Discuss the 11 key responsibilities for critical care. Provide a scenario where it is being adapted.

To achieve safe and quality client-centered care, nurses working in the critical care units are
envisioned to adopt not only the stated core competencies of registered nurses but also the specific
competencies stipulated in the following eleven major key responsibility areas:

Safe and Quality Nursing Care

Management of Resources
Legal Responsibilities
Ethico-Moral Responsibilities
Collaboration and Teamwork
Personal and Professional Development
Communication
 Health Education
Quality Improvement
Research
Record Management

https://www.ccnapi.org/news-and-events/critical-care-nursing-guidelines-standards-and-competencies/

11 Key Areas of Responsibility / Core Competency /

Indicators

11 Key Areas of Responsibility

1. Safe and  Quality  Nursing Care

Core Competency 1:
 Demonstrates knowledge base on the health /illness status of individual / groups

Indicators
• Identifies the health needs of the clients (individuals, families, population groups and/or
communities)
•  Explains the health status of the clients/ groups

 Core Competency 2.
Provides sound decision making in the care of individuals / families/groups considering their
beliefs and values

Indicators
• Identifies clients’ wellness potential and/or health problem
• Gathers data related to the health condition
• Analyzes the data gathered
• Selects appropriate action to support/enhance wellness response; manage the health problem
• Monitors the progress of the action taken

Core Competency 3:
Promotes safety and comfort and privacy of clients

Indicators
• Performs age-specific safety measures in all aspects of client care
• Performs age-specific comfort measures in all aspects of client care
• Performs age-specific measures to ensure privacy in all aspects of client care

 Core Competency 4:
Sets priorities in nursing care based on clients’ needs

Indicators
• Identifies the priority needs of clients
• Analyzes the needs of clients
• Determines appropriate nursing care to address priority needs/problems

 Core Competency 5:
Ensures continuity of care

Indicators
• Refers identified problem to appropriate individuals / agencies
• Establishes means of providing continuous client care

 Core Competency 6:
Administers medications and other health therapeutics

Indicators
• Conforms to the 10 golden rules in medication administration and health therapeutics

 Core Competency 7:
Utilizes the nursing process as framework for nursing
 
 7.1 Performs comprehensive and systematic nursing assessment
• Obtains informed consent
• Completes appropriate assessment forms
• Performs appropriate assessment techniques
• Obtains comprehensive client information
• Maintains privacy and confidentiality
• Identifies health needs 

 7.2   Formulates a plan of care in collaboration with clients and other members of the health
team
• Includes client and his family in care planning
• Collaborates with other members of the health team
• States expected outcomes of nursing intervention maximizing clients’ competence
• Develops comprehensive client care plan maximizing opportunities for prevention of problems
and/or enhancing wellness response
• Accomplishes client-centered discharge plan

7.3   Implements planned nursing care to achieve identified outcomes

• Explains interventions to clients and family before carrying them out to achieve identified
outcomes
• Implements nursing intervention that is safe and comfortable
• Acts to improve clients’ health condition or human response
• Performs nursing activities effectively and in a timely manner
• Uses the participatory approach to enhance client-partners empowering potential for healthy
life style/wellness

 7.4   Evaluates progress toward expected outcomes

• Monitors effectiveness of nursing interventions
• Revises care plan based on expected outcomes

2.  Management of Resources and Environment

Core Competency 1:
Organizes work load to facilitate client care

Indicators
• Identifies tasks or activities that need to be accomplished
• Plans the performance of tasks or activities based on priorities
• Verifies the competency of the staff prior to delegating tasks
• Determines tasks and procedures that can be safely assigned to other members of the  team
• Finishes work assignment on time 6

 Core Competency 2:
Utilizes financial resources to support client care

Indicators
• Identifies the cost-effectiveness in the utilization of resources 
• Develops budget considering existing resources for nursing care
Core Competency 3:
Establishes mechanism to ensure proper functioning of equipment

Indicators
• Plans for preventive maintenance program
• Checks proper functioning of equipment considering the:
- intended use
- cost benefits
- infection control
- safety
- waste creation and disposal storage
• Refers malfunctioning equipment to appropriate unit
  

Core Competency 4: 

Maintains a safe environment

Indicators
• Complies with standards and safety codes prescribed by laws
• Adheres to policies, procedures and protocols on prevention and control of infection
• Observes protocols on pollution-control (water, air and noise)
• Observes proper disposal of wastes
• Defines steps to follow in case of fire, earthquake and other emergency situations.

3. Health Education

Core Competency 1:
Assesses the learning needs of the clientpartner/s
Indicators
• Obtains learning information through interview, observation and validation
• Analyzes relevant information
• Completes assessment records appropriately
• Identifies priority needs

 Core Competency 2: 

Develops health education plan based on assessed and anticipated needs

Indicators
• Considers nature of learner in relation to: social, cultural, political, economic, educational and
religious factors.
• Involves the client, family, significant others and other resources in identifying learning needs
on behavior change for wellness, healthy lifestyle or management of health problems
• Formulates a comprehensive health education plan with the following components: objectives,
content, time allotment, teachinglearning resources and evaluation parameters
• Provides for feedback to finalize the plan

 Core Competency 3:
Develops learning materials for health

Indicators
• Develops information education materials appropriate to the level of the client
• Applies health education principles in the education  development of information education
materials

Core Competency 4: 

Implements the health education plan
Indicators
• Provides for a conducive learning situation in terms of time and place
• Considers client and family’s preparedness
• Utilizes appropriate strategies that  maximize opportunities for behavior change for
wellness/healthy life style
• Provides reassuring presence through active listening, touch, facial expression and gestures
• Monitors client and family’s responses to health education

 Core Competency 5: 

Evaluates the outcome of health education

Indicators
• Utilizes evaluation parameters
• Documents outcome of care
• Revises health education plan based on client response/outcome/s

4. Legal Responsibility

Core Competency 1:
Adheres to practices in accordance with the nursing law and other relevant legislation including
contracts, informed consent.

Indicators
• Fulfills legal requirements in nursing practice
• Holds current professional license
• Acts in accordance with the terms of contract of employment and other rules and regulations
• Complies with required continuing professional education
• Confirms information given by the doctor for informed consent
• Secures waiver of responsibility for refusal to undergo treatment or procedure
• Checks the completeness of informed consent and other legal forms

 Core Competency 2:
Adheres to organizational policies and procedures, local and national  

Indicators
• Articulates the vision, mission of the institution where one belongs
• Acts in accordance with the established norms of conduct of the institution / organization/legal
and regulatory requirements 

Core Competency 3: 

Documents care rendered to clients

Indicators
• Utilizes appropriate client care records and reports.
• Accomplishes accurate documentation in all matters concerning client care in accordance to
the standards of nursing practice.

5. Ethico-moral Responsibility

Core Competency 1:
Respects the rights of individual / groups

Indicators
• Renders nursing care consistent with the client’s bill of rights: (i.e. confidentiality of information,
privacy, etc.)
 Core Competency 2:
Accepts responsibility

Indicators
• Meets nursing accountability requirements as embodied in the job description and
accountability for
own decision and actions
• Justifies basis for nursing actions and judgment
• Projects a positive image of the profession

 Core Competency 3:
Adheres to the national and international code of ethics for nurses

Indicators
• Adheres to the Code of Ethics for Nurses and abides by its provision
• Reports unethical and immoral incidents to proper authorities

 6. Personal and Professional Development

Core Competency 1:
Identifies own learning needs

Indicators
• Identifies one’s strengths, weaknesses/ limitations
• Determines personal and professional goals and aspirations 

 Core Competency 2: 

Pursues continuing education

Indicators
• Participates in formal and non-formal education
• Applies learned information for the improvement of care 

 Core Competency 3:
Gets involved in professional organizations and civic activities

Indicators
• Participates actively in professional, social, civic, and religious activities
• Maintains membership to professional organizations
• Support activities related to nursing and health issues

 Core Competency 4:
Projects a professional image of the nurse

Indicators
• Demonstrates good manners and right conduct at all times
• Dresses appropriately
• Demonstrates congruence of words and action
• Behaves appropriately at all times

 Core Competency 5:
Possesses positive attitude towards change and criticism

Indicators
• Listens to suggestions and recommendations
• Tries new strategies or approaches 
• Adapts to changes willingly

 Core Competency 6:
Performs function according to professional standards 
Indicators
• Assesses own performance against standards of practice
• Sets attainable objectives to enhance nursing knowledge and skills
• Explains current nursing practices, when situations call for it

7. Quality Improvement

Core Competency 1: 

Gathers data for quality improvement

Indicators
• Identifies appropriate quality improvement methodologies for the clinical problems
• Detects variation in specific parameters i.e vital signs of the client from day to day
• Reports significant changes in clients’ condition/environment to improve stay  in the hospital 9
• Solicits feedback from client and significant others regarding care rendered

 Core Competency 2:
Participates in nursing audits and rounds

Indicators
• Shares with the team relevant information regarding  clients’ condition and significant changes
in clients’ environment
• Encourages the client to verbalize relevant changes in his/her condition
• Performs daily check of clients’ records / condition 
• Documents and records all nursing care and actions implemented

 Core Competency 3:
Identifies and reports variances

Indicators
• Reports to appropriate person/s significant variances/changes/occurrences immediately
•  Documents and reports observed variances regarding client care 

Core Competency 4:
Recommends solutions to identified problems

Indicators
• Gives an objective and accurate report on what was observed rather than an interpretation of
the event 
• Provides appropriate suggestions on corrective and preventive measures
• Communicates solutions with appropriate groups

8. Research

Core Competency 1:
Gather data using different methodologies

Indicators
• Specifies researchable problems regarding client care and community health
• Identifies appropriate methods of research for a particular client / community problem
• Combines quantitative and qualitative nursing design through simple explanation on the
phenomena observed

 Core Competency 2: 

Analyzes and interprets data gathered 

Indicators
• Analyzes data gathered using appropriate statistical tool
• Interprets data gathered based on significant findings

 Core Competency 3: 

Recommends actions for implementation 

Indicators
•  Recommends practical solutions appropriate to the problem based on the interpretation of
significant findings

 Core Competency 4:
Disseminates results of research findings

Indicators
• Shares/presents results of findings to colleagues / clients/ family and to others
• Endeavors to publish research
• Submits research findings to own agencies and others as appropriate

 Core Competency 5:
Applies research findings in nursing practice 

Indicators
• Utilizes findings in research in the provision of nursing care to individuals / groups /
communities
• Makes use of evidence-based nursing to enhance nursing practice 10

9. Records Management
Core Competency 1:
Maintains accurate and updated documentation   of client care 

Indicators
• Completes updated documentation of client  care
• Applies principles of record management
• Monitors and improves accuracy, completeness and reliability of relevant data
• Makes record readily accessible to facilitate client care

 Core Competency 2:
Records outcome of client care 

Indicators
• Utilizes a records system ex. Kardex or Hospital Information System (HIS)
• Uses data in their decision and policy making activities

 Core Competency 3:
Observes legal imperatives in record keeping 

Indicators
• Maintains integrity, safety, access and security of records
• Documents/monitors proper record storage, retention and disposal
• Observes confidentially and privacy of the clients’ records
• Maintains an organized system of filing and keeping clients’ records in a designated area
• Follows protocol in releasing records and other information
 
10. Communication

 Core Competency 1:
Establishes rapport with client, significant others and members of the health team
Indicators
• Creates trust and confidence
• Spends time with the client/significant others and members of the health team to facilitate
interaction 
• Listens actively to client’s concerns/significant others and members of the health team

 Core Competency 2:
Identifies verbal and non-verbal cues 

Indicators
• Interprets and validates client’s body language and facial expressions

 Core Competency 3:
Utilizes formal and informal channels

Indicators
• Makes use of available visual aids 
• Utilizes effective channels of communication relevant to client care management

 Core Competency 4:
Responds to needs of individuals, family, group and community

Indicators
• Provides reassurance through therapeutic touch, warmth and comforting words of
encouragement 
• Provides therapeutic bio-behavioral  interventions to meet the needs of clients

 Core Competency 5: 

Uses appropriate information technology to facilitate communication
Indicators
• Utilizes telephone, mobile phone, electronic media 
• Utilizes informatics to support the delivery of healthcare

11. Collaboration and Teamwork

Core Competency 1:
Establishes collaborative relationship with colleagues and other members of the health team

Indicators
• Contributes to decision making regarding clients’ needs and concerns
• Participates actively in client care management including audit
• Recommends appropriate intervention to improve client care
• Respect the role of other members of the health team
• Maintains good interpersonal relationship with clients , colleagues and other members of the
health team

 Core Competency 2:
Collaborates plan of care with other members of the health team

Indicators
• Refers clients to allied health team partners
• Acts as liaison / advocate of the client
• Prepares accurate documentation for efficient communication of services 
http://carleirish.blogspot.com/2012/05/11-key-areas-of-responsibility-core.html?m=1