yleSHarviointi – 2020 luvun osaamisen arviointia

Kliinisen ydinosaamisen arviointimenetelmien koulutus_tallenne

Webinaarin diat

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Lähes kaksi ja puoli vuotta on tiivistä yhteistyötä takana ja voidaan ylpeänä todeta, että YleSHarviointi -hanke on saavuttanut sille asetetut tavoitteet ja tehtävät. Ensimmäiseksi määriteltiin ja julkaistiin Sairaanhoitajan (180 op) osaamisvaatimukset ja niiden sisällöt. Osaamisvaatimusten mukaisesti kehitettiin 1) sairaanhoitajan kliinisen ydinosaamisen ohjaus- ja arviointimalli sekä 2) sairaanhoitajan ydinosaamisen (180 op) valtakunnallinen koe. Kaikki tulokset on tuotettu suomen, ruotsin ja englannin kielisinä. Valtakunnalliseen käyttöön kehitetyt opetus-, ohjaus- ja arviointimenetelmät ovat pääosin digitaalisia ja näin ollen saatavilla ja käytettävissä samanmuotoisina kaikissa ammattikorkeakouluissa.

Osaamisvaatimukset

Julkaistut osaamisvaatimukset on jaettu 13 pääkategoriaan: 1. Ammatillisuus ja eettisyys, 2. Asiakaslähtöisyys, 3. Kommunikointi ja moniammatillisuus, 4. Terveyden edistäminen, 5. Johtaminen ja työntekijyysosaaminen, 6. Informaatioteknologia ja kirjaaminen, 7. Ohjaus- ja opetusosaaminen sekä omahoidon tukeminen, 8. Kliininen hoitotyö, 9. Näyttöön perustuva toiminta, tutkimustiedon hyödyntäminen ja päätöksenteko, 10. Yrittäjyys ja kehittäminen, 11. Laadun varmistus, 12. Sosiaali- ja terveydenhuollon palvelujärjestelmä ja 13. Potilas- ja asiakasturvallisuus. Kategoriat sisältävät yhteensä 105 osaamisvaatimusta sekä niiden sisällöt. Osaamisvaatimukset ovat valtakunnallisesti opetussuunnitelman laadinnan perustana ja yhtenäistävät osaamisen kehittymistä 180 op:n opintojen aikana. Osaamisvaatimuksia päivitetään tarvittaessa nopeastikin, mm.  lainsäädännön muutosten aiheuttamat muutokset sairaanhoitajan tehtäviin.

Sairaanhoitajan kliinisen ydinosaamisen ohjaus- ja arviointimalli

Kehitetty malli sisältää kahdeksan erillistä kliinisen ydinosaamisen koetta: 1) Kliinisen hoitotyön perusosaaminen (tietotesti) 2) Sisätautien hoitotyön osaaminen (tietotesti), 3) Kirurgisen ja perioperatiivisen hoitotyön osaaminen (näyttökoe), 4) Lapsen, nuoren ja perheen hoitotyön osaaminen (näyttökoe), 5) Mielenterveys- ja päihdehoitotyön osaaminen: (tietotesti, OSVE-simulaatio), 6)  Ikääntyneen hoitotyön osaaminen (tietotesti) , 7) Hoitotyön osaaminen erilaisissa palveluympäristöissä (näyttökoe) sekä 8) Erityistukea tarvitsevan hoitotyön osaaminen: (tietotesti).

Kehitetyt kokeet muodostavat jatkumon, joka ohjaa ja tukee opiskelijan oppimisen kehittymistä. Tavoitteena on opintojen aikainen ohjaus ja opiskelijan osaamisen kehittymisen varmentaminen.

Sairaanhoitajan ydinosaamisen (180 op) valtakunnallinen koe

Opiskelijan arvioinnin jatkumo päättyy Sairaanhoitajan ydinosaamisen (180 op) valtakunnalliseen kokeeseen, jonka tavoitteena on varmentaa yleissairaanhoidosta vastaavan sairaanhoitajan (2013/55/EU) edellyttämä osaamisen. Koe sisältää 100 kysymystä (monivalintatehtäviä, potilastapauksia, oikein-väärin väittämiä). Lisäksi kokeeseen kuuluu erillinen lääkelakujen koe. Kokeen kysymykset on jaoteltu määriteltyjen osaamisvaatimusten mukaisesti ja yhteisesti on sovittu, kuinka monta kysymystä kustakin osaamiskategoriasta kokeeseen tulee. Tällä pyritään varmistamaan, että kaikille opiskelijoille tulee sama määrä kysymyksiä / kategoria sekä kysymysten painottuminen kategorioittain.

