. Disclosure information for the ACC Competency Management Committee is available online, online, as is the ACC disclosure policy for document development. Core Practice Doctorate Clinical Nurse Specialist (CNS) Competencies (RETIRED) (PDF). ). Develop, implement, and evaluate individualized, patient-centered educational strategies. x�͙�n�F����R*����� �-�)�[email protected]�\02����fZ��3+)eY�)-��MRK��ggf��iݔw���^e�M�/�(n�Mv�n���C6���Ȯ�eY�M���w_>6���z������|&��$���C!� H ��u1��IT���|��(�YA.�����wN,�+�rs�Ϯƣ���~�ǣ��_ǣc�����F�H)+.�΄Ȯ�S��ޜy���~�)�� -�RB���� ��3{ΚBLH�8��P%$T Know the indications, contraindications, and monitoring implications of medications used in management of adults with simple congenital heart disease. 7. 6. Such efforts will promote and enhance collaborative, high-quality, patient-centered care teams. 7. Skill to develop a plan for lifestyle interventions in patients with heart failure. Know the pathophysiology of acute heart failure in peripartum and postpartum women. Know pharmacotherapy for the management of patients with acute coronary syndromes. Skills to evaluate and manage patients with venous thromboembolism. 9. Know the utility of biomarkers in the management of patients with heart failure. Cardiac Arrhythmias and Electrophysiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2496, Table 8. The ACC Competency Management Committee determined that RWI are not relevant to the creation of a general cardiology competence statement but provided employment and affiliation information for authors and peer reviewers in Appendixes 1 and 2, respectively, along with disclosure reporting categories. Know advanced therapies for pericardial disease. Skill to prescribe an exercise program for patients with intermittent claudication due to peripheral artery disease. Skills to perform perioperative evaluation and manage patients undergoing vascular procedures. Know the characteristics of patients likely to have difficulty adhering to cardiac rehabilitation and corresponding management strategies. Skill to manage perioperative patients following surgical and percutaneous valvular heart disease procedures. "Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies" "PAs can bring cost-effective care to complex patients" View all . Skills to evaluate and manage patients with venous insufficiency. Skills to evaluate and manage patients with new-onset, chronic, and acutely decompensated heart failure. Stable Ischemic Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2506, Table 13. Contribute to the design and implementation of information systems to enhance safety, quality, and cost effectiveness. Skills to recognize and manage central line infection. Skill to participate in diagnostic and interventional procedures. Know the genetic implications of family history and environmental and lifestyle factors in the development and clinical course of cardiovascular disease. Vascular Medicine Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2509, Author Relationships with Industry and Other Entities (Relevant) 2512. This table represent the individuals, organizations, and groups that peer reviewed this document. Skill to educate patients with cardiovascular disease on a heart healthy diet regimen. Know the impact of lifestyle factors on the development and prevalence of arrhythmias and best practices for counseling. Know causes of angina pectoris not related to coronary artery disease. These competencies are unique to each of the clinical areas identified in Table 1. Skill to integrate assessment of left ventricular function into the management of patients with acute coronary syndromes. Authors were then selected to address the criteria specified in Section 1.1.1. Former Competency Management Committee co-chair, co-chair during this writing effort. Acknowledgments The College of Nurses of Ontario (CNO) would like to thank CNO members who participated in the review and revision of this document. Know the indications for right and left heart catheterization in patients with heart failure. Skill to perform a physical assessment and examination for patients with lipid disorders. Nurse practitioner practice is grounded in the five World Health Organization (WHO) principles of primary health care: accessibility, public participation, health promotion, appropriate technology and intersectoral collaboration. Nurse practitioner core competencies are an essential element of nurse practitioner competence assessment. Know the indications for cardiac rehabilitation. Skill to provide preoperative risk assessment for patients with cardiovascular disease undergoing noncardiac surgery. These competencies may be assessed by the review of one’s individual practice, by review of hospital data, or through performance assessments or practice improvement initiatives. Know the indications and recommendations for initial testing for known or suspected simple congenital heart disease in adults. Skill to refine the therapeutic plan of care of patients with valvular heart disease based on laboratory and diagnostic test results. Acute Coronary Syndromes Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2490, Table 5. Know the clinical manifestations, differential diagnosis, evaluation, and treatment for common venous disorders. Know the diagnostic testing for patients with heart failure. Pre-Order: Core Curriculum for Orthopaedic Nursing, 8th Edition. Know the phases of cardiac rehabilitation and indications for referral. The writing committee consisted of a broad range of members selected by the ACC, including an equal number of cardiovascular NPs and PAs with expertise in the following clinical areas: acute coronary syndromes, adult congenital heart disease, ambulatory and consultative care cardiology, cardiac arrhythmias and electrophysiology, cardiovascular disease prevention, critical care cardiology, heart failure, pericardial disease, stable ischemic heart disease, valvular heart disease, and vascular medicine. . Know the principles of exercise physiology and guidelines for physical activity in patients with cardiovascular disease. Use information technology and informatics literacy to enhance professional practice. Know the pathophysiology and management of bicuspid aortic valve and associated aortopathy. Maintain continuity of care with efficient and effective handoffs throughout transitions of care. NSTE-ACS = non–ST-elevation acute coronary syndrome, STEMI = ST-elevation myocardial infarction, Endorsed by the American Academy of Physician Assistants, American Association of Heart Failure Nurses, American Association of Nurse Practitioners, American Heart Association, American Nurses Credentialing Center, Association of Physician Assistants in Cardiology, Heart Rhythm Society, Physician Assistant Education Association, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and The National Organization of Nurse Practitioner Faculties. Skills to assess and manage patients in refractory heart failure requiring intravenous inotropic support. This competency framework addresses the common core competencies and the wider range of skills, knowledge and behaviours a nurse needs, to be a fully proficient General Practice Nurse (GPN). Know the laboratory testing to obtain at various stages of lipid management. Know