2 discussions in nursing

 Initial Substantive Posts: Your initial post should be substantive (approximately 200-300 words in length for each discussion question). In your substantive post you are encouraged to use references (you may use your textbook); show evidence of critical thinking. the 2 questions will be uploaded as discussion 1. Please use reference i provided and you can add more refences no more than 3 refences each.

Initial Substantive Posts: Your initial post should be substantive (approximately 200-300 words in length). In your substantive post you are encouraged to use references (you may use your textbook); show evidence of critical thinking as it applies to the concepts.

1.

Historical Perspectives on Nursing Today

What do you think would be the response of such historical nursing leaders as Florence Nightingale, Lillian Wald, and Mary Breckinridge if they could see what the profession of nursing looks like today?

https://www.youtube.com/watch?v=G034ftcZSZs

https://www.youtube.com/watch?v=ETGimIeTeis

2.

Nursing Competencies and Theoretical Knowledge

What are the specific competencies for nurses in relation to theoretical knowledge?

·

Below is an example of a substantive discussion post (This content is not from this course):

Neutropenia is a decrease in circulating neutrophils in the nonmarginal pool, which constitutes 4-5% of total body neutrophil stores (Braden, 2016). Something that should be investigated is the underlying cause for the neutropenia. Knowing what would point myself as the nurse in the direction to educate the patient and would help the physician in treating the condition. The likelihood of having complication from neutropenia are very high as usually the reason for neutropenia is overwhelming infection.

Common presenting symptoms of neutropenia include the following: (Braden, 2016)

· Low-grade fever

· Sore mouth

· Odynophagia

· Gingival pain and swelling

· Skin abscesses

· Recurrent sinusitis and otitis

· Symptoms of pneumonia (eg, cough, dyspnea)

· Perirectal pain and irritation

Diagnosing neutropenis is realatively easy as the doctor would need to order a complete blood cell count, differencial white blood cell count, and a peripheral smear that is to be reviewed by a pathologist. Other causes of neutropenia, in the absence of overwhelming infection, may be (1) decreased neutrophil production or ineffective granulopoiesis, (2) reduced neutrophil survival, and (3) abnormal neutrophil distribution and sequestration. Hematologic disorders that cause ineffective or decreased production include hypoplastic or aplastic anemia, megaloblastic anemias, leukemia, or drug-/toxin-induced neutropenia (Huether, 2012). Educating patient on the way to care for ones self at home is very important. Making sure that the patient takes all of their antibiotics and committing to keeping their follow up appointment is very important to her recovery.

General measures to be taken in patients with neutropenia include the following: (Braden, 2016)

· Remove any offending drugs or agents in cases involving drug exposure: If the identity of the causative agent is not known, stop administration of all drugs until the etiology is established

· Use careful oral hygiene to prevent infections of the mucosa and teeth

· Avoid rectal temperature measurements and rectal examinations

· Administer stool softeners for constipation

· Use good skin care for wounds and abrasions: Skin infections should be managed by someone with experience in the treatment of infection in neutropenic patients

Braden, C. (2016, February 26). 
Neutropenia. Retrieved from MedScape: http://emedicine.medscape.com/article/204821-overview

Huether, S., & McCance, K. (2012). 
Understanding Pathophysiology (5th ed.). [

https://bookshelf.vitalsource.com/#/books

/978-0-323-07891-7/cfi/0!/4/2/4/4@0:65.4]. Retrieved from 
https://bookshelf.vitalsource.com/#/books

Bottom of Form

Massachusetts Nurse of the Future
Nursing Core Competencies©

REGISTERED NURSE

P
RA

CT
IC

E E
NV

IR
ONMENT

PRACTICE ENVIROMENT

SA K K ASNURSING
KNOWLEDGE

Pa
tie

nt
–

Ce
nt

er
ed

Ca
re

Professi
onalism

Leadership

Systems-Based Informatics an

d

Technology

Co
m

m
u

n

ica
tio

n

Evidence-Based

Practice

Quality Improvement

Safety

Teamwork and

PR

AC
TIC

E

PRACTICE

Colla
boratio

n

Practice

K – Knowledge
A – Attitudes
S – Skills

Massachusetts Department of Higher Education Nursing Initiative
Revised March 2016

Nurse of the Future: Nursing Core Competencies© | 1

Table of Contents
Background 2

Defining NOF Nursing Core Competencies: Assumptions, Nursing Core
Competencies, and the Nursing Core Competency Model

3

Nursing Knowledge 8

The Nurse of the Future Nursing Core Competencies

>> Patient-Centered Care 10

>> Professionalism 14

>> Leadership 18

>> Systems-Based Practice 22

>> Informatics and Technology 26

>> Communication 32

>> Teamwork and Collaboration 37

>> Safety 42

>> Quality Improvement 45

>> Evidence-Based Practice 47

Glossary 51

Professional Standards 55

General Bibliography 56

Nurse of the Future: Nursing Core Competencies© | 2

Background

This third edition of the Nurse of the Future Core Nursing Competencies is a result of review and updating process since the original publication. The purpose
of the review was to ensure that the competencies reflect the many changes that have occurred in the health care environment and nursing practice over the
past five years. The competencies still represent the minimum expectations for all nurses as they complete their pre-licensure education. As nursing education
and practice continue to evolve in response to the needs of patients and the health care environment, these competencies will require ongoing review and
evaluation to ensure that they continue to define the expectations for entry into nursing practice.

In March 2006, the Massachusetts Department of Higher Education (DHE) and the Massa chusetts Organization of Nurse Executives (MONE) convened
a facilitated work ing session entitled Creativity and Connections: Building the Framework for the Future of Nursing Education and Practice. This
invitational session brought together 32 experienced professionals from the major statewide stakeholders in nursing education and practice. The group
included nurse leaders from a variety of prac tice settings, educators from both public and private higher education representing all degree levels, and
representatives from the Department of Higher Education, the Board of Registration in Nursing, the Massachusetts Center for Nursing (MCN), the
Massachusetts Association of Colleges of Nursing (MACN), the Massachusetts/Rhode Island League for Nursing (MARILN), and other national
accrediting agencies, including the National League for Nursing Accrediting Commission (NLNAC) and the Commission on Collegiate Nursing
Education (CCNE).

An important outcome of the conference was the development of the following mission statement to guide future work: Establish a formal coalition to
create a seamless progression through all levels of nursing that is based on consensus competencies which include transitioning nurses into their practice
settings. An additional key outcome involved the establishment of the following top priorities:

n Creation of a seamless progression through all levels of nursing education
n Development of sufficient consensus on competencies to serve as a framework for educational curriculum
n Development of a statewide nurse internship/preceptor program

At the end of the conference a working group was formed composed of deans and faculty representing all segments of nursing education, and nursing
practice leaders and clinical nursing staff representing the continuum of care. From 2006 through 2009, the working group researched and reviewed
standards, initiatives, and best practices in nursing education and formed a foundation for moving the priorities forward. To expedite the process, the
group formed two working committees: the Massachusetts Nurse of the Future (NOF) Competency Committee (see membership list, back cover), which
was charged with furthering the development of a seamless continuum of nursing education by identifying a core set of nursing competencies; and the
MONE Academic Practice Integration Committee, which was charged with using the identified competencies as a framework for developing a statewide
transition into practice model.

This report summarizes the work of the NOF Competency Committee. In the report, the committee describes the process it used to identify NOF Nursing
Core Competencies, presents the NOF Nursing Core Competency Model©, and defines the ten NOF Nursing Core Competencies and the knowledge,
attitudes and skills associated with each. Key terms used in the document are highlighted in bold and are defined in the Glossary.

Nurse of the Future: Nursing Core Competencies© | 3

Defining the Nurse of the Future Nursing Core Competencies and Core Competency Model

The NOF Competency Committee used a multi-step process to define a core set of nursing competencies for the nurse of the future. As a first step, the
group identified and synthesized competencies obtained from other states, current practice standards, education accreditation standards, national
initiatives, and projected patient demographic and health care profiles for Massachusetts. The committee also reviewed the Institute of Medicine’s core
competencies for all health care professionals (Institute of Medicine [IOM], 2003) and the Quality and Safety Education for Nurses model (Quality and
Safety Education for Nurses [QSEN], 2007). Information and data obtained through this process of research, analysis, and dialogue formed the basis for
the development of a preliminary set of NOF Nursing Core Competencies.
The committee then used a formalized process to obtain feedback on the preliminary set of core competencies from the nursing education and practice
community throughout the state. The feedback process included online opportunities, two statewide summits, on-campus meetings with faculty from
public and private associate and baccalaureate nursing education programs, and meetings with nursing leadership groups and nursing practice councils
from a variety of health care organizations across the state. Feedback was also obtained through a gap analysis process developed in consultation with a
nurse expert involved with the development of the QSEN competencies. Through this process, nursing programs and their clinical practice partners
evaluated their curriculum and identified gaps between what is currently being taught and what they determined should be taught for students to master
the NOF Nursing Core Competencies by graduation. Eight nursing programs in collaboration with their clinical practice partners participated in this
funded activity.
After synthesizing the feedback, the committee conducted another review of the literature, comparing the preliminary set of core competencies against
nationally accepted models, guidelines, and standards. The preliminary set of competencies was also compared to the CCNE Essentials of Baccalaureate of
Education (American Association of Colleges of Nursing [AACN], 2008), the Bologna Accords (Zabalegui, Loreto, & Josefa et al., 2006; Davies, 2008), the
Competency Outcomes and Performance Assessment (COPA) model (Lenburg, 1999), the National League for Nursing’s educational competencies for
graduates of associate degree nursing programs (National League for Nursing [NLN], 2000), and the Accreditation Council for Graduate Medical
Education competencies (Accreditation Council for Graduate Medical Education [ACGME], n.d.). Information and data obtained by the review and
feedback process was then incorporated into an updated version of the NOF Nursing Core Competencies.
The updated version of the core competencies is presented in this report and is also available online at www.mass.edu/nursing. The NOF Competency
Committee encourages nurses from practice, academe, and professional nursing organizations to review and disseminate the competencies. To help
monitor how they are used, the committee asks users of the NOF Nursing Core Competencies to complete the Tracking and Permission Form, also
available on the website.

Nurse of the Future: Nursing Core Competencies© | 4

ASSUMPTIONS
In developing the NOF Nursing Core Competencies, the Competency Committee identified a set of assumptions to serve as a framework for its work and
as guiding principles for the design of a competency-based education and practice partnership model. With the 2015 updating of the competencies, the
Nurse of the Future Working Group added some additional assumptions to reflect the changes in the health care and nursing education environment that
have emerged over the past 5 years. The assumptions include the following:
n Education and practice partnerships are key to developing an effective model.
• Nursing education and practice settings should facilitate individuals in moving more effectively through the educational system
• An integrated practice/education competency model will positively impact patient safety and improve patient care
• Nursing practice should be differentiated according to the registered nurse’s educational preparation and level of practice and further

defined by the role of the nurse and the work setting
• Practice environments that support and enhance professional competence across the continuum of care are essential
n It is imperative that leaders in nursing education and practice develop collaborative curriculum models to facilitate the achievement of a minimum

of a baccalaureate degree in nursing by all nurses.
• Advancing the education of all nurses is increasingly recognized as essential to the future of nursing practice
• Evidence has demonstrated that nurses with higher education levels have a positive impact on patient care
n A more effective educational system must be developed, one capable of incorporating shifting demographics and preparing the nursing

workforce to respond to current and future health care needs and population health issues.
• The NOF Nursing Core Competencies are designed to be applicable across all care settings and to encompass all patient populations across

the lifespan
• Evidence-based knowledge and sensitivity to variables such as age, gender, culture, health disparities, socioeconomic status, race and

spirituality are essential for caring for diverse populations in this global society
n The nurse of the future will be proficient in a core set of competencies.
• There is a differentiation in competencies among practicing nurses at various levels
• Competence is developed over a continuum and can be measured
n Nurse educators in education and in practice settings will need to use a different set of knowledge and teaching strategies to effectively integrate

the Nurse of the Future Nursing Core Competencies© into curriculum.
n The nurses’ role is integral in recognizing the social and cultural determinants of health that are essential to disease prevention and health

promotion efforts needed to improve health and health care and to build a culture of health across the Commonwealth and the nation.
n With societal shifts, information-related innovations and a focus on teamwork and collaboration, health professions education will be inter-

professional and focused on collaborative practice.
n To create competencies for the future, there must be an ongoing process of evaluation and updating of the competencies to insure that they are

reflective of contemporary health care practice.

Nurse of the Future: Nursing Core Competencies© | 5

ThE NURSE OF ThE FUTURE NURSING CORE COMPETENCIES
The NOF Nursing Core Competencies emanate from the foundation of nursing knowledge. The competencies, which will inform future nursing
practice and curricula, consist of the following:
n Patient-Centered Care n Leadership n Communication
n Professionalism n Systems-Based Practice n Teamwork and Collaboration
n Informatics and Technology n Safety n Quality Improvement
n Evidenced-Based Practice (EBP)

ThE NURSE OF ThE FUTURE CORE COMPETENCy MODEL
The Nurse of the Future Nursing Core Competency© model is a graphic representation of the NOF Nursing Core Competencies and their relationship to
nursing knowledge. In the model, nursing knowledge has been placed at the core to represent how nursing knowledge in its totality reflects the overarching
art and science of the nursing profession and discipline. The ten essential competencies, which guide nursing curricula and practice, emanate from this
central core and include patient-centered care, professionalism, leadership, systems-based practice, informatics and technology, communication,
teamwork and collaboration, safety, quality improvement, and evidence-based practice. The order of the competencies does not indicate any hierarchy, as
all the competencies are of equal importance. The competencies are connected by broken lines because distinction between individual competencies may
be blurred; the competencies overlap and are not mutually exclusive. The competencies are similarly connected to the core by a broken line to indicate the
reciprocal and continuous relationship between each of the competencies and nursing knowledge.
Nursing knowledge and each of the ten competencies are described in more detail in the following sections of this report. For each competency, a
definition is provided that identifies expectations for all professional nurses of the future. Essential knowledge, attitudes, and skills (KAS), reflecting the
cognitive, affective, and psycho-motor domains of learning, are also specified for each competency. The KAS identify expectations for initial nursing
practice following completion of a pre-licensure professional nursing educational program.

Nurse of the Future: Nursing Core Competencies© | 6

MASSAChUSETTS DEPARTMENT OF hIGhER EDUCATION
Nurse of the Future Nursing Core Competencies©

The Art and Science of Nursing

PR

AC
TI

CE
EN

VIRONMENT

PRACTICE ENVIRONMENT

K – Knowledge
A – Attitudes
S – Skills

S A K K A SNURSING
KNOWLEDGE

Pa
tie

nt
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te

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d

Ca
re

Professi
onalism

Leadership

Systems-Based

Inform
atics and

Technology

Co
m

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un

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at

io
n

Evidence-Based

Practice

Quality Improvement

Safety

Te
am

work
an

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P
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PRACTICE

Colla
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Practice

Nurse of the Future: Nursing Core Competencies© | 7

NOF CORE COMPETENCIES AND MODEL DEVELOPMENT REFERENCES

Accreditation Council for Graduate Medical Education. (n.d.). ACGME Outcome Project. Retrieved from
http://cores33webs.mede.uic.edu/GMEmilestone/ui/portal/external/gc_about.aspx

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice (Rev. ed.).
Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Davies, R. (2008). The Bologna process: The quiet revolution in nursing higher education. Nurse Education Today, 28(8), 935-942.

Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.

Lenburg, C. (1999). The framework, concepts, and methods of the Competency Outcomes and Performance (COPA) Model. Online Journal
of Issues in Nursing, 4(2). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals
/OJIN/TableofContents/Volume41999/No2Sep1999/COPAModel.html

National League for Nursing Council of Associate Degree Nursing Competencies Task Force. (2000). Educational competencies for
graduates of associate degree nursing programs. New York, NY: Author.

Quality and Safety Education for Nursing. (2007). Quality and safety competencies. Retrieved from
http://qsen.org/competencies/pre-licensure-ksas/

Zabalegui, A., Loreto, M., Josefa, M., Ricoma, R., Nuin, C., Mariscal, I., . . . Moncho, J. (2006). Changes in nursing education in the
European Union. Journal of Nursing Scholarship. 38(2), 114-118.

Nurse of the Future: Nursing Core Competencies© | 8

Nursing Knowledge

Nursing is a scholarly profession and practice-based discipline and is built on a foundation of knowledge that reflects nursing’s dual components of science
and art. Nursing knowledge in conjunction with a liberal education prepares learners to enter practice with identified core competencies.

A solid base in liberal education provides the distinguishing cornerstone for the study and practice of professional nursing (American Association of
Colleges of Nursing [AACN], 2008, p. 11). A strong foundation in liberal arts includes a general education curriculum that provides broad exposure to
multiple disciplines and ways of knowing. As defined by the Association of American Colleges and Universities (AAC&U), a liberal education is one that
intentionally fosters, across multiple fields of study, wide ranging knowledge of science, cultures, and society; high level intellectual and practical skills; an
active commitment to personal and social responsibility; and the demonstrated ability to apply learning to complex problems and challenges (AAC&U,
2007, p. 4). A liberal education includes both the sciences and the arts (AACN, 2008, p.10).

As a scientific discipline, nursing draws on a discrete body of knowledge that incorporates an understanding of the relationships among nurses, patients,
and environments within the context of health, nursing concepts and theories, and concepts and theories derived from the basic sciences, humanities, and
other disciplines. The science of nursing is applied in practice through a critical thinking framework known as the nursing process that is composed of
assessment, diagnosis, planning, implementation, and evaluation. The steps of the nursing process serve as a foundation for clinical decision-making and
evidence-based practice. Nurses use critical thinking to integrate objective data with knowledge gained from an assessment of the subjective experiences
of patients and groups, and to apply the best available evidence and research data to the processes of diagnosis and treatment. Nurses use clinical
reasoning to respond to the needs of the populations they serve and to develop strategies to support optimal outcomes that are most appropriate to the
patient or situation while being mindful of resource utilization. Nurses continually evaluate the quality and effectiveness of nursing practice and seek to
optimize outcomes (American Nurses Association [ANA], 2004).

The art of nursing is based on a framework of caring and respect for human dignity. The art and science of nursing are inextricably linked, as a
compassionate approach to patient care carries a mandate to provide that care competently. Competent care is provided and accomplished through
delegated, independent and interdependent practice (Koloroutis, 2004, pp. 123-25), and through collaborative practice (Tomey, 2009, p. 397) involving
other colleagues and/or the individuals seeking support or assistance with their health care needs (ANA, 2004, p. 12).

With the globalization of health care and the development of collaborative teams to address and sustain effective quality care, nursing knowledge can
serve as the foundation to engage other professionals in interprofessionality and link to interprofessional competencies, knowledge and practice (Meleis,
2015).

The distinctive focus of the discipline of nursing is on nursing actions and processes, which are directed toward human beings and take into account the
environment in which individuals reside and in which nursing practice occurs (Fawcett & Garity, 2009). This distinctive focus is reflected in the
metaparadigm of nursing, which identifies human beings (patients), the environment, health, and nursing as the subjective matter of interest to nurses
(ANA, 2004). In the context of nursing knowledge, these constructs are defined as follows:

Nurse of the Future: Nursing Core Competencies© | 9

Human beings/patients – the recipient of nursing care or services. This term was selected for consistency and recognition and support of the historically
established tradition of the nurse-patient relationship and recipients of nursing care. Patients may be individuals, families, groups, communities, or
populations. Further, patients may function in independent, interdependent, or dependent roles, and may seek or receive nursing interventions related
to disease prevention, health promotion, or health maintenance, as well as illness and end-of-life care. Depending on the context or setting, patients may at
times more appropriately be termed clients, consumers, or customers of nursing services (AACN, 1998, p. 2).

Environment – the atmosphere, milieu, or conditions in which an individual lives, works, or plays (ANA, 2004, p. 47).

Health – an experience that is often expressed in terms of wellness and illness, and may occur in the presence or absence of disease or injury (ANA, 2004, p.
48).

Nursing – is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations (ANA, 2001, p. 5).

NURSING KNOWLEDGE REFERENCES

American Association of Colleges of Nursing. (1998). The essentials of baccalaureate education for professional nursing practice.
Washington, DC: Author.

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice
(Rev. ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author.

American Nurses Association. (2004). Nursing scope and standards of practice. Silver Springs, MD: Author.

Association of American Colleges and Universities. (2007). College learning for the new global century. Washington, DC: Author.

Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing practice. Philadelphia, PA: F.A. Davis.

Koloroutis, M. (Ed.). (2004). Relationship-based care: A model for transforming practice. New York, NY: Springer.

Meleis A. (2015). Interprofessional Education: A summary of reports and barriers to recommendations. Journal of Nursing
Scholarship 48(1), 106-11.

Tomey, A. M. (2009). Guide to nursing management and leadership (8th ed.). St. Louis, MO: Mosby Elsevier.

Nurse of the Future: Nursing Core Competencies© | 10

Patient-Centered Care
The Nurse of the Future will provide holistic care that recognizes an individual’s preferences, values, and needs and respects the patient or designee as a
full partner in providing compassionate, coordinated, age and culturally appropriate, safe and effective care.

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Identifies components of
nursing process appropriate
to individual, family, group,
community, and population health
care needs across the life span

A1a Values use of scientific inquiry, as demonstrated in the
nursing process, as an essential tool for provision of nursing care

A1b Appreciates the differences between data collection and
assessment

S1a Provides priority-based nursing
care to individuals, families, and groups
through independent and collab orative
application of the nursing process

S1b Demonstrates cognitive, affective,
and psychomo tor nursing skills when
delivering patient care

K2 Understands that care and
services are delivered in a variety
of settings along a continuum of
care that can be accessed at any
point

A2a Values and respects assessing health care situation from the
patient’s perspective and belief systems

A2b Respects and encourages the patient’s participation in
decisions about health care and services

S2 Assesses patient values, preferences,
decisional capacity, and expressed needs
as part of ongoing assessment, clinical
interview, implementation of care plan,
and evaluation of care

K3 Understands multiple
dimensions of patient-centered
care including:
a. Patient/family/community

preferences, values
b. Coordination and integration

of care
c. Information, communication,

and education
d. Physical comfort and emotional

support
e. Involvement of family and

significant other
f. Care transition and continuity

A3a Respects the patient’s perspective regarding own health and
concerns

S3a Communicates patient values,
preferences, and expressed needs
to other members of health care team

S3b Seeks information from appropriate
sources on behalf of patient

Nurse of the Future: Nursing Core Competencies© | 11

K4a Demonstrates understanding
of the diversity of the human
condition

K4b Describes how cultural
diversity, ethnic, spiritual and
socioeconomic backgrounds
function as sources of patient,
family, and community values

K4c Understands how human
behavior is affected by
socioeconomics, culture, race,
spiritual beliefs, gender identity,
sexual orientation, lifestyle, and
age

K4d Understands the effects
of health and social policies on
persons from diverse backgrounds
and cultures

A4a Values opportunities to learn about all aspects of
human diversity and the inherent worth and uniqueness of
individuals and populations

A4b Recognizes impact of personal attitudes, values and
beliefs regarding delivery of care to diverse clients

A4c Supports patient-centered care for individuals and groups
whose values differ from their own

S4a Provides patient-centered care with
sensitivity and respect for the diversity of
human experience

S4b Implements nursing care to
meet the holistic needs of patient on
socioeconomic, cultural, ethnic, and
spiritual values and beliefs influencing
health care and nursing practice

S4c Works collaboratively with health
care providers from diverse backgrounds
and cultures

S4d Demonstrates caring practices
toward patient, significant others,
and groups of people receiving care

K5a Demonstrates comprehensive
understanding of health across the
continuum, including the concepts
of pain, palliative care, and quality
of life

K5b Demonstrates understanding
of promoting health and wellness

A5a Appreciates the role of the nurse in relieving all types and
sources of pain and suffering

A5b Recognizes the impact of personal values and beliefs about
the management of pain and suffering and end-of-life care

A5c Fosters strategies to promote health maintenance/
motivation

S5a Assesses presence and extent of
physical and emotional comfort

S5b Elicits expectations of patient and
family for relief of pain, discomfort, or
suffering and end-of-life care

S5c Initiates treatments to relieve pain
and suffering in light of patient values,
preferences, and expressed needs

Nurse of the Future: Nursing Core Competencies© | 12

PATIENT-CENTERED CARE BIBLIOGRAPhy

Accreditation Council for Graduate Medical Education. (n.d.) ACGME Outcome Project. Retrieved from
http://cores33webs.mede.uic.edu/GMEmilestone/ui/portal/external/gc_about.aspx

Alexander, M., & Runciman, P. (2003). ICN framework of competencies for the generalist nurse: Report of the development, process,
and consultation. Geneva, Switzerland: International Council of Nurses.

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice.
Washington, DC: Author.

American Association of Colleges of Nursing. (2006). Hallmarks of quality and safety: Baccalaureate competencies and curricular
guidelines to assure high quality and safe patient care. Washington, DC: Author.

American Association of Colleges of Nursing. (2007). White paper on the education and role of the clinical nurse leader.
Washington, DC: Author.

Colorado Council on Nursing Education. (2007). The Colorado Nursing Articulation Model 2002-2005. Publication of the
Colorado Trust. Retrieved from
http://www.centralcoahec.org/documents/The_Colorado_Nursing_Articulation_Model_2007_update

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, . . . Warren, J. (2007). Quality and safety education for
nurses. Nursing Outlook, 55(3), 122-131.

Day, L., & Smith, E. (2007). Integrating quality and safety into clinical teaching in the acute care setting. Nursing Outlook, 55(3), 138-143

Dreher, M., Everett, L., & Hartwig, S. (2001). The University of Iowa Nursing Collaboratory: A partnership for creative education and
practice. Journal of Professional Nursing, 17(3), 114-120.

Fleming, V. (2006). Developing global standards for initial nursing and midwifery education. In Background paper on nurse and
midwifery education standards in Interim Report of Proceedings. Geneva, Switzerland: World Health Organization.

Hobbs, J. L. (2009). A dimensional analysis of patient-centered care. Nursing Research, 58(1), 52-62.

Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.

Kennedy, H. P., Fisher, L., Fontaine, D., & Martin-Holland, J. (2008). Evaluating diversity in nursing education: A mixed method study.
Journal of Transcultural Nursing, 19, 363-370.

Koloroutis, M. (2004). Relationship based care: A model for transforming practice. Minneapolis, MN: Creative Health Management.

National Council of State Boards of Nursing. (2009). Description of NCSBN’s Transition to Practice Model. Retrieved from
https://www.ncsbn.org/2013_TransitiontoPractice_modules

National League for Nursing. (2005). Board of Governors position statement on transforming nursing education. Retrieved from
http://www.nln.org/docs/default-source/about/archived-position-statements/transforming052005 ?sfvrsn=6

National League for Nursing Accrediting Commission, Inc. (2008). NLNAC accreditation manual. New York, NY: Author.

National League for Nursing Council of Associate Degree Nursing Competencies Task Force. (2000). Educational competencies for
graduates of associate degree nursing programs. New York, NY: Author.

Nurse of the Future: Nursing Core Competencies© | 13

Nichols, B. (2007). Building global alliances III: The impact of global nurse migration on health service delivery. Philadelphia, PA:
Commission on Graduates of Foreign Nursing Schools.

Oregon Consortium for Nursing Education Competencies. (2007). Retrieved from
http://www.ocne.org/students/Curriculum.html

Ohio League for Nursing. (n.d.). Ohio Nursing Articulation Model: September, 2003-2005. Retrieved from
http://www.ohioleaguefornursing.org/associations/4237/files/HFFinalDocument

Ponte, P. R., Glazer, G., Dann, E., McCollum, K., Gross, A., Tyrrell, R., . . . Washington, T. (2007). The power of professional nursing
practice – An essential element of patient and family centered care. The Online Journal of Issues in Nursing, 12(1),
Manuscript 3. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/
OJIN/TableofContents/Volume122007/No1Jan07/tpc32_316092.aspx

Potempa, K. (2002). Finding the courage to lead: The Oregon experience. Nursing Administration Quarterly, 26(4), 9-15.

Quality and Safety Education for Nursing. (2007). Quality and Safety Competencies. Retrieved from http://qsen.org/competencies/

Smith, J., & Crawford, L. (2003). Report on findings from the practice and professional issues survey. Chicago, IL: National Council of
State Boards of Nursing, Inc.

Nurse of the Future: Nursing Core Competencies© | 14

Professionalism
The Nurse of the Future will demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal,
ethical, regulatory, and humanistic principles.

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1a Understands the concept of
accountability for own nursing
practice

K1b Justifies clinical decisions

A1a Accepts responsibility for own behavior

A1b Shows commitment to provision of high quality, safe, and
effective patient care

S1a Demonstrates accountability for own
nursing practice.

S1b Exercises critical thinking and clinical
reasoning within standards of practice

K2 Describes legal and regulatory
factors that apply to nursing
practice

A2a Values professional standards of practice

A2b Values and upholds legal and regulatory principles

S2a Uses recognized professional
standards of practice

S2b Implements plan of care within legal,
ethical, and regulatory framework of
nursing practice

K3 Understands the professional
standards of practice, the
evaluation of that practice, and the
responsibility and accountability
for the outcome of practice

A3a Recognizes personal capabilities, knowledge base, and areas
for development

A3b Values collegiality, openness to critique, and peer review

S3a Demonstrates professional
comportment

S3b Provides and receives constructive
feedback to/from peers

K4a Describes factors essential
to the promotion of professional
development

K4b Describes the role of a
professional organization shaping
the culturally congruent practice
of nursing

K4c Understands the importance
of reflection to advancing practice
and improving outcomes of care

A4a Committed to life-long learning

A4b Values the mentoring relationship for professional
development

A4c Values and is committed to being a reflective practitioner

S4a Participates in life-long learning

S4b Demonstrates ability for reflection in
action, reflection for action, and reflection
on action

Nurse of the Future: Nursing Core Competencies© | 15

K5a Understands the concept of
autonomy and self-regulation in
nursing practice

K5b Understands the culture of
nursing, cultural congruence and
the health care system

A5 Recognizes the responsibility to function within acceptable
behavioral norms appropriate to the discipline of nursing and the
health care organization

S5a Seeks ways to advocate for
nursing’s role, professional autonomy,
accountability, and self-regulation

S5b Promotes and maintains a positive
image of nursing

S5c Recognizes and acts upon breaches
of law relating to nursing practice and
professional codes of conduct

K6 Understands role and
responsibilities as patient advocate

A6 Values role and responsibilities as patient advocate S6 Serves as a patient advocate

K7 Understands ethical principles,
values, concepts, and decision
making that apply to professional
nursing practice, interprofessional
collaboration and patient care

A7a Values the application of ethical principles in daily practice

A7b Values acting in accordance with code of ethics and
accepted standards of practice

A7c Clarifies personal and professional values and recognizes
their impact on decision making and professional behavior

A7d Values acting with honesty and integrity in relationships
with patients, families, and other team members across the
continuum of care

S7a Incorporates American Nurses
Association’s Code of Ethics into
daily practice

S7b Utilizes an ethical decision-making
framework in clinical situations

S7c Identifies and responds to ethical
concerns, issues, and dilemmas that affect
nursing practice

S7d Enlists system resources and
participates in efforts to resolve ethical
issues in daily practice

S7e Recognizes moral distress and seeks
resources for resolution

Nurse of the Future: Nursing Core Competencies© | 16

K8a Understands responsibilities
inherent in being a member of the
nursing profession

K8b Recognizes the relationship
between personal health, self care,
resilience and the ability to deliver
sustained quality care

K8c Recognizes the relationship
between civic and social
responsibility and volunteerism
with the advancement of one’s
own practice and the profession
of nursing

K8d Contributes to building and
fostering a nurturing & healthy
work environment, promoting
health safety in the workplace

A8a Recognizes need for personal and professional behaviors
that promote the profession of nursing

A8b Values and upholds altruistic and humanistic principles

S8a Understands the history and
philosophy of the nursing profession

S8b Incorporates professional nursing
standards and accountability into practice

S8c Advocates for professional standards
of practice using organizational and
political processes

S8d Understands limits to one’s scope
of practice and adheres to licensure law
and regulations

S8e Articulates to the public the
values of the profession as they relate
to patient welfare

S8f Advocates for the role of the
professional nurse as a member of the
interdisciplinary health care team

S8g Develops goals for health, self-
renewal, and professional development

S8h Assumes social and civic
responsibility through participation in
community volunteer activities

S8i Assumes professional responsibility
through participation in professional
nursing organizations

Nurse of the Future: Nursing Core Competencies© | 17

PROFESSIONALISM BIBLIOGRAPhy

Alexander, M., & Runciman, P. (2003). ICN framework of competencies for the generalist nurse: Report of the development, process, and
consultation. Geneva, Switzerland: International Council of Nurses.

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice.
Washington, DC: Author.

American Association of Colleges of Nursing. (2006). Hallmarks of quality and safety: Baccalaureate competencies and curricular
guidelines to assure high quality and safe patient care. Washington, DC: Author.

American Association of Colleges of Nursing. (2007). White paper on the education and role of the clinical nurse leader. Washington,
DC: Author.

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author.

Colorado Council on Nursing Education. (2007). The Colorado Nursing Articulation Model 2002-2005. Publication of the Colorado
Trust. Retrieved from http://www.centralcoahec.org/documents/The_Colorado_Nursing_Articulation_Model_2007_
update

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007).Quality and safety education
for nurses. Nursing Outlook, 55(3), 122-131.

Dreher, M., Everett, L., & Hartwig, S., (2001). The University of Iowa Nursing Collaboratory: A partnership for creative education
and practice. Journal of Professional Nursing, 17(3), 114-120.

Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.

Jeffreys, M. R. (2010). Teaching Cultural Competence in Nursing and Health Care: Inquiry, Action, and Innovation. (2nd ed.)
New York, NY: Springer.

National Council of State Boards of Nursing. Description of NCSBN’s Transition to Practice Model. (2009).Retrieved from
https://www.ncsbn.org/2013_TransitiontoPractice_modules

National League for Nursing. (2005). Board of Governors position statement on transforming nursing education. Retrieved from
http://www.nln.org/docs/default-source/about/archived-position-statements/transforming052005 ?sfvrsn=6

National League for Nursing Accrediting Commission, Inc. (2008). NLNAC accreditation manual. New York, NY: Author.

National League for Nursing Council of Associate Degree Nursing Competencies Task Force. (2000). Educational competencies for
graduates of associate degree nursing programs. New York, NY: Author.

Ohio League for Nursing. (n.d.). Ohio Nursing Articulation Model: September, 2003-2005. Retrieved from
http://www.ohioleaguefornursing.org/associations/4237/files/HFFinalDocument

Oregon Consortium for Nursing Education Competencies. (2007). Retrieved from http://www.ocne.org/students/Curriculum.html

Potempa, K. (2002). Finding the courage to lead: The Oregon experience. Nursing Administration Quarterly, 26(4), 9-15.

Quality and Safety Education for Nursing. Quality and safety competencies. (2007). Retrieved from http://qsen.org/competencies/

Nurse of the Future: Nursing Core Competencies© | 18

Leadership
The Nurse of the Future will influence the behavior of individuals or groups of individuals within their environment in a way that will facilitate the
establishment and acquisition/achievement of shared goals.

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Identifies leadership skills
essential to the practice of nursing

A1 Recognizes the role of the nurse as leader S1 Integrates leadership skills of systems
thinking, communication, and facilitating
change in meeting patient care needs

K2 Understands critical thinking
and problem-solving processes

A2 Values critical thinking processes in the management of
client care situations

S2a Uses systematic approaches in
problem solving

S2b Demonstrates purposeful, informed,
outcome-oriented thinking

K3a Understands human behavior,
individual and group performance

K3b Identifies the roles and skills
of the health care team

A3a Recognizes the centrality of a interprofessional team
approach to patient care

A3b Values the diversity and inclusion of perspectives and
expertise of each member of the health care team

S3a Demonstrates ability to effectively
participate within health care teams

S3b Promotes a productive culture by
valuing individu als and their contributions

S3c Models effective communication and
promotes cooperative behaviors

S3d Demonstrates tolderance for different
viewpoints

K4 Understands the need to
monitor one’s own feelings and
emotions, to discriminate among
them and use this information to
guide thinking and actions

A4a Recognizes that personal attitudes, beliefs and experiences
influence one’s leadership style

A4b Recognizes the limits of one’s own role and competence
and, where necessary, consults with other health professionals
with the appropriate competencies

A4c Values fairness and open mindedness

A4d Values an environment encouraging creative thinking and
innovations

A4e Values courage as a leadership skill

S4a Clarifies biases, inclinations, strengths,
and self-limitations

S4b Adapts to stressful situations

S4c Seeks appropriate mentors

S4d Acts as an effective role model and
resource for students and support staff

S4e Demonstrates ability to stand up for
beliefs and does not avoid challenges

Nurse of the Future: Nursing Core Competencies© | 19

K5 Explains the importance,
necessity, and process of change

A5a Recognizes one’s own reaction to change and strives to
remain open to new ideas and approaches

A5b Values new ideas and interventions to improve patient care

S5a Implements change to improve
patient care

S5b Anticipates consequences, plans
ahead, and changes approaches to
improve outcomes

S5c Participates in the change process
to improve patient care, the work
environment, and patient and staff
satisfaction

K6 Understands the principles of
accountability and delegation

A6a Accepts accountability and responsibility for one’s own
professional judgment and actions

A6b Accepts accountability for nursing care delegated to others

A6c Recognizes the value of delegation

S6 Delegates selected nursing activities
to unlicensed personnel to maintain or
improve the patient’s health and well-
being, or promote comfort

K7 Understands the complexity
of the health care delivery system
including how patient care services
are organized and financed, and
how reimbursement is structured

A7a Recognizes the impact of sociocultural, economic, legal, and
political factors Influencing health care delivery and practice

A7b Values the roles of provider groups across the continuum of
care

S7a Acts as a champion for health care
consumers and quality outcomes

S7b Understands and articulates
individual organization’s financial drivers

S7c Demonstrates an understanding the
complexity involved in decision making
in Health care relating to population
management across the continuum of
care

K8 Understand how health care
issues are identified, how health
care policy is both developed and
changed

A8 Recognizes how the health care process can be influenced
through the efforts of nurses and other health care professionals,
as well as lay and special advocacy groups

S8 Participates as a nursing professional
in political processes and grassroots
legislative efforts to influence health care
policy

Nurse of the Future: Nursing Core Competencies© | 20

K9 Understands the need to
withstand, recover or grow in the
face of stressors and changing
demands

A9 Recognizes the need to think about the future instead of the
past

S9a Seeks opportunities for improvement
and ongoing learning

S9b Demonstrates ability to work with
ambiguity and tension

S9c Focuses energy to achieve goals and
outcomes

K10 Articulates the impact of one’s
own leadership style in committing
individuals to action

A10 Recognizes the value of leadership to empower others and
enhance collaboration and shared decision making

S10 Uses group discussion, agreement
and consensus building to enhance
collaboration and shared decision making

Nurse of the Future: Nursing Core Competencies© | 21

LEADERShIP BIBLIOGRAPhy

Alexander, M., & Runciman, P. (2003). ICN framework of competencies for the generalist nurse: Report of the development, process, and
consultation. Geneva, Switzerland: International Council of Nurses.

Alfaro-LeFevre, R. (2009). Critical thinking and clinical judgment. St. Louis, MO: Saunders Elsevier.

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice (Rev. ed.).
Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

American Organization of Nurse Executives. (2015). AONE nurse executive competencies. Retrieved from
www.aone.org/resources/nec

American Organization of Nurse Executives. (2015). AONE Post-Acute Care Competencies for the Nurse Leader, AONE Post-Acute Care
Task Force. Retrieved from http://www.aone.org/search?q=Post+Acute+Competencies&site=AONE&client=AONE_
FRONTEND_1&proxystylesheet=AONE_FRONTEND_1&output=xml&filter=0&oe=UTF-8

Bellack, J., Morjikian, R., Barger, S., Strachota, E., Fitzmaurice, J., Lee, A.. . . O’Neil, E. (2001). Developing BSN leaders for the future:
Fuld Leadership Initiative for Nursing Education (LINE). Journal of Professional Nursing, 17(1), 23-32.

Carlson, K. (2015) Promoting Nurse Resilience. MultiBriefs. Retrieved from
http://exclusive.multibriefs.com/content/promoting-nurse-resilience/medical-allied-healthcare

Institute of Medicine. (2010). The future of nursing: Leading change, advancing Health. Washington, DC: National Academies Press.

Jennings, B., Scalzi, C. C., Rodgers, J. D., & Keane, A. (2007). Differentiating nursing leadership and management competencies.
Nursing Outlook, 55(4), 169-175.

National League for Nursing Accrediting Commission, Inc. (2008). NLNAC accreditation manual. New York, NY: Author.

Polard, C., Wild, C. (2014) Nursing leadership competencies – Low fidelity simulation as a teaching strategy. Nurse Education in
Practice, 14(6), 620-626.

Rousel, L. (2013) Management and Leadership for Nurse Administrators. Burlington, MA: Jones & Learning.

Sherman, R. O. (2003). Nursing Leadership Institute Leadership Competency Model. Retrieved from
http://nursing.fau.edu/uploads/docs/358/nursing_leadership_model2

Shirey, M. R. (2007). Leadership Perspectives: Competencies and tips for effective leadership: From novice to expert. Journal of Nursing
Administration, 37(4), 167-170.

Wilmoth, M. C., & Shapiro, S. (2014). The Intentional Development of Nurses as Leaders. Journal of Nursing Administration, 44(6),
333-338.

Nurse of the Future: Nursing Core Competencies© | 22

Systems-Based Practice
The Nurse of the Future will demonstrate an awareness of and responsiveness to the larger context of the health care system, and will demonstrate the
ability to effectively call on work unit resources to provide care that is of optimal quality and value (Adapted from ACGME, n.d.).

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Understands and is responsive
to the larger context and system of
health care

A1a Appreciates the role of new staff nurses in the operations of
an effective work unit

A1b Appreciates how the elements of the work unit impact one’s
practice

S1 Plans, organizes, and delivers patient
care in the context of the work unit

K2a Understands the impact
of health care system changes
on planning, organizing, and
delivering patient care at the work
unit level

K2b Understands interrelationships
among nursing, the nursing work
unit, and organizational goals

A2a Appreciates the complexity of the work unit environment

A2b Recognizes the complexity of individual and group practice
on a work unit

A2c Appreciates the impact of one’s deci sions on the work unit

A2d Recognizes the importance of work unit systems in
providing supplies, medications, equipment, and information in a
timely and accurate fashion

A2e Appreciates role in identifying work unit inefficiencies and
operational failures

S2a Considers the influences of the health
care system, work unit, and patient/family
when making patient care decisions

S2b Seeks to solve problems encountered
at the point of care

S2c Makes management aware of clinical
and work unit problems encountered in
daily practice

S2d Identifies inefficiencies and failures
on the work unit, such as those involving
supplies, medications, equipment, and
information

S2e Participates in solving work unit
inefficiencies and operational failures
that impact patient care, such as
those involving supplies, medications,
equipment, and information

Nurse of the Future: Nursing Core Competencies© | 23

K3a Understands the concept of
patient care delivery models

K3b Understands role and
responsibilities as a member of
the health care team in planning
and using work unit resources to
achieve quality patient outcomes

K3c Understands the relationship
between the outcomes of one’s
own nursing care and work unit
resources

A3a Acknowledges the tension that may exist between a goal-
driven and a resource-driven patient care delivery model

A3b Values the contributions of each member of the health care
team to the work unit

A3c Values the management of one’s own time as a critical
work unit resource in delivering patient care

A3d Values the partnerships required to coordinate health care
activities that can affect work unit performance

S3a Considers resources available on the
work unit when contributing to the plan of
care for a patient or group of patients

S3b Practices cost effective care and
resource allocation that does not
compromise quality of care

S3c Collaborates with members of the
health care team to prioritize resources,
including one’s own work time and
activities delegated to others, for the
purposes of achieving quality patient
outcomes

S3d Evaluates outcomes of one’s own
nursing care

S3e In collaboration with others, uses
evidence to facilitate work unit change to
achieve desired patient outcomes

K4 Understands role and
responsibilities as patient
advocate, assisting patient in
navigating through the health
care system

A4a Values role and responsibilities as patient advocate

A4b Values partnerships in providing high quality patient care

A4c Values effective communication and information sharing
across disciplines and throughout transitions in care

A4d Appreciates role and responsibilities in using education and
referral to assist the patient and family through transitions across
the continuum of care

S4a Serves as a patient advocate

S4b Assists patients and families in
dealing with work unit and health care
system complexities

S4c Uses education and referral to assist
the patient and family through care
transitions

Nurse of the Future: Nursing Core Competencies© | 24

K5 Is aware of global aspects of
health care

A5a Appreciates the potential of the global environment to
influence patient health

A5b Appreciates the potential of the global environment to
influence nursing practice

S5 Engages in self-reflection on one’s
role and responsibilities related to global
health issues

Nurse of the Future: Nursing Core Competencies© | 25

SySTEMS-BASED PRACTICE BIBLIOGRAPhy

Accreditation Council for Graduate Medical Education. (n.d.). ACGME Outcome Project. Retrieved from
http://cores33webs.mede.uic.edu/GMEmilestone/ui/portal/external/gc_about.aspx

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice (Rev.
ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Barnum, B., & Kerfoot, K. (1995). The resource-driven model. In The nurse as executive (4th ed.) (pp. 10-14). Gaithersburg, MD: Aspen.

Bleich, M. R. (2014) Developing leaders as system thinkers – part 1. Journal of Continuing Education for Nurses, 45(4), 158-259.

Bleich, M. R. (2014) Developing leaders as system thinkers – part 2. Journal of Continuing Education for Nurses, 45(5), 201-202.

Bleich, M. R. (2014) Developing leaders as system thinkers – part 3. Journal of Continuing Education for Nurses, 45(6), 246-248.