Kehitettyjen arviointisisältöjen ja –menetelmien tarkoituksena ei ole rajoittaa ammattikorkeakoulujen autonomiaa. Menetelmät kohdentuvat sairaanhoitajan ydinosaamiseen, joka koulutuksen aikana tulee arvioida kaikilta sairaanhoitajan tutkinnon suorittavilta. Yhteisten kokeiden käytön avulla on mahdollista tehostaa ja yhtenäistää opettajien työtä. Opettajat voivat siten kohdentaa omaa työaikaansa muun muassa opetuksen kehittämiseen.  

Opiskelijan näkökulmasta kehitetyt menetelmät tukevat tavoitteellista opiskelua.  Ajatuksena on motivoida opiskelijaa aikaisempaa sitoutumaan opintoihin aikaisempaa paremmin koko opiskeluprosessin ajan ja opiskelemaan osaamisen kannalta oleellisia asioita. Arviointimenetelmien avulla opiskelijoilla on mahdollisuus osoittaa osaamisensa eri tilanteissa esimerkiksi aiemmin hankitun osaamisen tunnistamisen osalta.

Tulosten levittäminen ja käyttöönotto

Hankkeen tuloksista on viestitty ahkerasti tiedotteilla ja webinaareilla ammattikorkeakoulujen opettajille ja esimiehille, työelämän edustajille, ammattijärjestöille ja myös kansainvälisesti. Ulkoista viestintää on toteutettu muun muassa blogikirjoitusten, artikkeleiden ja keskeisten sidosryhmien tilaisuuksissa tapahtuneiden esittelyjen kautta, kuten Sairaanhoitajapäivillä. Tuloksista on kerrottu myös kahdessa kansainvälisessä konferenssissa.

Teija Korhonen TtT, lehtori, Savonia-ammattikorkeakoulu

Marja Silén-Lipponen projektipäällikkö,FT, yliopettaja, Savonia-ammattikorkeakoulu

Tässä blogissa kuvataan yleissairaanhoitajan kliinisen ydinosaamisen arviointiin laadittujen kokeiden kehittämistä. Kokeiden kehittämisessä on erotettavissa kolme sykliä. Ensimmäisessä syklissä laadittiin tietotesti yhdestä kliinisen ydinosaamisen osa-alueesta, luotiin oppimisalusta, tallennettiin koekysymykset oppimisalustalle sekä testattiin tietotestin ja oppimisalustan toimintaa. Toisessa syklissä laadittiin kokeet kahdeksasta kliinisen ydinosaamisen osa-alueesta ja laajennettiin teknistä oppimisalustan testausta erilaisilla tehtävillä. Tämän lisäksi myös pilotoitiin kokeita useissa ammattikorkeakouluissa. Kolmannessa kehittämissyklissä kokeita muokattiin edelleen ja viimeisteltiin otettavaksi käyttöön ammattikorkeakouluissa keväällä 2021. Kehittämisessä tehtiin tiivistä yhteistyötä hankkeen työpakettien 2, 3 ja 4 välillä. Työpaketti 2 vastasi kokeiden laatimisesta, työpaketti 3 oppimisalustan (Moodle) toteutuksesta ja työpaketti 4 kokeiden pilotoinnista.

Ensimmäinen kehittämissykli

Sairaanhoitajan kliinisen ydinosaamisen ohjaus- ja arviointimallin kehittämistyö käynnistyi syksyllä 2019 sairaanhoitajan kliinisen ydinosaamisen osa-alueiden määrittelyllä hankkeessa aiemmin tuotettujen osaamisvaatimusten perusteella. Kliinisen ydinosaamisen ohjaus- ja arviointimalliin valittiin kahdeksan osa-aluetta, joiden osaamista arvioidaan opintojen aikana. Nämä alueet ovat kliinisen hoitotyön perusosaaminen, sisätautien hoitotyön osaaminen, kirurgisen ja perioperatiivisen hoitotyön osaaminen, lapsen, nuoren ja perheen hoitotyön osaaminen, mielenterveys- ja päihdehoitotyön hoitotyön osaaminen, ikääntyneen hoitotyön osaaminen, hoitotyön osaaminen erilaisissa palveluympäristöissä ja erityistukea tarvitsevan hoitotyön osaaminen. Valitut kliinisen ydinosaamisen osa-alueet ovat keskeiset opintojen alueet kaikissa terveysalan ammattikorkeakouluissa ja muodostavat jatkumon päätyen sairaanhoitajakoulutuksen ydinosaamisen (180 op) valtakunnalliseen kokeeseen.

