Nurse Professional Standards Board Documentation

Nurse Professional Standards Board Documentation 


Nurse Professional Standards Board

Addressing the Four Dimensions of Nursing Practice

The following guidance is provided to optimize your success with this process. Your thoughtful responses to each of the 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 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 was done? – ACTION


What difference did it make? – OUTCOME 


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

Please refer to the template which I have attached for better understanding. 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: Practice, Ethics, Resource Utilization, Education/Career Development, Performance, Collegiality, Collaboration, Quality of Care, Research all make up the 9 criteria.

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