Dolansky, M. A., & Moore, S. M. (2013) Quality and safety education for nurses (QSEN): The key is systems thinking. The Online Journal
of Issues in Nursing, 18(3). Retrieved from http://www.nursingworld.org/Quality-and-Safety-Education-for-Nurses.html

Graham, M., Naqvi, Z., Encandela, J., Byland, R., Calero-Breckhemer, A., & Schmidt, H. (2009). Advances in Health Science Education,
14, 187-203.

Guralnick, S., Ludwig, S., & Englander, R. (2014). Domains of competence: Systems-based practice. Academic Pediatrics, 14(2S), S70-S79.

Joint Commission Resources, Inc. (2007). Front line of defense: The role of nurses in preventing sentinel events (2nd ed.). Oakbrook
Terrace, IL: Author.

Koloroutis, M. (Ed.). (2004). Relationship-based care: A model for transforming practice. Minneapolis, MN: Creative Health Care
Management.

Nelson, E. C., Batalden, P. B., & Godfrey, M. M. (2007). Quality by design: A clinical microsystems approach. San Francisco, CA: Jossey-Bass.

Porter-O’Grady, T., & Malloch, K. (2011). Quantum leadership advancing innovation transforming healthcare (3rd ed.). Sudbury, MA:
Jones & Bartlett Learning.

Tucker, A. L., & Spear, S. J. (2006). Operational failures and interruptions in hospital nursing. HSR: Health Services Research,
41(3 Pt 1), 643-662.

Nurse of the Future: Nursing Core Competencies© | 26

Informatics and Technology
The Nurse of the Future will be able to use advanced technology and to analyze as well as synthesize information and collaborate in order to make critical
decisions that optimize patient outcomes. (National Academies of Sciences, Engineering, and Medicine. 2015)

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1a Understands basic computer
science concepts

K1b Identifies the basic
components of the computer
systems

A1 Recognizes the importance of basic computer competence to
evolving nursing practice

S1a Demonstrates proficiency in:
• Concepts of information and

communication technology
• Foundations of basic computer

systems (i.e., software, operating
systems, hardware, networks,
peripheral devices, computer systems,
internet and web based applications,
wireless technology)

• Foundations of database management
• Data Security

S1b Demonstrates proficiency in basic
computer skills related to personnel
management (i.e., admin), education, and
desktop software

Nurse of the Future: Nursing Core Competencies© | 27

K2a Describes Information
Management concepts (i.e.,
communication theories)

K2b Describes standardized
terminology in a care environment
that reflects nursing’s unique
contribution to patient outcomes

K2c Describes the foundation of
Nursing Informatics:
• Distinguishes between

healthcare and nursing
informatics

• Describes Informatics
Knowledge and its relationship
to Regulations, Human
Factors, and Change
Management

K2d Describes an understanding
of electronic communication
strategies among healthcare
providers in the healthcare system

A2a Values the importance of nursing data to improve nursing
practice

A2b Appreciates the use of electronic communications strategies
in the delivery of patient care

S2a Uses data, as presented through
the Electronic Health Record (E.H.R.), to
inform clinical decisions and deliver safe,
quality patient care

S2b Uses data from nursing and all
relevant sources, including technology, to
inform the delivery of care

S2c Uses informatics, and knowledge of
the larger healthcare delivery system, to
support and enhance patient care

S2d Utilizes Electronic communication
strategies (E.H.R., mHealth, Personal
health records)

K3 Explains why information and
technology skills are essential for
the professional nurse

A3 Appreciates the necessity for all health professionals to seek
lifelong, continuous learning of information management

S3a Uses information and it’s sources,
critically and incorporates selected
information into his or her own
professional knowledge database

S3b Seeks education about how
information is managed in the care setting

S3c Performs basic troubleshooting when
using applications

Nurse of the Future: Nursing Core Competencies© | 28

K4 Understands Core Components
of the E.H.R. and their application
within the larger health care
information system:
• Core components of the E.H.R.

(Ancillary Systems, Clinical
Data Repository, Physician
Documentation, Bar-Coded
Medications Administration
(BCMA), Continuity of Care
Document transactions and
Decision Support)

• Nursing specific applications
and relationship to entire
E.H.R. (Clinical documentation,
Computerized Provider Order
Entry (CPOE), BCMA, Patient
Monitoring, Decision Support,
Clinical Guidelines)

• Consumer applications
• Social Media

A4 Values the importance of technology on patient care and
quality and safety outcomes

S4a Demonstrates skills in using patient
care technologies, information systems,
and communication devices that support
safe nursing practice

S4b Demonstrates proficiency in basic
computer skills related to communication,
and data access

S4c Utilizes telecommunication
technologies to assist in effective
communication in a variety of healthcare
settings

S4d Applies safeguards and decision
making support tools embedded in
patient care technologies and information
systems to support a safe practice
environment for both patients and
healthcare workers

S4e Utilizes E.H.R. systems to document
interventions related to achieving nurse
sensitive outcomes

S4f Applies patient care technologies as
appropriate to address the needs of a
diverse patient population

Nurse of the Future: Nursing Core Competencies© | 29

K5a Describes the E.H.R.
implementation process

K5b Identifies the different roles
involved in system design, analysis
and management, including core
nursing responsibilities associated
with an E.H.R. implementation

K5c Defines informatics skills
required in system development
(i.e., system evaluation, design,
testing, and training)

A5 Values nurses’ involvement in design, selection,
implementation and evaluation of information technologies to
support patient care

S5a Participates in E.H.R. System
Implementation (i.e., system evaluation,
design implementation, testing, training ,
optimization and project management)

S5b Works in interdisciplinary teams to
make decisions regarding the application
of technologies and the acquisition of
data

S5c Recognizes that redesign of workflow
and care processes should precede
implementation of care technology to
facilitate nursing practice

S5d Participates in evaluation of
information systems in practice
settings through policy and procedure
development

K6a Describes patient access,
rights and engagement as pertain
to E.H.R.

K6b Understands the principles of
data integrity, professional ethics
and legal rights of the patient

A6 Recognizes that greater patient engagement contributes to
better health outcomes

S6a Utilizes strategies to protect data and
maintains data integrity

S6b Upholds ethical standards related to
data security, regulatory requirements,
confidentiality, and clients’ right to privacy

S6c Teaches patients about healthcare
technologies

S6d Adapts the use of technologies to
meet patient needs

K7a Describes how technology
and information management are
related to the quality and safety of
patient care

K7b Describes the role of
information technology in
improving patient care outcomes
and creating a safe care
environment

A7a Appreciates the limits of technology, recognizing there are
nursing practices that cannot be performed by computers or
technology

A7b Appreciates the contributions of technology as a tool to
improve patient safety and quality

S7a Uses data and statistical analysis
to evaluate practice, perform quality
improvement and enhance patient safety

S7b Uses information Management tools
to monitor outcomes of care process

S7c Advocates for the use of new patient
care technologies for safe, quality care

Nurse of the Future: Nursing Core Competencies© | 30

K8 Describes the integration of
research and evidenced based
practice into the E.H.R

A8 Values technology as a tool for generating knowledge and
guiding clinical practice

S8a Conducts on-line literature searches

S8b Provides for efficient data collection

S8c Uses applications to manage
aggregated data

S8d Integrates evidenced based standards
to support clinical practice

K9 Describe emerging areas of
informatics that will influence the
development of the E.H.R., patient
care and professional practice

A9 Values informatics as an evolving discipline S9 Discusses the value of emerging
trends (i.e., Health care Information
Exchange, Data Analytics, Population
Health Management, Patient and Family
Engagement) and how they will influence
healthcare reform

Nurse of the Future: Nursing Core Competencies© | 31

INFORMATICS AND TEChNOLOGy BIBLIOGRAPhy

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice
(Rev. ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

American Nurses Association. (2015). Nursing Informatics: Scope and Standards of Practice 2nd Edition. Silver Springs, MD:
Nursebooks.org.

National Academies of Sciences, Engineering, and Medicine. (2016) Assessing Progress on the Institute of Medicine Report The Future
of Nursing. Washington, DC: The National Academies Press, doi:10.17226/21838

The Massachusetts Core Competencies: A Toolkit for Implementation in Education and Practice Settings. (2014). Retrieved from
http://campaignforaction.org/sites/default/files/MAAC_CoreCompetenciesToolkit_052014

Yoon, S., Yen, P.-Y., & Bakken, S. (2009). Psychometric Properties of the Self-Assessment of Nursing Informatics Competencies Scale
(SANICS). Studies in Health Technology and Informatics, 146, 546–550.

Nurse of the Future: Nursing Core Competencies© | 32

Communication
The Nurse of the Future will interact effectively with patients, families, and colleagues, fostering mutual respect and shared decision making, to enhance
patient satisfaction and health outcomes.
Therapeutic Communication

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1a Understands the principles of
effective communication through
various means

K1b Knows grammar, spelling, and
health care terminology

A1a Accepts responsibility for communicating effectively

A1b Recognizes one’s individual responsibility to communicate
effectively utilizing a collegial tone and voice

S1a Uses clear, concise, and effective
written, electronic, and verbal
communications

S1b Documents interventions and
outcomes of care according to
professional standards and work unit
policy

K2a Understands visual, auditory,
and tactile communication

K2b Understands the
physiological, psychosocial,
developmental, spiritual, and
cultural influences on effective
communication

K2c Describes the impact of one’s
own communication style on
others

A2a Values different means of communication (auditory, visual,
and tactile)

A2b Values mutually respectful communication

A2c Values individual cultural and personal diversity

A2d Respects persons’ rights to make decisions in planning care

S2a Chooses the right setting and time to
initiate conversation

S2b Assesses the patient’s readiness/
willingness to communicate

S2c Assesses the patient’s ability to
communicate

S2d UtilizedUtilizes patient preferences
for visual, auditory, or tactile
communication

S2e Assesses barriers to effective
communication

S2f Makes appropriate adaptations in
own communication based on patient and
family assessment

S2g Assesses the impact of use of self in
effective communication

Nurse of the Future: Nursing Core Competencies© | 33

K3a Understands the nurse’s role
and responsibility in applying the
principles of verbal and nonverbal
communication

K3b Understands the nurse’s role
and responsibility in applying
principles of active listening

K3c Recognizes the value
of validation in an effective
therapeutic relationship

A3a Values the therapeutic use of self in patient care

A3b Appreciates the dynamics of physical and emotional
presence on communication

A3c Appreciates the influences of physiological, psychosocial,
developmental, spiritual, and cultural influences on one’s own
ability to communicate

A3d Acknowledges that acceptance of another person’s
behaviors will enhance the therapeutic relationship and facilitate
communication

S3a Establishes rapport

S3b Actively listens to comments,
concerns, and questions

S3c Demonstrates effective interviewing
techniques

S3d Provides opportunity to ask and
respond to questions

S3e Assesses verbal and non-verbal
responses

S3f Adapts communication as needed
based on patient’s response

S3g Distinguishes between effective and
ineffective communication with patients
and families

S3h Utilizes selected forms and levels
of validation to minimize conflict and
enhance the therapeutic relationship

K4 Identifies techniques for
reducing violent and/or disruptive
behavior

A4 Recognizes situations where de-escalation techniques are
required to prevent violence and aggression levels of validation
to minimize conflict and enhance the therapeutic relationship

S4 Utilizes verbal and non-verbal
communication skills to reduce and
manage violent and/or disruptive behavior

Nurse of the Future: Nursing Core Competencies© | 34

Collegial Communication & Conflict Resolution

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K5a Understands what each health
team member uniquely provides in
terms of patient care

K5b Interprets differences in
communication styles among
patients and families, nurses, and
other members of the health team

K5c Understands the various
modes to communicate with
members of the health care team

