What are the NP Core Competencies?

Daniel Bal
Updated March 21, 2023
Edited by
What must nurse practitioners learn? This article summarizes the core NP competencies according to the NONPF.
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Diverse male and female young medical students confidently take notesCredit: SDI Productions | E+ | Getty Images

The National Organization of Nurse Practitioner Faculties (NONPF) created a list of nine core competencies to use as guidelines for nurse practitioner (NP) programs. These guidelines help ensure that NPs acquire the necessary skills in the field.

The core competencies apply to all NP specializations and population foci. Each competency includes a list of suggested curriculum content that can help programs properly educate their nursing students.

While the NONPF does not require institutions to use their suggested curriculum, it does provide a roadmap that can guide students to practice nursing successfully.

This guide provides an overview of the following nine core competencies, including how they contribute to nursing curricula and professional NP practice:

  • Scientific Foundation
  • Leadership
  • Quality
  • Practice Inquiry
  • Technology and Information Literacy
  • Policy
  • Health Delivery System
  • Ethics
  • Independent Practice

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Nurse Practitioner Core Competencies

The NONPF’s core competencies ensure that nursing programs provide aspiring NPs with the necessary training for the field. Each of the competencies applies to all NPs, regardless of their specialization and population foci.

These core competencies are the foundation of most programs taught at both the master’s and doctoral levels. They may also appear as questions on board certification exams.

1 | Scientific Foundation Competencies

Scientific foundation competencies focus on the analysis and use of data that can help assess, enhance, and improve healthcare delivery. It emphasizes evidence-based care using both qualitative and qualitative research.

The content also includes practices in health literacy, vulnerable populations, and cultural sensitivity.

The science foundation core competency includes the following objectives and expectations:

  • Critically analyze data and evidence for improving advanced nursing practice.
  • Integrate knowledge from the humanities and sciences within the context of nursing science.
  • Translate research and other forms of knowledge to improve practice processes and outcomes.
  • Develop new practice approaches based on the integration of research, theory, and practice knowledge.

2 | Leadership

Leadership competencies focus on professional accountability, scholarship, and advocacy. These skills help ensure that nurse practitioner students understand their scope and standards of practice and are prepared to lead healthcare teams. The leadership competencies also cover cultural sensitivity, engagement in professional organizations, and communication skills.

The quality core competency includes the following objectives and expectations:

  • Assume complex and advanced leadership roles to initiate and guide change.
  • Provide leadership to foster collaboration with multiple stakeholders (e.g., patients, community, integrated healthcare teams, and policymakers) to improve healthcare.
  • Demonstrate leadership that uses critical and reflective thinking.
  • Advocate for improved access, quality, and cost-effective healthcare.
  • Advance practice through the development and implementation of innovations incorporating principles of change.
  • Communicate practice knowledge effectively, both orally and in writing.
  • Participate in professional organizations and activities that influence advanced practice nursing and/or health outcomes of a population focus.

3 | Quality

The quality competency emphasizes the assessment of research and how it can help improve health outcomes. NPs need to access, assess, and apply the most up-to-date data while considering how cost, safety, and access to healthcare impact the quality of care.

Nurses must evaluate current policies and organizational structures to determine if and how they can increase the quality of care by making systematic changes.

The quality core competency includes the following objectives and expectations:

  • Use the best available evidence to continuously improve the quality of clinical practice.
  • Evaluate the relationships between access, cost, quality, and safety and their influence on healthcare.
  • Evaluate how organizational structure, care processes, financing, marketing, and policy decisions impact the quality of healthcare.
  • Apply skills in peer review to promote a culture of excellence.
  • Anticipate variations in practice and be proactive in implementing interventions to ensure quality.

4 | Practice Inquiry

Practice inquiry provides nurses with the ability to apply research to clinical settings. This competency ensures that NPs understand research materials and translate that information into practice. Nurses must use critical thinking skills to determine how current research can increase the effectiveness of standards or modify guidelines to positively benefit health outcomes.

The practice inquiry core competency includes the following objectives and expectations:

  • Provide leadership in the translation of new knowledge into practice.
  • Generate knowledge from clinical practice to improve practice and patient outcomes.
  • Apply clinical investigative skills to improve health outcomes.
  • Lead practice inquiry, individually or in partnership with others.
  • Disseminate evidence from inquiry to diverse audiences using multiple modalities.
  • Analyze clinical guidelines for individualized application into practice.

5 | Technology and Information Literacy

With the constant development of new technologies, NPs must be able to incorporate these advances to improve patient outcomes. Using new technology to access, manage, create, and evaluate health-related information allows them to practice more efficiently. NPs who integrate nursing and communication technology (informatics) can potentially increase the effectiveness of their care.

