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Perioperative Care Coordinator Nurse Competency Statements
OCTOBER 1999, VOL 70, NO 4
Perioperative Care Coordinator Nurse Competency Statements he Nursing Practice Committee has completed development of the perioperative care coordinator nurse competency statements. The perioperative care coordinator is defined in the “Working document on perioperative nursing roles”:
A perioperative nurse who is responsible and accountable for optimizing available resources while independently and collaboratively assessing, planning, implementing, and evaluating the care of the surgical patient is practicing in a perioperative care coordinator role. In this expanded role, the perioperative nurse is responsible for providing leadership,clinical expertise, andfunctional direction to other members of the health care team to achieve optimal patient outcomes. This role may include, but is not limited to, surgical case manager, intraoperative patient cure coordinator,patientfamily educator, cost-reduction specialist, industry educatorlconsultant,registered nurse $rst assistant, and udministratoc ’ The perioperative care coordinator should have mastered the skills outlined in the “Competency Statements in Perioperative Nursing.” AORN strongly believes that the best foundation for the perioperative care coordinator role is perioperative nursing. The Nursing Practice Committee developed a preliminary list of broad competencies that they believe fall within the category of perioperative care coordinator. This list was distributed to the specialty assemblies’ governing councils in July 1998 for input, with the intent that the final competencies would be broad in nature and represent commonalities in required knowledge and skills. A survey using the preliminary list of Competencies and a template for use in defining the knowledge and skills necessary for the unique roles within the specific specialty assembly were sent to the governing councils of the following specialty assemblies: Advanced Technology: Lasers
and Minimally Invasive Surgery; Ambulatory Surgery; Business, Industry & Consulting; Management; Nurse Educator/Clinical Nurse Specialist; Nurses in Perioperative Informatics; and RN First Assistant. The survey responses were reviewed and suggestions were incorporated into the perioperative care coordinator competency statements. The Nursing Practice Committee completed the final revision of the statements in November 1998, and the document was referred to the AORN nurse researchers (ie, Suzanne Beyea, RN, PhD, CS; Leslie Nicoll, RN, MS, MBA, PhD) for review and comment. The researchers approved the document in December 1998. The AORN Board of Directors reviewed and approved the perioperative care coordinator nurse competency statements at the February 1999 Board meeting. The perioperative care coordinator competency statements are intended to serve as an “umbrella” of competencies that can be adapted for specific roles. The following competency statements are a sampling of activities a perioperative care coordinator might perform. The list is not exhaustive, nor is the perioperative care coordinator required to perform all activities listed to demonstrate a particular competency. The Nursing Practice Committee believes the following competencies will need to be revisited as the role of the perioperative care coordinator evolves. Members of the Nursing Practice Committee who worked on development of the competencies in 1998 were Antonia B. Hughes, RN, BSN, CNOR, chair; Diane L. Fecteau, RN, MSA, Pat Hickey, RN, BSN, CNOR Lillian H. Nicolette, RN, MSN, CNOR; Brenda J. McKonly, RN, CNOR; and Ramona L. Conner, RN, MSN, staff consultant. RAMONA CONNER RN, MSN NURSING PRACTICE COMMIITEE STAFFcowsuiwa NOTE 1. “Working document on perioperative nursing roles,” AORN Journal 67 (January 1998) 4.
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CHANGE MANAGEMENT
Competency statements 1 . The perioperative care coordinator is competent to coordinate, facilitate, and manage change efforts.
Measurable criteria 1 .l Coordinates, implements, and eva Iuates change process.
Example 1 . l . l Participates in the development of the project plan. 1.1.2 Assists with the implementation of the change.
1 .1.3Assesses the need, readiness, and environment for change. 1.2 Demonstrates knowledge of the change process. 2. The perioperative care coordinator seeks new knowledge.
2.1 Demonstrates commitment to professional improvement.
2.1 . 1 Meets the necessary requirements to maintain CNOR, certificates (eg, advanced degree in nursing), CRNFA, and competency assessment, development, validation, and record maintenance.
3. The perioperotive care coordinator supports learning process of staff members and clients.
3.1 Demonstrates knowledge of learning system and motivation theory.
3.1.1 Participates in the assessment of the environment to identify current status.
3.2 Provides learning opportunities.
3.2.1 Develops, implements, and evaluates a learning plan and timeline within the context of the project plan.
COUABORl\llVE/CONSULTATIVE/NEGOTIATION SKILLS
Competency statements 1. The perioperativecare coordinator is competent in the use of collaboration and negotiation.
Measurable criteria 1 . 1 Demonstrates appropriate negotiation/collaborationskills.
Example 1.1.1 Collects necessary data and information related to all stakeholders.
1 . 1.2 Collects and analyzes data required to facilitate collaboration and negotiation with stakeholders. 1 . 1.3Reviews the advance case schedule and initiates interventions/ consultation as needed. 1.2 Demonstrates effectiveness in negotiations and compromise as needed to ensure positive outcome.
1.3Uses appropriate communication techniques to facilitate negotiation. 2. The perioperative care coordinator holds a consultative role.
2.1 Directs colleagues in a specific area of perioperative nursing.
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2.1 .1 Serves as a resource to others in an area of qualification (eg, lasers, specialty procedures, staffing, pain management).
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COMMUNICATION SKILLS
Competency statements
1 , The perioperative care coordinator is competent in verbal, written, and listening skills.
