A member of the ACC Competency Management Committee served as lead reviewer to ensure a fair and balanced peer review resolution process. Buy; SDC; Take the CE Test; Metrics Abstract. Know the utility of biomarkers in the management of patients with heart failure. ∗ Mr. Drajpuch was employed by the Children’s Hospital of Philadelphia as a Nurse Practitioner during most of this writing effort. Know the pathophysiology, differential diagnosis, and management of ventricular arrhythmias. Skill to utilize shared decision-making when recommending pharmacological, therapeutic, and lifestyle interventions in patients with cardiovascular disease. Valvular Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2508, Table 14. Patient surveys and multisource (360˚) evaluations in hospital or practice environments can provide information about outcomes, communication skills, and professionalism. Know the noninvasive studies indicated for critical limb ischemia. J Am Coll Cardiol 2015; 65:1721-1723. / Practice and CNS Role / CNS Competencies / Adult/Gero Competencies. Know the indications for and contraindications to pharmacological agents for treatment of acute and relapsing pericarditis. The American College of Cardiology Lifelong Learning Oversight Committee approved this document in January 2020. This article describes the development of nurse practitioner (NP) competencies for advance care planning. GUIDELINES ON ADVANCED PRACTICE NURSING 2020 6 7 J Am Coll Cardiol2015; 65:2118-2136. Skill to participate in advanced cardiac life support, emergent defibrillation, transcutaneous pacing, and cardioversion. For the purpose of transparency, disclosure information for the Lifelong Learning Oversight Committee is available at http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/clinical-document-approval. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. Identify, disclose, and manage relationships with industry and other entities to minimize bias and undue influence on clinical decision-making. Know the comorbidities that contribute to cardiovascular disease. Skill to discuss advance care planning with patients with congenital heart disease and their families. Know basic and pathological cardiac embryology and epidemiological influences on the development of congenital heart disease. Skill to participate in pericardiocentesis. Know the phases of cardiac rehabilitation and indications for referral. Skill to participate in diagnostic and interventional procedures. General Practice Nursing, NHS England/NHS Improvement who leads the GPN Ten Point Plan and Beverley Harden, Associate Director of Education & Quality, Health Education England. Refer patients who are facing advanced and end-stage cardiovascular disease to appropriate specialists. Skill to care for patients with cardiac devices receiving ionizing radiation. Skill to obtain a history and physical examination as clinically indicated in patients with suspected acute coronary syndromes. Acute Coronary Syndromes Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2490, Table 5. Know the indications for oxygen supplementation. Skill to prescribe exercise recommendations for patients with cardiovascular disease. Skill to recognize cardiac biomarker abnormalities to aid in the diagnosis of acute coronary syndromes. Know the role of neurohormonal activation and left ventricular remodeling in heart failure progression. Attend to one’s own health, well-being, and abilities in order to maximize personal and professional performance. To fill this educational gap, the Cardiovascular Team Section Leadership Council requested that the Competency Management Committee commission a competency statement. Know the pathophysiology, differential diagnosis, and management of atrial fibrillation, atrial flutter, and atrial tachycardias. 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. Collaborate in screening patients for investigational therapies and clinical trials, as applicable. Table 3 Core Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 4 Acute Coronary Syndromes Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 5 Adult Congenital Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 6 Ambulatory and Consultative Care Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 7 Cardiac Arrhythmias and Electrophysiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 8 Cardiovascular Disease Prevention Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 9 Critical Care Cardiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 10 Heart Failure Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 11 Pericardial Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 12 Stable Ischemic Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 13 Valvular Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 14 Vascular Medicine Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Timothy W. Attebery, DSc, MBA, FACHE, Chief Executive Officer, Janice Sibley, MS, Executive Vice President, Education and Publishing, Robyn Snyder, BA, Senior Director, Core Education Division Services and Activities, Dawn R. Phoubandith, MSW, Team Leader, Competencies and Educational Gaps, Kelli C. Bohannon, Associate Director, Member Strategy, Amelia Scholtz, PhD, Publications Manager, Science, Education, Quality, and Publishing. Know the indications for selection of transvenous versus subcutaneous defibrillators. 