the primary prevention application of various cardiovascular risk assessment tools (e.g., atherosclerotic cardiovascular disease risk). Skills to recognize and manage complications of central venous pressure, invasive arterial, and/or hemodynamic monitoring systems. Know the role of neurohormonal activation and left ventricular remodeling in heart failure progression. Please refer to http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with-industry-policy for definitions of disclosure categories or additional information about the ACC Disclosure Policy for Writing Committees. Know the causes, symptoms, and indications for diagnostic testing and referral for inherited and acquired forms of thrombophilia. Know the risks and benefits of exercise in adults with complex congenital heart disease, including those with associated pulmonary hypertension. Skills to evaluate and manage hospitalized survivors of cardiac arrest. Know the noninvasive studies indicated for critical limb ischemia. The definitions are available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043418/. Skill to provide perioperative care to patients receiving cardiac implantable electronic devices. Skill to recognize abnormalities in segmental limb blood pressure measurements, pulse volume recordings, Doppler waveforms, and treadmill exercise test results in patients with known or suspected peripheral artery disease. Skill to manage patients with acute myocardial infarction and associated complications. Know the pathophysiology and clinical findings of heart failure in adults with simple congenital heart disease. Skills to initiate management of urgent or emergent cardiovascular conditions and prioritize management of patients with multicomponent illness. Know the indications for referring patients to heart failure clinics for advanced therapies, including mechanical circulatory support and/or heart transplant. Retrieved October 22, 2020, from Wittmann-Price, R. A., Godshall, M., & Wilson, L. (2017). Continuing education for NPs and PAs is important for ensuring high-quality care, fostering practice collaboration, sharing best practices, and providing an opportunity for self-assessment and reflection. Know the risk of arrhythmias and sudden death in patients with congenital or acquired structural heart disease. View Article Google Scholar; 2. Skill to utilize vasoactive and inotropic medications in the treatment of hypotension, heart failure, and shock. Skill to recognize cardiac devices that are designated magnetic resonance imaging conditional. American Academy of PAs Research Department. Committee members represented a diversity of geographic location; urban, suburban, and rural practice settings; academic and community-based practice settings; institution size; gender; ethnicity; and stage in career (early, mid, and later), as well as those who exemplified practice acumen and team model care expertise. Skill to obtain a history and physical examination as clinically indicated in patients with suspected acute coronary syndromes. Skill to manage patients with chronic ischemic heart disease and associated risk factors. Know the indications, risks, and complications of device extraction. Know the pharmacological and lifestyle interventions for the treatment of lipid disorders for primary and secondary prevention. A similar structure has been used by the ACC to describe the aligned general cardiology lifelong learning competencies that all practicing cardiologists are expected to maintain. Know the contraceptive methods considered safe and efficacious for women with simple congenital heart disease. Practice Resources. Know secondary prevention strategies for patients with acute coronary syndromes. Although no members participated in a formal representational role from other professional societies, the writing committee is composed of authors who are engaged in NP, PA, and cardiovascular specialty organizations. Know the noninvasive imaging studies indicated for screening family members at risk for connective tissue disorders. Know the management strategies for patients with advanced and end-stage heart failure. Valvular Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2508, Table 14. Skill to obtain a problem-focused history and physical examination in patients with coronary artery disease and variant angina. Know the indications for and limitations of ambulatory arrhythmia monitoring. Core Competencies. Many hospital systems also now use the 6-domain structure as part of medical staff privileging and peer-review professional competence assessments. Since the 1995 publication of its Core Cardiovascular Training Statement (COCATS) (1), the American College of Cardiology (ACC) has played a central role in defining the knowledge, experiences, skills, and behaviors expected of all clinical cardiologists upon completion of training. Know blood pressure thresholds and goals for nonpharmacological and pharmacological therapies. Know the management of valvular heart disease in pregnancy and women of childbearing age. ACHD = adult congenital heart disease; BACH = Boston Adult Congenital Heart; UPMC = University of Pittsburgh Medical Center. The writing committee convened by conference call and e-mail to finalize the document outline, develop the initial draft, revise the draft based on committee feedback, and ultimately approve the document for external peer review. Know the New York Heart Association functional classes (I, II, III, and IV) and stages (A, B, C, and D) of heart failure. Know the findings associated with mechanical complications of myocardial infarction. Skills to assess and participate in the management of adults with infective endocarditis associated with congenital heart disease. Nurse Practitioner Core Competencies with Suggested Curriculum Content 2017 In the development of the nurse practitioner (NP) population-focused competencies, a task force had extensive discussions of competencies vs. content. Skill to educate adult patients with congenital heart disease on prevention of thrombosis, thromboembolism, endocarditis, and on optimal oral health practices. Most clinical care teams that utilize NPs and PAs report enhanced practice performance, physician efficiency, revenue generation, improved clinical outcomes, and enhanced patient satisfaction (2–9). Know the clinical conditions that affect central venous, direct arterial, and hemodynamic waveform configuration, including arrhythmias, blood pressure changes, and fluid status. Skill to participate in hemodynamic catheterizations in patients with heart failure. Skill to obtain a history and physical examination for patients with elevated blood pressure and hypertension. Halperin J.L., Williams E.S., Fuster V., et al. Know the pathophysiology, differential diagnosis, and management of cardiac conduction disturbances. Demonstrate high ethical standards in personal and professional conduct. Know the indications for surveillance imaging in patients with stable valvular heart disease. Educate healthcare professionals about diagnosis and management of patients with a condition in one’s area of expertise. Know the inherited arrhythmia syndromes and indications for genetic testing and counseling for patients and family members. Know the causes, symptoms, and indications for diagnostic testing and referral for inherited and acquired forms of vasculitis. Skill to perform clinical assessments for patients in all forms of shock. Skills to recognize and medically manage specific wide complex tachycardias (e.g., monomorphic and polymorphic ventricular tachycardia). Reprint Department via fax (212-633-3820) or e-mail (E-mail: [email protected]com. Approved March 20, 2020 ACNM Core Competencies for Basic Midwifery Practice The Core Competencies for Basic Midwifery Practice include the fundamental knowledge, skills, and abilities expected of new midwives certified by the American Midwifery Certification Board (AMCB). Skill to assess biological, psychosocial, and cultural factors that influence learning of patients with heart failure. 