Measurable criteria
1 . l Demonstrates knowledge of communication techniques, both verbal and nonverbal. 1.2 Evaluates the effectiveness of communication and modifies techniques as appropriate.
Example
1 . 1 .l Communicates client needs to health care team members.
1 .1.2 Communicates effectively with health care team members. 1.2.1 Identifies special needs of the patients and communicates these to other team members. 1.2.2 Applies communication techniques appropriately in a given situation. 1.2.3 Utilizes a variety of communication techniques and tools appropriate to each situation. 1.2.4 Solicits feedback on effectiveness of communication on an ongoing basis.
1.3Guides others to develop effective communication skills.
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1.3.1Provides information on how to communicate more effectively.
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CONFLICT RESOLVnON
Competency statements
1 . The perioperative care coordinator is competent in the area of conflict resolution.
Measurable criteria
1 . 1 Demonstrates knowledge of conflict resolution techniques.
Example
1 .l , l Applies the technique of conflict resolution. 1.1.2 Ensures a professional climate while dealing with a conflict.
1.2 Takes the necessary steps and utilizes the appropriate chain of command within scope of responsibility.
1.2.1 Identifies the necessary sources to help in conflict resolution.
1.3Effectively mediates conflicts among department needs.
1.3.1 Considers all aspects of a conflict before drawing conclusions.
1.4 Effectively solves inter/intradepartmental problems.
1.4.1 Handles disruptive behavior with firmness and professionalism.
1.5 Evaluates the outcome of conflict resolution. 2. The perioperative care coordinator is competent in facilitating meetings and group processes.
2.1 Demonstrates knowledge of facilitation techniques by exercising competencies in: communication collaborationhegotiation critical thinking interpersonal/social skills conflict resolution
2.1.1 Assesses the setting in which facilitation is requiredkequestedto include: historical perspective stakeholders desired outcome timeline 2.1.2 Prepares appropriately for the situation. 2.1.3 Applies the competencies for: communication collaboration/negotiation critical thinking interpersonal/sociol skills conflict resolution
2.2 Evaluates the effectiveness of the facilitation.
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2.2.1 Seeks feedback from group members.
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CONSULTATION SKIUS
Competency statements
1 , The perioperative care coordinator is competent in counseling techniques for patients, families, physicians, and superiors.
Measurable criteria
1 , l Demonstrates knowledge of counseling staff members.
Example
1.1 . l Identifies the need for disciplinary action. 1 . 1.2 Demonstrates a professional and caring altitude while counseling stoff members.
1.2 Demonstrates knowledge of counseling patients and their fa milies.
1.2.1 Identifies a patient's need through assessment and evaluation.
1 2 . 2 Provides counseling according to patient's age, cultural background, and identified limitotion(s). 1.2.3 Involves the patient's family and/or significant other for better outcome.
2. The perioperative care coordinator is competent in the skills required to provide consultative services.
2.1 Demonstrates an ability to exercise skills in assessment, planning, implementation, and evaluation.
2.1.l Assesses environment and client needs/exceptions. 2.1.2 Collects appropriate data. 2.1.3 Analyzes data. 2.1.4 Develops plan to accomplish the goals of the consultation.
3. The perioperative care coordinator is competent in consultation skills.
2.2 Demonstrates knowledge and competency in: change management collaborationlnegotiation conflict resolution critical thinking financiallresource management interpersonallsocial skills coaching political skills teaching facilitation project management
2.2.1 Assists, supports implementation plan utilizing the skills and techniques appropriate to the situation.
3.1 Communicates pertinent information in an organized, logical, and concise manner to physicians, patients, and families.
3.1. l Uses advanced communication skills to effectively distribute and retrieve information.
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c R m c m THINKING
Competency statements 1 . The perioperative care coordinator is competent exercising critical thinking skills in all aspects of his or her role.
Measurable criteria
Example
1 .1 Demonstrates knowledge of critical thinking skills.
1 .1 .l Analyzes and synergizes information as a means of approaching a situation, issue, decision.
1.2Gathers and interprets infarmation, applies critical thinking skills,
1.2.1Applies previously acquired critical thinking skills in the assessment, planning, implementation, and evaluation phases of activities/ encounters.
FINANCIALIRESOURCE MANAGEMENT
Competency statements 1, The perioperative care coordinator is competent to manage budgetary responsibilities within his or her role.
Measurable criteria
Example
1 .1 Demonstrates knowledge of financial implications of materials, equipmentt and human resources.
efficient manner.
1.2Implements practices to support the budgetary plan.
1.2.1Participates in the handling and care of supplies and equipment.
1.1 .l Utilizes staff resources in an 1.1.2Manages materials, supplies, and equipment.
1.2.2Participates in the budget process. 1.2.3Identifies resource requirements. 1.2.4Communicates budget considerations and provides feedback to staff members, physicians, and administrators as needed.
1.2.5Provides justification for variances. 2.The perioperative care coordinator is competent in the development of a detailed proposal for a perioperative project.
2.1 Develops clear written proposals for improvement.
2.1.l Reviews relevant literature. 2.1.2Logically argues points that support effectiveness, efficiency, and budget implications of proposed projects.
2.1.3Presents proposal to administration in a concise format. 2.1.4Develops budget for completed proposed project.
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INTERPERSOWSOCIAL SKILLS
Competency statements 1 , The perioperative care coordinator is competent in interpersonaVsocia1 skills with clients, colleagues, and peers.
Measurable criteria
Example
1 . 1 Demonstrates knowledge of appropriate conduct, internal and external, of the work environment.