Ensimmäisessä kokeiden kehittämissyklissä laadittiin koe kliinisen hoitotyön perusteiden osaamiseen, jotta saataisiin tuntuma valitun oppimisalustan toimivuudesta, rajoitteista ja laaditun kokeen soveltuvuudesta osaamisen arviointiin. Kliinisen ydinosaamisen osa-alueiden ydinsisältöjen ja niiden arviointimenetelmien laatimiseksi työryhmässä muodostettiin osa-aluekohtaisia tiimejä eri ammattikorkeakouluja edustavista opettajista, joilla on kyseisen osa-alueen asiantuntemusta. Tällä haluttiin varmistaa, että osaamisen arviointi ei heijasta vain yhden ammattikorkeakoulun tai opettajan näkemystä. Kliinisen ydinosaamisen alueille määriteltiin keskeinen arvioitava sisältö ja arviointimenetelmät. Kokeissa ei ole lääkelaskuja, vaan ammattikorkeakoulut toteuttavat ne erillisesti omien toteutustapojensa mukaisesti.

Kliinisen ydinosaamisen arviointimenetelmien oppimisalustaksi valikoitui DigiCampuksen Moodle-oppimisympäristö ja sen tarkoituksena on toimia tulevaisuudessa ammattikorkeakoulujen yhteisenä oppimisalustana. Moodle on yksi käytetyimmistä verkko-oppimisympäristöistä Suomessa ja kansainvälisesti ja sen käytöstä on saatu hyviä oppimistuloksia hoitotyön opetuksessa. Moodlen valintaa tukivat opettajien kokemukset siitä, että Moodleen on mahdollista perustaa pedagogisesti selkeä, opiskelijan osaamista arvioiva oppimisympäristö.

Työpaketissa 2 kehitettiin kahdeksalle kliinistä ydinosaamista arvioivalle osa-alueelle kokeita (tie-totestit, simulaatiot, näyttökokeet), joiden avulla sairaanhoitajaopiskelijoiden osaamista arvioidaan opintojen eri vaiheissa. Kokeiden kehittämisen ohella laadittiin ohjeita opiskelijoille kokeisiin valmistautumiseen, opettajille kokeiden järjestämiseen ja ohjeet kokeiden tallentamiseen Moodleen ja kokeiden pisteytykseen.

Työpaketti 3 tallensi kehitetyn materiaalin Digicampuksen Moodleen sairaanhoitajan kliinisen ydinosaamisen alueiden mukaan. Jokainen osa-alue kuvitettiin, jotta niiden ilme olisi lukijalle visuaalinen. Moodleen tallennettiin tietotestejä, ohjeita sekä kuvauksia simulaatiotilanteista sekä niiden arvioimisesta. Tietotestien kysymykset tallennettiin tietokantaan eli kysymyspankkiin, josta niitä voidaan tarvittaessa ottaa käyttöön myös muihin tentteihin. Ennen kysymysten tallentamista ne otsikoitiin aihealueiden mukaisesti, koska otsikointi helpottaa oikeiden kysymysten löytämistä kysymyspankista ja mahdollistaa kysymysten tallentamisen kokeeseen aihepiireittäin.

Työpaketti 3:ssa tallentaminen sujui hyvin, koska työtä tekevillä oli Moodlen ja kliinisen ydinosaamisen osa-alueiden sisällöllistä osaamista. Kliinisen ydinosaamisen eri osa-alueiden sisällöllinen asiantuntijuus helpotti tallennustyötä ja tallennusvaiheessa esiin tulleiden epäselvien kysymysten selkiyttämistä. Tallentamisessa oli sisällön asiantuntemuksen lisäksi etuna digipedagogiikan tuntemus, sillä joidenkin kysymysten kohdalla piti harkita mikä on selkein tapa toteuttaa kysymykset verkko-oppimisympäristössä. 

Kliinisen hoitotyön perusteiden osaamisen kokeen pilotoinnissa oli ensisijaisena tavoitteena saada tietoa oppimisalustan toiminnasta ja kokeen käytettävyydestä. Pilotointiin osallistui opiskelijoita kahdesta ammattikorkeakoulusta tekemällä kokeen ja antamalla siitä palautetta. Opiskelijoiden lisäksi palautetta antoivat ammattikorkeakoulujen opettajat ja työssä olevat sairaanhoitajat. Ensimmäisen pilotin tulokset olivat rohkaisevia ja koe vaikutti kokonaisuudessaan toimivalta. Palautteen perusteella tunnistettiin tarve selkeyttää kysymyksiä ja tehtävätyyppejä sekä tarkastella joidenkin kysymysten vaikeusastetta.