4. Assess for and manage human responses exhibited by individuals with cardiovascular disease (e.g., depression, spiritual distress, nonadherence, decisional conflict). Know general concepts and modes of mechanical ventilation (e.g., tidal volume, fraction of inspired oxygen, positive end-expiratory pressure). Skill to obtain point-of-care echocardiographic images, including those for assessment of left ventricular function, pericardial effusion, central venous pressure estimation, aortic dimensions, and significant valvular dysfunction. Know the history and physical examination findings and their limitations in the evaluation of patients with heart failure. Respectfully participate in interdisciplinary care teams and consider opposing viewpoints for management. Patient surveys and multisource (360˚) evaluations in hospital or practice environments can provide information about outcomes, communication skills, and professionalism. Know the pharmacology, classes, indications, contraindications, risks, and interactions of medications commonly used for prevention and treatment of cardiovascular disease. Use practice data to assess appropriateness, quality, and safety of cardiovascular care. Skills to recognize and manage abnormalities in remote monitoring of implanted cardiac devices. Know the natural history of simple congenital heart disease. American Association of Nurse Practitioners. Skill to participate in the insertion of permanent pacemakers, internal cardiac defibrillators, or cardiac resynchronization devices. Skill to participate in advanced cardiac life support, emergent defibrillation, transcutaneous pacing, and cardioversion. Skill to recommend lifestyle interventions for patients with stable coronary artery disease. Heart Failure Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2503, Table 11. Know the pathophysiology, differential diagnosis, and management of ventricular arrhythmias. Know the indications for diagnostic testing for adults with complex congenital heart disease. Adult Congenital Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2492, Table 6. Clinical competencies for NPs and PAs are designed to promote a framework for educational initiatives and practice performance. The American Nurses Credentialing Center endorsed the document in April 2020. Skill to select the appropriate noninvasive or invasive diagnostic study for patients with known or suspected coronary artery disease. Skills to initiate management of patients with suspected acute aortic syndromes and coordinate care to ensure medical stability. To implement CBE, existing NP core competencies need to be reduced in number and … Laurant M., van der Biezen M., Wijers N., "Nurses as substitutes for doctors in primary care", "Expanding the role of advanced nurse practitioners—risks and rewards", "Practice information by state: what you need to know about NP practice in your state", "Cardiovascular nursing: scope and standards for practice". 8. Know basic lipoprotein biochemistry and metabolism. Select two Massachusetts Nurse of the Future Nursing Core Competencies that you believe will have the most impact on your future professional nursing practice. Know the pathophysiology, differential diagnosis, and management of atrial fibrillation, atrial flutter, and atrial tachycardias. 2020 ACC clinical competencies for nurse practitioners and physician assistants in adult cardiovascular medicine: a report of the ACC Competency Management Committee. Model cardiovascular teams are composed of members including but not limited to cardiologists, NPs, PAs, behavioral scientists, cardiovascular technologists, clinical nurse specialists, data/informatics professionals, exercise physiologists, genetic counselors, nurses, occupational therapists, pharmacists, physical therapists, registered dieticians, and social workers. Practice within organization bylaws and state and federal regulations governing nurse practitioner and physician assistant practice. Skill to participate in tilt table testing. Know the comorbidities associated with lipid disorders. Psychiatric Mental Health Nurse Practitioner Competencies (PDF file) The page you are accessing is a downloadable PDF file. Susan D. Housholder-Hughes, DNP, ACNS-BC, ANP-BC, FACC. J Am Coll Cardiol 2015; 65:1721-1723. Know the indications for implantation of permanent pacemakers. Know the impact of pregnancy in women with simple congenital heart disease. – least references included in your post. Know the indications for insertion of implantable cardioverter-defibrillators. Copies: This document is available on the World Wide Web sites of the American College of Cardiology ( www.acc.org), American Academy of Physician Assistants ( www.aapa.org), American Association of Heart Failure Nurses ( www.aahfn.org), American Association of Nurse Practitioners ( www.aanp.org), American Heart Association ( www.heart.org), Association of Physician Assistants in Cardiology ( www.cardiologypa.org), Heart Rhythm Society ( www.hrsonline.org), Physician Assistant Education Association ( www.paeaonline.org), Preventive Cardiovascular Nurses Association ( www.pcna.net), Society for Cardiovascular Angiography and Interventions ( www.scai.org), and The National Organization of Nurse Practitioner Faculties ( www.nonpf.org). The ACC approved the document for publication with endorsement from the American Academy of Physician Assistants, American Association of Heart Failure Nurses, American Association of Nurse Practitioners, American Heart Association, American Nurses Credentialing Center, Association of Physician Assistants in Cardiology, Heart Rhythm Society, Physician Assistant Education Association, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and The National Organization of Nurse Practitioner Faculties. Know the genetic syndromes and corresponding pathophysiology associated with congenital heart disease. Know the arrhythmia and conduction complications associated with STEMI. Skills to evaluate and collaboratively manage patients with valvular heart disease. J Am Coll Cardiol2015; 65:1721-1723. Collaborate with all team members to reduce preventable hospitalizations for patients with cardiovascular disease. Skills to calculate global atherosclerotic cardiovascular disease risk for primary prevention and plan an appropriate treatment plan based on risk level. Skill to integrate invasive hemodynamic data and angiographic findings in the management of patients with acute coronary syndromes. Table 1 