1 . 1 . 1 Conducts self in a manner that reflects pride and respect in oneself and others.
1.2 Utilizes knowledge of organizational, behavioral, and social norms.
1.2.1 Identifies, adapts to, and functions within established norms. 1.2.2 Conduct, attire, and language are appropriate for the situation.
1.3Adapts to and functions within identified organizational, behavioral, and social norms.
1.3.1Recognizes and maximizes own social strength.
MENTORINGICOACHINGSKIUS
Competency statements
1 , The perioperative care coordinator is competent to mentor and coach others to improve performance, enhance skills, and develop career options.
Measurable criteria
1 . l Demonstrates skills in mentoringkoaching.
Examble
1 , 1 . l Provides guidance, support, and constructive feedback within the context of the role. 1 .1.2 Presents self as a professional nurse and a role model. 1 .1.3Demonstrates a high level of self-esteem and a positive attitude.
1 .1.4 Identifies the opportunities to coach and act as a preceptor.
2. The perioperative care coordinator is competent in counseling techniques for patients, families, ph@cians, and superiors.
1.2 Utilizes appropriate resources to support the mentoringlcoaching effort.
1.2.1 Promotes perioperative nursing growth and development.
1.3 Provides feedback as it pertains to staff performance.
1.3.1Provides information regarding resources available to address the developmental needs of the individual@).
2.1 Demonstrates knowledge of counseling staff members.
2.1 .l Identifies the need for disciplinary oction. 2.2.1 Demonstrates CI professional and caring attitude while counseling staff members.
2.2 Demonstrates me skills of a coach and a preceptor.
2.2.2 Identifies patient's needs through assessment and evaluation. 2.2.3 Provides counseling according to patient's age, cultural background, and identified limitation(s). 2.2.4 Involves the patient's family and or significant other to establish and achieve outcome. 2.3 Communicates significant information in an organized, logical, and concise manner to physicians, patients, and families. 629 AORN JOURNAL
2.3.1 Uses advanced communication skills to effectively distribute and retrieve information.
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P O M C A L SKIUS
Competency statements
1 , The perioperative care coordinator is competent in utilizing political skills.
Measurable criteria
1 . 1 Demonstrates knowledge of the organizafion's political culture and its implications in relation to his or her role.
Example
1 , l , l Assesses the political climate within the organization insofar as formal and informal leaders, internal and external drivers, and relationships of processes and resources. 1 ,1.2 Assists with the development of strategies to address the political influences impacting an activity outcome.
1.2 Demonstrates knowledge ofthe external political structure and its effect an the organization.
1.2.1 Maintains currency of knowledge of external politics through reading, networking, and professional involvement. 1.2.2 Applies knowledge of the poiitical arena to the activities of the role.
PROFES!3ONAL SKILLS
Competency statements
1 , The perioperative care coordinator is competent in perioperative practice.
Measurable criteria
Example
1 . 1 Demonstrates excellent perioperative clinical skills.
1 . l .1 Continuously advances perioperative education.
1.2 Is an active member of the perioperative professional organization.
1.2.1 Participates in perioperative research. 1.2.2 Promotes perioperative nursing in the community.
2. The perioperative care coordinator is competent in demonstrating professionol skills.
2.1 Demonstrates knowledge af correlating history and physical assessments with abnormal laboratory values and x-rays.
2.1 , 1 Evaluates abnormal laboratory values with patient's history.
2.2 Identifies surgical anatomy relevant to procedure.
2.2.1 Assists to ligate and divide specific anatomy relevant to procedure.
2.1.2 Participates in patient's physical assessment.
2.2.2 Anticipates equipment and implant needs. 3. The perioperative care coordinator is competent in the professional specialty of his or her practice role.
3.1 Demonstrates knowledge of the field of practice in which he or she specializes.
3.1.1 Attends educational programs that contribute ta his or her body of knowledge; reads o diverse pool of resources to maintain and enhance knowledge and skills. 3.1.2 Applies learning within the context of his or her role.
3.2 Maintains active membership in professional organization(s).
3.2.1 Attends meetings of his or her professional organization(s). 3.2.2 Actively participates in the business of his or her professional organizotion(s) by serving on cornmittees, holding office, etc.
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QUALITY IMPROVEMENT
Competency statements
1 , The perioperative care coordinator is competent in improving patient care.
Measurable criteria
1 . 1 Is an active participant in process for improving patient care.
Example
1 . 1 .1 Studies process and makes suggestions. 1.1.2 Disseminates information related to quality improvement (QI) initiative.
1.2 Participates in continuous QI improvement process.
1.2.1 Initiates process. 1.2.2 Active member of QI initiative. 1.2.3Supports initial process.
1.3 Active member of initiative for quality improvement.
1.3.1Makes suggestions, initiates process. 1.3.2 Facilitates and/or supports the implementation of 81 process.
1.4 Evaluates results of QI initiative.
1.4.1 Reevaluates data to determine result of 81 initiative.
1.5 Implements practical changes as a result of QI measurements. TIEACHING S K I U S
Competency statements
1 . The perioperative care coordinator is competent in teaching concepts, skills, and processes.
Measurable criteria
Example
1 . 1 Demonstrates the knowledge required to be able to teach different age groups.
1 , l .l Applies the principles of learning.
1.2 Identifies the individual needs of a patient according to age, culture, and learning ability.
1.2.1 Assesses learning needs of participants.
1.3Demonstrates knowledge of adult learning theoty.
