1. Scientific Foundation
   1. Critically analyzes data and evidence for improving advanced nursing practice.
   2. Integrates knowledge from the humanities and sciences within the context of nursing science.
   3. Translates research and other forms of knowledge to improve practice processes and outcomes.
   4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.
2. Leadership
   1. Assumes complex and advanced leadership roles to initiate and guide change.
   2. Provides leadership to foster collaboration with multiple stakeholders (e.g., patients, community, integrated healthcare teams, and policy makers) to improve health care.
   3. Demonstrates leadership that uses critical and reflective thinking.
   4. Advocates for improved access, quality, and cost-effective health care.
   5. Advances practice through the development and implementation of innovations incorporating principles of change.
   6. Communicates practice knowledge effectively, both orally and in writing.
   7. Participates in professional organizations and activities that influence advanced practice nursing and/or health outcomes of a population focus.
3. Quality
   1. Uses best available evidence for continuous quality improvement of clinical practice.
   2. Evaluates the relationships among access, cost, quality, and safety and their influence on health care.
   3. Evaluates how organizational structure, care processes, financing, marketing, and policy decisions impact the quality of health care.
   4. Applies skills in peer review to promote a culture of excellence.
   5. Anticipates variations in practice and is proactive in implementing interventions to ensure quality.
4. Practice Inquiry
   1. Provides leadership in the translation of new knowledge into practice.
   2. Generates knowledge from clinical practice to improve practice and patient outcomes.
   3. Applies clinical investigative skills to improve health outcomes.
   4. Leads practice inquiry, individually or in partnership with others.
   5. Disseminates evidence from inquiry to diverse audiences using multiple modalities.
   6. Analyzes clinical guidelines for individualized application into practice.
5. Technology and Information Literacy
   1. Integrates appropriate technologies for knowledge management to improve health care.
   2. Translates technical and scientific health information appropriate for various users’ needs.
      1. Assesses the patient’s and caregiver’s educational needs to provide effective, personalized health care.
      2. Coaches the patient and caregiver for positive behavioral change.
   3. Demonstrates information literacy skills in complex decision-making.
   4. Contributes to the design of clinical information systems that promote safe, quality, and cost-effective care.
   5. Uses technology systems that capture data on variables for the evaluation of nursing care.
6. Policy
   1. Demonstrates an understanding of the interdependence of policy and practice.
   2. Advocates for ethical policies that promote access, equity, quality, and cost.
   3. Analyzes ethical, legal, and social factors influencing policy development.
   4. Contributes in the development of health policy.
   5. Analyzes the implications of health policy across disciplines.
   6. Evaluates the impact of globalization on healthcare policy development.
   7. Advocates for policies for safe and healthy practice environments.
7. Health Delivery Systems
   1. Applies knowledge of organizational practices and complex systems to improve healthcare delivery.
   2. Effects healthcare change using broad-based skills including negotiating, consensus-building, and partnering.
   3. Minimizes risk to patients and providers at the individual and systems level.
   4. Facilitates the development of healthcare systems that address the needs of culturally diverse populations, providers, and other stakeholders.
   5. Evaluates the impact of healthcare delivery on patients, providers, other stakeholders, and the environment.
   6. Analyzes organizational structure, functions, and resources to improve the delivery of care.
   7. Collaborates in planning for transitions across the continuum of care.
8. Ethics
   1. Integrates ethical principles in decision-making.
   2. Evaluates the ethical consequences of decisions.
   3. Applies ethically sound solutions to complex issues related to individuals, populations, and systems of care.
9. Independent Practice
   1. Functions as a licensed independent practitioner.
   2. Demonstrates the highest level of accountability for professional practice.
   3. Practices independently managing previously diagnosed and undiagnosed patients.
      1. Provides the full spectrum of healthcare services to include health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative, and end-of-life care.
      2. Uses advanced health assessment skills to differentiate between normal, variations of normal, and abnormal findings.
      3. Employs screening and diagnostic strategies in the development of diagnoses.
      4. Prescribes medications within scope of practice.
      5. Manages the health/illness status of patients and families over time.
   4. Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making.
      1. Works to establish a relationship with the patient characterized by mutual respect, empathy, and collaboration.
      2. Creates a climate of patient-centered care to include confidentiality, privacy, comfort, emotional support, mutual trust, and respect.
      3. Incorporates the patient’s cultural and spiritual preferences, values, and beliefs into health care.
      4. Preserves the patient’s control over decision making by negotiating a mutually acceptable plan of care.
      5. Develops strategies to prevent one’s own personal biases from interfering with delivery of quality care.
      6. Addresses cultural, spiritual, and ethnic influences that potentially create conflict among individuals, families, staff, and caregivers.