Competency Framework for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine, Ambulatory and Consultative Care Cardiology, Cardiac Arrhythmias and Electrophysiology. Eric S. Williams, MD, MACC‡Former Competency Management Committee member; member during this writing effort.Former Competency Management Committee co-chair, co-chair during this writing effort.Former Competency Management Committee chair, chair during this writing effort. Table 3 Core Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 4 Acute Coronary Syndromes Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 5 Adult Congenital Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 6 Ambulatory and Consultative Care Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 7 Cardiac Arrhythmias and Electrophysiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 8 Cardiovascular Disease Prevention Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 9 Critical Care Cardiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 10 Heart Failure Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 11 Pericardial Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 12 Stable Ischemic Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 13 Valvular Heart Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Table 14 Vascular Medicine Competencies for Cardiovascular Nurse Practitioners and Physician Assistants, Timothy W. Attebery, DSc, MBA, FACHE, Chief Executive Officer, Janice Sibley, MS, Executive Vice President, Education and Publishing, Robyn Snyder, BA, Senior Director, Core Education Division Services and Activities, Dawn R. Phoubandith, MSW, Team Leader, Competencies and Educational Gaps, Kelli C. Bohannon, Associate Director, Member Strategy, Amelia Scholtz, PhD, Publications Manager, Science, Education, Quality, and Publishing. Skill to recognize symptoms and ECG changes suggestive of ischemic heart disease and variant angina. 2nd edition. Know the correlation between hemodynamic waveforms and patient physiology. These competencies are for … Skill to identify genetic syndromes in adults with congenital heart disease. Know the indications for, contraindications to, and pharmacology of vasoactive and inotropic medications used to treat patients with heart failure, hypotension, or shock. Know the complications associated with contrast agents. Skills to evaluate and manage patients with extracranial carotid and vertebral artery disease. Know the indications for, expected outcomes of, and complications of surgery in patients with pericardial diseases. Given the document design, the competencies that define an individual’s practice may overlap with multiple topic areas even for highly specialized practitioners. Know the indications for implantable devices in patients with heart failure. Skill to utilize noninvasive imaging reports for diagnosis and follow-up care of patients with vascular disease. Certified Nurse Educator (CNE) Review Manual, Third Edition. Know the entrance testing requirements for a cardiac rehabilitation phase II program and methods for developing a management plan. STEP 1: NEW/UPDATED DOCUMENT REVIEW Review the following documents as they become available on … Core Competencies and Scope of Practice in Nursing Informatics November 30, 2020 / in / by developer The continued integration of information technology within the nursing profession is resulting in the development of nursing informatics as a distinct specialty. Know basic and pathological cardiac embryology and epidemiological influences on the development of congenital heart disease. Promote patient and family access to community resources and interdisciplinary care services/providers to enhance effective self-care behaviors and promote well-being. Skills to obtain a cardiovascular family history and to recommend family screening as indicated. Know the indications for interrogation of cardiac implantable electronic devices. Skill to recognize cardiac device system infection. Patient Care that is compassionate, appropriate, and effective for treating health problems and promoting health. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Orthopaedic Nurses Week; Congress 2020 Virtual Bundles; Past and Future Congresses; Evaluations and Certificates; Outreach & Volunteer Opportunities; NAON Awards . Skill to identify individuals who may be considered for device system extraction. 3 0 obj Skills to assess and manage patients with pulmonary arterial hypertension. Know the indications for and risks of left atrial appendage occlusion/exclusion devices and procedures. Journal of the American College of Cardiology, A Report of the ACC Competency Management Committee, "ACC 2015 core cardiovascular training statement (COCATS 4) (revision of COCATS 3)", "2015 ACC health policy statement on cardiovascular team-based care and the role of advanced practice providers". Skill to triage patients by phone or in person according to their presenting symptoms and medical urgency. Know the epidemiology of cardiovascular conditions, including incidence, prevalence, age, gender, and ethnicity, and the implications for diagnostics, management, and surveillance recommendations. Know the noninvasive diagnostic studies and indications for vascular screening for carotid artery disease, abdominal aortic aneurysm, and peripheral artery disease. Skill to recognize patients with common inflammatory disorders or systemic diseases that may adversely impact cardiovascular disease risk. Skill to identify patients with acute cardiovascular disorders or high-risk conditions who require immediate treatment, specialty consultation, and/or hospitalization. Identify and address socioeconomic barriers impacting cardiovascular care and refer to other team members as needed. Buy; SDC; Take the CE Test; Metrics Abstract. Know the risks, benefits, indications, and timing for diagnostic coronary angiography. Know the pathophysiology, differential diagnosis, and natural history of pericarditis, pericardial effusion/tamponade, and constrictive pericarditis. Former Competency Management Committee member; member during this writing effort. A member of the ACC Competency Management Committee served as lead reviewer to ensure a fair and balanced peer review resolution process. All tables distinguish competencies generally expected of all cardiovascular NPs and PAs (left column) from those generally expected of selected cardiovascular NPs and PAs based on background, specialized knowledge, skills, experience, and practice focus (right column). Know the risks, preventive measures, and treatments for acquired heart disease in the congenital heart disease population. Skill to assess the cardiovascular risks associated with recreational and/or competitive sports, physically demanding occupations, and other vigorous physical activities. Know the cardiovascular benefits of aerobic and resistance exercise. Know the pharmacological agents and nonpharmacological therapies for preventing and treating thrombotic complications in adults with congenital heart disease. Know the hemodynamic and mechanical complications in patients with STEMI. J Clin Outcomes Manag2016; 23:455-461. Skill to classify angina pectoris using a functional classification system. Know the indications for cardiac catheterization for