Introduction
Standards and competencies for maternal and child health (MCH) home visiting nursing contribute to positive health outcomes for pregnant women, children and their families. Competencies specify the technical, interpersonal and critical thinking skills necessary to meet the established and acceptable practice.
The purpose of the maternal and child health home visiting nursing standards and competencies is to:
- Provide family centered MCH home visiting nursing care that contributes to the achievement of the Healthy Babies objectives;
- Define specific performance criteria to ensure a standard level of practice for MCH home visiting nurses; and
- Provide guidelines for self-assessment and professional development.
Through Healthy Babies, a collaborative effort among maternal and child health nurses from public health, home health, and hospitals was established and resulted in the development of standards and competencies for maternal and child health home visiting nursing practice across the state of Vermont. For more information, contact Healthy Babies, Vermont Department of Health, 800-464-4343, ext. 7333.
Competency Areas
Sixteen competencies were first identified using three major categories: 1. community health nursing, 2. general areas of MCH home visiting nursing, and 3. specific areas of MCH home visiting nursing. Of these 16, the following 4 competencies were selected for development, field testing, and implementation:
1. teaching skills,
2. prenatal nursing care,
3. postpartum and newborn nursing care, and
4. breastfeeding.
Competency Model
Each competency area has 3 components: technical skills, interpersonal skills, and critical thinking skills. Each competency criteria under these three areas are measurable and reflect current MCH home visiting nursing practice. These 3 components are defined as follows:
A. Technical skills: showing specific knowledge or techniques of maternal and child health home visiting such as:
a. methods of offering material to a client,
b. warning signs for preterm labor,
c. predisposing factors for postpartum depression, or
d. interventions to prevent engorgement.
B. Interpersonal skills: showing communication skills with a client and others in a variety of circumstances related to maternal and child health home visiting nursing such as:
a. creates opportunity for client to practice new skills,
b. assists the client in devising a plan of action in the event of pre-term
labor,
c. demonstrates respect for parent's role as primary care giver & first
teacher of their infant, or
d. elicits mother's feelings and concerns regarding breastfeeding.
C. Critical thinking skills: showing careful analysis of information ascertained that leads to sound maternal and child health home visiting nursing interventions such as:
a. adapts interventions to client's specific needs, culture, and family
values,
b. builds a realistic plan of care considering family dynamics, family dynamics,
family support and community relations,
c. adjusts nutrition teaching based on such factors as breastfeeding, food
preferences, family resources, eating habits, eating disorders, weight fain/loss
and client goals, or
d. recognizes own knowledge limitations re: breastfeeding and consults other
sources as needed.
Measuring competency
Each competency is described using measurable criteria. For each criteria there is a suggested validation technique using such methods as observation, return demonstration, role play, client record audit, written test and case study analysis. As well, a resource book, written test, & references are provided for the technical skills component of each competency.
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