1.3.1Provides safe environment for learning.
1.1.2 Active involvement as a participant.
1.3.2 Creates relevant learning experience. 2. Maintains current knowledge of educational principles and skills, as well as new techniques, treatments, and procedures as appropriate to the practice area.
2.1 Monitors current trends in education and research as well as in new technology and procedures.
2.1 , 1 Constantly learns more through journals, research, and attendance at servicesklasses.
2.2.1 Networks with education and industry representatives.
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OTHERRESEARCH UnUZATlON
Competency statements
Measurable criteria
1 . The perioperative care coordinator is competent to read and evaluate research applicable to perioperotive setting.
1 . 1 Identifies perioperative research and its relationship to clinical setting.
1 .1.1 Regularly reviews research reports applicable to perioperative setting.
1 .1.2 Evaluates the validity of research reports applicable to perioperative setting. 1.2 Implements and evaluates pilot projects for potential change suggested by perioperative research studies.
OTHER-ORGANIZAllONL
Example
1.2.1 Replicates a research finding on a pilot basis.
1.2.2 Evaluatesfanalyzes pilot project's published research report for appropriateness of implementations in clinical setting.
SKILLS
Competency statements 1. The perioperative core coordinator is competent in organizationalskills within the workplace.
Measurable criteria
1 . l Collaborates with other disciplines to facilitate the delivery of patient care.
Example 1 .l . 1 Participates in o variety of role dimensions: provider of care, educator, consultant, researcher, and manager.
1.1.2 Serves as a member of a multidisciplinaryteam planning care for the periaperotive patient.
1.1.3Minimizes role conflict and territorialip. 1 .1.4 Acts as a resource persan in relationship to areas of clinical expertise. 1.1.5 Provides educational programs to colleagues in areas of clinical expertise.
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OTnER-PROJECT
MANAGEMENT
Competency statements 1 The perioperotive care coordinator is competent in the management of multiple projects. ~
Measurable criteria 1.l Demonstrates knowledge in the principles of project management.
Example 1 .l .l Assesses the requirements of the client and of the scope of the project.
1 .1.2 Develops project plan and establishes priorities in associated timeline.
1.1.3Identifies and incorporates stakeholders into 011 aspects of the project. 1 . I ,4 Assists and oversees the implementationof the project plan. 1 .1.5Measures completion of milestones on on ongoing basis. 1 .1.6 Evoluates effectiveness of the outcome. 1.2 Demonstrates competency in: change management communication collaboratiorVnegotiation consultation financial management interpersonoVsocial skills quality improvement facilitation technology
1.1.7 Reports resuits to client@). 1.2.1 Applies competencies in those described.
OTHERTECHNOLOGY
Competency statements 1 , The perioperative care coordinator is competent in the use of relevant technology.
Measurable crlterla
1 . 1 Demonstrates knowledge of current technology.
Example
1 , l , l Applies knowledge and skills to the use of the hardware and softwore and relative clinical technology. 1.1.2 Utilizes common software applications for word processing, spreadsheets, and presentotions.
1.1.3Utilizes technology in exercising competencies in: communication teaching financial management consultation project management 1.1.4Utilizes the Internet as on educational resource. 1.2 Maintains currency of knowledge of technology by reading, attending
seminars, and utilizing relevant hardware and soflwore applications. 636 AORN JOURNAL
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OTIIER-SURGICAL CASE MANAGEMENT
Competency statements 1. The perioperative care coordinator will be responsible for the care of the surgical patient before, during, and after the surgical procedure.
Measurable criteria 1.1 Collaborates with patient, significant others, and health care team members to assess, plan, implement, and evaluate surgical care.
Example 1.1.1 Cares for multiple patients either in one service or many. 1 .1.2 Schedulesherifies accurate scheduling of procedure and all related supplies and equipment. 1 .1.3 Contacts team members from other disciplines to coordinate care.
1 .1.4 Acts as a resource person in relationship to areas of clinical expertise. 1.1.5 Provides educational programs to colleagues in areas of clinical expertise. 1.2 Demonstrates the ability to coordinate multiple patients and surgical caseloads. 2. The perioperative care coordinator will manage intraoperative patient care on on ongoing and principle basis.
2.1 Provides care, consulting intraoperatively as needed.
2.1.1 Prepares for patient care introoperatively and assists RN with care through advisory role.
Emergency Room Physicians Often Misjudge Patients’ Pain Physicians do not always accurately judge whether anesthesia is needed for painful, frequently performed emergency room procedures, according to a recent study in the June 1999 issue of Annals of Emergency Medicine. Researchers at the State University of New York, Stony Brook, evaluated more than 1,100 emergency room procedures and asked the patients and physicians involved to assess the level of pain associated with the 15 most common procedures. They found the correlation between patient and practitioner pain assessments in individual patients to be poor to fair. Although both patients and physicians identified nasogastric intubations, abscess drainages, fracture reductions, and urethral catheterizationsas the most
painful of emergency room procedures, their views differed as to whether anesthetics are needed before these procedures. Physicians administered local anesthetics in 12.8%of the procedures, yet 17.1% of the patients-those who gave higher pain scores-stated that they would definitely request anesthetics if they were to undergo similar procedures in the future. Researchers conclude that physicians should be sensitive to their patients’ individual anesthetic needs before performing painful procedures. A J Singer et al, “Comparison of patient and practitioner ossessments of pain from commonly petformed emergency depanhent procedures, “Annals of Emergency Medicine 33 (June 1999) 652-658.
