Creating an Evidence-Based Progression for Clinical Advancement Programs

In American Journal of Nursing, Kathleen Burke and colleagues validate core competencies and knowledge, skills, and attitudes (KSAs) that were previously developed for professional nursing practice. The researchers then assess the integration and progression of these competencies in clinical advancement programs. Clinical experts from 13 Magnet hospitals participated in quality improvement rounds aimed at reaching consensus on how much the KSAs have been incorporated into clinical advancement. The group found that all of the core competencies assessed were essential at all levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs needed in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a need for more KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement. These results suggest that incorporating the competencies and KSAs into a framework for clinical advancement will likely result in more clearly defined roles and expectations; enhance accountability; and elevate and promote nursing practice.