adults with simple congenital heart disease. Know the effects of lifestyle, activity level, body mass, nutrition, tobacco, alcohol, and recreational drug use in patients with and at risk of cardiovascular disease. Objective evaluation of clinical competence in the practice setting can be challenging and sometimes overlooked. Know the objective and subjective methods to assess volume status in patients with heart failure. Know the causes, pathophysiology, and natural history of aortic, carotid, renal, mesenteric, and extremity peripheral artery diseases. This document does not delineate these highly specialized competencies but rather focuses on the NP and PA competencies that typically apply in most practice settings. A modified Delphi method was used to engage NPs in achieving consensus for advance care planning competencies. Know the management of complex lipid abnormalities (e.g., familial hypercholesterolemia). Skills to evaluate and manage patients with bradyarrhythmias and heart block. Skill to participate in the insertion of temporary transvenous pacemakers, measure pacing and sensing device thresholds, and monitor pacemaker function. To avoid actual, potential, or perceived conflict of interest resulting from relationships with industry or other entities (RWI), writing committee members and peer reviewers were required to disclose all current healthcare-related relationships. The basic assumption of CBE is that the student will demonstrate acquisition of the identified essential knowledge, skills, and attitudes expected for the designated educational process before leaving the learning environment. To ensure transparency, comprehensive healthcare-related disclosure information, for authors and peer reviewers has been posted online. Silver Spring, MD: Nursesbooks, 2015. Skills to initiate and manage pharmacological and nonpharmacological interventions for patients with lipid disorders. Skill to facilitate shared decision making regarding reproductive options and family planning for men and women with congenital heart disease. Skills to obtain clinical history and physical examination to determine functional capacity and volume status in patients with heart failure. Know the symptoms, physical findings, and evaluation of acute pericarditis, pericardial effusion/tamponade, and constrictive pericarditis. Know the arrhythmias common in complex congenital heart disease and indications for referral to electrophysiologists with expertise in congenital heart disease. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals. Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American College of Cardiology. Know the indications, risks, and expected outcomes of surgical and endovascular interventions for patients with thoracic and/or abdominal aortic aneurysm. The cardiovascular competencies, organized in a topic format, identify the competencies for clinical cardiovascular NPs and PAs, as well as aspects of cardiovascular medicine that exceed core expectations and may be maintained or achieved by some cardiovascular NPs and PAs depending on their background and practice focus (see Table 1). According to the ACC, a person has a relevant relationship if: a) the relationship or interest relates to the same or similar subject matter, intellectual property or asset, topic, or issue addressed in the document; b) the company/entity (with whom the relationship exists) makes a drug, drug class, or device addressed in the document, or makes a competing drug or device addressed in the document; or c) the person or a member of the person’s household, has a reasonable potential for financial, professional or other personal gain or loss as a result of the issues/content addressed in the document. Critical Care Cardiology Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2501, Table 10. Know the indications for catheter- and surgical-based interventions in patients with valvular heart disease. endobj CNS Competencies CNS Competencies. Appropriately seek and integrate advice from consultants in a timely manner. Know the clinical findings and complications of right ventricular infarction. Skills to initiate and monitor diagnostic testing indicated for patients with elevated blood pressure and hypertension. Skill to manage pain and sedation for patients in the critical care setting. 2. NLN Core Competencies Note: The task statements that accompany each competency can be found in NLN Core Competencies for Nurse Educators: A Decade of Influence (2019) and The Scope of Practice for Academic Nurse Educators & Academic Clinical Nurse Educators (2020). 3. Know the role of local and systemic inflammation on the development and progression of atherosclerotic disease. Skills to recognize and manage prosthetic valve complications. Know factors that may affect accuracy of blood pressure measurement. Skills to assess and manage statin-associated muscle symptoms. Know discharge criteria for the critical care unit. Attain and maintain nurse practitioner and/or physician assistant certification per respective credentialing organizations. Know the potential for neurocognitive and psychological issues in adults with congenital heart disease. Know the pharmacology, indications, contraindications, and expected outcomes of antithrombotic medications in patients with peripheral artery disease. Know the indications for wearable devices. Review medical records, complete documentation, and communicate diagnostic findings and management strategies to patients and collaborating healthcare professionals in a timely manner. It is important to recognise that these competencies may take time to fully develop and consolidate, progress will vary according to working context and the individual. Know the indications for duplex ultrasonography of the aortic, carotid, renal, mesenteric, and extremity arteries; arterial bypass grafts and stents; aortic endografts; and intracranial vessels. Know the indications and management of hypothermia in cardiac arrest survivors. Skills to develop, implement, manage, and evaluate an evidence-based, age-appropriate plan of care for patients with lipid disorders. "A comparison of conventional and expanded physician assistant hospitalist staffing models at a community hospital" Laurant M., van der Biezen M., Wijers N., et al. Know the indications and contraindications of reperfusion therapies in patients with STEMI. All ACC competence and training statements, therefore, include examples of tools that can be used to assess achievement of the individual components of competency (see Section 1.2.2.). The American Association of Heart Failure Nurses, Association of Physician Assistants in Cardiology, Heart Rhythm Society, Preventive Cardiovascular Nurses Association, and Society for Cardiovascular Angiography and Interventions endorsed the document in February 2020. Skills to recognize cardiac arrhythmias in adults with congenital heart disease and refer to electrophysiologists with expertise in congenital heart disease. Know the psychosocial factors that contribute to cardiovascular disease and principles of management. Skill to participate in the insertion of implantable loop recorders. American Nursing Association. Skills to evaluate and manage patients with upper and lower extremity peripheral artery disease. Skill to distinguish causes of chest pain, palpitations, fatigue, lightheadedness, syncope, dyspnea, and edema through patient history, physical examination findings, and appropriate testing. 