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Perioperative Care Coordinator Nurse Competency Statements he Nursing Practice Committee has completed development of the perioperative care coordinator nurse competency statements. The perioperative care coordinator is defined in the “Working document on perioperative nursing roles”:
A perioperative nurse who is responsible and accountable for optimizing available resources while independently and collaboratively assessing, planning, implementing, and evaluating the care of the surgical patient is practicing in a perioperative care coordinator role. In this expanded role, the perioperative nurse is responsible for providing leadership,clinical expertise, andfunctional direction to other members of the health care team to achieve optimal patient outcomes. This role may include, but is not limited to, surgical case manager, intraoperative patient cure coordinator,patientfamily educator, cost-reduction specialist, industry educatorlconsultant,registered nurse $rst assistant, and udministratoc ’ The perioperative care coordinator should have mastered the skills outlined in the “Competency Statements in Perioperative Nursing.” AORN strongly believes that the best foundation for the perioperative care coordinator role is perioperative nursing. The Nursing Practice Committee developed a preliminary list of broad competencies that they believe fall within the category of perioperative care coordinator. This list was distributed to the specialty assemblies’ governing councils in July 1998 for input, with the intent that the final competencies would be broad in nature and represent commonalities in required knowledge and skills. A survey using the preliminary list of Competencies and a template for use in defining the knowledge and skills necessary for the unique roles within the specific specialty assembly were sent to the governing councils of the following specialty assemblies: Advanced Technology: Lasers
and Minimally Invasive Surgery; Ambulatory Surgery; Business, Industry & Consulting; Management; Nurse Educator/Clinical Nurse Specialist; Nurses in Perioperative Informatics; and RN First Assistant. The survey responses were reviewed and suggestions were incorporated into the perioperative care coordinator competency statements. The Nursing Practice Committee completed the final revision of the statements in November 1998, and the document was referred to the AORN nurse researchers (ie, Suzanne Beyea, RN, PhD, CS; Leslie Nicoll, RN, MS, MBA, PhD) for review and comment. The researchers approved the document in December 1998. The AORN Board of Directors reviewed and approved the perioperative care coordinator nurse competency statements at the February 1999 Board meeting. The perioperative care coordinator competency statements are intended to serve as an “umbrella” of competencies that can be adapted for specific roles. The following competency statements are a sampling of activities a perioperative care coordinator might perform. The list is not exhaustive, nor is the perioperative care coordinator required to perform all activities listed to demonstrate a particular competency. The Nursing Practice Committee believes the following competencies will need to be revisited as the role of the perioperative care coordinator evolves. Members of the Nursing Practice Committee who worked on development of the competencies in 1998 were Antonia B. Hughes, RN, BSN, CNOR, chair; Diane L. Fecteau, RN, MSA, Pat Hickey, RN, BSN, CNOR Lillian H. Nicolette, RN, MSN, CNOR; Brenda J. McKonly, RN, CNOR; and Ramona L. Conner, RN, MSN, staff consultant. RAMONA CONNER RN, MSN NURSING PRACTICE COMMIITEE STAFFcowsuiwa NOTE 1. “Working document on perioperative nursing roles,” AORN Journal 67 (January 1998) 4.
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CHANGE MANAGEMENT
Competency statements 1 . The perioperative care coordinator is competent to coordinate, facilitate, and manage change efforts.
Measurable criteria 1 .l Coordinates, implements, and eva Iuates change process.
Example 1 . l . l Participates in the development of the project plan. 1.1.2 Assists with the implementation of the change.
1 .1.3Assesses the need, readiness, and environment for change. 1.2 Demonstrates knowledge of the change process. 2. The perioperative care coordinator seeks new knowledge.
2.1 Demonstrates commitment to professional improvement.
2.1 . 1 Meets the necessary requirements to maintain CNOR, certificates (eg, advanced degree in nursing), CRNFA, and competency assessment, development, validation, and record maintenance.
3. The perioperotive care coordinator supports learning process of staff members and clients.
3.1 Demonstrates knowledge of learning system and motivation theory.
3.1.1 Participates in the assessment of the environment to identify current status.
3.2 Provides learning opportunities.
3.2.1 Develops, implements, and evaluates a learning plan and timeline within the context of the project plan.
COUABORl\llVE/CONSULTATIVE/NEGOTIATION SKILLS
Competency statements 1. The perioperativecare coordinator is competent in the use of collaboration and negotiation.
Measurable criteria 1 . 1 Demonstrates appropriate negotiation/collaborationskills.
Example 1.1.1 Collects necessary data and information related to all stakeholders.
1 . 1.2 Collects and analyzes data required to facilitate collaboration and negotiation with stakeholders. 1 . 1.3Reviews the advance case schedule and initiates interventions/ consultation as needed. 1.2 Demonstrates effectiveness in negotiations and compromise as needed to ensure positive outcome.
1.3Uses appropriate communication techniques to facilitate negotiation. 2. The perioperative care coordinator holds a consultative role.
2.1 Directs colleagues in a specific area of perioperative nursing.
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2.1 .1 Serves as a resource to others in an area of qualification (eg, lasers, specialty procedures, staffing, pain management).
OCTOBER 1999, VOL 70, NO 4
COMMUNICATION SKILLS
Competency statements
1 , The perioperative care coordinator is competent in verbal, written, and listening skills.
Measurable criteria
1 . l Demonstrates knowledge of communication techniques, both verbal and nonverbal. 1.2 Evaluates the effectiveness of communication and modifies techniques as appropriate.