The technology and information literacy core competency includes the following objectives and expectations:

  1. Integrate appropriate technologies for knowledge management to improve healthcare.
  2. Translate technical and scientific health information appropriate for various users’ needs.
    • 2.a. Assess the patient’s and caregiver’s educational needs to provide effective, personalized healthcare.
    • 2.b. Coach the patient and caregiver for positive behavioral change.
  3. Demonstrate information literacy skills in complex decision-making.
  4. Contribute to the design of clinical information systems that promote safe, quality, and cost-effective care.
  5. Use technology systems that capture data on variables for the evaluation of nursing care.

6 | Policy

Healthcare policy refers to the guidelines used to oversee and fund decisions related to patient care. These policies ultimately determine the allocation of resources at the local, state, or federal levels.

Knowledge of various policies helps prepare nurses to influence legislation that can better the healthcare system and their patients. These policies are not solely geared directly toward healthcare, as social issues such as education, poverty, and violence also have an impact on the medical community.

The policy core competency includes the following objectives and expectations:

  1. Demonstrate an understanding of the interdependence of policy and practice.
  2. Advocate for ethical policies that promote access, equity, quality, and cost.
  3. Analyze ethical, legal, and social factors influencing policy development.
  4. Contribute to the development of health policy.
  5. Analyze the implications of health policy across disciplines.
  6. Evaluate the impact of globalization on healthcare policy development.
  7. Advocate for policies for safe and healthy practice environments.

7 | Home Delivery System

This focuses on teaching nurses how to plan, develop, and implement programs within various target communities. Nurses learn how to develop appropriate methods of healthcare delivery that can address the needs of patients, providers, and other stakeholders.

After determining the needs of various populations, nurses collaborate with communities in addressing the improvements needed to deliver effective and efficient care.

The health delivery system’s core competency includes the following objectives and expectations:

  1. Apply knowledge of organizational practices and complex systems to improve healthcare delivery.
  2. Effect healthcare change using broad-based skills, including negotiating, consensus-building, and partnering.
  3. Minimize risk to patients and providers at the individual and systems level.
  4. Facilitate the development of healthcare systems that address the needs of culturally diverse populations, providers, and other stakeholders.
  5. Evaluate the impact of healthcare delivery on patients, providers, other stakeholders, and the environment.
  6. Analyze organizational structure, functions, and resources to improve the delivery of care.
  7. Collaborate in planning for transitions across the continuum of care.

8 | Ethics

The ethics competency provides NPs with the ability to understand the code of ethics within the healthcare community. NPs must consider the ethical implications of their decisions and assess how it affects their delivery of care. This knowledge helps ensure NPs can navigate the dilemmas within the medical community, allowing them to make the best decisions for their patients.

The ethics core competency includes the following objectives and expectations:

  1. Integrate ethical principles in decision-making.
  2. Evaluate the ethical consequences of decisions.
  3. Apply ethically sound solutions to complex issues related to individuals, populations, and systems of care.

9 | Independent Practice

The independent practice competency ensures NPs have the necessary academic and professional training to work as licensed independent practitioners. The competency ensures that nurses can provide all of the services permitted by law. These services include assessing, diagnosing, and treating patients with minimal direction, oversight, or supervision.

Independent or supervised practice is mandated by the state in which the NP works. States allow for either full practice, reduced access, or restricted access. Full practice states allow NPs to diagnose, treat, and prescribe medication without physician oversight. Reduced access requires physician oversight to prescribe medication. Restricted access requires physician oversight to diagnose, treat, and prescribe medication.

The independent core competency includes the following objectives and expectations:

  1. Function as a licensed independent practitioner.
  2. Demonstrate the highest level of accountability for professional practice.
  3. Practice independently managing previously diagnosed and undiagnosed patients.
    • 3.a. Provide the full spectrum of healthcare services including health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative, and end-of-life care.
    • 3.b. Use advanced health assessment skills to differentiate between normal variations of normal and abnormal findings.
    • 3.c. Employ screening and diagnostic strategies in the development of diagnoses.
    • 3.d Prescribe medications within the scope of practice.
    • 3.e. Manage the health/illness status of patients and families over time.
  4. Provide patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making.
    • 4.a. Work to establish a relationship with the patient characterized by mutual respect, empathy, and collaboration.
    • 4.b. Create a climate of patient-centered care to include confidentiality, privacy, comfort, emotional support, mutual trust, and respect.
    • 4.c. Incorporates the patient’s cultural and spiritual preferences, values, and beliefs into healthcare.
    • 4.d. Preserves the patient’s control over decision-making by negotiating a mutually acceptable plan of care.
    • 4.e. Develops strategies to prevent one’s own personal biases from interfering with the delivery of quality care.
    • 4.f. Addresses cultural, spiritual, and ethnic influences that potentially create conflict among individuals, families, staff, and caregivers.
  5. Educate professional and lay caregivers to provide culturally and spiritually sensitive, appropriate care
  6. Collaborate with both professionals and other caregivers to achieve optimal care outcomes.
  7. Coordinate transitional care services in and across care settings.
  8. Participate in the development, use, and evaluation of professional standards and evidence-based care.

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Page last reviewed: May 12, 2022

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