19/11/2020 Office hours this holiday season. Refer patients who are facing advanced and end-stage cardiovascular disease to appropriate specialists. Know the management interventions for patients experiencing complications of arterial catheterization. Tables 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, and 14 encompass the medical knowledge and patient care and procedural skill competencies related to the 11 clinical areas identified in Table 1. Pericardial Disease Competencies for Cardiovascular Nurse Practitioners and Physician Assistants 2505, Table 12. Know the clinical signs and symptoms of end-stage heart failure and the indications for referring patients for palliative care and hospice. Skills to perform and interpret findings of physical examination for detection of acute and chronic arterial compression syndromes. 1. The ACC Competency Management Committee oversees development of competency statements for cardiovascular specialists covering the entire career spectrum. Skills to evaluate patients with thoracic and abdominal aortic aneurysms and refer for surgical or endovascular intervention. Skills to recognize and manage musculoskeletal limitations during cardiac rehabilitation sessions. Criteria for Evaluation of Nurse Practitioner Programs (2016) View 2002, 2008, 2012 Versions. Skills to recognize and medically manage specific supraventricular arrhythmias (e.g., atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia). Know the indications for and characteristic findings of imaging studies used to evaluate patients with pericardial diseases. Available at: https://www.aapa.org/news-central/2018/04/pas-can-bring-cost-effective-care-complex-patients/. Skill to recognize cardiac arrhythmias and perioperative complications in patients with valvular heart disease. Know the indications for genetic testing and counseling in patients with known or suspected inherited thoracic aortic syndromes. The NACNS CNS Statement for Clinical Nurse Specialist Practice and Education (3 rd ed.) Skills to identify, evaluate, and manage patients at high risk for sudden cardiac death. Know the postprocedure complications of catheter ablation in patients with atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. Know the clinical findings of common connective tissue conditions that can affect the peripheral circulation. Identify cost, resource utilization, and value when caring for patients with cardiovascular disease. Accessed July 18, 2019. A scholarly approach to literature review is required to evaluate evidence, address clinical questions, and enhance outcomes. Know the indications, contraindications, complications, and components of invasive and hemodynamic monitoring. Skill to interpret coronary angiography report findings for patients with acute coronary syndromes. Skill to recognize cardiac biomarker abnormalities to aid in the diagnosis of acute coronary syndromes. Skills to evaluate and manage patients with inherited and acquired forms of thrombophilia. Renew your Annual Practising Certificate read more. One impetus for this request was the 2015 ACC Health Policy Statement on Cardiovascular Team-Based Care and the Role of Advanced Practice Providers (2) that highlighted the importance of team-based delivery of cardiovascular care and advocated for development of a nationally-recognized set of core competencies. Skills to evaluate and coordinate management of patients with peripheral and visceral artery aneurysms and refer candidates for surgical or endovascular intervention. Skill to discuss advance care planning with patients with congenital heart disease and their families. Skill to utilize concepts of behavioral change models and lifestyle interventions to assist patients with cardiovascular disease. Know the pathophysiology and clinical findings of pulmonary arterial hypertension. Know invasive methods of calculating cardiac output, including Fick and thermodilution methods. Know the indications for advanced lipid therapies (e.g., PCSK9 [proprotein convertase subtilisin kexin 9] inhibitors). Skill to assist in surgical or percutaneous interventions. It also helps to increase awareness of the roles that NPs and PAs have within the cardiovascular team. It is important to recognize that some NPs and PAs acquire exceptional clinical acumen and a high level of expertise and technical proficiency in advanced skills such as emergency response systems, inserting temporary pacemakers, and performing pericardiocentesis, depending on their level of experience and training, state licensure, and institutional privileging. Know the nonpharmacological interventions for the treatment of elevated blood pressure and hypertension. Know lifestyle interventions for management of patients with stable ischemic heart disease, variant angina, post. Know the differential diagnoses and distinguishing characteristics of heart murmurs and sounds, vascular bruits, and peripheral pulses. Know the indications, contraindications, and adverse effects of anticoagulants in patients with atrial fibrillation and flutter. Know the management and diagnostic strategies for patients with nonischemic heart failure, including strategies associated with pregnancy and chemotherapy. Skills to utilize and titrate medical therapy for patients with heart failure in both the hospital and outpatient care settings. Skills to prevent and manage complications associated with contrast agents. Skills to monitor, recognize, and manage arrhythmias during exercise testing. Skill to recognize normal/abnormal 12-lead ECGs and rhythm strips. Contact Us. Utilize the concepts of motivational interviewing when counseling patients. Know the risks associated with noncardiac surgery in adults with congenital heart disease. Skill to select evidence-based pharmacological therapy for patients with stable ischemic heart disease. Registered nurses in British Columbia must meet the entry-level competencies to be eligible to practice in the province. Skills to evaluate and manage patients with supraventricular tachyarrhythmias. Skill to perform clinical assessments for patients in acute heart failure. Know the physical examination findings of repaired and unrepaired forms of congenital heart disease in adults. "Nurses as substitutes for doctors in primary care" 3. ACC = American College of Cardiology; ACPC = adult congenital/pediatric cardiology; APP = advanced practice provider; CEO = chief executive officer; CHI = Catholic Health Initiatives; CV = cardiovascular; EP = electrophysiology; FIT = fellow in training; HF&T = heart failure and transplant; MCS = mechanical circulatory support; NE = northeast; NP = nurse practitioner; PA = physician assistant; UCONN = University of Connecticut. Skills to recognize and manage signs and symptoms that indicate an adverse response to exercise during cardiac rehabilitation sessions. Scholarly activity and clinical research are also important in lifelong learning and professional competency. Develop the practice of lifelong learning, including regular review of journals and practice guidelines, appropriate