The Four Dimensions of Nursing

Nurse III
This assignment MUST be written @ Level III because a PMHNP is at this level of performance
FYI: THIS ASSIGNMENT IS FOR A PSYCHIATRIC MENTAL HEALTH PRACTITIONER ROLE
Responsibilities
The nurse in this role functions as part of the Mental Health Service Line (MHSL). This nurse demonstrates a thorough knowledge of Major Psychiatric Diagnoses and substances dependence/abuse. The NP will provide psychiatric emergency on-call crisis support and other duties as assigned by the supervisor and/or Director of MHSL. The NP will be responsible to the Chief of MH, Service Line designee or other NM with practice accountability to the ADPCS/Nurse Executive.
In order for a nurse to get boarded (level of nursing position/salary determination), the nurse must submit three things:

1. Four Dimensions of Nursing/ 9 sub-elements (New Hire Dimensions)
A narrative/ bullet points (written description of examples of nursing experience that relate to the nine nurse qualification standards that are outlined below). Be sure to write about any leadership position, any committee work, group project, nursing care improvements, outcomes/results, presentations you did, sharing education with the staff, etc.

2. Complete the Checklist that is attached and return it to me via email.

3. Provide recent performance evaluations

Nine Nurse Qualification Criteria Defining Performance Requirements

(Practice Dimension)
• Practice. Extent to which the RN effectively uses the nursing process components of assessment, diagnosis, outcome identification, planning, implementation, and evaluation in varied practice settings.
• Resource Utilization. Extent to which the RN considers factors related to safety, effectiveness, and cost in planning and delivering care.
• Ethics. Extent to which the RN makes decisions and takes action in an ethical manner

(Professional Development/Education Dimension)
• Performance. Extent to which the RN evaluates his/her own nursing practice as well as the performance of others.
• Education/Career Development. Extent to which the RN acquires and uses current knowledge for self and others.

(Collaboration Dimension)
• Collegiality. Extent to which the RN contributes to the professional development of peers, colleagues, and others.
• Collaboration. Extent to which the RN collaborates with clients, significant others, and other health care and service providers.

(Scientific Inquiry Dimension)
• Quality of Care. Extent to which the RN systematically evaluates and improves the quality and effectiveness of nursing practice and health care delivery.
• Research. Extent to which the RN uses research in practice

Videos https://vaww(dot)fsccollaboration(dot)fsc(dot)va(dot)gov/fps/PFD/Learning%20Catalog/Self%20Service%20Portal%20%20(SSP)/VAFSCCustomerPortalVideo.mp4

Nine Dimensions of Nursing Practice
Due July 4th
Template for VA NPSB (Nurse Professional Salary Board)
**Nurse Professional Standards Board**
Addressing the Four Dimensions (Nine Criteria) of Nursing Practice
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 grade. 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) that are measurable and 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 is the issue/problem? – ISSUE/PROBLEM
What was done (intervention)? - ACTION
For Whom? - POPULATION
What difference did it make? – OUTCOME (Measureable)
When; Did it last? – SUSTAINABILITY
Please see the following table for additional guidance:
**Template Designed by Rick A. Madison RN, MN, Nurse Recruiter,
Criteria Nurse I Nurse II Nurse III
This assignment MUST be written @ Level III because a PMHNP is at this level of performance
Nursing Practice PRACTICE Demo Independence;
No charge activities required 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.
Example template, fill in areas of your personal strength, only ONE is required although two is given
NPSB Input
Nine Criteria of Nursing Practice
I. NURSING PRACTICE DIMENSION:
PRACTICE--
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
ETHICS--
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
- - - - - - - - - - - - - - - - - - - - - - - -
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
RESOURCE--UTILIZATION
Issue/Problem:
Action:

Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
II. PROFESSIONAL ROLE DIMENSION:
EDUCATION—CAREER DEVELOPMENT
Issue/Problem:

Action:

Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
PERFORMANCE--
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________

Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________

III. COLLABORATION DIMENSION:
COLLEGIALITY--
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:

Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
COLLABORATION-
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
Issue/Problem:
Action:

Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________

IV. SCIENTIFIC INQUIRY DIMENSION:
QUALITY OF CARE--
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________

Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
RESEARCH--
Issue/Problem:
Action:

Population:
Outcome(s):
Sustainability:
____________________________________________________________________________________________
Issue/Problem:
Action:
Population:
Outcome(s):
Sustainability: