How can clinical informatics be applied to nursing council competencies? Can nurses demonstrate they meet the competencies for registered nurses that describe the nurses’ scope of practice?  In this series of articles, Deb Boyd discusses each nursing council domain, and how it relates to nursing informatics.
 

Domain one: Professional responsibility

This domain contains competencies that relate to professional, legal and ethical responsibilities and cultural safety. These include being able to demonstrate knowledge and judgement and being accountable for own actions and decisions, while promoting an environment that maximises health consumer safety, independence, quality of life and health. (Nursing Council of New Zealand, 2016)
 
Competency 1.1
Accepts responsibility for ensuring that his/her nursing practice and conduct meet the standards of the professional, ethical and relevant legislated requirements. (Nursing Council of New Zealand, 2016)
 
This competency requires nurses to be fully cognisant of the requirements of practice under the various legal frameworks we work within. Digital systems can greatly support nurses practice by ensuring all of the legal frame works and standards are included in any system design. For example, when developing digital medicines management systems, the rules related to controlled drugs and section 29 medications can be included in the clinical support rules that the system uses. The actions a nurse is required to take using the electronic record can be controlled by not allowing you to progress to the next step until all of the compliance data has been entered.
 
Competency 1.2
Demonstrates the ability to apply the principles of the Treaty of Waitangi Te Tiriti o Waitangi to nursing practice. (Nursing Council of New Zealand, 2016)
 
This competency requires nurses to be competent in their knowledge and understanding of their Treaty obligations and again this information can be used in system design. For example, working in Primary Care in partnership with Māori healthcare providers to understand the needs of their enrolled population (healthcare consumers) as a first step. Then being able to translate those requirements into a meaningful workflow that can result in the development of a digital system where nursing assessment and ongoing commentary of patient progress via clinical notes can occur.
 
Competency 1.3
Demonstrates accountability for directing, monitoring and evaluating nursing care that is provided by enrolled nurses and others. (Nursing Council of New Zealand, 2016)
 
System design can include this by identifying who is caring for the patient through log in processes and using delegations to automatically require second sign offs for processes that require clinical oversight. This is already occurring in platforms such as MedChart. System controls can be designed to recognise different levels of authority linked to positions ie RN and EN.
 
Competency 1.4
Promotes an environment that enables health consumer safety, independence, quality of life, and health. (Nursing Council of New Zealand, 2016)
 
Nurses can promote patient safety by using digital technology as a communication tool whilst protecting a patient’s privacy. For example, some systems allow you to apply a particular coloured alert to a patient’s digital record which identifies a status, perhaps an infection control risk or someone requiring isolation or protection if immune compromised. In a digital hospital, the colour alert system can be replicated in the patient’s room information that displays their name without the need to also write the requirements on a bed card. These systems provide efficiency as it is easy to update a changed status from a computer without the need to have to go and write new bed cards.
 
Competency 1.5
Practises nursing in a manner that the health consumer determines as being culturally safe. (Nursing Council of New Zealand, 2016)
 
Nurses must manage people’s personal information safely. Using digital systems to capture the patient’s personal information supports cultural safety.   Systems can be set up to apply in built rules and alerts (system protections) to manage sensitive information that may require privacy. Software already in use such as Trendcare (for example) has the capability to makes notes about a patients care needs or dietary requirements which supports culturally safe practice.
 
References
 
Nursing Council of New Zealand. (2007). Competencies for registered nurses. Wellington, New Zealand: Author. (Amended September, 2016).

Read Domain two: Management of nursing care here