use criteria, consensus statements, and participation in scientific and continuing professional education meetings. Iglehart J.K. Know the epidemiology, pathophysiology, stages, and natural history of heart failure. Requests may be completed online via the Elsevier site ( https://www.elsevier.com/about/our-business/policies/copyright/permissions). "ACC 2015 core cardiovascular training statement (COCATS 4) (revision of COCATS 3)" Skill to utilize diagnostic testing for initial diagnosis and follow-up care of patients with cardiovascular disease. Seton Heart Institute—Associate Chief of Cardiology for Education; Dell Medical School—Associate Professor of Medicine, Mayo Clinic, Department of Cardiovascular Medicine—Associate Professor of Medicine, Boston Children’s Hospital BACH Cardiology—Physician Assistant, United Heart and Vascular Clinic, AllinaHealth—Nurse Practitioner-Electrophysiology, Baylor Scott & White Health—Nurse Practitioner in Advanced Heart Failure Clinic, Penn Medicine, Heart and Vascular Intensive Care Unit—Nurse Practitioner, Bozeman Deaconess Cardiology Consultants—Cardiologist, Mayo Clinic, Department of Cardiovascular Diseases—Nurse Practitioner, Lucile S Packard Children’s Hospital Stanford—Program Director, ACHD Service; Stanford Hospital and Clinics—Clinical Associate Professor, University of Michigan—Nurse Practitioner, Adjunct Clinical Faculty, School of Nursing, Emory Healthcare—Director of Strategic and Programmatic Initiatives, Heart and Vascular, Einstein Health Network, Greater Philadelphia Region; Bryn Mawr Medical Specialists—Physician Assistant, Stanford University—Associate Program Director, Clinical Assistant Professor, Cardiology, Intermountain Heart Institute, Intermountain Healthcare and Rocky Mountain University of Health Professions Physician Assistant Program—Cardiology Research Physician Assistant, Vanderbilt Heart and Vascular Institute—Professor of Medicine, Director, CV Medicine Fellowship Program. Former Competency Management Committee chair, chair during this writing effort. endobj Know the common cardiovascular complications of noncardiac surgery. Know the prognostic features for patients with acute coronary syndromes and corresponding management strategies. These core competencies apply to all nurse practitioners, regardless their medical specialty or patient population focus. Know the cardiovascular toxicity, drug interactions, and side effects of the major classes of medications used for common noncardiac conditions. The competencies are organized in seven content domains: Management of Patient Health/Illness Status, The Nurse Practitioner-Patient Relationship, The Teaching-Coaching Function, Professional Role, Managing and Negotiating Health Care Delivery Systems, Monitoring and Ensuring the Quality of Health Care Practices and Culturally-Sensitive Care (NONPF, 2006). %PDF-1.7 Skill to recognize causes of angina pectoris not related to coronary artery disease. Know the indications for, contraindications to, and pharmacology of anticoagulant, antithrombin, and antiplatelet agents, and their reversal agents. Know the indications, risks and benefits, and optimal timing for pharmacological and electrical cardioversion. Skills to recognize and manage patients with postural orthostatic tachycardia syndrome, inappropriate sinus tachycardia, and neurocardiogenic syncope. Know the indications for selection of pacemaker systems and cardiac resynchronization therapy. ONE Award Submissions ; Outstanding Orthopaedic Nurse Practice Award; Online Store; Online Store. Accessed November 14, 2019. Know the differential diagnosis, clinical presentation, ECG changes, and imaging and biomarker features for diagnosis and risk stratification of patients with NSTE-ACS and other nonischemic causes of myocardial injury. Skill to identify needs of individuals and families with inherited arrhythmia disorders. The American College of Cardiology requests that this document be cited as follows: Rodgers GP, Linderbaum JA, Pearson DD, Fernandes SM, Housholder-Hughes SD, Mendes LA, Berg NC, Day J, Drajpuch D, Erb B Jr, Farquhar-Snow M, Johnson H, Keegan P, Kindler C, Larsen R, Le VT, Nickolaus MJ, Phillips CM, Ross L, Webb SR, Zado ES. Competency-based education (CBE) provides a framework for nursing programs including those educating nurse practitioners (NPs). Know the causes, pathophysiology, and natural history of coagulopathies that increase patient risk for deep vein thrombosis and pulmonary emboli. Practice within the scope of personal expertise, training, and technical skills. In addition, 56 content reviewers participated in peer review representing cardiologists, NPs, and PAs with expertise in the clinical topics addressed in this document as well as diversity across stage in career, practice setting, and geographic location, resulting in over 1,000 peer review comments. Competencies for Registered Nurses will take effect September 2020. Skill to recognize ST-segment changes on continuous ECG monitoring suggestive of acute coronary syndromes. Skills to evaluate and manage patients with inherited and acquired forms of vasculitis. When practicing at the full scope of education, training, and licensure, NPs and PAs improve access to care and provide comprehensive clinical care, including diagnosis, management, test ordering and interpretation, procedure participation, patient education, and care coordination. Integrates knowledge from the humanities and sciences within the context of nursing science. Adult-Gerontology Clinical Nurse Specialist (CNS) Competencies (2010) (PDF) National Office 11130 Sunrise Valley Dr. #350 Reston, VA 20191 Please send check payments to: NACNS c/o NACNS Accounting 401 Edgewater Place, Suite 600 Wakefield, MA … Skill to participate in pericardiocentesis. Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. Know the natural history of complex congenital heart disease. However, after months and years of clinical experience, one would anticipate aspirational development into deeper knowledge and specialty skills based on practice area and model. Know which medications, genetics, and/or disease conditions increase the risk for lipid abnormalities. These minimum general competencies were endorsed by the ACGME in February 1999 ( www.acgme.org) and all Residency Review Committees and Institutional Review Committees were to include this minimum language in their respective Program and Institutional Requirements by June 2001. Know the clinical manifestations, differential diagnosis, evaluation, and management of aortic, carotid, renal, mesenteric, and extremity peripheral artery diseases. Skills to interpret cardiovascular imaging reports and apply results to clinical decision making. Skills to develop, implement, and evaluate patient-centric education plans for patients with heart failure. Skill to provide age appropriate, culturally-sensitive education regarding lifestyle modification to patients with cardiovascular disease and their family members. Skills to obtain and interpret a problem-focused history and physical examination for patients entering cardiac rehabilitation. Know the management of arrhythmias in pregnancy and women of childbearing age. © 2020 American College of Cardiology Foundation. Available at: https://www.nihcr.org/analysis/improving-care-delivery/prevention-improving-health/pcp-workforce-nps/. Know the indications for referring patients for evaluation of endomyocardial biopsy. Skill to integrate history and physical findings to develop a differential diagnosis in adults with congenital heart disease. Cardiovascular NP and PA Competencies 2487, Table 1. Know normal arterial blood gas values and clinical implications of abnormal findings. Know the risks and benefits of exercise in adults with simple congenital heart disease. Know admission criteria for the critical care unit. Skills to manage appropriate pain and/or sedating agents and monitor therapeutic effects for patients receiving mechanical ventilatory support. Know the risk reduction strategies for populations at increased risk for cardiovascular disease. Know ECG features associated with myocardial ischemia and baseline ECG abnormalities that may impact exercise ECG interpretation. Skill to manage patients on mechanical ventilator support. The writing committee met the College’s disclosure requirements for RWI as described in the Preamble. Skills to recognize and manage abnormal findings in ambulatory rhythm monitoring. Latest Practice News. The list of peer reviewers, employment information, and affiliations for the review process is included in Appendix 2. Know the principles of adult learning theories to plan and deliver education for atherosclerotic cardiovascular disease risk reduction. Skill to recognize adverse effects of antihypertensive medications. Know the psychosocial impact of cardiac device therapies. Know the prognostic factors used to assess patients with acute coronary syndromes and advanced heart failure. Know interventions to reduce risk of deterioration of physical and mental functioning in patients with acute heart failure. 0=!�#�A�IO�Z!=�IHHڄ��C����x �� }BBc��' ����#h ĄUE;7 b²��b�`º��G�� ~ Ą��,� 1ai!2`@LX[Hz� ^\,�J��q�J�7[OOԤ.��Nf�穙���l�zR�,~zY�y�*�^�S�|w. Skills to educate patients and family members on congenital heart defect anatomy and physiology and promote lifelong heart healthy self-care behaviors. The statement emphasized the important collaboration between cardiologists, nurse practitioners (NPs), physician assistants (PAs), and other cardiovascular team members in the care of patients. . It also identifies aspects of cardiovascular medicine that exceed core expectations and may be maintained or achieved by some specialized NPs and PAs, depending on their expertise, skills, practice agreements, and licensure. . Know the clinical manifestations of acute aortic syndromes, including dissection, intramural hematoma, and penetrating ulcer. Know the indications for antibiotics for infective endocarditis prophylaxis in patients with valvular heart disease. Know the indications for, contraindications to, pharmacology, and adverse effects of drugs used to treat patients with heart failure. Know palliative care management strategies in patients with refractory heart failure. Journal of the American Association of Nurse Practitioners: March 2020 - Volume 32 - Issue 3 - p 200-217. doi: 10.1097/JXX.0000000000000384. Capstack T.M., Segujja C., Vollono L.M., Moser J.D., Meisenberg B.R., Michtalik H.J. Know the epidemiology of cardiovascular disease. Skill to manage cardiac arrhythmias and perioperative complications in patients with valvular heart procedures. NLN. Skills to order and assess laboratory testing at various stages of lipid management. High-performing cardiovascular care teams aspire for each member to practice at the top of his or her education, training, licensure, and experience with clearly defined roles. There are several ways cardiovascular NPs and PAs can maintain competency and expand lifelong learning in practice (ensuring currency with the evolving art and science of the field) and assess their own professional needs for education and performance improvement. Skills to initiate and manage dual antiplatelet therapy and/or anticoagulants in patients with acute coronary syndromes. Know the effect of arrhythmias on heart failure status, initial treatment of arrhythmias, and referral for patients with arrhythmias. Solicit and incorporate feedback from patients, colleagues, and healthcare professionals to improve clinical performance. Know the indications for and contraindications to noninvasive and invasive testing in the evaluation of patients with stable ischemic heart disease, variant angina, post. Skill to facilitate timely referral to cardiac rehabilitation following acute coronary syndromes. Skills to evaluate and manage patients with lymphedema. Skill to manage patients with valvular heart disease with complex comorbid conditions. Know the indications for and contraindications to computed tomographic angiography, magnetic resonance angiography, and invasive angiography in patients with known or suspected venous and arterial disease. This resulting document describes the key anticipated competencies for cardiovascular NPs and PAs, including those in general cardiovascular practices and those in focused areas of cardiovascular medicine. Rather, it is intended to delineate those competencies relevant to services that cardiovascular NPs and PAs provide to patients within the care delivery system of a cardiovascular practice. Skills to perform and evaluate a cardiac risk assessment in patients undergoing vascular procedures. For copies of this document, please contact Elsevier Inc. Relationships in this table are modest unless otherwise noted. These competencies define exactly what knowledge and skills are necessary to treat patients under our care. These represent the entry into practice competencies upon graduation from a NP educational program. This document is not intended to describe independent practice for a particular discipline or outline training standards. Know the complications of vascular access. Skills to evaluate and manage patients with syncope. Know the indications, risks, and benefits for electrophysiology studies and catheter ablations. Know the management strategies and corresponding contraindications for patients with heart failure, including pharmacotherapy and interventional options. Know the anatomy, pathophysiology, and presenting symptoms of adults with complex congenital heart disease. Skill to interpret results of an ankle-brachial index test report. Know the common cardiac arrhythmias in patients with valvular heart disease and treatment strategies. Attend to one’s own health, well-being, and abilities in order to maximize personal and professional performance. This article describes the development of nurse practitioner (NP) competencies for advance care planning. This document identifies competencies for the NP and PA members of the cardiovascular care team. Skills to manage and coordinate care for postoperative patients admitted to the critical care unit following surgery or catheter-based intervention. Skills to perform a cardiovascular risk assessment and to develop an evidence-based treatment plan. ACGME = Accreditation Council for Graduate Medical Education. Competency is a topic of great interest to educators and administrators in practice disciplines, particularly health care disciplines such as nursing.
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