Know the indications for wearable devices. Know the pathophysiology, differential diagnosis, and management strategies for patients with syncope. For procedural or diagnostic laboratory activities, assessment tools may include registry and/or hospital data, appropriate use criteria, and metrics developed by professional organizations. Recommendations in these statements are based on available evidence and, where evidence is lacking, reflect the consensus of expert opinion. J Am Coll Cardiol 2020;75:2483–2517. Most clinical care teams that utilize NPs and PAs report enhanced practice performance, physician efficiency, revenue generation, improved clinical outcomes, and enhanced patient satisfaction (2–9). Acknowledgments The College of Nurses of Ontario (CNO) would like to thank CNO members who participated in the review and revision of this document. † Ms. Nickolaus was employed by the UPMC Susquehanna Heart & Vascular Institute as a Nurse Practitioner during most of this writing effort. Know the management of arrhythmias in pregnancy and women of childbearing age. Skill to obtain a history and physical examination for patients with elevated blood pressure and hypertension. Attain and maintain nurse practitioner and/or physician assistant certification per respective credentialing organizations. Competency is a topic of great interest to educators and administrators in practice disciplines, particularly health care disciplines such as nursing. Know the indications for selection of pacemaker systems and cardiac resynchronization therapy. ∗ Mr. Drajpuch was employed by the Children’s Hospital of Philadelphia as a Nurse Practitioner during most of this writing effort. Know the epidemiology, pathophysiology, stages, and natural history of heart failure. Skill to recognize cardiac devices that are designated magnetic resonance imaging conditional. Skills to recognize and manage noncardiac medical conditions that may affect patients in the cardiovascular critical care setting. High-performing cardiovascular care teams aspire for each member to practice at the top of his or her education, training, licensure, and experience with clearly defined roles. 3. Core Competencies and Scope of Practice in Nursing Informatics November 30, 2020 / in / by developer The continued integration of information technology within the nursing profession is resulting in the development of nursing informatics as a distinct specialty. Skill to participate in insertion of an invasive and/or hemodynamic monitoring vascular access catheter. Journal of the American College of Cardiology, A Report of the ACC Competency Management Committee, "ACC 2015 core cardiovascular training statement (COCATS 4) (revision of COCATS 3)", "2015 ACC health policy statement on cardiovascular team-based care and the role of advanced practice providers". 1. Know the indications for referral of patients with advanced or complex valvular heart disease to a multidisciplinary heart team. Know the indications for endocarditis prophylaxis in adults with congenital heart disease. Know the pharmacology, indications, contraindications, and side effects of antiarrhythmic medications. Pericardial Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2505, Table 12. NLN Core Competencies Note: The task statements that accompany each competency can be found in NLN Core Competencies for Nurse Educators: A Decade of Influence (2019) and The Scope of Practice for Academic Nurse Educators & Academic Clinical Nurse Educators (2020). Know the characteristics of patients likely to have difficulty adhering to cardiac rehabilitation and corresponding management strategies. You may retrieve this document by clicking the following link: Skill to refine the therapeutic plan of care of patients with pericardial disease based on laboratory and diagnostic test results. Writing committee members volunteered their time to this effort. Know the differential diagnoses of symptoms commonly associated with heart failure. Know the effects of age on cardiovascular function, response to medications, and risks of diagnostic and therapeutic procedures. Approved March 20, 2020 ACNM Core Competencies for Basic Midwifery Practice The Core Competencies for Basic Midwifery Practice include the fundamental knowledge, skills, and abilities expected of new midwives certified by the American Midwifery Certification Board (AMCB). Skills to identify and participate in the management of arrhythmias and conduction disturbances in patients with acute coronary syndromes. "Expanding the role of advanced nurse practitioners—risks and rewards" Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals. The cardiovascular competencies, organized in a topic format, identify the competencies for clinical cardiovascular NPs and PAs, as well as aspects of cardiovascular medicine that exceed core expectations and may be maintained or achieved by some cardiovascular NPs and PAs depending on their background and practice focus (see Table 1). Skill to perform a physical assessment and examination for