Example
1 . 1 .l Communicates client needs to health care team members.
1 .1.2 Communicates effectively with health care team members. 1.2.1 Identifies special needs of the patients and communicates these to other team members. 1.2.2 Applies communication techniques appropriately in a given situation. 1.2.3 Utilizes a variety of communication techniques and tools appropriate to each situation. 1.2.4 Solicits feedback on effectiveness of communication on an ongoing basis.
1.3Guides others to develop effective communication skills.
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1.3.1Provides information on how to communicate more effectively.
OCTOBER 1999, VOL 70, NO 4
CONFLICT RESOLVnON
Competency statements
1 . The perioperative care coordinator is competent in the area of conflict resolution.
Measurable criteria
1 . 1 Demonstrates knowledge of conflict resolution techniques.
Example
1 .l , l Applies the technique of conflict resolution. 1.1.2 Ensures a professional climate while dealing with a conflict.
1.2 Takes the necessary steps and utilizes the appropriate chain of command within scope of responsibility.
1.2.1 Identifies the necessary sources to help in conflict resolution.
1.3Effectively mediates conflicts among department needs.
1.3.1 Considers all aspects of a conflict before drawing conclusions.
1.4 Effectively solves inter/intradepartmental problems.
1.4.1 Handles disruptive behavior with firmness and professionalism.
1.5 Evaluates the outcome of conflict resolution. 2. The perioperative care coordinator is competent in facilitating meetings and group processes.
2.1 Demonstrates knowledge of facilitation techniques by exercising competencies in: communication collaborationhegotiation critical thinking interpersonal/social skills conflict resolution
2.1.1 Assesses the setting in which facilitation is requiredkequestedto include: historical perspective stakeholders desired outcome timeline 2.1.2 Prepares appropriately for the situation. 2.1.3 Applies the competencies for: communication collaboration/negotiation critical thinking interpersonal/sociol skills conflict resolution
2.2 Evaluates the effectiveness of the facilitation.
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2.2.1 Seeks feedback from group members.
OCTOBER 1999, VOL 70, NO 4
CONSULTATION SKIUS
Competency statements
1 , The perioperative care coordinator is competent in counseling techniques for patients, families, physicians, and superiors.
Measurable criteria
1 , l Demonstrates knowledge of counseling staff members.
Example
1.1 . l Identifies the need for disciplinary action. 1 . 1.2 Demonstrates a professional and caring altitude while counseling stoff members.
1.2 Demonstrates knowledge of counseling patients and their fa milies.
1.2.1 Identifies a patient's need through assessment and evaluation.
1 2 . 2 Provides counseling according to patient's age, cultural background, and identified limitotion(s). 1.2.3 Involves the patient's family and/or significant other for better outcome.
2. The perioperative care coordinator is competent in the skills required to provide consultative services.
2.1 Demonstrates an ability to exercise skills in assessment, planning, implementation, and evaluation.
2.1.l Assesses environment and client needs/exceptions. 2.1.2 Collects appropriate data. 2.1.3 Analyzes data. 2.1.4 Develops plan to accomplish the goals of the consultation.
3. The perioperative care coordinator is competent in consultation skills.
2.2 Demonstrates knowledge and competency in: change management collaborationlnegotiation conflict resolution critical thinking financiallresource management interpersonallsocial skills coaching political skills teaching facilitation project management
2.2.1 Assists, supports implementation plan utilizing the skills and techniques appropriate to the situation.
3.1 Communicates pertinent information in an organized, logical, and concise manner to physicians, patients, and families.
3.1. l Uses advanced communication skills to effectively distribute and retrieve information.
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c R m c m THINKING
Competency statements 1 . The perioperative care coordinator is competent exercising critical thinking skills in all aspects of his or her role.
Measurable criteria
Example
1 .1 Demonstrates knowledge of critical thinking skills.
1 .1 .l Analyzes and synergizes information as a means of approaching a situation, issue, decision.
1.2Gathers and interprets infarmation, applies critical thinking skills,
1.2.1Applies previously acquired critical thinking skills in the assessment, planning, implementation, and evaluation phases of activities/ encounters.
FINANCIALIRESOURCE MANAGEMENT
Competency statements 1, The perioperative care coordinator is competent to manage budgetary responsibilities within his or her role.
Measurable criteria
Example
1 .1 Demonstrates knowledge of financial implications of materials, equipmentt and human resources.
efficient manner.
1.2Implements practices to support the budgetary plan.
1.2.1Participates in the handling and care of supplies and equipment.
1.1 .l Utilizes staff resources in an 1.1.2Manages materials, supplies, and equipment.
1.2.2Participates in the budget process. 1.2.3Identifies resource requirements. 1.2.4Communicates budget considerations and provides feedback to staff members, physicians, and administrators as needed.
1.2.5Provides justification for variances. 2.The perioperative care coordinator is competent in the development of a detailed proposal for a perioperative project.
2.1 Develops clear written proposals for improvement.
2.1.l Reviews relevant literature. 2.1.2Logically argues points that support effectiveness, efficiency, and budget implications of proposed projects.
2.1.3Presents proposal to administration in a concise format. 2.1.4Develops budget for completed proposed project.
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INTERPERSOWSOCIAL SKILLS
Competency statements 1 , The perioperative care coordinator is competent in interpersonaVsocia1 skills with clients, colleagues, and peers.