Toinen kehittämissykli

Toinen kokeiden kehittämissykli toteutettiin syksyn 2019 – kevään 2020 aikana, jolloin työpaketti 2 korjasi kliinisen hoitotyön perusteiden osaamisen pilotissa olleet koekysymykset ja tehtävät saatujen palautteiden perusteella sekä laati lisää tehtäviä. Tässä vaiheessa laadittiin kokeet myös kliinisen ydinosaamisen muille osa-alueille, joita olivat sisätautien hoitotyön osaaminen, kirurgisen ja perioperatiivisen hoitotyön osaaminen, lapsen, nuoren ja perheen hoitotyön osaaminen, mielenterveys- ja päihdehoitotyön osaaminen, ikääntyneen hoitotyön osaaminen, hoitotyön osaaminen eri palveluympäristöissä ja erityistukea tarvitsevan asiakkaan hoitotyön osaaminen. Tietotestien lisäksi koemenetelmiksi tulivat näyttökoe, simulaatio ja strukturoitu videokoe.

Toisessa syklissä pilotoinnin tavoitteena oli saada tietoa kliinisen ydinosaamisen kokeiden käytettävyydestä ja soveltuvuudesta arviointiin. Kahdeksan ydinosaamisen kokeen pilotointiin osallistui 11 ammattikorkeakoulua. Jokainen koe pilotoitiin vähintään kahdessa ammattikorkeakoulussa. Pilotoinnissa suunniteltiin erilaisille koetyypeille sopiva menettelytapa, palautteenkeruu ja ne toteutettiin tiiviissä yhteistyössä työpaketissa 4 mukana olleiden ammattikorkeakoulujen kesken. Opiskelijoiden ja opettajien kokeista antama palaute oli ensiarvoisen tärkeää jatkokehittämisen kannalta. Yksi keskeisistä huomioista oli, että simulaatio on varsin hankalasti sovellettavissa tämän tyyppisessä arvioinnissa, koska se on menetelmänä runsaasti aikaa vievä ja yksiselitteisten arviointikriteerien muodostaminen haastavaa. Lisäksi eri ammattikorkeakoulujen mahdollisuudet toteuttaa simulaatioita ovat erilaiset, joten se päädyttiin korvaamaan muilla arviointimenetelmillä. Kokonaisuudessaan kuitenkin pilotoinnin tulokset olivat myönteisiä, ja sen perusteella kehitettyjen kokeiden voidaan todeta soveltuvan kliinisen ydinosaamisen arviointiin. Pilotissa kerätyn palautteen perusteella kokeita muokattiin edelleen paremmiksi muun muassa tehtävien ja ohjeiden selkeyden osalta.

KUVIO 1. Kliinisen ydinosaamisen kokeiden kehittämissykli 1 ja 2

Kolmas kehittämissykli

Kolmas kehittämissykli noudatteli osittain samaa polkua kuin edelliset, mutta tässä vaiheessa tavoitteena oli valmistaa palautteiden perusteella pilotoidut kokeet tuotantokäyttökuntoon.

Tällöin työpaketin 2 tiimit muokkasivat kokeita, lisäsivät koemateriaalia ja viimeistelivät yhdessä työpaketti 3:n kokeita tallentavan henkilön kanssa kokeiden ohjeistuksia, koe- ja lähdemateriaaleja ja kokeiden rakennetta. Kokeiden ja muun materiaalin kääntämiseksi ruotsin ja englannin kielille tehtiin yhteistyötä kääntäjien kanssa.