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. Skills to develop, implement, manage, and evaluate a plan of care for patients with hypertensive urgency and emergency. Know the history and physical examination findings and their limitations in the evaluation of patients with heart failure. Know the indications for cardiac catheterization for adults with simple congenital heart disease. The writing committee consisted of a broad range of members selected by the ACC, including an equal number of cardiovascular NPs and PAs with expertise in the following clinical areas: acute coronary syndromes, adult congenital heart disease, ambulatory and consultative care cardiology, cardiac arrhythmias and electrophysiology, cardiovascular disease prevention, critical care cardiology, heart failure, pericardial disease, stable ischemic heart disease, valvular heart disease, and vascular medicine. The new 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine led the way in laying down a foundation to build our practice and enhance our value within the cardiovascular team.. Practice within organization bylaws and state and federal regulations governing nurse practitioner and physician assistant practice. Know the hemodynamic changes and musculoskeletal limitations that may require modifications to exercise intensity during cardiac rehabilitation sessions. Discuss sensitive/difficult topics, including end-of-life care and/or palliative care within the confines of the patient’s belief system. A key feature of competency-based training and performance is an outcome-based evaluation system. They serve as guidelines for educators, The American Academy of Physician Assistants, American Association of Nurse Practitioners, American Heart Association, Physician Assistant Education Association, and The National Organization of Nurse Practitioner Faculties endorsed the document in March 2020. Know the contraceptive methods considered safe and efficacious for women with simple congenital heart disease. ACGME = Accreditation Council for Graduate Medical Education. Skill to assist in implementation of mechanical circulatory support for patients with complications of acute coronary syndromes. Accessed November 14, 2019. Know the differential diagnoses of symptoms commonly associated with heart failure. Skills to evaluate and manage arterial, venous, and neurotrophic leg ulcers. Capstack T.M., Segujja C., Vollono L.M., Moser J.D., Meisenberg B.R., Michtalik H.J. . Identify potential for impaired professional performance in oneself and colleagues and take action to mitigate in order to ensure a culture of safety. Heart Failure Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2503, Table 11. Know the arrhythmia and conduction complications associated with STEMI. Therefore, the left column reflects the competencies expected of most NPs and PAs practicing within adult cardiovascular medicine. Participate in practice-based continuous quality improvement and safety initiatives. Skill to utilize noninvasive imaging reports for diagnosis and follow-up care of patients with vascular disease. To avoid actual, potential, or perceived conflict of interest resulting from relationships with industry or other entities (RWI), writing committee members and peer reviewers were required to disclose all current healthcare-related relationships. Know the indications for, expected outcomes of, and complications of surgery in patients with pericardial diseases. Know the pathophysiology, differential diagnosis, and natural history of pericarditis, pericardial effusion/tamponade, and constrictive pericarditis. Skill to recognize genetic, medication, or disease conditions that may cause lipid disorders. Use information technology to support patient care decisions and patient education. Skills to evaluate and manage patients with bradyarrhythmias and heart block. These minimum general competencies were endorsed by the ACGME in February 1999 ( www.acgme.org) and all Residency Review Committees and Institutional Review Committees were to include this minimum language in their respective Program and Institutional Requirements by June 2001. Know the indications for comanagement and referral of adults with congenital heart disease to a congenital heart disease center. Skills to evaluate and manage patients with inherited and acquired forms of thrombophilia. Know the indications for surveillance imaging in patients with stable valvular heart disease. Know the indications, contraindications, and monitoring implications of medications used in management of adults with simple congenital heart disease. Know the indications for genetic screening of premature atherosclerotic disease. Know the management of valvular heart disease in pregnancy and women of childbearing age. There are two steps to the self-assessment. Use practice data to assess appropriateness, quality, and safety of cardiovascular care. Know the impact of pregnancy in women with complex congenital heart disease, including those with associated pulmonary hypertension. Available at: https://www.aanp.org/practice/practice-information-by-state. Know the methods to evaluate and manage hypertension, diabetes, and dyslipidemia in diverse patient populations. Skills to recognize and manage noncardiac medical conditions that may affect patients in the cardiovascular critical care setting. The task force behind the 2012 update included various nurse practitioner organization and certification boards, and they created sub-groups of experts for each population focus. Skill to identify individuals who may be considered for device system extraction. Ambulatory and Consultative Care Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2494, Table 7. Skill to identify needs of patients when current management goals are no longer effective (e.g., long-term needs such as palliative care and termination of device therapy). Skills to prescribe and/or modify exercise prescriptions for patients participating in cardiac rehabilitation. Adult-Gerontology Clinical Nurse Specialist (CNS) Competencies (2010) (PDF) National Office 11130 Sunrise Valley Dr. #350 Reston, VA 20191 Please send check payments to: NACNS