K5d Discusses effective strategies
for communicating and resolving
conflict

K5e Understands the principles of
group process and negotiation

K5f Acknowledges the presence
of an authority gradient in the
healthcare team

A5a Cares about people as individuals, valuing all members of
the health care team and their roles as important to patient care

A5b Appreciates the contributions of others in helping patient
and families achieve health goals

A5c Recognizes the limitations of electronic communication in
real time processing

A5d Recognizes that each individual involved in a conflict has
accountability for it and should work to resolve it

A5e Acknowledges negotiation as a strategy to identify mutually
acceptable ways to meet patient care objectives

A5f Accepts graded assertiveness as a technique to
communicate

S5a Demonstrates empathy and concern
while ensuring organizational goals are
met

S5b Asserts views in a straightforward
unambiguous manner

S5c Selects the appropriate
communication mode (verbal v.
electronic) for the situation

S5d Uses standardized communication
approaches in all communications and in
care transitions

S5e Uses a structured approach to
communicate effectively with colleagues

S5f Contributes to resolution of conflict
through negotiation

S5g Expresses concern through as
stepped process, escalating as the safety
of the patient and the situation requires

K6 Identifies cultural variations in
approaches to interactions with
others

A6 Identifies how one’s own personality, preferences, and
patterns of behavior impact communication with others

S6 Applies self-reflection to better
understand one’s own manner of
communicating with others

K7 Examines the role of the
nurse in assuring patient privacy,
security, and confidentiality

A7 Accepts responsibility to maintain patient confidentiality S7 Distinguishes which members of the
healthcare team have a valid right to know
selected patient information

Nurse of the Future: Nursing Core Competencies© | 35

Teaching/Learning

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K8a Understands the influences
of different learning styles on the
education of patients and families

K8b Identifies differences in
auditory, visual, and tactile
learning styles

K8c Understands the principles of
teaching and learning

K8d Is aware of the three domains
of learning: cognitive, affective,
and psychomotor

K8e Understands the concept of
health literacy

K8f Understands the process of
cooperative learning

K8g Understands the purpose of
health education

A8a Values different means of communication used by patients
and families

A8b Recognizes learning styles vary by individual

A8c Values the patient’s right to know the reason for chosen
interventions

A8d Values the need for teaching in all three domains of learning

A8e Accepts responsibility to insure the patient receives health
information that is understandable

A8f Values cooperative learning strategies as a method to
facilitate learning

A8g Accepts the role and responsibility for providing health
education to patients and families

S8a Assesses factors that influence the
patient’s and family’s ability to learn,
including readiness to learn, preferences
for learning style, and levels of health
literacy

S8b Incorporates facts, values, and skills
into teaching plan

S8c Assists patients and families in
accessing and interpreting health
information and identifying healthy
lifestyle behaviors

S8d Provides relevant and sensitive health
education information and advice to
patients and families

S8e Participates in cooperative learning

S8f Discusses clinical decisions with
patients and families

S8g Evaluates patient and family learning

Nurse of the Future: Nursing Core Competencies© | 36

COMMUNICATION BIBLIOGRAPhy

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice (Rev. ed.).
Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Bednarz, H, Schim, S., & Doorenbos, A. (2010). Cultural diversity in nursing education: Perils, pitfalls, and pearls. Journal of Nursing
Education, 49(5), 253-260.

Bloom, B. S. (1956). Taxonomy of educational objectives, the classification of educational goals, Handbook I: Cognitive domain. New York,
NY: David McKay.

Colorado Council on Nursing Education. (2007). The Colorado Nursing Articulation Model: 2002-2005. Publication of the Colorado
Trust. Retrieved from http://www.centralcoahec.org/documents/nursing_articulation

Curtis, K., Tzannes, A., & Rudge, T. (2011). How to talk to doctors – A guide for effective communication. International Nursing Review,
58(1), 13-20.

Harvey, P., & Ahmann, E. (2014). Validation: A Family-Centered Communication Skill. Pediatric Nursing 40(3), 143-147.

Hughes, R. G. (Ed.). (2008). Patient safety and quality: An evidence-based handbook for nurses. AHRQ Publication No. 08-0043.
Rockville, MD: Agency for Healthcare Research and Quality.

IOM Committee on Health Literacy. (2004). Health literacy: A prescription to end confusion. Washington, DC: The National Academies
Press.

Jackson, D. (2008). Collegial trust: Crucial to safe and harmonious workplaces [Editorial]. Journal of Clinical Nursing, 17(12), 1541-1542.

Johnson, D. W., Johnson, R., & Smith, K. (1998). Active learning: Cooperation in the college classroom. Edina, MN: Interaction Book.

Lancaster, G., Kolakowshy-Hayner, S., & Greer-Williams, N. (2015). Interdisciplinary communication and collaboration among physicians,
nurses, and unlicensed assistive personnel. Journal of Nursing Scholarship, 47(3), 275-284.

Ohio League for Nursing. (n.d.). Ohio Nursing Articulation Model: September, 2003-2005. Retrieved from
http://www.ohioleaguefornursing.org/associations/4237/files/HFFinalDocument

Price, O., & Baker, J. (2012). Key components of de-escalation techniques: A thematic synthesis. International Journal of Mental Health
Nursing, 21(4), 310-319.

Potempa, K. (2002). Finding the courage to lead: The Oregon experience. Nursing Administration Quarterly, 26(4), 9-15.

Robinson, F., Gorman, G., Slimmer, L., & Yudkowsky, R. (2010). Perceptions of effective and ineffective nurse-physician communication in
hospitals. Nursing Forum, 45(3), 206-216

Nurse of the Future: Nursing Core Competencies© | 37

Teamwork and Collaboration
The Nurse of the Future will function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared
decision making, team learning, and development (Adapted from QSEN, 2007).

Self

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Identifies own strengths,
limitations, and values in
functioning as a member of a team

A1a Recognizes responsibility for contributing to effective team
functioning

A1b Appreciates the importance of collaboration

A1c Recognizes the value of mutual respect and collegial trust
among team members

S1a Acts with honesty and integrity when
working with patients, families, and team
members

S1b Demonstrates self-awareness of
strengths and limitations as a team
member

S1c Initiates plan for self-development as
a team member

S1d Acts collaboratively with integrity,
consistency, and respect for diverse and
differing views

Team

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K2 Describes scope of practice,
team mission, objectives, norms
and resources and roles of
interdisciplinary and nursing
health care team members

A2 Values the perspectives and expertise of all health team
members

S2a Functions competently within own
scope of practice as a member of the
health care team

S2b Uses knowledge of one’s own
role and those of other professions to
appropriately assess and address the
healthcare needs of the patients and
populations served

Nurse of the Future: Nursing Core Competencies© | 38

K3 Identifies contributions of other
individuals and groups in helping
patients and families achieve
health goals

A3 Respects the centrality of the patient and family as core
members of any health care team

S3a Practices collaborative decision-
making and practice through
accommodation, negotiation, coordination
and shared accountability

S3b Assumes the role of team member or
leader based on the situation

K4 Describes strategies for
identifying and managing overlaps
in team member roles and
accountabilities

A4 Respects the unique professional and cultural attributes that
members bring to a team

S4a Initiates requests for assistance when
situation warrants it

S4b Manages, within the scope of
practice, areas of overlap in role and/or
accountability in team member functioning

S4c Integrates the contributions of others
in assisting patient/family to achieve
health goals

Nurse of the Future: Nursing Core Competencies© | 39

Team Communication

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K5 Understands the impact of the
effective collegial communication
on patient outcomes

A5 Values teamwork and the relationships upon which it is based S5a Adapts own communication style
to meet the needs of the patient, family,
team and situation

S5b Demonstrates commitment to team
goals

S5c Solicits input from other team
members to improve individual and team
performance

S5d Shares instructive feedback on
performance in respectful ways

Effect of Team on Safety & Quality

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K6a Understands the impact of
effective team functioning on
safety and quality of care

K6b Discusses how authority and
hierarchy influence teamwork and
patient safety

A6a Recognizes the risks associated with transferring patient
care responsibilities to another professional (“hand-off”) during
care transitions

A6b Appreciates patient-centered problem solving as the
overarching framework for team’s care delivery process

S6a Follows communication practices to
minimize risks associated with transfers
between providers during care transitions

S6b Asserts own position/perspective in
discussions about patient care

S6c Chooses communication styles
that diminish the risks associated
with authority gradients among team
members

Nurse of the Future: Nursing Core Competencies© | 40

Impact of Systems on Team Functioning

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K7a Identifies systems factors that
facilitate or interfere with effective
team functioning

K7b Identifies lateral violence as
a barrier to teamwork and unit
functioning

K7c Identifies civility as a
facilitator of effective teamwork
and unit functioning

K7d Explores strategies for
improving work units to support
team functioning

A7a Recognizes tensions between professional autonomy and
systems factors

A7b Recognizes behaviors that contribute to lateral violence

A7c Recognizes behaviors that promote civility within the team
and work setting

A7d Values the creation of system solutions in achieving quality
of care

S7a Contributes to effective team
functioning

S7b Practices strategies including
cognitive rehearsal to minimize lateral
violence

S7c Practices strategies including
patience, prudence, kindness, respect and
tact to encourage and support civility

S7d Participates in designing work units
that support effective teamwork

Nurse of the Future: Nursing Core Competencies© | 41

TEAMWORK AND COLLABORATION BIBLIOGRAPhy

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice
(Rev. ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Center for American Nurses (2008). Lateral violence and bullying in nursing. Retrieved from https://www.mc.vanderbilt.edu/root/
pdfs/nursing/center_lateral_violence_and_bullying_position_statement_from_center_for_american_nurses

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007). Quality and safety education for
nurses. Nursing Outlook, 55(3), 122-131.

Edmonson, C., (2010). Moral Courage and the Nurse Leader. OJIN: The Online Journal of Issues in Nursing, 15 (3) Manuscript 5.
DOI: 10.3912/OJIN.Vol15No03Man05

Fritz, J., (2011). Civility in the workplace. Spectra, 11- 15.

Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. Journal of
Continuing Education in Nursing, 35(6), 257-6.

Griffin, M., Clark, C. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10
years later. Journal of Continuing Education in Nursing, 45(12), 535-542.

Interprofessional Education Collaborative. (2011). Core competencies for interprofessional collaborative practice. Report of an expert
panel. Washington, DC: Author.

Interprofessional Education Collaborative. (2011). Team-based competencies building a shared foundation for education and practice.
Conference Proceedings. Washington, DC: Author.

Jackson, D. (2008). Collegial trust: Crucial to safe and harmonious workplaces [Editorial]. Journal of Clinical Nursing, 17(12), 1541 1542.

Quality and Safety Education for Nursing. (2014). Quality and safety competencies. Retrieved from
http://qsen.org/competencies/pre-licensure-ksas/

van Schaik, S., O’Brien, B., Almeida, S., & Adler, S. (2014). Perceptions of interprofessional teamwork in low-acuity settings: A
qualitative analysis. Medical Education, 48(6), 583-592.

Nurse of the Future: Nursing Core Competencies© | 42

Safety
The Nurse of the Future will minimize risk of harm to patients and providers through both system effectiveness and individual performance (QSEN, 2007).

