Health Care Education and Nursing In Advance Level In advanced nursing education, domains, competencies, and sub-competencies guide the development of nurses at both entry-level and advanced-level practice. These frameworks ensure that nurses are prepared to meet the complex demands of healthcare. Additionally, understanding social determinants of health and evidence-based practice is integral to nursing education and practice.
Domains, Competencies, and Sub-Competencies for Nursing Education
Domain 1: Knowledge for Nursing Practice
Descriptor: This domain involves the integration, translation, and application of both established and evolving nursing knowledge, including insights from other disciplines. It forms the foundation for clinical judgment and innovation in nursing practice. Nurses must have a strong liberal arts and sciences background to function as independent and competent practitioners.
Contextual Statement: This domain reflects nursing as a scientific discipline that incorporates multiple perspectives, guided by nursing history, knowledge, and science. Nurses use this knowledge to understand themselves, others, and the healthcare environment, thereby enabling safe, quality care and the development of clinical judgment.
Domain 2: Person-Centered Care
Descriptor: Person-centered care focuses on the individual within their complex social and personal context. Care is holistic, individualized, compassionate, and evidence-based, designed to meet the unique needs of the person while respecting diversity, equity, and inclusion.
Contextual Statement: At the core of nursing practice, person-centered care requires respect for individual preferences, values, and needs. Nurses form meaningful partnerships with patients and their families, ensuring that care is aligned with their lived experiences. Nurses use clinical judgment and evidence-based practice to diagnose and plan care across various settings and developmental stages.
Domain 3: Population Health
Descriptor: Population health spans the continuum of care, from public health initiatives to disease management. It involves collaboration with various stakeholders, including public health organizations, communities, healthcare institutions, and governments, to improve equitable health outcomes for populations.
Contextual Statement: Nurses play a key role in advocating for policies and interventions that promote health equity at local, national, and global levels. They are involved in emergency preparedness, responding to public health crises, and working to reduce disparities by addressing the social determinants of health.
Domain 4: Scholarship for the Nursing Discipline
Descriptor: Scholarship in nursing includes the generation, synthesis, translation, application, and dissemination of nursing knowledge. This process improves healthcare outcomes and informs best practices in nursing education and clinical practice.
Contextual Statement: Nursing scholarship includes research, evidence-based practice, and the integration of scientific findings into nursing care. Nurses must understand the research process, critically appraise studies, and apply evidence to clinical decision-making. Ethical considerations and advocacy for patients are integral to nursing scholarship.
Domain 5: Quality and Safety
Descriptor: This domain focuses on the application of principles of safety and improvement science to enhance healthcare quality while minimizing risk. Nurses must integrate systematic approaches to ensure both individual and system-wide safety.
Contextual Statement: Nurses promote a culture of safety and quality by identifying risks, reporting adverse events, and advocating for non-punitive environments that encourage the prevention and mitigation of errors. Safety science includes awareness of workplace hazards, from burnout to biological risks, with a focus on maintaining a just and supportive environment for both patients and providers.
Domain 6: Interprofessional Partnerships
Descriptor: Interprofessional collaboration is critical for delivering comprehensive, patient-centered care. Nurses work intentionally across professions to optimize healthcare delivery, improve outcomes, and enhance the healthcare experience.
Contextual Statement: Team-based care requires understanding the dynamics of healthcare teams and leveraging the strengths of diverse professionals to improve patient outcomes. Nurses contribute their unique knowledge and perspectives to interprofessional teams, ensuring care is coordinated and aligned with patient and family preferences.
Domain 7: Systems-Based Practice
Descriptor: Systems-based practice involves responding to and leading within complex healthcare systems. Nurses effectively coordinate resources to provide safe, quality, and equitable care to diverse populations.
Contextual Statement: Nurses lead efforts to improve healthcare delivery through systems thinking, which includes understanding how different healthcare environments function and interact. They must consider the financial, regulatory, and structural aspects of healthcare systems and work to address systemic issues such as structural racism and inequities that impact patient care.
Domain 8: Informatics and Healthcare Technologies
Descriptor: Nurses use informatics and healthcare technologies to manage data, improve decision-making, and enhance the delivery of care. These technologies enable the collection and analysis of health information to support clinical practice.
Contextual Statement: Informatics processes transform how healthcare teams interact with patients and systems. Nurses must be proficient in using technologies that support communication, improve care quality, and drive clinical decision-making. They also have a responsibility to advocate for equitable access to health information technologies, especially for vulnerable populations.
Domain 9: Professionalism
Descriptor: Professionalism in nursing involves the cultivation of a professional identity that reflects nursing’s values and characteristics. This includes accountability, ethical behavior, and a commitment to ongoing personal and professional development.
Contextual Statement: Professionalism is fostered through continuous reflection and engagement in the nursing profession. Nurses uphold the values of integrity, altruism, and social justice, taking responsibility for mentoring others and giving back to the profession. Professional identity evolves over time, shaped by a nurse’s experiences and contributions to the field.
Domain 10: Personal, Professional, and Leadership Development
Descriptor: Nurses engage in lifelong learning and self-reflection to promote personal health, well-being, and resilience. They also develop leadership skills that empower them to advocate for patients, the profession, and the healthcare system.
Contextual Statement: Leadership in nursing requires self-awareness and a commitment to ongoing growth. Nurses must be adaptable, resilient, and capable of leading in diverse contexts, from patient care to healthcare policy. They play a critical role in promoting diversity and retention in the profession, while also managing the stresses and challenges of the healthcare environment.
What Is Evidence-Based Practice in Health Education?
Evidence-based practice (EBP) is a problem-solving approach that combines the best available evidence from research, patient care data, clinical expertise, and patient preferences. It ensures that healthcare decisions are informed by scientific evidence while being tailored to the unique needs of individuals and families (Melnyk et al., 2010).
EBP emphasizes not only the use of data but also the consideration of whose perspectives are represented, how the evidence is created, and what questions remain unanswered. It is crucial to assess potential harms that may arise from healthcare interventions and to incorporate cultural safety into the practice of EBP (Nursing Mutual Aid, 2020).
Health Policy in Health Education
Health policy involves making decisions that direct healthcare systems toward achieving improved health outcomes. Nurses have a significant role in advocating for policies that affect healthcare delivery, patient outcomes, and the nursing profession. Engaging in health policy can include interpreting, evaluating, and leading policy change to improve healthcare at local, national, and global levels (Keller & Ridenour, 2021).
Nurses influence health policy through:
- Advocacy for patient-centered care
- Engagement in legislative processes
- Participation in policy evaluation and implementation
Social Determinants of Health
Social determinants of health (SDOH) refer to the conditions in which people are born, live, work, play, and age that affect their health, well-being, and quality of life. These factors contribute to health disparities and inequities in areas such as economic stability, access to education, healthcare, and social support (Healthy People 2030).
Nursing practice addresses SDOH through:
- Assessment of patient needs in the context of their social environment
- Health promotion and education to address disparities
- Advocating for policy changes that improve health equity
- Incorporating SDOH into care planning and patient teaching
SDOH are closely linked to diversity, equity, and inclusion, and addressing them is essential for achieving health equity and improving health outcomes.
Conclusion
Advanced-level nursing education encompasses a comprehensive framework of domains, competencies, and sub-competencies designed to prepare nurses for complex healthcare roles. Nurses use evidence-based practice to integrate the best available research with clinical expertise and patient values, while advocating for policies that promote health equity. Understanding the social determinants of health allows nurses to address disparities and improve healthcare outcomes, further demonstrating the importance of a holistic, patient-centered approach to nursing practice.