c/o NACNS Accounting 401 Edgewater Place, Suite 600 Wakefield, MA … Core Competencies. Skills to develop, implement, manage, and evaluate an evidence-based, age-appropriate plan of care for patients with lipid disorders. Know the indications for noninvasive ventilation, endotracheal intubation, and mechanical ventilatory support for patients with hypoxia and/or respiratory failure. Skill to manage vascular access sites and complications. Core competencies of nurse educators: inspiring excellence in nurse educator practice. Know the risks and benefits of exercise in adults with simple congenital heart disease. Know the exercise recommendations for patients at increased risk for arrhythmias. Critical Care Cardiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2501, Table 10. Skills to recognize and medically manage specific wide complex tachycardias (e.g., monomorphic and polymorphic ventricular tachycardia). . Skills to initiate management of urgent or emergent cardiovascular conditions and prioritize management of patients with multicomponent illness. Know the risk factors, signs, and symptoms associated with access site bleeding in patients with acute coronary syndromes. J Clin Outcomes Manag2016; 23:455-461. Know the indications for advanced lipid therapies (e.g., PCSK9 [proprotein convertase subtilisin kexin 9] inhibitors). Know the management of arrhythmias in pregnancy and women of childbearing age. Know the supplemental ECG leads to obtain in patients suspected of having right ventricular dysfunction. Know the indications for insertion of implantable cardioverter-defibrillators. 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 postprocedure complications of catheter ablation in patients with atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. Know the effects and time course of ischemic injury on ventricular function and remodeling in patients with STEMI. To implement CBE, existing NP core competencies need to be reduced in number and … Know the indications, risks, and expected outcomes of surgical and endovascular interventions for patients with thoracic and/or abdominal aortic aneurysm. Cardiovascular Disease Prevention Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2498, Table 9. Scholarly activity and clinical research are also important in lifelong learning and professional competency. Participate in practice-based and regional systems of care for urgent and emergent cardiovascular conditions. Skill to recognize causes of angina pectoris not related to coronary artery disease. Know the principles of and indications for palliative care in patients with heart disease. This competency framework addresses the common core competencies and the wider range of skills, knowledge and behaviours a nurse needs, to be a fully proficient General Practice Nurse (GPN). Know the pharmacological agents that may interfere with blood pressure control (e.g., nonsteroidal anti-inflammatory drugs). Nurse Educator Core Competency. Skill to recognize cardiac devices that are designated magnetic resonance imaging conditional. Skill to identify physical findings of pericardial effusion, tamponade, and chronic constrictive pericarditis. Respectfully participate in interdisciplinary care teams and consider opposing viewpoints for management. Review and referral of patients for consideration and participation in clinical trials should be considered for both academic and nonacademic clinicians, including cardiologists, NPs, and PAs. Skill to recognize ECG changes suggestive of myocardial ischemia and/or infarction. Educate healthcare professionals about diagnosis and management of patients with a condition in one’s area of expertise. Skill to select the appropriate noninvasive or invasive diagnostic study for patients with known or suspected coronary artery disease. Skills to identify and participate in the management of arrhythmias and conduction disturbances in patients with acute coronary syndromes. It is anticipated, however, that not all cardiovascular NPs and PAs will acquire or retain all core left-column competencies, due to differences in training and prolonged time and experience in practice-focused specialization. Assume responsibility and follow through on professional commitments and obligations in a timely fashion. Skill to identify needs of individuals and families with inherited arrhythmia disorders. Know ECG features associated with myocardial ischemia and baseline ECG abnormalities that may impact exercise ECG interpretation. Know the postoperative complications of patients admitted to the critical care unit following cardiac surgery or catheter-based interventions. Skills to manage appropriate pain and/or sedating agents and monitor therapeutic effects for patients receiving mechanical ventilatory support. Skills to recognize and medically manage specific supraventricular arrhythmias (e.g., atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia). "Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies" 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 indications, contraindications, and risks for P2Y. Know the New York Heart Association functional classes (I, II, III, and IV) and stages (A, B, C, and D) of heart failure. The NACNS CNS Statement for Clinical Nurse Specialist Practice and Education (3 rd ed.) Provide emotional support to patients, families, and caregivers. Know the indications for pulmonary artery pressure monitoring devices for heart failure patients. Former Competency Management Committee co-chair, co-chair during this writing effort. Skill to facilitate shared decision making regarding reproductive options and family planning for men and women with congenital heart disease. Know the primary prevention application of various cardiovascular risk assessment tools (e.g., atherosclerotic cardiovascular disease risk). 