KUVIO 2. Kliinisen ydinosaamisen kokeiden kehittäminen tuotantokäyttöön

Johtopäätökset ja yhteenveto

Sairaanhoitajien kliinisen ydinosaamisen ohjaus- ja arviointimallin sekä kokeiden kehittäminen on ollut monivaiheinen prosessi. Laadittu kliinisen osaamisen arviointimalli sisältää keskeisten sairaanhoitajakoulutuksen ydinosaamisalueet yli 1350 tehtävä- ja kysymysmäärällä. Silti kaikkea osaamisen arviointia ei nyt laadituilla kokeilla tavoiteta, vaan ammattikorkeakoulujen on huolehdittava itsenäisesti puuttuvien osa-alueiden arvioinnista. Kullekin kliinisen ydinosaamisen alueelle tarvitaan jatkossa myös uusia tehtäviä ja kysymyksiä. Tavoitteena onkin ylläpitää päivittyvää ja ajantasaista sairaanhoitajan kliinisen ydinosaamisen arviointimallikokonaisuus sisältöineen ja arviointimenetelmineen. Tämä toteutuu tulevaisuudessa kiinteällä ammattikorkeakoulujen välisen yhteistyön ja koulutuksen yhtenäisyyden ylläpitämisellä.

Tiina Nurmela, yliopettaja, koulutusvastaava Turun AMK

Nea Lehtimäki, lehtori, tutkintovastaava Metropolia AMK

Mika Alastalo, lehtori, Laurea amk

yleSHarviointi-hanke järjesti webinaarin, jossa esiteltiin hankkeessa tuotettuja ohjaus- ja arviointimenetelmiä.

Ohessa linkki webinaarin nauhoitteiseen. Katso nauhoite tästä

Webinaarin diat Webinaari 6.2.2020

Besides national legislation, the competence requirements in nursing are regulated by EU Directive (2013/55/EU). According to the directive, the education of nurses responsible for general nursing care in the member states of the European Union consists of 180 credits. In Finland, the required number of credits is 210.

The requirements for competences and contents of education are based on the principle: once written, not repeated. This means, for example, that when one of the competence requirements in the Professional and Ethical Competence category is the ability to work in compliance with nursing care values, principles and ethical codes and with the current legislation governing health care services, the same requirements apply to all activities in the Clinical Nursing category as well, although not mentioned separately.

The competence requirements in some of the competence categories emphasize knowledge of other fields, for example, legislation. The requirement for the ability to encounter a patient with terminal condition, for example, has been recorded under Palliative Care category, although the ability to encounter a patient is, at the same time, a part of patient-centred approach. Likewise, pain management has been included as one of the subjects in the Palliative Care category, although pain management is a subject of its own with its competence requirements and contents.
Each competence requirement has been recorded under the most relevant competence category. For example, promotion of sexual health is included in the Clinical Nursing category (instead of Promotion of Health category), as the Promotion of Health category does not include other specific subjects either, and as promotion of health is a part of clinical nursing of all age, client and patient groups as well.
The competence requirements were first published in January 2019, and they were open for commenting until 30 August 2019. Based on the comments, some amendments and additions were made to the competence requirements.

The competence requirements will be used as a basis for planning the curriculum.

A national examination for nurses (180 ECTS credits) will be introduced gradually as from the beginning of 2021. The project will define the assignment of weight value to questions in each of the competence categories in the national examination.

These competence requirements have been established in collaboration with EduPal and Sote Peda 24/7, both leader projects of the Ministry of Education and Culture.

Reference to the competence requirements and contents
Universities of Applied Sciences and other educational actors may publish these competence requirements and contents on their websites by adding a link to this page of Savonia to their publications.
In accordance with good practice, the qualification requirements and contents may be quoted to the required extent provided that the reference is cited. The internet address of the website must be visible in all re-publications as: https://blogi.savonia.fi/ylesharviointi/2019/01/31/yleissairaanhoitajan-180-op-osaamisvaatimuslauseet-ja-sisallot-julkaistu/

COMPETENCE REQUIREMENTS AND THEIR CONTENTS

The competency requirements have been divided into the following sub-areas: 1)Professialisim and ethics, 2) Client-centred care, 3) Communication and multi-professionalism, 4) Health promotion, 5) Leadership and professional co-operation skills of the employee, 6) Information technology and documentation , 7) Guidance and education competence and supporting self-care, 8) Clinical nursing, 9) Evidence-based practice, utilization of research knowledge and decision-making, 10) Entrepreneurship and development , 11) Quality management, 12) Service system of health care and social welfare services, 13) Patient and client safety

Professialisim and ethics

1) Functions in accordance with the values, ethical guidelines and principles of nursing care, and evaluates their implementation in daily nursing care.
• Philosophy of nursing care
• Values, principles and ethical guidelines
• Autonomy and the right to self-determination
• Human dignity and human rights
• Identification and processing of ethical issues

2) Complies with current legislation and information guidance in their work.
• Up-to-date legislation governing health care services
• Normative, resource and information guidance governing health care services

3) Has adopted the professional identity of a nurse and committed to the principles of a service profession.
• Profession of a nurse and its special features
• Principles of service profession

4) Demonstrates ability to function in the role of an expert in nursing care and to accept responsibility for their actions.
• Expertise in nursing care
• Responsibility and accountability in nursing care
• Recognition of the limits of their personal competence and those of professional groups.

