Four Dimensions (Nine Criteria) of Nursing Practice

**Nurse Professional Standards Board**
Addressing the Four Dimensions (Nine Criteria) of Nursing Practice
Self Assessment
Congratulations on your selection for an RN position with the North Texas VA Medical Center! As part of the salary determination process for Registered Nurses, you will be evaluated by a panel of your peers (Nurse Professional Standards Board or NPSB) against the Four Dimension of Nursing Practice. The responsibility of the NPSB is to ensure that you meet established qualifications and subsequently establish a pay level recommendation. As such, your response to the Nine Dimensions has a direct impact on the establishment of your pay.

The following guidance is provided to optimize your success with this process. Although daunting at times, your thoughtful responses to each of the Nine Criteria within the Four Dimensions are critical to the outcome of your salary determination. The NPSB has an opportunity to qualify you at one of three grades: Nurse I, Nurse II, or Nurse III. Within Nurse I, there are also three levels—Level 1, Level 2, and Level 3. When considering your responses, be advised of the following qualification standards for each grade:

Nurse I: Associate Degree/Diploma required. In each of the Four Dimensions, the Board is looking for INDIVIDUAL growth and development in clinical practice to increasing levels of self direction.
Nurse II: Bachelor’s Degree in Nursing required. (Associate in Nursing/Diploma with Bachelor’s in health-related field may be considered). In each of the Four Dimensions, the Board will expect UNIT level contributions and leadership.
Nurse III: Master’s Degree in Nursing required. (BSN with Master’s in health-related field may be considered). In each of the Four Dimensions, SUSTAINED LEADERSHIP resulting in program contributions and outcomes BEYOND THE UNIT/PRACTICE SETTING. That is, involvement at the ORGANIZATIONAL LEVEL is expected.
NOTE: Both educational requirements and meeting the Four Dimension standards for that particular grade are required to be recommended for that grade.

The Four Dimensions of Nursing Practice are as follows: Nursing Practice (Practice, Ethics, Resource Utilization); Professional Role-Leadership (Education/Career Development, Performance); Collaboration (Collegiality, Collaboration) and Scientific Inquiry (Quality of Care, Research). NOTE: Leadership is not one of the dimensions, but leadership principles are expected to be woven throughout the established categories.
Each of the Nine Criteria should be addressed by you citing examples (at least one) to support the qualifications standards. One example may suffice to support all criteria under a single Dimension, but all criteria must be met…NOT just the Dimension. As a template for your response, the following guidance is offered:

​What as done? - ACTION
​For Whom? - POPULATION
​What difference did it make? - OUTCOME
​When? – SUSTAINABILITY
Please see the following table for additional guidance:
***** If you want additional information/clarification, please see http://vaww1(dot)va(dot)gov/NURSING/psb.asp


Criteria
Nurse I
Nurse II
Nurse III
Nursing Practice
PRACTICE
Demo Independence;
No charge activities required
Demo Leadership;
Charge Nurse/Unit Level
Leadership at Service, Service Line, or Medical Center Level; looking for organized processes or systems

ETHICS
Assumes responsibility for Individual judgments/actions
Serves as resource in indentifying ethical issues
Leadership in anticipating risks, resolving ethical issues and dilemmas, analyzing trends, and taking appropriate action

RESOURCE UTILIZATION
Effectively plans/directs flow of patient care and nursing resources
Identifies potential problems involving resources or pt safety and takes action to avert (Team/Unit)
Manages and analyzes resources, evaluates options and takes actions that impact organization outcomes beyond the unit/practice area.
Professional Role
EDUCATION/CAREER DEVELOPMENT
Seeks knowledge for indiv competency (indiv educ plan/reads health care literature)
Participates in educational activities to enhance role performance at the unit/team level
Implements educational plan to meet changing needs of program/ service



PERFORMANCE
Incorporates feedback into personal development (self-assessment)
Self-evaluation and evaluation of others
Self-evaluation and evaluation of program or service effectiveness (recommending/implementing changes)
Collaboration
COLLEGIALITY
Attends/participates in staff meetings and in-services.
Educates colleagues, preceptor and mentoring roles
Coaches in team building: active involvement in group accomplishments; sharing expertise outside of the facility.

COLLABORATION
Team participation, interpersonal skills, develops collaborative plans of care
Uses group process to identify, analyze, and resolve care problems
Leadership and decision-making role in use of group process for interdisciplinary problem-solving beyond unit/practice setting.
Scientific Inquiry
QUALITY OF CARE
Use QI findings to guide OWN practice (NOT the RN providing quality care)
Participates in QI activities (data collection, analysis, recommendations, etc) at the Unit level
Initiates/Leads QI activities at the program, service, and/or facility level

RESEARCH
Awareness of research; uses to validate/change own practice
Uses research to validate or change Work group/Team practice
Demonstrates leadership in collaboration with others in research activities, across programs/services, to validate & improve practice
​
You may use the template below for your submission (or use your own format if desired). Expand the document as needed to individualize with your examples/input. The template supports two examples for each Criteria, although only ONE is required.
NPSB Input
Nine Criteria of Nursing Practice

Name:​Date:

​NURSING PRACTICE DIMENSION:

​PRACTICE--​Action:

​Population:

​Outcome(s):

​Sustainability:
- - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​ETHICS--​Action:

​Population:

​Outcome(s):

​Sustainability:
- - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​RESOURCE--​Action:
​UTILIZATION
​Population:

​Outcome(s):

​Sustainability:
- - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​PROFESSIONAL ROLE DIMENSION:

​EDUCATION--​Action:
​CARRER DEV
​Population:

​Outcome(s):

​Sustainability:
​ - - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​PERFORMANCE--​Action:

​Population:

​Outcome(s):

​Sustainability:
​- - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​COLLABORATION DIMENSION:

​COLLEGIALITY--​Action:

​Population:

​Outcome(s):

​Sustainability:
​- - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​COLLABORATION-​Action:

​Population:
​Outcome(s):

​Sustainability:
​ - - - - - - - - - - - - - - - - - - - - - - - -
​Action:
​
​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​SCIENTIFIC INQUIRY DIMENSION:

​QUALITY OF CARE--​Action:

​Population:

​Outcome(s):

​Sustainability:
​ - - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:
​-------------------------------------------------------------------------------------
​RESEARCH--​Action:
​
​Population:

​Outcome(s):

​Sustainability:
​ - - - - - - - - - - - - - - - - - - - - - - - -
​Action:

​Population:

​Outcome(s):

​Sustainability:

​_______________________________________________(Your Signature/Date on last page)



I certify that, to the best of my knowledge and belief, all of the information on and attached to this document
is true, correct, complete, and made in good faith. I understand that a false or fraudulent answer to any question or item on any part of this declaration or its attachments may be grounds for not hiring me, or for firing
me after I begin work.