Definition/Introduction
The American Nurses Association (ANA) defines standards for registered nurses. The Nursing Professional Development (NPD): Scope and Standards of Practice describe the competencies that NPD practitioners should perform. The roles of all nursing specialties, including those of NPD practitioners, are evolving with the changing healthcare landscape. The ANA and other specialty organizations periodically review and revise standards. The latest edition of the NPD scope and standards was published in 2022 by the Association for Nursing Professional Development.
A diverse, global group of NPD practitioners was convened to update these standards. They used research findings conducted by Harper and Maloney in the spring of 2020 and other current literature to ensure that the new standards reflected current and future NPD practice.[1][2] Harper and Maloney used a mixed-methods study to identify the utility and challenges of the 3rd edition of the scope and standards, current and future issues and trends impacting NPD practice, and skills and competencies needed by NPD practitioners over the next five years. They followed that with a Delphi method study to obtain consensus on the world café items to be used to inform this update of the NPD scope and standards.
The definition of NPD in the current standards was updated to state, “Nursing professional development is a nursing practice specialty that improves the professional practice and role competence of nurses and other healthcare personnel by facilitating ongoing learning, change, and role competence and growth with the intention of improving population health through indirect care” p. 1.
The revised standards include an updated systems practice model comprised of inputs, throughputs, and outputs. Rainford et al. described the practice model and changes in the latest edition of the standards. Inputs include environmental scanning, the learner, the seven NPD roles, and the NPD standards. Throughputs include the organizational mission and vision and the six key areas of responsibility of NPD practitioners. Areas of NPD responsibility are: 1) orientation and onboarding; 2) competency management; 3) education; 4) role development; 5) collaborative partnerships; and (6) inquiry.[3]
Outputs include learning, change, and professional role competence and growth, which contribute to optimal care and population health. The focus of NPD practice is the healthcare consumer/partner, who is defined as a “patient, person, client, family, group, community, or population who collaborates with the interprofessional healthcare team and maintains autonomy to engage in decision making about activities/treatments/therapies to promote health.” p. 119.
Three years after the 2016 standards were published, Harper and Maloney identified that although the standards have promoted uniformity of titles and alignment with the scope of practice, the specialty needs more work in the areas of advocacy, research, and engagement.[3] In an article about the development of the updated edition, they outlined some of the work that had been done to inform the latest edition of the standards.[4]
Issues of Concern
The seven roles and six responsibilities of the NPD practitioner did not change; however, there were numerous changes in the standards, some of which are summarized below.
- The term NPD “generalist” was eliminated. The two categories of educators are NPD practitioners (minimum of a baccalaureate degree in nursing) and NPD specialists (minimum of a graduate degree in nursing or related field and certification in NPD). Certification requires a minimum of a baccalaureate degree in nursing.
- Diversity, equity, and inclusion have been incorporated throughout the standards.
- There is a focus on NPD initiatives, such as analyzing department outcomes, in addition to programs and activities.
- The definition of NPD practitioner expanded to include NPD practice judgment. This is defined as “the identification and interpretation of the learner’s needs and the decision to act – or not act- on those needs using typical, modified, or new NPD interventions as appropriate, similar to clinical judgment and includes contextual reasoning based on knowledge of the learner” p. 123.
- The term lifelong learning was replaced with the term ongoing professional learning. Lifelong learning does not differentiate between personal and professional development, whereas ongoing professional learning focuses on the continual acquisition of professional knowledge, skills, and abilities throughout one’s career.
- The NPD scope of practice, represented by the NPD Practice Model, has been updated to identify the healthcare consumer/partner as the overall beneficiary of the outputs and outcomes of NPD practice. The organization’s mission and vision became the hub around which the NPD responsibilities are organized, and the NPD standards are now part of the inputs of the model.
- The NPD standards have been revised to align with the ANA Nursing: Scope and Standards of Practice; 4. As a result, several standards were renamed, and others were combined and redefined. For example:
- The previous standard 5-B, Facilitation of Positive Learning and Practice Environments, was incorporated into Standard 18, Environmental Health, and the new standard 5-B focuses on Health Teaching and Promotion.
- Standard 5-C, Consultation, was incorporated into Standard 15, Quality of Practice.
- Additions included standards for Advocacy (Standard 8), Respectful and Equitable Practice (Standard 9), and Communication (Standard 10).