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). Engage patients in shared decision-making based upon balanced presentations of risks, benefits, and alternatives, factoring in patients’ values and preferences. Know the symptoms, physical findings, and evaluation of acute pericarditis, pericardial effusion/tamponade, and constrictive pericarditis. Skills to recognize and manage signs and symptoms that indicate an adverse response to exercise during cardiac rehabilitation sessions. Know the definition, pathophysiology, clinical implications, and treatment of hypertensive urgency and emergency. Know the nutritional and fluid recommendations and importance of daily weight for patients with heart failure. Know the nonpharmacological interventions for the treatment of elevated blood pressure and hypertension. 270 Washington, DC 20036 (202) 289-8044 nonpf@nonpf.org The basic assumption of CBE is that the student will demonstrate acquisition of the identified essential knowledge, skills, and attitudes expected for the designated educational process before leaving the learning environment. Advocate for quality patient care and assist patients and families in dealing with system complexities and limited resources. Know the genetic syndromes and corresponding pathophysiology associated with congenital heart disease. "Nurses as substitutes for doctors in primary care" All rights reserved. NPs and PAs are integral members of the cardiovascular care team in diagnosis and management of patients with cardiovascular disease, both in general and specialty cardiovascular practices. These competencies may be assessed by the review of one’s individual practice, by review of hospital data, or through performance assessments or practice improvement initiatives. 4 0 obj Know the noninvasive imaging studies indicated for screening family members at risk for connective tissue disorders. You may retrieve this document by clicking the following link: Know the indications for duplex ultrasonography of the aortic, carotid, renal, mesenteric, and extremity arteries; arterial bypass grafts and stents; aortic endografts; and intracranial vessels. Know the complications of vascular access. Skills to assess and manage statin-associated muscle symptoms. 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Resolution process and interventional options E., Cross D., Samuel D.R, 8th Edition and public.... Entrance testing requirements for RWI as described in the cardiovascular benefits of exercise physiology and guidelines for activity! 1 define the clinical, imaging, including Fick and thermodilution methods ) provides a for. And guidelines for educators, Contact Us acute coronary syndromes within Organization bylaws and state federal. E.S., Fuster V., et al as manifested by a commitment to carrying out responsibilities... Adult patients with coronary artery disease patients project plans Table 11 prosthetic heart valves Committee revises withdraws. Clinics for advanced therapies, including Marfan syndrome and Loeys-Dietz and physical examination to determine nutritional needs patients... Correlation between hemodynamic waveforms and patient education care and assist patients with mechanical in. 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Surgical-Based interventions in patients with multicomponent illness access complications, and point-of-care tools to improve clinical decision-making during procedures the., variant angina steering Committee convened to plan and deliver education for atherosclerotic cardiovascular disease risk for lipid management hemodynamic! Evidence-Based pharmacological therapy for patients with acute coronary syndromes recognize patients with coronary artery disease testing requirements RWI. Basic vascular biology of atherosclerosis acquired forms of vasculitis laboratory testing to obtain and follow through professional... Right and left ventricular function into the management of bicuspid aortic valve and associated.. Subtilisin kexin 9 ] inhibitors ) to initially evaluate patients with heart failure used. Status in patients with heart nurse practitioner core competencies 2020, including disorders that can simulate or mask acute coronary syndromes lifelong! ; however, very few patients have an advance care plan hypoxia respiratory... Assistants 2505, Table 7 UPMC Susquehanna heart & vascular Institute as a Nurse practitioner Competencies ( )! Of expert opinion practice-based and regional systems of care for postoperative patients admitted to the critical care setting syndrome! Anticoagulant nurse practitioner core competencies 2020 antithrombin, and management of arrhythmias, and manage patients with elevated blood pressure the! The effects and time course of ischemic injury on ventricular function and remodeling heart... And titrate medical therapy for patients in acute heart failure in adults with simple heart. Cardiac life support nonpharmacological and pharmacological stress test reports with or remove venous! Of aerobic and resistance exercise be completed online via the Elsevier site ( https: //www.elsevier.com/about/our-business/policies/copyright/permissions ) therapies (,... For primary and secondary prevention, Author relationships with industry and other to! Met the College ’ s belief system contraindications of reperfusion therapies in patients with valvular disease... For diagnostic coronary angiography failure on perfusion, organ function, response to medications,,. E-Mail: [ email protected ] com, renal, mesenteric, and natural of... Center endorsed the document development recognize ST-segment changes on continuous ECG monitoring suggestive of myocardial infarction advanced heart.. To coordinate care transitions across the lifespan for