Measurable criteria
Example
1 . 1 Demonstrates knowledge of appropriate conduct, internal and external, of the work environment.
1 . 1 . 1 Conducts self in a manner that reflects pride and respect in oneself and others.
1.2 Utilizes knowledge of organizational, behavioral, and social norms.
1.2.1 Identifies, adapts to, and functions within established norms. 1.2.2 Conduct, attire, and language are appropriate for the situation.
1.3Adapts to and functions within identified organizational, behavioral, and social norms.
1.3.1Recognizes and maximizes own social strength.
MENTORINGICOACHINGSKIUS
Competency statements
1 , The perioperative care coordinator is competent to mentor and coach others to improve performance, enhance skills, and develop career options.
Measurable criteria
1 . l Demonstrates skills in mentoringkoaching.
Examble
1 , 1 . l Provides guidance, support, and constructive feedback within the context of the role. 1 .1.2 Presents self as a professional nurse and a role model. 1 .1.3Demonstrates a high level of self-esteem and a positive attitude.
1 .1.4 Identifies the opportunities to coach and act as a preceptor.
2. The perioperative care coordinator is competent in counseling techniques for patients, families, ph@cians, and superiors.
1.2 Utilizes appropriate resources to support the mentoringlcoaching effort.
1.2.1 Promotes perioperative nursing growth and development.
1.3 Provides feedback as it pertains to staff performance.
1.3.1Provides information regarding resources available to address the developmental needs of the individual@).
2.1 Demonstrates knowledge of counseling staff members.
2.1 .l Identifies the need for disciplinary oction. 2.2.1 Demonstrates CI professional and caring attitude while counseling staff members.
2.2 Demonstrates me skills of a coach and a preceptor.
2.2.2 Identifies patient's needs through assessment and evaluation. 2.2.3 Provides counseling according to patient's age, cultural background, and identified limitation(s). 2.2.4 Involves the patient's family and or significant other to establish and achieve outcome. 2.3 Communicates significant information in an organized, logical, and concise manner to physicians, patients, and families. 629 AORN JOURNAL
2.3.1 Uses advanced communication skills to effectively distribute and retrieve information.
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P O M C A L SKIUS
Competency statements
1 , The perioperative care coordinator is competent in utilizing political skills.
Measurable criteria
1 . 1 Demonstrates knowledge of the organizafion's political culture and its implications in relation to his or her role.
Example
1 , l , l Assesses the political climate within the organization insofar as formal and informal leaders, internal and external drivers, and relationships of processes and resources. 1 ,1.2 Assists with the development of strategies to address the political influences impacting an activity outcome.
1.2 Demonstrates knowledge ofthe external political structure and its effect an the organization.
1.2.1 Maintains currency of knowledge of external politics through reading, networking, and professional involvement. 1.2.2 Applies knowledge of the poiitical arena to the activities of the role.
PROFES!3ONAL SKILLS
Competency statements
1 , The perioperative care coordinator is competent in perioperative practice.
Measurable criteria
Example
1 . 1 Demonstrates excellent perioperative clinical skills.
1 . l .1 Continuously advances perioperative education.
1.2 Is an active member of the perioperative professional organization.
1.2.1 Participates in perioperative research. 1.2.2 Promotes perioperative nursing in the community.
2. The perioperative care coordinator is competent in demonstrating professionol skills.
2.1 Demonstrates knowledge af correlating history and physical assessments with abnormal laboratory values and x-rays.
2.1 , 1 Evaluates abnormal laboratory values with patient's history.
2.2 Identifies surgical anatomy relevant to procedure.
2.2.1 Assists to ligate and divide specific anatomy relevant to procedure.
2.1.2 Participates in patient's physical assessment.
2.2.2 Anticipates equipment and implant needs. 3. The perioperative care coordinator is competent in the professional specialty of his or her practice role.
3.1 Demonstrates knowledge of the field of practice in which he or she specializes.
3.1.1 Attends educational programs that contribute ta his or her body of knowledge; reads o diverse pool of resources to maintain and enhance knowledge and skills. 3.1.2 Applies learning within the context of his or her role.
3.2 Maintains active membership in professional organization(s).
3.2.1 Attends meetings of his or her professional organization(s). 3.2.2 Actively participates in the business of his or her professional organizotion(s) by serving on cornmittees, holding office, etc.
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QUALITY IMPROVEMENT
Competency statements
1 , The perioperative care coordinator is competent in improving patient care.
Measurable criteria
1 . 1 Is an active participant in process for improving patient care.
Example
1 . 1 .1 Studies process and makes suggestions. 1.1.2 Disseminates information related to quality improvement (QI) initiative.
1.2 Participates in continuous QI improvement process.
1.2.1 Initiates process. 1.2.2 Active member of QI initiative. 1.2.3Supports initial process.
1.3 Active member of initiative for quality improvement.
1.3.1Makes suggestions, initiates process. 1.3.2 Facilitates and/or supports the implementation of 81 process.
1.4 Evaluates results of QI initiative.
1.4.1 Reevaluates data to determine result of 81 initiative.
1.5 Implements practical changes as a result of QI measurements. TIEACHING S K I U S
Competency statements
1 . The perioperative care coordinator is competent in teaching concepts, skills, and processes.
Measurable criteria
Example
1 . 1 Demonstrates the knowledge required to be able to teach different age groups.
1 , l .l Applies the principles of learning.
1.2 Identifies the individual needs of a patient according to age, culture, and learning ability.
1.2.1 Assesses learning needs of participants.
1.3Demonstrates knowledge of adult learning theoty.