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Identifies human factors and
basic safety design principles that
affect safety

A1 Recognizes the cognitive and physical limitations of human
performance

S1 Demonstrates effective use of
technology and standardized practices
that support safe practice

K2 Describes the benefits and
limitations of commonly used
safety technology

A2 Recognizes the tension between professional autonomy and
standardization

S2 Demonstrates effective use of strategies
at the individual and systems levels to
reduce risk of harm to self and others

K3 Discusses effective strategies
to enhance memory and recall and
minimize interruptions

A3 Recognizes that both individuals and systems are accountable
for a safe culture

S3 Uses appropriate strategies to reduce
reliance on memory and interruptions

K4a Delineates general categories
of errors and hazards in care

K4b Describes factors that create
a culture of safety

K4c Describes optimal processes
for communicating with patients/
families experiencing adverse
events

A4a Recognizes the importance of transparency in
communication with the patient, family, and health care team
around safety and adverse events

A4b Recognizes the complexity and sensitivity of the clinical
management of medical errors and adverse events

S4a Participates in collecting and
aggregating safety data

S4b Uses organizational error reporting
system for “near miss” and error reporting

S4c Communicates observations or
concerns related to hazards and errors
involving patients, families, and/or health
care team

S4d Utilizes timely data collection to
facilitate effective transfer of patient care
responsibilities to another professional
during transitions in care (“hand-offs”)

S4e Discusses clinical scenarios in which
sensitive and skillful management of
corrective actions to reduce emotional
trauma to patients/families is employed

S4f Participates in safety surveys

Nurse of the Future: Nursing Core Competencies© | 43

K5 Describes how patients,
families, individual clini cians,
health care teams, and systems
can contribute to promoting safety
and reducing errors

A5 Recognizes the value of analyzing systems and individual
accountability when errors or near misses occur

S5 Participates in analyzing errors and
designing systems improvements

K6a Describes processes used in
understanding causes of error and
in allocation of responsibility and
accountability

K6b Discusses potential and actual
impact of established patient safety
resources, initiatives and regulations

K6c Describes the elements
for sustaining a High Reliable
Organization (HRO)

A6a Values the systems’ benchmarks that arise from established
safety initiatives

A6b Values the importance for using a model for applying the
principles of reliability to healthcare systems: prevent failure,
identify and mitigate failure and redesign processes on identified
failure

A6c Values the paradigm that works to promote patient safety
and efficient healthcare delivery

S6a Uses established safety resources for
professional development and to focus
attention on assuring safe practice

S6b Participates within methods for
evaluating and improving the overall
reliability of a complex system

S6c Uses elements identified by AHRQ
when delivering care: awareness of
operations, reluctance to accept excuses,
preoccupation with failure, deferring to
expertise, continuous resiliency

Nurse of the Future: Nursing Core Competencies© | 44

SAFETy BIBLIOGRAPhy

Agency for Healthcare Research and Quality [AHRQ] (2015). Patient safety indicators. Retrieved from
http://qualityindicators.ahrq.gov/Modules/psi_overview.aspx

Agency for Healthcare Research and Quality [AHRQ] (2015). Patient safety network: Glossary. Retrieved from
http://www.psnet.ahrq.gov/glossary.aspx

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice
(Rev. ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Crigger, N., & Godfrey, N. (2014). Professional wrongdoing: Reconciliation and recovery. Journal of Nursing Regulation, 4(4), 40-45.

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007). Quality and safety education for
nurses. Nursing Outlook, 55(3), 122-131.

Healthcare Performance Improvement. (2009). SEC and SSER patient safety measure system for healthcare (Rev. 1). Virginia Beach, VA:
Author. Retrieved from http://hpiresults.com/docs/PatientSafetyMeasurementSystem

Institute for Health Care Improvement (IHI). Develop a culture of safety. Retrieved from
http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/Changes/Develop+a+Culture+of+Safety.htm

Institute of Medicine. (1999). To err is human: Building a safer health care system. Washington, DC: The National Academies Press.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: The National
Academies Press.

Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: The National Academies Press.

Leape, L. (2000). Reporting of medical errors: Time for reality check. Quality in Healthcare, 9(3), 144-145.

Leape, L., & Berwick, D. (2000). Safe health care: Are we up to it? British Medical Journal, 320, 725-26.

Leape, L., Lawthers, A. G., Brennan, T. A., & Johnson, W. G. (1993). Preventing medical injury. Quality Review Bulletin, 19(5), 144-149.

Massachusetts Coalition for Prevention of Medical Errors. (2006). When things go wrong: Responding to adverse events. A consensus
statement of the Harvard hospitals. Retrieved from http://www.macoalition.org/documents/respondingToAdverseEvents

Mattox, E. A. (2012). Strategies for improving patient safety: Linking task to error type. Critical Care Nurse, 32(1), 52-78.

Mengis, J. & Nicolon, D. (2010). Root cause analysis in clinical event. Nursing Management, 16(9), 16-20.

Nolan, T., Resar, R., Haradenm C., & Griffin, F. A. (2004). Improving the reliability of healthcare. IHI Innovation Series Whitepaper.
Cambridge, MA. Institute of Healthcare Improvement.

Reason, J. (2000). Human error: Models and management. British Journal of Medicine, 320, 768-770.

The Joint Commission. (2009). 2009 National Patient Safety Goals Hospital Program.

The Joint Commission (2015). National Patient Safety Goals. Retrieved at http://www.jointcommission.org/hap_2015_npsgs/

Nurse of the Future: Nursing Core Competencies© | 45

Quality Improvement
The Nurse of the Future uses data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously
improve the quality and safety of health care systems. (QSEN, 2007)

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Describes the nursing context
for improving care

A1 Recognizes that quality improvement is an essential part of
nursing

S1a Actively seeks information about
quality initiatives in their own care
settings and organization

S1b Actively seeks information about
quality improve ment in the care setting
from relevant institutional, regulatory and
local/national sources

K2 Comprehends that nursing
contributes to systems of care and
processes that affect outcomes

A2 Recognizes how team collaboration is important to quality
improvement and values the input from the interprofessional
team

S2 Participates in the use of a quality
improvement model and tools to make
processes of care interdependent and
explicit

K3 Explains the importance of
variation and measurement in
providing quality nursing care with
awareness, of diverse populations
and/or issues

A3a Appreciates how standardization supports quality
patient care

A3b Recognizes how unwanted variation compromises care

S3 Participates in the use of quality
improvement tools to assess performance
and identify gaps between local and best
practices

K4 Describes approaches
for improving processes and
outcomes of care

A4 Recognizes the value of what individuals and teams can do to
improve care processes and outcomes of care

S4a Participates in the use of quality
improvement practices and implements
changes in the delivery of care with
consideration for population based health
care

S4b Implements best practices for
preventing harm

Nurse of the Future: Nursing Core Competencies© | 46

QUALITy IMPROVEMENT BIBLIOGRAPhy

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice
(Rev. ed.). Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007). Quality and safety education
for nurses. Nursing Outlook, 55(3), 122-131.

Dolansky, M., & Moore, S. (2013). Quality and Safety Education in Nursing (QSEN): The key is systems thinking. Online Journal of
Issues in Nursing, 18(3). Manuscript 1. Retrieved from http://www.nursingworld.org/Quality-and-Safety-Education-for-
Nurses.html

Institute of Healthcare Improvement (2015). How to improve. Retrieved at
http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Massachusetts Coalition for Prevention of Medical Errors. (2006). When things go wrong: Responding to adverse events. A consensus
statement of the Harvard hospitals. Retrieved from http://www.macoalition.org/documents/respondingToAdverseEvents

Miller R., Winterton T., & Hoffman, W. (2014). Building a Whole New Mind: An Interprofessional Experience in Patient Safety and
Quality Improvement Education Using the IHI Open School. South Dakota Medicine, 17-22.

The Joint Commission. (2009). 2009 National Patient Safety Goals Hospital Program.

The Joint Commission. (2015). Hospital: 2016 National Patient Safety Goals. Retrieved from
http://www.jointcommission.org/standards_information/npsgs.aspx

Nurse of the Future: Nursing Core Competencies© | 47

Evidence-Based Practice
The Nurse of the Future will identify, evaluate, and use the best current evidence coupled with clinical expertise and consideration of patients’ preferences,
experience and values to make practice decisions (Adapted from QSEN, 2007).

KNOWLEDGE ATTITUDES/BEhAVIORS SKILLS

K1 Demonstrates knowledge of
basic scientific methods and
processes

A1a Appreciates strengths and weaknesses of scientific
bases for practice

A1b Values the need for ethical conduct in practice and research

S1a Participates in the development of
clinical questions for potential research

S1b Critiques/appraises research for
application to practice

S1c Participates in data collection and
other research activities

S1d Follows the guidelines and
requirements pertaining to Human Subject
Protection for conducting research

K2 Describes the concept of
evidence-based practice (EBP),
including the components
of research evidence, clinical
expertise, and patient/family
values

A2 Values the concept of EBP as integral to determining best
clinical practice

S2 Bases individualized care on best
current evidence, patient values,
and clinical expertise

K3 Describes reliable sources for
locating evidence reports and
clinical practice guidelines

A3 Appreciates the importance of accessing relevant clinical
evidence

S3 Locates evidence reports related to
clinical practice topics and guidelines
within appropriate databases

K4 Differentiates clinical opinion
from research and evidence
summaries

A4 Appreciates that the strength and relevance of evidence
should be determinants when choosing clinical interventions

S4a Applies research and evidence
reports related to area of practice

S4b Understands the use of best practice
and evidence at the patient level, clinical
level, population level and across the
system

Nurse of the Future: Nursing Core Competencies© | 48

K5 Explains the role of evidence in
determining best clinical practice

A5a Questions the rationale of supporting routine approaches to
care processes and decisions

A5b Values the need for continuous improvement in clinical
practice based on new knowledge

S5 Facilitates integration of new evidence
into standards of practice, policies, and
nursing practice guidelines

K6a Identifies evidence-based
rationale when developing and/or
modifying clinical practices

K6b Understands data collection
methodologies appropriate to
individuals, families, and groups in
meeting health care needs across
the life span

A6 Acknowledges own limitations in knowledge and clinical
expertise before seeking evidence and modifying clinical practice

S6 Uses current evidence and clinical
experience to decide when to modify
clinical practice

Nurse of the Future: Nursing Core Competencies© | 49

EVIDENCE-BASED PRACTICE BIBLIOGRAPhy

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice (Rev. ed.).
Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education-resources/baccessentials08

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007). Quality and safety education for
nurses. Nursing Outlook, 55(3), 122-131.

Dearholt, S., & Dang, D. (2012). John Hopkins nursing evidence based practice model and guidelines (2nd ed.) Indiana, IN: Sigma Theta
Tau International.

Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing practice. Philadelphia, PA: F. A. Davis.

Fineout-Overholt, E., Williamson, K. M., Gallagher-Ford, L., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence based practice, Step by step:
Following the evidence: Planning for sustainable change. American Journal of Nursing, 111(1), 54-60.
doi: 10.1097/01.NAJ.0000393062.83761.c0

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence based practice: Step by step: Implementing an
evidence based practice change. American Journal of Nursing, 111(3):54-60.
doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Rolling Out the
Rapid Response Team. American Journal of Nursing, 111(5):42-47.
doi: 10.1097/01.NAJ.0000398050.30793.0f

Grove, S. K., Burns, N., & Gray, J. R. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St.
Louis, MO: Saunders Elsevier.