- Standard 11, Change Management, was incorporated into Standard 12, Leadership.
- Standard 9, Evidence-Based Practice and Research, was incorporated into Standard 14, Scholarly Inquiry.
- Content from Standard 16 Mentorship/Advancing the Profession was incorporated into multiple standards, including Standard 12, Leadership, Standard 14, Scholarly Inquiry, and Standard 16, Professional Practice Evaluation.
- Standard 15, Resource Utilization, was included with Standard 17, Resource Stewardship.
Dickerson and Durkin [5] describe how the first six standards apply the nursing process framework to NPD practice. The first standard, assessment, broadened the process to include the use of evidence-based assessment techniques to guide relevant data collection. Other additions include creating a safe environment for competency assessment and keeping abreast of technological advances that could influence assessment, from the span of assessment for the NPD specialist s “department, organization, system and community dynamics” p. 5.
Standard 2, diagnosis, discusses analyzing assessment data to identify actual and potential practice gaps that could impact the performance of healthcare team members. The importance of differentiating professional development issues from system or compliance issues was emphasized. The difference between the NPD practitioner and specialist is in their scope: the NPD practitioner focuses on the individual or unit level, whereas the specialist considers departmental and organizational needs.
Standard 3, outcomes identification, focuses on developing measurable outcomes for a plan designed to meet the diagnosed needs. Learners and other key stakeholders are involved in the process of formulating measurable, evidence-based, context-specific outcomes. These outcomes reflect the values of the organization, stakeholders, and learners and align with regulations.
Standard 4, planning, includes the development of NPD initiatives, respecting diversity, using instructional design principles, and preparing content reflective of expected outcomes using current evidence. Planning interprofessional initiatives and using NPD practice judgment to prioritize elements of the plan are competencies for the NPD practitioner. In addition, the NPD specialist uses systems thinking throughout the planning process.
Standard 5, implementation, has two subcomponents: standard 5-A, coordination, and standard 5-B, health teaching and health promotion. The goal of this standard is to ensure quality and safety for the healthcare consumer/partner. In addition to the use of practice judgment, the NPD practitioner adjusts implementation strategies recognizing the learner’s needs, readiness, ability to learn, language, and cultural preferences.
Competencies in standard 5-A include coordination and recognizing the role of others, including stakeholders, professional development associates, and interprofessional team members, in implementing the plan and associated processes. There is also a competency for transitions in practice and to practice, including preceptor preparation and assignment.
Competencies in the new standard 5-B, health teaching, and health promotion, outline how the NPD practitioner can focus on strategies to teach and promote wellness. The basis of this standard is the role of the NPD practitioner in promoting healthy lifestyles, disease prevention, and self-care in learners, as well as providing education to help clinical staff promote wellness in their healthcare consumers/partners.
Standard 6, evaluation, addresses the achievement of progress towards attainment of outcomes.
The NPD practitioner evaluates the outcomes of the established plan, where the NPD specialist focuses on process and impact. Using appropriate methods and instruments, the NPD practitioner analyzes, documents, and disseminates the results of evaluation data. The NPD specialist synthesizes the evaluation data to determine the impact on the healthcare consumer/partner and population health.
Standards 7-18 describe the professional performance or a competent level of behavior in the professional role. All registered nurses are expected to engage in professional role activities, including leadership and mentorship, among others, reflective of their education, experience, and position.
Standard 7, ethics, emphasizes the importance of following the Code of Ethics for Nurses, Nursing: Scope and Standards of Practice, and other regulatory standards to guide practice. This standard incorporates the concept of social justice and respectful, compassionate treatment in practice, as well as safeguarding sensitive information. The specialist analyzes ethical issues and provides leadership when addressing ethical issues.
Standard 8, advocacy, is a new standard in this edition. ANA defines advocacy in the Nursing: Scope and Standards of Practice as “the act or process of pleading for, supporting, or recommending a cause or course of action. Advocacy may be for persons (whether an individual, group, population or society) or an issue, such as potable water or global health.” p. 109. The NPD practitioner demonstrates advocacy in all roles and settings. This includes championing the voice of the healthcare consumer/partner and promoting the value of NPD practice. The NPD specialist advances NPD as a specialty and engages with interprofessional colleagues and professional organizations to advance NPD practice.
