mission

toprotect

and

promotethehealthof

all

residen

tsthrough

implemen

tingprimary

prevention

strategies

that


sfrom

starting,

spread

ing,

orprogressing

�Participates

indep

artm

entan

dpossibly

communityem

ergency

respon

setrainingan

ddrillsin

supporto

fdisaster

prepared

ness

�Assumes

respon

sibility

forow

nprofessional

develop

men

tby

pursuing

education

,participatingin

professional

committees

andworkgrou

ps,an

dcontributingto

awork

environmen

twhere

continual

improvemen

tsin

practicearepursued

�Participates

inresearch

and

dem

onstration

projects

that

seek

toim

prove

the


Appen

dix

A.Con

tinued

.

Nursingclass:

b

(level

ofPH

practice)

competen

cy.

RN

(indiv.)

PHN

fieldnurse

(indiv./comm.)

Nursepractitioner

(indiv./sys.)

Clinical

nursespec.

(com

m./sys.)

Nursingsupervisor

(com

m./sys.)

�Participates

inqu

ality

man

agem

entactivities

usingqu

ality

improvemen

tan

devaluationap

proaches

�Perform

sin

aman

ner

consisten

twithsite/

orga

nizational

productivitygo

als

�Align

spracticewith

overallo

rgan

izational

goals

�Creates

acu

lture

ofethical

stan

dardswithin

orga

nizationsan

dcommunities

�Iden

tifies

internal

and

external

issues

that

may

impactdeliveryof

essential

med

ical

and


�Con

tributesto

develop

men

t,im

plemen

tation

,and

mon

itoringof

orga

nizational

perform

ance

stan

dards

�Usesthelega

land

political

system

sto

effect

chan

ge

determinenew

waysto

address

healthissues

�Participates

inqu

ality

man

agem

entactivities

usingqu

ality

improvemen

tan

devaluationap

proaches

�Perform

sin

aman

ner

consisten

twithsite/

organizational

productivitygo

als

�Creates

acu

lture

ofethical

stan

dardswithin

organizationsan

dcommunities

�Iden

tifies

internal

and

external

issues

that

may

impactdeliveryof

essential

med

ical

and


�Con

tributesto

develop

men

t,im

plemen

tation

,and

mon

itoringof

organizational

perform

ance

stan

dards

�Usesthelega

land

political

system

sto

effect

chan

ge�

Helpscreate

keyvalues

andshared

vision

anduses

theseprinciplesto

guide

action

healthof

individualsan

dpop

ulation

s,an

ddeterminenew

waysto

address

healthissues

�Participates

inqu

ality

man

agem

entactivities

usingqu

ality

improvemen

tan

devaluationap

proaches

�Perform

sin

aman

ner

consisten

twithsite/

orga

nizational

productivitygo

als

�Creates

acu

lture

ofethical

stan

dardswithin

orga

nizationsan

dcommunities

�Iden

tifies

internal

and

external

issues

that

may

impactdeliveryof

essential

med

ical

and


�Con

tributesto

develop

men

t,im

plemen

tation

,and

mon

itoringof

orga

nizational

perform

ance

stan

dards

�Usesthelega

land

political

system

sto

effect

chan

ge�

Helpscreate

keyvalues

andshared

vision

anduses

theseprinciplesto

guide

action

�Su

pports

thesystem

toad

dress

ethical

issues

within

nursingan

dthe

orga

nization

�Applies

thetheo

ryof

orga

nizational

structures


Appendix B: General WorkplaceExpectations Document

General Workplace Expectations for NursingPublic Health—Seattle & King CountyWorking for public health represents a varied set ofworking conditions and environments for nurses.WSNA labor contracts cover the general areas ofwages, hours, and working conditions. The informa-tion being provided to you in this document is intend-ed as a guideline for new and seasoned nursingemployees. Although some items may seem obviousand ‘‘common sense,’’ it identifies what is expected inthe professional workplace.

Nursing practice within public health observes acustomer service model that is client centered. Nursesare expected to consider both client and businessneeds in providing care, and in any decision-makingprocess.

It is expected that nurses working for publichealth will be in compliance with the following expec-tations. If there are any questions, please contact asupervisor or site manager.