Melnyk, B. M., & Fineout-Overholt, E. F. (2005). Evidence-based practice in nursing and healthcare. Philadelphia, PA: Lippincott Williams
& Wilkins.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011) Evidence based practice, Step by step: Sustaining evidence
based practice policies and an innovative model. American Journal of Nursing, 111(9), 57-60
doi: 10.1097/01.NAJ.0000405063.97774.0e

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice, Step by step: Igniting a spirit of
Inquiry. American Journal of Nursing, 109(11), 49-52.
doi: 10.1097/01.NAJ.0000363354.53883.58

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice, Step by step: The seven steps of
evidence based practice. American Journal of Nursing, 110 (1), 51-53.
doi: 10.1097/01.NAJ.0000366056.06605.d2

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K .M. (2010). Evidence based practice, Step by step: Asking the clinical
question: A key step in evidence based practice. American Journal of Nursing, 110 (3), 58-61.
doi: 10.1097/01.NAJ.0000368959.11129.79

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence based practice, Step by step: Searching the
evidence. American Journal of Nursing, 110(5), 41-47.
doi: 10.1097/01.NAJ.0000372071.24134.7e

Nurse of the Future: Nursing Core Competencies© | 50

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence Based Practice, Step by step: Critical
Appraisal of the Evidence: Part I. American Journal of Nursing, 110 (7), 47-52.
doi: 10.1097/01.NAJ.0000383935.22721.9c

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence based practice, Step by step: Critical
appraisal of the evidence: Part II: Digging deeper, examining the “keeper” studies. American Journal of Nursing, 110 (9), 41-48.
doi: 10.1097/01.NAJ.0000388264.49427.f9

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K .M. (2010). Evidence based practice, Step by step: Critical appraisal
of the evidence Part III. American Journal of Nursing, 110 (11), 43-51.
doi: 10.1097/01.NAJ.0000390523.99066.b5

Nurse of the Future: Nursing Core Competencies© | 51

Glossary
Adverse event Any injury caused by medical care (Massachusetts Coalition for the Prevention of Medical Errors, 2006).

Authority Gradient The command hierarchy of power, or the balance of power, measured in terms of steepness. The authority gradient
can influence both patient care and organizational decisions by repressing those in subordinate positions, keeping
them from influencing or making decisions they consider to be the most appropriate (Edmonson, 2010).

Care Transitions Patient moves between healthcare providers and between settings within a facility and between facilities, inclusive
of the home

Clinical reasoning Reasoning across time about particular situations and through changes in the patient’s condition or concerns
and/or changes in the clinician’s understanding of the patient’s clinical condition or concerns (Benner, Sutphen,
Leonard-Kahn & Day, 2008).

Cognitive rehearsal Behavioral technique generally consisting of three parts:
• Participating in didactic instruction about incivility and lateral violence
• Identifying and rehearsing specific phrases to address incivility and lateral violence
• Practicing the phrases to become adept at using them (Griffin, 2014).

Collaborative practice This practice can include interdisciplinary teams, nurse-physician interaction in joint practice, or nurse-physician
collaboration in care giving. Collaboration is cooperative and synergistic. The interaction between nurse and
physicians or other health care team members in collaborative practice should enable the knowledge and skills of
the professions to influence the quality of patient care (Tomey, 2009).

Collegial trust A form of personal trust that relates to our colleagues and refers to the expectations that they will behave
professionally, work with integrity and do the things they say they are going to do, or the things we can rightfully
expect them to do (such as follow established protocols etc.) (Jackson, 2008)

Cooperative learning Student interactions in purposefully structured groups that encourage individual flexibility and group learning
through positive interdependence, individual accountability, face-to-face interaction, appropriate use of
collaborative skills, and regular self-assessment of team functioning.

Critical thinking The disciplined, intellectual process of applying skillful reasoning as a guide to belief or action (Paul, Ennis & Norris).
In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with
openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care
(Heaslip, 2008).

Nurse of the Future: Nursing Core Competencies© | 52

Culturally congruent practice Healthcare that is customized to fit within the patient’s values, beliefs, traditions, practices and lifestyles (Jeffreys,
2010).

Data Integrity Secured and protected transmission of information between patients and their providers or designated others,
including clinicians and other staff following all legal, ethical, and organization policies to protect and maintain
confidentiality (Technology Information Guiding Educational Reform, 2009).

Delegated practice Assessments and interventions in this realm are determined by the medical plan of care and specific provider-
directed interventions. The nurse carries out these delegated functions when his or her knowledge, experience,
and judgment confirm that the specific medical order is appropriate and safe for the patient being served
(Koloroutis, 2004).

Domains of learning Cognitive domain of learning skills revolves around knowledge, comprehension, and thinking through a
particular topic.

Affective domain of learning skills describes the way people react emotionally in terms of attitudes and feelings.
Psychomotor domain of learning skills describes the ability to physically perform a task or behavior.
(Bloom, 1956)

Evidence-based practice Uses the current best evidence to make decisions about patient care. Integrates the search for and critical appraisal
of current evidence relating to a clinical question, the nurse’s expertise, and the patient’s preferences and values
(Melnyk and Fineout-Overholt, 2005).

Research utilization tends to use knowledge typically from one study while evidence-based practice incorporates
the expertise of the practitioner and patient preferences and values (Melnyk and Fineout-Overholt, 2005).

Global health The health of populations around the world in an environment that disregards national borders and transcends the
perspectives and concerns of individual nations, instead reflecting factors including global political, economic, and
workforce issues (American Association of Colleges of Nursing, 2008).

Goal-driven model Nursing care delivery model in which the work flow originates in the nurse’s assessment of patient needs and
assumes that the resources required to deliver a comprehensive package of care based on patient needs will be
forthcoming. The goals for the patient drive the care (Barnum & Kerfoot, 1995).

Hand-off Transfer of verbal and/or written communication about patient condition between care providers (QSEN, 2007).

Health literacy The degree to which individuals can obtain, process, and understand the basic health information and services they
need to make appropriate health decisions (IOM, 2004).

Health care team(s) Interprofessional and multidisciplinary members across the continuum of care

Nurse of the Future: Nursing Core Competencies© | 53

High reliable organization There are 5 key concepts essential for any improvement initiative to succeed: 1) Sensitivity to operations, 2)
Reluctance to simplify, 3) Preoccupation with failure, 4) Deference to expertise, and 5) Resilience.

Independent practice The nurse conducts assessments and interventions for the purpose of promoting health and healing. The focus is on
the patient’s response to actual or potential health problems (Koloroutis, 2004).

Interdependent practice The nurse initiates communication with other members of the health care team to assure that the patient
and family receive the full scope of interdisciplinary expertise and services commensurate with a coordinated and
integrated plan of care (Koloroutis, 2004).

Interprofessionality The process by which professionals reflect on and develop ways of practicing that provides an integrated and
cohesive answer to the needs of the client/family/population It involves continuous interaction and knowledge
sharing between professionals, organized to solve or explore a variety of education and care issues all while seeking
to optimize the patient’s participation (Interprofessional Education Collaborative, 2011).

Lateral violence Nurses covertly or overtly directing their dissatisfaction inward toward each other, toward themselves, and toward
those less powerful than themselves (Griffin, 2004).

Learning styles Particular methods (visual, auditory, and tactile) of interacting with, taking in, and processing information that
allows the individual to learn.

Near miss An event or situation that did not produce a patient injury, but only because of chance.

Operational failures The inability of the work system to reliably provide information, services, and supplies, when, where, and to whom
needed (Tucker, 2006).

Patient safety Freedom from accidental or preventable injuries produced by medical care (Massachusetts Coalition for the
Prevention of Medical Errors, 2006).

Professional comportment Demonstrates professional behaviors, including attention to appearance, demeanor, respect for self and others,
and attention to professional boundaries with patients and families as well as among caregivers (Benner, 2008).

Quality improvement practices Planned or systematic actions that require the open exchange of information to guide improvement or system
changes.

Quality improvement model and
tools

Documents used to collect data for investigation and analysis of events.

Nurse of the Future: Nursing Core Competencies© | 54

Resource-driven model Nursing care delivery models in which the nurse takes into account the environment and the resources it holds to
determine what goals can reasonably be met for a patient or group of patients. This requires the nurse to make
the best selection of goals and use scarce resources appropriately (Barnum & Kerfoot, 1995).

Safety culture Commitment to safety that permeates all levels of health care delivery (Agency for Health care Research and
Quality, n.d.).

Work unit The practice environment in which the nurse/team delivers care to patients/families.

Nurse of the Future: Nursing Core Competencies© | 55

Professional Standards

Professional standards developed by the following organizations were used as a framework for the NOF Nursing Core Competencies:

>> Accreditation Council for Graduate Medical Education (ACGME)

>> Agency for Healthcare Research and Quality (AHRQ)

>> American Association of Colleges of Nursing (AACN)

>> American Nurses Association (ANA)

>> American Organization of Nurse Executives (AONE)

>> Bologna Accord

>> Commission on Collegiate Nursing Education (CCNE)

>> Competency Outcomes and Performance Assessment (COPA)

>> Institute of Medicine (IOM)

>> International Council of Nurses (ICN)

>> Interprofessional Education and Collaboration (IPEC)

>> National Council of State Boards of Nursing (NCSBN)

>> National League for Nursing (NLN)

>> National League for Nursing Accrediting Commission, Inc. (NLNAC)

>> Quality and Safety Education for Nurses (QSEN)

Nurse of the Future: Nursing Core Competencies© | 56

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Nurse of the Future Competency Committee- 2016 Review
Margery Chisholm, RN, EdD, ABPP, Professor, School of Nursing, MGH Institute of Health Professions

Genevieve Conlin, DNP, MS/MBA, RN, NEA-BC, Associate Chief Nursing Officer, Ambulatory Services, Boston Medical Center

Eileen Costello, DNP, RN, CNE, Dean, Health Professions, Public Service Programs, and Social Sciences, Mount Wachusett Community College *
Judith Cullinane, MSN, RN, CCRN, Professional Development Director, Pediatrics, Tufts Medical Center and Associate Professor of Practice, Simmons College
School of Nursing and Health Sciences

Anna Hagopian, MSN, RN, Nurse Educator, Metro West Medical Center

Diane Hanley, MS RN-BC EJD, Associate Chief Nursing Officer, Professional Practice, Nursing Quality and Education, Boston Medical Center, Co-Chair

Mary Kennedy, MS, RN-BC, CEO, Aegis Informatics LLC; Clinical Instructor, Northeastern University

Karen Devereaux Melillo, PhD, A-GNP-C, FAANP, FGSA, Professor & Interim Dean, School of Nursing, College of Health Sciences, UMass Lowell *

Judith M. Pelletier, MSN, RN, Director of the Practical Nursing Program, Upper Cape Cod Technical High School *

Marita Prater, MS, RN, Vice President for Patient Care Services, CNO; Sturdy Memorial Hospital

Lorraine Schoen, MS, BSN, RN, Director of Clinical Affairs, Massachusetts Hospital Association

Maureen Sroczynski, DNP, RN, President/CEO, Farley Associates, Inc. *

Mary Tarbell, MS, RN, Assistant Professor/Division of Nursing, American International College

Marie Tobin, DNP, MPH, RN, NEA-BC, Director, Centralized Clinical Placement Program, Department of Higher Education

Diane M. Welsh, DNP APRN CNE, Associate Dean, Nursing; Associate Professor, Regis College, Co-Chair *

Patricia M. Crombie, MSN, RN, Director, Healthcare-Nursing, Department of Higher Education & Project Director, Massachusetts Action Coalition

Dale Earl, Project Manager, Healthcare-Nursing, Department of Higher Education; Copy Editor

ADDITIONAL CONTRIBUTORS
Alice Chamberlain, RN, BSN, Clinical Informatics Nurse; Sturdy Memorial Hospital

Sarah Collins PhD, RN, Senior Clinical and Nurse Informatician; Clinical Informatics, Partners eCare, Partners Healthcare Systems Instructor in Medicine,
Harvard Medical School & Brigham and Women’s Hospital

Andrew B. Phillips, PhD, RN, Assistant Professor, School of Nursing, MGH Institute of Health Professions, Massachusetts General Hospital, Partners HealthCare
System

Po-Yin Yen, PhD, RN, Research Assistant Professor; Department of Biomedical Informatics; The Ohio State University

Michelle Smith, MS, RN, Associate Professor of Nursing, Mount Wachusett Community College; Bibliography editor

Michelle Woodward, Web Content Specialist, Department of Higher Education; Design Editor

* Served on original Nurse of the Future Competency Committee