patients with lipid disorders. Use practice data to assess appropriateness, quality, and safety of cardiovascular care. Skill to utilize noninvasive imaging reports for diagnosis and follow-up care of patients with vascular disease. Know the clinical manifestations, differential diagnosis, evaluation, and management of aortic, carotid, renal, mesenteric, and extremity peripheral artery diseases. Know the normal and abnormal findings in patients with heart failure with preserved and reduced ejection fraction who undergo hemodynamic catheterization. The American Association of Heart Failure Nurses, Association of Physician Assistants in Cardiology, Heart Rhythm Society, Preventive Cardiovascular Nurses Association, and Society for Cardiovascular Angiography and Interventions endorsed the document in February 2020. Know the arrhythmias common in adults with simple congenital heart disease and referral indications to electrophysiologists with expertise in congenital heart disease. Know the prognostic factors used to assess patients with acute coronary syndromes and advanced heart failure. Skills to evaluate and manage patients with supraventricular tachyarrhythmias. Know the indications and contraindications of primary percutaneous coronary intervention as initial reperfusion strategies. Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American College of Cardiology. ONE Award Submissions ; Outstanding Orthopaedic Nurse Practice Award; Online Store; Online Store. The implementation of the National Nursing Core Competency Standards (NNCCS) for Nursing education and practice is an exciting experience. Practice within the scope of personal expertise, training, and technical skills. Skill to assess the cardiovascular risks associated with recreational and/or competitive sports, physically demanding occupations, and other vigorous physical activities. Tables 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, and 14 encompass the medical knowledge and patient care and procedural skill competencies related to the 11 clinical areas identified in Table 1. Know the management of valvular heart disease in pregnancy and women of childbearing age. Core Practice Doctorate Clinical Nurse Specialist (CNS) Competencies (RETIRED) (PDF). The writing committees reflect the diversity of cardiovascular medicine, including content experts, general cardiology and sub-subspecialty practitioners in both academic and private practice settings, and early, mid-, and later-career representatives. J Am Coll Cardiol2015; 65:1721-1723. The document was reviewed by 4 official representatives from the ACC and 25 reviewers representing the following organizations: the Accreditation Review Commission on Education for the Physician Assistant, American Academy of Physician Assistants, American Association of Heart Failure Nurses, American Association of Nurse Practitioners, American Heart Association, American Nurses Credentialing Center, Association of Physician Assistants in Cardiology, Heart Failure Society of America, Heart Rhythm Society, National Organization of Nurse Practitioner Faculties, Physician Assistant Education Association, Preventive Cardiovascular Nurses Association, and the Society for Cardiovascular Angiography and Interventions. Skills to evaluate and manage patients with inherited and acquired forms of thrombophilia. Professionalism as manifested by a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Know the indications for implantable devices in patients with heart failure. Skills to obtain clinical history and physical examination to determine functional capacity and volume status in patients with heart failure. Skill to recognize cardiac arrhythmias and perioperative complications in patients with valvular heart disease. Skills to manage appropriate pain and/or sedating agents and monitor therapeutic effects for patients receiving mechanical ventilatory support. Skills to initiate management of urgent or emergent cardiovascular conditions and prioritize management of patients with multicomponent illness. Skills to perform and interpret findings of physical examination for detection of acute and chronic arterial compression syndromes. Know the indications for diagnostic testing for adults with complex congenital heart disease. Skills to evaluate and coordinate management of patients with peripheral and visceral artery aneurysms and refer candidates for surgical or endovascular intervention. Know the risk reduction strategies for populations at increased risk for cardiovascular disease. Skills to initiate and monitor diagnostic testing indicated for patients with elevated blood pressure and hypertension. Know the indications for, contraindications to, and pharmacology of anticoagulant, antithrombin, and antiplatelet agents, and their reversal agents. View all . Demonstrate high ethical standards in personal and professional conduct. It also helps to increase awareness of the roles that NPs and PAs have within the cardiovascular team. Former Competency Management Committee chair, chair during