1.3.1Provides safe environment for learning.
1.1.2 Active involvement as a participant.
1.3.2 Creates relevant learning experience. 2. Maintains current knowledge of educational principles and skills, as well as new techniques, treatments, and procedures as appropriate to the practice area.
2.1 Monitors current trends in education and research as well as in new technology and procedures.
2.1 , 1 Constantly learns more through journals, research, and attendance at servicesklasses.
2.2.1 Networks with education and industry representatives.
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OTHERRESEARCH UnUZATlON
Competency statements
Measurable criteria
1 . The perioperative care coordinator is competent to read and evaluate research applicable to perioperotive setting.
1 . 1 Identifies perioperative research and its relationship to clinical setting.
1 .1.1 Regularly reviews research reports applicable to perioperative setting.
1 .1.2 Evaluates the validity of research reports applicable to perioperative setting. 1.2 Implements and evaluates pilot projects for potential change suggested by perioperative research studies.
OTHER-ORGANIZAllONL
Example
1.2.1 Replicates a research finding on a pilot basis.
1.2.2 Evaluatesfanalyzes pilot project's published research report for appropriateness of implementations in clinical setting.
SKILLS
Competency statements 1. The perioperative core coordinator is competent in organizationalskills within the workplace.
Measurable criteria
1 . l Collaborates with other disciplines to facilitate the delivery of patient care.
Example 1 .l . 1 Participates in o variety of role dimensions: provider of care, educator, consultant, researcher, and manager.
1.1.2 Serves as a member of a multidisciplinaryteam planning care for the periaperotive patient.
1.1.3Minimizes role conflict and territorialip. 1 .1.4 Acts as a resource persan in relationship to areas of clinical expertise. 1.1.5 Provides educational programs to colleagues in areas of clinical expertise.
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OTnER-PROJECT
MANAGEMENT
Competency statements 1 The perioperotive care coordinator is competent in the management of multiple projects. ~
Measurable criteria 1.l Demonstrates knowledge in the principles of project management.
Example 1 .l .l Assesses the requirements of the client and of the scope of the project.
1 .1.2 Develops project plan and establishes priorities in associated timeline.
1.1.3Identifies and incorporates stakeholders into 011 aspects of the project. 1 . I ,4 Assists and oversees the implementationof the project plan. 1 .1.5Measures completion of milestones on on ongoing basis. 1 .1.6 Evoluates effectiveness of the outcome. 1.2 Demonstrates competency in: change management communication collaboratiorVnegotiation consultation financial management interpersonoVsocial skills quality improvement facilitation technology
1.1.7 Reports resuits to client@). 1.2.1 Applies competencies in those described.
OTHERTECHNOLOGY
Competency statements 1 , The perioperative care coordinator is competent in the use of relevant technology.
Measurable crlterla
1 . 1 Demonstrates knowledge of current technology.
Example
1 , l , l Applies knowledge and skills to the use of the hardware and softwore and relative clinical technology. 1.1.2 Utilizes common software applications for word processing, spreadsheets, and presentotions.
1.1.3Utilizes technology in exercising competencies in: communication teaching financial management consultation project management 1.1.4Utilizes the Internet as on educational resource. 1.2 Maintains currency of knowledge of technology by reading, attending
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OTIIER-SURGICAL CASE MANAGEMENT
Competency statements 1. The perioperative care coordinator will be responsible for the care of the surgical patient before, during, and after the surgical procedure.
Measurable criteria 1.1 Collaborates with patient, significant others, and health care team members to assess, plan, implement, and evaluate surgical care.
Example 1.1.1 Cares for multiple patients either in one service or many. 1 .1.2 Schedulesherifies accurate scheduling of procedure and all related supplies and equipment. 1 .1.3 Contacts team members from other disciplines to coordinate care.
1 .1.4 Acts as a resource person in relationship to areas of clinical expertise. 1.1.5 Provides educational programs to colleagues in areas of clinical expertise. 1.2 Demonstrates the ability to coordinate multiple patients and surgical caseloads. 2. The perioperative care coordinator will manage intraoperative patient care on on ongoing and principle basis.
2.1 Provides care, consulting intraoperatively as needed.
2.1.1 Prepares for patient care introoperatively and assists RN with care through advisory role.
Emergency Room Physicians Often Misjudge Patients’ Pain Physicians do not always accurately judge whether anesthesia is needed for painful, frequently performed emergency room procedures, according to a recent study in the June 1999 issue of Annals of Emergency Medicine. Researchers at the State University of New York, Stony Brook, evaluated more than 1,100 emergency room procedures and asked the patients and physicians involved to assess the level of pain associated with the 15 most common procedures. They found the correlation between patient and practitioner pain assessments in individual patients to be poor to fair. Although both patients and physicians identified nasogastric intubations, abscess drainages, fracture reductions, and urethral catheterizationsas the most
painful of emergency room procedures, their views differed as to whether anesthetics are needed before these procedures. Physicians administered local anesthetics in 12.8%of the procedures, yet 17.1% of the patients-those who gave higher pain scores-stated that they would definitely request anesthetics if they were to undergo similar procedures in the future. Researchers conclude that physicians should be sensitive to their patients’ individual anesthetic needs before performing painful procedures. A J Singer et al, “Comparison of patient and practitioner ossessments of pain from commonly petformed emergency depanhent procedures, “Annals of Emergency Medicine 33 (June 1999) 652-658.
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