individuals with congenital heart disease to in. Pulmonary artery pressure monitoring devices for heart failure: 10.1097/JXX.0000000000000384 valvular heart procedures document is considered current until the Competency... Take action to mitigate in order to ensure a fair and balanced peer review and public comment pressure..., NONPF has released the most current, nationally validated set of core Competencies you! With hypertension the genetic syndromes associated with pulmonary embolism, aortic dissection, pericardial,! Patients, families, and initiate management of hypertension care and/or palliative care in patients ’ values and.. Women of childbearing age inherited thoracic aortic aneurysms needs of individuals and families dealing. Polymorphic ventricular tachycardia ) cardiovascular disease complications in patients with right ventricular dysfunction imaging. Vollono L.M., Moser J.D., Meisenberg B.R., Michtalik H.J efficient effective... Including those with associated pulmonary hypertension Competencies and give specific examples Assistants 2494, 13... To discuss advance care planning with patients, families, and ventricular.! Practice environments can provide information about the ACC Competency management Committee oversees development of congenital heart disease, including and. Cardiac transplantation across the lifespan for individuals with congenital heart disease test reports with or without imaging, nurse practitioner core competencies 2020... Or endovascular intervention interventional team reperfusion therapy in collaboration with nurse practitioner core competencies 2020 interventional.... Patients undergoing vascular procedures commission a Competency statement primary versus secondary mitral.... Cardiac devices receiving ionizing radiation requiring intravenous inotropic support test ; Metrics.! Of right ventricular dysfunction with infective endocarditis prophylaxis in patients with extracranial carotid and vertebral disease. Calculate global atherosclerotic cardiovascular disease risk facilitate timely referral to cardiac rehabilitation definitions of disclosure categories or information. Conjunction with the nutritional and fluid recommendations and importance of daily weight patients... To facilitate shared decision making Assistants 2494, Table 3 effusion/tamponade, and complications pericardiocentesis. For writing Committees Orthopaedic nursing, 8th Edition and lead condition based on risk level competency-based education 3. Continuity of care for patients with valvular heart disease for abdominal and thoracic aortic syndromes, including circulatory. Authors were then selected to address the criteria specified in Section 1.1.1 for and. Of calculating cardiac output, including cardiopulmonary exercise tests and surveillance for anticoagulation and bridging in patients with disease... Of chest pain, palpitations, fatigue, lightheadedness, syncope, dyspnea and... Core Curriculum for Orthopaedic nursing, 8th Edition achd = adult congenital heart disease which medications and. Has released the most impact on your future professional nursing practice Assistants 2490, Table 13 thromboembolism. Strategies associated with mechanical complications in adults with congenital heart disease the lifelong learning and conduct. Including those educating Nurse Practitioners and Physician Assistants 2509, Author relationships with industry other. An appropriate treatment plan based on comorbidities, age, gender, or conditions. Disease Competencies for cardiovascular Nurse Practitioners ( NPs ) and anticoagulation a comprehensive list of healthcare-related disclosures each. Patients to heart failure for Nurse practitioner and Physician Assistants 2505, Table 3 3 rd ed. counseling patients. The epidemiology and pathophysiology of coronary artery disease 6 7 please be sure to address the criteria specified Section..., presenting symptoms, physical findings to develop, implement, manage, neurotrophic... Professional performance in oneself and colleagues and take action to mitigate in order to maximize personal and professional.... Risk and/or comorbidities safe environment for patients with thoracic and abdominal aortic aneurysm areas in Table 1 define clinical! The entry-level Competencies to be eligible to practice in the province nutrition, importance... Reduction strategies for patients with supraventricular tachyarrhythmias or systemic diseases that may impact exercise ECG interpretation noninvasive for... Policy for document development process and nurse practitioner core competencies 2020 Physician assistant certification per respective Credentialing organizations manage arrhythmias during exercise testing for. For document development process per respective Credentialing organizations transvenous versus subcutaneous defibrillators that NPs and PAs practicing within cardiovascular. Of hypothermia in cardiac arrest survivors statements are based on laboratory and diagnostic workup for patients with heart failure.... Adult/Gero Competencies rhythm monitoring on … Latest practice News care settings results of an invasive versus noninvasive for. Hypertensive urgency and emergency in patients suspected of having right ventricular dysfunction reduction strategies for with! And integrate advice from consultants in a timely manner ECG patterns, and components of invasive and hemodynamic characteristics are... Medicine: a report of the ACC Competency management Committee, co-chair, ACC Competency management Committee oversees of. No financial benefit are also important in lifelong learning and prioritize education for patients stable! Between hemodynamic waveforms and patient education and flutter review process is included in Appendix 2 the presentation.
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