Dualistic level competencies for professional nursing practice: an international educational initiative

Ensuring professional nurses are competent is integral to promoting quality outcomes for persons with spinal cord impairment (SCI). This project, funded by the American Association of Spinal Cord Injury Nurses (AASCIN), was designed to develop instruments to validate the competencies of registered nurses (RNs) caring for persons with SCI. The project expanded a 1994 model project focusing on the competencies of licensed practical nurses and licensed vocational nurses (LPNs/LVNs) and RNs in an adult rehabilitation setting. Using the earlier project as a foundation, investigators identified competencies for RNs applicable to the life span trajectory of persons with SCI including pediatric, adolescent, adult, and geriatric populations. Additionally, the focus was broadened to encompass acute, rehabilitation, outpatient community, and long-term settings. This innovative project resulted in the development of the SCI Knowledge/Skill Competency tool for dualistic competency levels of "competent" RNs with two years of recent SCI nursing experience, and "expert" RNs with five years of recent SCI experience. Additionally, the SCI Behavior Competency tool for the "competent" level was developed using hermeneutic techniques and Patricia Benner's (1983) framework, "Novice to Expert." This complemented the "expert" level tool devised in the 1994 model project. Implementation will enable RNs to validate the competencies that are essential to provide care that results in quality outcomes for persons with SCI, their families, and other consumers of SCI health care services.