Standard 9, respectful and equitable practice, another new addition, stresses the importance of cultural humility and social equity in addition to resisting systemic racism and demonstrating diversity, equity, and inclusion in one’s practice. The current standards indicate that the specialist develops partnerships to promote allyship, defined as “a lifelong process of building relationships based on trust, consistency, and accountability with marginalized individuals and/or groups” p. 116.
Standard 10 focuses on communication. Concepts related to communication had been intertwined throughout many of the standards in the previous version but are elevated to a separate standard in the updated edition. The NPD practitioner must communicate effectively with all healthcare personnel in the practice and learning environments. This includes using evidence-based tools and providing non-judgmental, specific feedback to others.
Standard 11, collaboration, describes the interaction between the NPD practitioner, colleagues, academic partners, and other key stakeholders. This includes partnering with others to effect change and promote population health. The NPD specialist advances interprofessional collaboration using NPD practice judgment and expertise.
Standard 12, leadership, defines leadership competencies within the interprofessional practice and learning environments and the profession and includes competencies for change management as well. This standard encompasses both formal and informal leadership and includes the concepts of emotional intelligence, shared decision-making, and just culture. The NPD specialist creates and sustains mentoring processes, leads change, and advances a culture of innovation, organizational learning, and continuous professional development. Johnson and Smith [6] discussed preparing NPD practitioners in their leadership roles, focusing on management and leadership skills.
Standard 13, education, focuses on the ongoing professional learning of the NPD practitioner, as they seek knowledge and competence that reflects current NPD practice and promotes futuristic thinking. The value of reflective practice and inquiry, precepting, and seeking NPD certification is also addressed within this standard.
Standard 14, scholarly inquiry, formerly evidence-based practice (EBP), focuses on integrating scholarship, evidence, and research findings into NPD practice. Acting as a champion of scientific inquiry, participating in inquiry at various levels, and disseminating inquiry findings are some of the competencies of this standard. The NPD specialist applies principles of implementation science, leads quality and safety initiatives, and mentors others in inquiry.
Standard 15, quality of practice, describes the contributions of the NPD practitioner to quality nursing, healthcare, and NPD practice. This includes mentoring others, using quality improvement processes to enhance nursing, healthcare, and NPD practice, and reporting outcomes of professional development initiatives. The NPD specialist analyzes NPD department quality outcomes to demonstrate impact, models expert practice and synthesizes evaluation data to guide decision-making.
Standard 16, professional practice evaluation, pertains to NPD practitioners evaluating their own practice, as well as others’ nursing practice. This involves reflection and self-evaluation., facilitating learners’ identification of their professional development needs, and engaging in systematic peer review. The NPD specialist leads in developing standards and guidelines for NPD practice evaluation.
Standard 17, resource stewardship, previously resource utilization, involves the NPD practitioner using appropriate resources to plan, provide, and sustain evidence-based NPD initiatives that are safe, effective, financially responsible, and used judiciously. This includes identifying resources needed, monitoring resource allocation and utilization, and considering factors related to quality, effectiveness, and cost in planning, implementing, and evaluating NPD initiatives. The NPD specialist analyzes the cost-effectiveness, cost-benefit, and return on investment associated with NPD practice.
Standard 18, environmental health, concerning environmental safety and health within the practice and learning environments, is another new standard in this edition. Incorporating the social determinants of health into the interprofessional practice and learning environment, addressing bullying and incivility, and promoting the use of emotional intelligence are included in this standard. The NPD specialist establishes best practices for creating and sustaining positive interprofessional and learning environments and creates processes that support seamless transitions to practice and between practice settings.
There is often confusion about the differences in the role of the NPD practitioner, clinical nurse specialist, academic clinical nurse educator, and academic educator. A table comparing these various nursing specialties is a much-needed resource created for this edition. The table provides a comparison of the definition, requirements, certification/secondary licensure, and roles/responsibilities of each of these groups to provide additional clarity to the differences in these roles.
Another excellent resource is a table providing examples of the use of NPD roles in each area of responsibility. Although NPD roles vary depending on one’s setting and practice area, this table provides concrete examples of how the NPD practitioner meets the various responsibilities in each of the roles.
Competencies for the NPD specialist in all standards provide a framework for the advanced certification in nursing professional development, a portfolio-based certification exam offered by the Competency and Credentialing Institute. Information about this exam was outlined in an article by Di Leonardi [7]. Harper and colleagues [8] wrote an article on developing this advanced certification.
Nursing Professional Development Standards