CE: Original Research: Creating an Evidence-Based Progression for Clinical Advancement Programs

Area of Science:

• Nursing Education
• Healthcare Quality Improvement
• Professional Development

Background:

• The Institute of Medicine (IOM) and Quality and Safety Education for Nurses (QSEN) identified six core nursing competencies.
• Integration of these competencies into clinical practice and evidence of progression in advancement programs remain limited.
• An academic health system developed eight competency domains and 186 knowledge, skills, and attitudes (KSAs) for professional nursing practice.

Purpose of the Study:

• To validate the eight developed competency domains and 186 KSAs.
• To determine the developmental progression of these KSAs across four levels of a clinical advancement program.

Main Methods:

• The Delphi technique was employed for validation by nursing leadership and clinical experts.
• Experts from 13 Magnet-designated hospitals participated in consensus-building Delphi rounds.
• The study focused on reaching agreement on the developmental progression of 186 KSAs through four clinical advancement levels.

Main Results:

• Two Delphi rounds achieved expert consensus on all eight competency domains and 186 KSAs.
• All eight competency domains were deemed essential across all four practice levels.
• KSAs shifted from safety and patient-centered care at novice levels to professionalism, teamwork, technology, and quality improvement at advanced levels.

Conclusions:

• Implementing the eight competency domains and 186 KSAs into clinical advancement programs can clarify roles and enhance accountability.
• This framework promotes nursing practice, potentially improving clinical outcomes and quality of care.
• The competency domains offer a foundation for enhancing position descriptions, evaluations, recognition, and training programs.