Nursing Practices and Domain In Nursing Education In nursing education, domains represent broad, distinguishable areas of competence that collectively form a framework for nursing practice. These Essentials outline 10 domains that serve as the foundation for competency-based education in nursing. These domains have been adapted from the interprofessional work initiated by Englander (2013) and tailored specifically for the nursing discipline. Each domain includes a description of competencies and sub-competencies, providing clear expectations for nursing professionals at various levels of education and practice.
Although the domains are presented as separate entities, nursing practice often requires the integration of multiple domains in any given situation or patient encounter. Together, these domains support a comprehensive, competence-based framework that shapes the practice of nursing and distinguishes it from other health professions.
Domains for Nursing Education
Domain 1: Knowledge for Nursing Practice
This domain emphasizes the integration, translation, and application of nursing knowledge. It draws from established and evolving nursing knowledge, as well as insights from other disciplines, including liberal arts, natural sciences, and social sciences. This broad base of knowledge forms the foundation for clinical judgment and innovation in nursing practice. Competency in this domain ensures that nurses can make informed decisions and respond to changing healthcare demands with a deep understanding of their profession.
Domain 2: Person-Centered Care
Person-centered care focuses on the individual in a holistic manner, accounting for the person’s family, culture, and specific circumstances. This type of care is individualized, equitable, respectful, compassionate, and evidence-based. It builds on a scientific body of knowledge that guides nurses in providing care that is developmentally appropriate and tailored to the unique needs of each patient, regardless of specialty or functional area.
Domain 3: Population Health
This domain addresses healthcare at a broader level, focusing on the health of populations rather than individual patients. Population health encompasses a wide range of healthcare activities, from public health initiatives to disease management. It involves collaboration with traditional and non-traditional partnerships, including public health agencies, healthcare providers, industry, academia, local governments, and community organizations. The goal is to improve equitable health outcomes for entire populations.
Domain 4: Scholarship for the Nursing Discipline
Scholarship in nursing involves the generation, synthesis, translation, application, and dissemination of nursing knowledge. This domain emphasizes the nurse’s role in contributing to the advancement of the nursing discipline through research and scholarship. Nurses use this knowledge to improve healthcare outcomes and transform healthcare systems. Scholarship also includes the critical evaluation of evidence and the application of research findings in practice.
Domain 5: Quality and Safety
The quality and safety domain focuses on minimizing harm and improving healthcare outcomes through improvement science and safety principles. Nurses are expected to ensure that both systems and individual performance promote safe, high-quality care. Competency in this domain means that nurses understand and apply strategies to reduce risks to patients and healthcare providers, and work to continuously improve the effectiveness of healthcare delivery.
Domain 6: Interprofessional Partnerships
Interprofessional partnerships emphasize intentional collaboration among healthcare professionals and stakeholders, including patients, families, communities, and care team members. The goal is to optimize patient care by enhancing healthcare experiences and improving outcomes. Nurses in this domain work alongside professionals from other fields to ensure that patients receive comprehensive, well-coordinated care that draws on diverse perspectives and expertise.
Domain 7: Systems-Based Practice
Nurses are expected to respond to and lead within complex healthcare systems. This domain focuses on the nurse’s ability to navigate and coordinate resources within the healthcare system to provide safe, high-quality, and equitable care. Nurses use systems thinking to assess, evaluate, and improve the delivery of care within healthcare institutions, ensuring that diverse populations have access to the services they need.
Domain 8: Informatics and Healthcare Technologies
This domain covers the use of information and communication technologies in healthcare. Nurses use informatics to gather and analyze data, make informed decisions, and support clinical practice. Technologies such as electronic health records (EHRs), telemedicine, and decision-support systems are integral to enhancing care quality and improving patient outcomes. Nurses must also use informatics to stay current with best practices, professional standards, and regulatory requirements.
Domain 9: Professionalism
Professionalism in nursing is about developing and sustaining a professional identity, which includes being accountable, having a collaborative disposition, and adhering to ethical values that define nursing. Nurses are expected to display behaviors that reflect the core characteristics and values of the profession. Professionalism also involves nurses taking responsibility for their actions and decisions, consistently upholding standards of practice.
Domain 10: Personal, Professional, and Leadership Development
Nurses are encouraged to engage in self-reflection, lifelong learning, and activities that promote personal health, resilience, and well-being. This domain focuses on the development of leadership skills and the pursuit of nursing expertise. It emphasizes the importance of self-care and professional growth, allowing nurses to evolve both personally and professionally. Leadership development, in particular, is essential for nurses to assert leadership roles within their teams and the broader healthcare system.
These 10 domains provide a comprehensive framework for understanding the essential competencies that nurses need to be effective, ethical, and professional in their practice. They guide the design of nursing curricula, ensuring that nursing education programs adequately prepare graduates for the complexities of modern healthcare. As healthcare evolves, these domains may also adapt to reflect new challenges and innovations in the field of nursing.
By ensuring that nursing students and practicing nurses develop proficiency across these domains, the Essentials ensure a standardized level of competency that strengthens the nursing profession and enhances patient care.