this writing effort. Nursing Education Perspectives (National League for Nursing), 29 (4), 217–219. Know the normal physiological function of the autonomic nervous system. These relationships were reviewed and updated in conjunction with all meetings and/or conference calls of the writing committee during the document development process. Skill to integrate clinical information and test results to assess risk, establish diagnosis, formulate treatment, and manage follow-up for patients with cardiovascular disease. Know the risks and benefits of exercise in adults with simple congenital heart disease. Know the definition, characteristics, prognosis, diagnostic recommendations, and evidence-based treatment options for management of hypertension. Know the causes, pathophysiology, and natural history of aortic, carotid, renal, mesenteric, and extremity peripheral artery diseases. Rather, it is intended to delineate those competencies relevant to services that cardiovascular NPs and PAs provide to patients within the care delivery system of a cardiovascular practice. %���� Given the document design, the competencies that define an individual’s practice may overlap with multiple topic areas even for highly specialized practitioners. Know the risks, benefits, and importance of timing of an invasive versus noninvasive strategy for the management of patients with NSTE-ACS. Know the pathophysiology of acute heart failure in peripartum and postpartum women. stream "A comparison of conventional and expanded physician assistant hospitalist staffing models at a community hospital" Skill to risk stratify patients for potential bleeding risk on anticoagulation. Know the causes, symptoms, and indications for diagnostic testing and referral for inherited and acquired forms of vasculitis. Know the indications, contraindications, and monitoring implications of medications used in adults with complex congenital heart disease. Know the complications of vascular access. Know the indications for and characteristic findings of imaging studies used to evaluate patients with pericardial diseases. The general cardiovascular competencies for NPs and PAs provide a foundation for practice, given individual learning needs, practice setting, and baseline knowledge. Skills to identify and initiate management for hemodynamic instability/compromise in patients with acute coronary syndromes. Know the risks and benefits of exercise in adults with complex congenital heart disease, including those with associated pulmonary hypertension. Ambulatory and Consultative Care Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2494, Table 7. Identify one AACN BSN Essential that will be most important in improving quality in your future nursing practice. Skill to utilize diagnostic testing for initial diagnosis and follow-up care of patients with cardiovascular disease. Core competencies of nurse educators: inspiring excellence in nurse educator practice. Brush J.E., Handberg E.M., Biga C., et al. Know the potential for neurocognitive and psychological issues in adults with congenital heart disease. Skills to recognize and manage central line infection. Skill to perform basic and advanced cardiac life support. Skill to manage hemodynamically unstable patients. In addition, 56 content reviewers participated in peer review representing cardiologists, NPs, and PAs with expertise in the clinical topics addressed in this document as well as diversity across stage in career, practice setting, and geographic location, resulting in over 1,000 peer review comments. Know the mechanisms and clinical implications of essential, secondary, masked, white-coat, and resistant hypertension. 2014;11(1):5-15.PubMed Google Scholar Crossref. Know the indications and recommendations for initial testing for known or suspected simple congenital heart disease in adults. "A comparison of conventional and expanded physician assistant hospitalist staffing models at a community hospital", "PAs can bring cost-effective care to complex patients", "Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies", ACC disclosure policy for document development, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043418/, https://www.aanp.org/practice/practice-information-by-state, https://www.aapa.org/news-central/2018/04/pas-can-bring-cost-effective-care-complex-patients/, https://www.nihcr.org/analysis/improving-care-delivery/prevention-improving-health/pcp-workforce-nps/, http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with-industry-policy, http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/clinical-document-approval, https://www.elsevier.com/about/our-business/policies/copyright/permissions. Know the history and physical examination findings and their limitations in the evaluation of patients with heart failure. Skills to assess and manage patients in refractory heart failure requiring intravenous inotropic support. Committee members represented a diversity of geographic location; urban, suburban, and rural practice settings; academic and community-based