Communication: Communication is expectedto be respectful and professional at all times. Conver-sations with clients, co-workers, outside agencies,supervisors, and visitors should demonstrate respectfor each individual.

Some examples of what is expected include listen-ing to the information or concern, and demonstrating awillingness to be helpful in any situation that arises.

Nursing personnel are expected to observe allconfidentiality safeguards required by departmentpolicies and in accordance with state and federalprivacy laws.

Reliability: Nursing employees are expected tobe regular in attendance. Unscheduled absences ad-versely impact the ability of public health to providequality service to our clients and result in expensivereplacement costs to achieve our mission. Nursingemployees are expected to be ready to begin and endwork on schedule. Arriving late or leaving earlier thanthe scheduled work times, breaks, or meal periodsmust be approved in advance by the appropriatesupervisor.

Appearance: Public health provides many serv-ices in a variety of settings and locations. This meansthat a wide range of clothing/dress may be appropri-ate, depending on job duties and location of the nurse.In general, the information below should serve as a

toprofessional

practice

�Con

tributesto

develop

men

t,im

plemen

tation

,and

mon

itoringof

orga

nizational

perform

ance

stan

dards

�Provides

learning

environmen

tlead

ingto

orga

nizationcapacity

building

�Facilitates

orga

nizationch

ange

andindividual

role

redefinition

�Understan

dspublic

healthorga

nizationas

one

orga

nizationwithin

adyn

amicsystem


guideline to ensure that we are professional inappearance and consistent with specific clothingrequirements of each job location:

— During work hours, dress is expected to beneat, respectful, professional, modest, comfortable,and designed to allow the nurse to perform therequired job duties.

Some examples of inappropriate dress includeworn, ripped, frayed, torn, or unkempt clothing. Also,items that display obscene, profane, discriminatory,provocative, or inflammatory words/pictures arenot acceptable. Items advertising alcoholic beverages,drugs, drug paraphernalia, or tobacco products arenot acceptable. Pool/beach attire, see-through gar-ments, halter tops, bare midriff/back tops, tank tops/muscle shirts, low-cut blouses, and pants are also con-sidered unprofessional attire.

— Professional appearance also includes compli-ance with OSHA/WSHA requirements. Specifically,nurses are required to wear closed toed shoes in allclinical areas. Nurses are to use personal protectiveequipment whenever appropriate. Additionally, it isstrongly recommended that nursing staff not wearartificial nails, because they have been associatedwith the spread of infection and disease in clinicalsettings.

Conduct: Nurses working for public health areexpected to conduct themselves in a safe, profes-sional, and efficient manner. They are expectedto treat the department, its property, and other em-ployees respectfully, and with integrity and honesty.

Nurses are expected to be in full compliance withall County and Public Health policies related to conduct,including but not limited to, Nondiscrimination andAntiharassment policies, HIPPA requirements, Work-place Violence Prevention policies, and King CountyEmail policies and restrictions. The county policy isclear regarding use of County equipment for personaluse, and nurses are expected to be in full compliance.

Reporting for work under the influence of alcoholor controlled substances is prohibited as outlined inthe King County Chemical Dependence and Impair-ment Policy. Any unlawful conduct is also prohibited,including but not limited to, gambling, disorderlyconduct, vandalism, and damaging of company prop-erty or the property of other employees.

Nurses are expected to maintain appropriate pro-fessional boundaries with public health clients.

As information, the use of personal cell phones isdiscouraged, except when taking/making personalcalls during scheduled lunch and/or break times inan area that is not disruptive to operations.

SUMMARY: The nursing staff in public healthare committed, skilled, and professional individualswho work toward a goal of improving the health ofKing County residents. As representatives of publichealth, the nursing staff at all levels have a responsi-bility to always conduct themselves in a professionalmanner, fully complying with the expectations ex-pressed above. Nurses should not hesitate to contacttheir supervisors if they have any questions relative tothese expectations.


A Competency-Based Approach to Public Health Nursing ... · A Competency-Based Approach to Public Health Nursing Performance Appraisal ... Managing the Core Functions.

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