Nursing specialty organizations, such as the Association for Nursing Professional Development (ANPD), are considered "designated stewards of specialty nursing knowledge and seek publication of the specialty nursing scope of practice statement and standards to delineate and guide that unique practice" (Finnell, Thomas, Nehring, McLoughlin, & Bickford, 2015.) Nursing specialties are defined by their scope and standards of practice that are developed by the organization. Following a systems approach, these documents communicate the who, what, where, when, why, and how of the specialty while providing guidance for specialty practitioners. In addition, these documents align with foundational nursing documents-the Nursing: Scope and Standards of Practice (American Nurses Association [ANA], 2015a) and the Code of Ethics for Nurses With Interpretive Statements (ANA, 2015b). The third edition of Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016) continues to focus on strengthening nursing professional development (NPD) as a specialty practice area in a complex healthcare environment. This column provides an overview of the influences and resulting major revisions in this latest edition intended to guide current and future practice.
INFLUENCE OF HEALTHCARE TRENDS
Following a legacy that started with the initial Standards for Nursing Professional Development: Continuing Education and Staff Development (ANA, 1994) the workgroup charged by the ANPD Board of Directors with updating the scope and standards considered changes in healthcare resulting from advances in clinical practice, national initiatives, and global priorities since the 2010 edition (ANA & National Nursing Staff Development Organization, 2010). Environmental scanning by the workgroup revealed a healthcare landscape that continues to be impacted by reform such as the Affordable Care Act and changing reimbursement models. The current focus on pay for performance that includes penalties for avoidable events necessitates continued emphasis on safety and quality care. Furthermore, these reforms are shifting care delivery from an inpatient to a community setting. As a result, NPD practitioners must be prepared to demonstrate their financial impact as well as an ability to meet the professional development needs of nurses and other healthcare staff in a variety of settings.
In both the inpatient and community setting, teamwork is increasingly recognized as an important precursor to delivering safe, quality patient care (Institute of Medicine, 2003). Although interprofessional education has been a focus for academic education for some time, interprofessional continuing education (IPCE) has recently moved to the forefront in clinical practice. NPD practitioners are increasingly being called upon to deliver IPCE.
Finally, a continued emphasis on evidence-based practice is anticipated for the NPD specialty (Harper & Maloney, 2016). Even though the benefits of evidence-based practice are well documented (Lee, Johnson, Newhouse, & Warren, 2013; Polit, & Beck, 2016), the NPD practitioner is constantly challenged to overcome the barriers and promote evidence-based practice.
INFLUENCE OF RESEARCH FINDINGS
Research conducted by Warren and Harper (2015) also influenced revision of the Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016). In their NPD Role Delineation Study, Warren and Harper identified seven professional roles to move NPD practice into the future:
* Learning facilitator
* Leader
* Partner for practice transitions
* Change agent
* Champion for scientific inquiry
* Mentor
* Advocate for NPD specialty
PRIMARY REVISIONS
The healthcare trends and research described above resulted in several significant revisions to the Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016). These revisions included a broadening of the description of the settings in which NPD is practiced, a change in definition of NPD, movement from intertwined elements of practice to roles, and identification of generalist and specialist levels of NPD practice.
Although the prior edition of the Nursing Professional Development: Scope and Standards of Practice (ANA & NNSDO, 2010) acknowledged that NPD practice occurs in a variety of settings, this edition broadens the description of NPD practice settings. Practice settings include acute, intermediate, and long-term care; residential and community settings; as well as virtual settings-any setting where the NPD practitioner supports quality outcomes.
In every setting, the increased emphasis on IPCE and collaborative practice as a key component of improving quality care and patient safety necessitated expansion of the definition of nursing professional development. This expanded definition of NPD includes other disciplines and indicates that NPD is "a specialized nursing practice that facilitates the professional role development and growth of nurses and other healthcare personnel along the continuum from novice to expert" (Harper & Maloney, 2016, p. 6).
In addition to expanding the definition of NPD, role descriptions that align with the research evidence from Warren and Harper (2015) as delineated above were included. These roles expand on the intertwined elements of practice from the prior edition of the Nursing Professional Development: Scope and Standards of Practice (ANA & NNSDO, 2010), demonstrating the NPD practitioner's role in the organization and differentiating it from the role of the academic nurse educator.
Another significant change to the Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016) is differentiation of the NPD generalist and the NPD specialist. This distinction aligns with the Nursing: Scope and Standards of Practice (ANA, 2015a) that differentiates the competencies of the generalist registered nurse and the graduate-prepared registered nurse. It also acknowledges the existing variation in education level, knowledge, and experience of those who practice NPD: NPD practitioners. The NPD practitioner is an umbrella term that encompasses both the generalist and the specialist.
The NPD generalist is a bachelor's-prepared nurse either with or without NPD certification. A master's-prepared NPD practitioner who is not certified is also a generalist. The NPD specialist delineation is reserved for those with both a graduate degree and certification in NPD. Functionally, NPD generalists use their skills and knowledge of the specialty whereas NPD specialists develop tools, theories, and knowledge. Public comment revealed widespread support for differentiation of the generalist and specialist as a framework for advancement. This change supports professional development for the practitioner while advocating for the NPD specialty.
Ultimately, these revisions necessitated change in the NPD practice model. These changes will be described in detail in the next column.
IMPLICATIONS FOR PRACTICE
The intent of the Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016) is not to serve as an addition on a bookshelf but to be used as a living document to help guide NPD practice. Bradley (2010) noted that because the scope and standards "defines the scope of the specialty and articulates expectations for practice and performance, it needs to serve as a relevant and useful framework for the nurses in NPD practice to define their scope and role responsibilities in their own practice" (p. 139). The founder of ANPD and former editor of this Journal, Belinda Puetz (2010) challenged NPD practitioners to "[horizontal ellipsis]learn how to make the scope and standards of practice come alive in your work," and that by doing so, "you will realize that nursing professional development, like other specialty areas of practice, is guided by a scope of practice and governed by standards of practice and professional performance as well" (p. 95).
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