   5. Educates professional and lay caregivers to provide culturally and spiritually sensitive, appropriate care.
   6. Collaborates with both professional and other caregivers to achieve optimal care outcomes.
   7. Coordinates transitional care services in and across care settings.
   8. Participates in the development, use, and evaluation of professional standards and evidence-based care.

These pediatric population-focused competencies expand on core competencies. The role of the primary care PNP is to provide care to children from birth through young adulthood with an in-depth knowledge and experience in pediatric primary health care including well child care and prevention/management of common pediatric acute illnesses and chronic conditions. PNP students should demonstrate competence in the categories as described by the end of the program. The evaluation form uses the items under the Independent Practice Competency to measure progress in practicum courses.

1. Scientific Foundation
   1. Contributes to knowledge development for improved child and family-centered care.
   2. Participates in child and family-focused quality improvement, program evaluation, translation, and dissemination of evidence into practice.
   3. Delivers evidence-based practice for pediatric patients.
2. Leadership
   1. Advocates for unrestricted access to quality cost effective care within healthcare agencies for children and families.
3. Quality
   1. Recognizes the importance of collaborating with local, state, and national child organizations to foster best practices and child safety.
4. Practice Inquiry
   1. Ensures pediatric assent and consent, and/or parental permission when conducting clinical inquiry.
   2. Promotes research that is child-centered and contributes to positive change in the health of or the health care delivered to children.
5. Technology and Information Literacy
   1. Promotes development of information systems to assure inclusion of data appropriate to pediatric patients, including developmental and physiologic norms.
   2. Considers developmental level of child and the family when translating health information to support positive health outcomes.
   3. Uses pediatric focused simulation based learning to improve practice.
6. Policy
   1. Advocates for local, state, and national policies to address the unique needs of children and families.
   2. Uses relevant policy specific to children to direct appropriate patient care, and to advocate against financial and legislative restrictions that limit access or opportunity.
7. Health Delivery System
   1. Optimizes outcomes for children and their families by facilitating access to other healthcare services (e.g., mental health) or to community and educational settings.
   2. Facilitates parent–child shared management and transition to adult care as developmentally appropriate.
   3. Applies knowledge of family, child development, healthy work environment standards, and organizational theories and systems to support safe, high quality, and cost-effective care within healthcare delivery systems.
   4. Facilitates transitions across settings including health care, mental health, community, and educational services to optimize outcomes.
8. Independent Practice – The evaluation form is based on the following criteria.
   1. Conducts age-appropriate comprehensive advanced physical, mental, and developmental assessment across pediatric lifespan.
   2. Assesses growth, development, and mental/behavioral health status across the pediatric lifespan.
   3. Assesses for evidence of physical, emotional or verbal abuse, neglect, and the effects of violence on the child and adolescent.
   4. Analyzes the family system (i.e., family structure, cultural influences etc.) to identify contributing factors that might influence the health of the child/adolescent and/or family.
   5. Assesses patient’s, family’s, or caregiver’s knowledge and behavior regarding age-appropriate health indicators and health risks.
   6. Performs age-appropriate comprehensive and problem-focused physical exams.
   7. Performs a systematic review of normal and abnormal findings resulting in a differential diagnosis encompassing anatomical, physiological, motor, cognitive, developmental, psychological, and social behavior across the pediatric lifespan.
   8. Identifies nutritional conditions and behavioral feeding issues and implements appropriate educational, dietary, or medical treatments/interventions.
   9. Interprets age-appropriate, developmental, and condition-specific screening and diagnostic studies to diagnosis and manage the well, minor acute, or chronic conditions in the pediatric scope of practice.
   10. Promotes healthy nutritional and physical activity practices.
   11. Provides health maintenance and health promotion services across the pediatric lifespan.
   12. Activates child protection services and recommends/incorporates other resources on behalf of children or families at risk.
   13. Partners with families to coordinate family-centered community and healthcare services as needed for specialty care and family support.
   14. Incorporates health objectives and recommendations for accommodations, as appropriate, into educational plans (IEP).
   15. Assists the parent/child in coping with developmental behaviors and facilitates the child’s developmental potential.
   16. Recognizes and integrates the perspectives of intradisciplinary collaboration in developing and implementing the plan of care.
   17. Understands the complexity and interaction of nonpharmacologic and pharmacologic therapies required in the care of children.