practice settings; institution size; gender; ethnicity; and stage in career (early, mid, and later), as well as those who exemplified practice acumen and team model care expertise. For copies of this document, please contact Elsevier Inc. Skill to provide age appropriate, culturally-sensitive education regarding lifestyle modification to patients with cardiovascular disease and their family members. October 20, 2020. Skill to utilize vasoactive and inotropic medications in the treatment of hypotension, heart failure, and shock. Refer patients who are facing advanced and end-stage cardiovascular disease to appropriate specialists. Skills to evaluate and manage patients with venous thromboembolism. All tables distinguish competencies generally expected of all cardiovascular NPs and PAs (left column) from those generally expected of selected cardiovascular NPs and PAs based on background, specialized knowledge, skills, experience, and practice focus (right column). Know the effects of diabetes mellitus, obesity, hypertension, lipid disorders, physical inactivity, obstructive sleep apnea, psychological stress, diet, and tobacco use on the development and progression of atherosclerosis and corresponding management strategies. The definitions are available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043418/. Know the indications to refer patients with peripheral artery disease; aortic, renal, and mesenteric artery disease; and carotid disease for medical, surgical, and endovascular therapies. Utilize clinical practice guidelines, appropriate use criteria, and point-of-care tools to improve clinical decision-making. Skills to obtain a cardiovascular family history and to recommend family screening as indicated. Available at: https://www.nihcr.org/analysis/improving-care-delivery/prevention-improving-health/pcp-workforce-nps/. Know the postprocedure complications of catheter ablation in patients with atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. Reprint Department via fax (212-633-3820) or e-mail (E-mail: [email protected]com. A modified Delphi method was used to engage NPs in achieving consensus for advance care planning competencies. Know the pharmacology, classes, indications, contraindications, risks, and interactions of medications commonly used for lipid management. Skill to interpret coronary angiography report findings for patients with acute coronary syndromes. Know the objective and subjective methods to assess volume status in patients with heart failure. Silver Spring, MD: Nursesbooks, 2015. Skills to identify, evaluate, and manage patients at high risk for sudden cardiac death. 2nd edition. A person is deemed to have a significant interest in a business if the interest represents ownership of ≥5% of the voting stock or share of the business entity, or ownership of ≥$5,000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person’s gross income for the previous year. Know the complications associated with contrast agents. Collaborate with healthcare professionals in other disciplines to optimize the care of patients with complex and multisystem disease. Know the indications for, contraindications to, and pharmacology of vasoactive and inotropic medications used to treat patients with heart failure, hypotension, or shock. Integrates knowledge from the humanities and sciences within the context of nursing science. Skill to participate in hemodynamic catheterizations in patients with heart failure. Skills to initiate management of patients with suspected acute aortic syndromes and coordinate care to ensure medical stability. Skills to order and assess diagnostic and/or laboratory studies for patients entering cardiac rehabilitation. Skill to recommend lifestyle interventions for patients with stable coronary artery disease. Copies: This document is available on the World Wide Web sites of the American College of Cardiology ( www.acc.org), American Academy of Physician Assistants ( www.aapa.org), American Association of Heart Failure Nurses ( www.aahfn.org), American Association of Nurse Practitioners ( www.aanp.org), American Heart Association ( www.heart.org), Association of Physician Assistants in Cardiology ( www.cardiologypa.org), Heart Rhythm Society ( www.hrsonline.org), Physician Assistant Education Association ( www.paeaonline.org), Preventive Cardiovascular Nurses Association ( www.pcna.net), Society for Cardiovascular Angiography and Interventions ( www.scai.org), and The National Organization of Nurse Practitioner Faculties ( www.nonpf.org). Also noted was the lack of formal postgraduate training programs for NPs and PAs such that most cardiovascular knowledge and skills are learned through practice experience from more experienced and tenured clinicians on the team. Skill to participate in intubation and extubation of patients from mechanical ventilatory support. Skill to participate in the insertion of permanent pacemakers, internal cardiac defibrillators, or cardiac resynchronization devices. Skill to recognize patients with common inflammatory disorders or systemic diseases that may adversely impact cardiovascular disease risk. Know the indications, risks and benefits, and optimal timing for pharmacological and electrical cardioversion. Therefore, the left column reflects the competencies expected of most NPs and PAs practicing within adult cardiovascular medicine. Participate in clinical conferences and team-based meetings to enhance communication and care of patients with cardiovascular disease. Advocate for quality patient care and assist patients and families in dealing with system complexities and limited resources. Know basic lipoprotein biochemistry and metabolism. RN Continuing Competency Program Forms 2020 2 REGISTRATION NUMBER: Part A: Self-Assessment Instructions Completing a self-assessment each year helps you review the practice expectations for RNs and monitor your progress from one year to the next. Anyone who is practising as a nurse in new Zealand must have an Annual Practising certificate (APC) To renew your APC please log on to the MyNC portal. 7. Former Competency Management Committee member; member during this writing effort. Identify barriers to learning and prioritize education for patients with cardiovascular disease. Know the indications for genetic screening of premature atherosclerotic disease. Know the differential diagnoses of chest pain, palpitations, fatigue, lightheadedness, syncope, dyspnea, and peripheral edema. Know the indications, contraindications, and management strategies for mechanical circulatory support in patients with heart failure. Use information technology to support patient care decisions and patient education. Utilize the concepts of motivational interviewing when counseling patients. Know the indications and management of hypothermia in cardiac arrest survivors. Know revascularization strategies for patients with acute coronary syndromes. . 20/11/2020 A reminder to renew your APC if it's due to expire soon. Skill to provide perioperative care to patients receiving cardiac implantable electronic devices. Know the common cardiovascular complications of noncardiac surgery. Know the impact of pregnancy in women with simple congenital heart disease. Know the comorbidities associated with lipid disorders. Know the anatomy, pathophysiology, and presenting symptoms of adults with complex congenital heart disease. Skills to recognize and participate in the management of adults with neurocognitive disorders and congenital heart disease. Skills to recognize and medically manage specific supraventricular arrhythmias (e.g., atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia). Practice-Based Learning and Improvement that involve investigation and evaluation of their own patient care, self-appraisal, assimilation of scientific evidence, and improvements in patient care. Know the differentiating features of arterial, venous, and neurotrophic leg ulcers. Skill to manage vascular access sites and complications. Know the psychosocial factors that contribute to cardiovascular disease and principles of management. When practicing at the full scope of education, training, and licensure, NPs and PAs improve access to care and provide comprehensive clinical care, including diagnosis, management, test ordering and interpretation, procedure participation, patient education, and care coordination. Know general concepts and modes of mechanical ventilation (e.g., tidal volume, fraction of inspired oxygen, positive end-expiratory pressure). Entry-to-Practice. Iglehart J.K. Practice Resources. Know the typical and atypical presentations of angina, including disorders that can simulate or mask acute coronary syndromes. All ACC competence and training statements, therefore, include examples of tools that can be used to assess achievement of the individual components of competency (see Section 1.2.2.). Know the transitional and outpatient strategies to avoid preventable hospitalizations in patients recently discharged with heart failure. Know the pharmacological and lifestyle interventions for the treatment of lipid disorders for primary and secondary prevention. Know the nonpharmacological interventions for the treatment of elevated blood pressure and hypertension. Know the differences in etiology, evaluation, and management of primary versus secondary mitral regurgitation. Skill to monitor for side effects, intolerance, or nonadherence to cardiovascular treatment. Know the pharmacology, classes, indications, contraindications, risks, and interactions of medications commonly used for hypertension management. Skill to recognize symptoms and ECG changes suggestive of ischemic heart disease and variant angina. Skill to recognize ST-segment changes on continuous ECG monitoring suggestive of acute coronary syndromes. Know the indications for right and left heart catheterization in patients with heart failure. GUIDELINES ON ADVANCED PRACTICE NURSING 2020 6 7 Practitioners … Skill to care for patients with direct arterial catheters, central venous catheters, and/or hemodynamic monitoring systems.