5) Demonstrates ability to assess and develop their own skills.
• Self-assessment, development and marketing of their personal competence

6) Demonstrates ability to intervene in unprofessional conduct.
• Code of ethics for professionals in health care and social welfare services
• Collegiality in nursing care

7) Recognizes their limits in coping, seeks support and uses different forms of support available.
• Promoting wellbeing at work

8) Demonstrates knowledge of career opportunities for nurses.
• Working as an expert The Action Model of Expertise (AME)
• Planning of competence and career development
• Career development opportunities

9) Complies with occupational safety regulations
• Ergonomics in nursing care
• Prevention of threatening and dangerous situations, and identification and management of risks
• Proper handling of sharps
• Radiation safety

Client-centred care

1) Respects clients/patients and encounters them as experts of and actors in their own lives.
• Humane and respectful encounter
• Enhancing participation of the client/patient
• Supporting inclusion of nearest ones
• Supporting resources of the client

2) Demonstrates ability to encounter vulnerable patient groups in nursing care.
• Vulnerable client groups
• Equality, non-discrimination

3) Demonstrates ability to encounter client/patients from different cultures individually.
• Individual nursing care
• Cultural background in encounters and interaction with the client

Communication and multi-professionalism

1) Demonstrates knowledge of professional communication.
• Target-oriented and situation-specific communication
• Assertiveness in communication

2) Demonstrates knowledge of professional interaction in nursing care with client/patients of different ages and backgrounds and their family members and loved ones.
• Cognitive and emotional communication skills
• Respectful interaction with the client
• Confidence-inspiring and empowering interaction
• Touching as a part of interaction
• Communication with clients of different ages and backgrounds
• Interaction with clients and their nearest ones for maintenance of patient safety
• Client-centred interaction

3) Demonstrates knowledge of independent communication and interaction in his or her native language, the second official language of Finland, and at least one foreign language.
• Finnish, Swedish and a foreign language

4) Understands his or her own responsibilities and those of other professionals in health care and social welfare services, as well as the significance of controlled and flexible division of duties in the client’s /patient’s holistic care.
• Roles and responsibilities of professionals in health care and social welfare services in different phases of the service chain
• Work as an expert in nursing care

5) Demonstrates good work community skills when working in multidisciplinary teams, environments and networks.
• Emotional intelligence in interaction
• Cooperation in teams and multidisciplinary environments

Health promotion

1) Demonstrates ability to apply current research data and other information from the field of health promotion to their work with client/patients.
• Principles of health and disease
• Public health, promotion of health and prevention of disease, primary health care
• Normative, resource and information guidance in health promotion
• Ethics of health promotion

2) Identifies risk factors of clients/patients and provides early support to those in need.
• Connection between life style and health
• Prevention and early identification of risk behaviour connected with life style, prevention, and early identification of accident
risks.Directing support to those in need.
• Evaluation of functional capacity
• Wellbeing analytics in the use of medical records and statistical data

3) Plans and implements interventions promoting health and functional capacity of individuals and groups of clients/patients in multidisciplinary collaboration.
• Evidence-based promotion of health and functional capacity and rehabilitation
• Health-promoting education
• Encouraging healthy lifestyle and self-care by supporting preventive behaviour models and commitment to care
• Community health promotion
• Prevention of common infectious diseases
• Vaccinations
• Monitoring and evaluation of health promotion

4) Recognizes existing and new threats to health and knows how to integrate them in the promotion of health of clients/patients.
• Predicting concerns in health and wellbeing
• Potential of artificial intelligence in health promotion

Leadership and professional co-operation skills of the employee

1) Demonstrates ability to priorize the task flexibly
• Prioritizing and organizing activities
• Self-management and situation management

2) Motivates members of their working community and is able to give and receive feedback.
• Receiving and giving feedback
• Leadership in team work in work shift

3) Demonstrates ability to work according to the principles of cost-efficiency, Sustainable development taking into account the environment
• Use, recycling and disposal of materials
• Cost awareness and economic activity

4) Demonstrates ability to guide fellow students and co-workers.
• Guidance
• Mentoring
• Student mentoring

5) Demonstrates ability to develop and adapt their ways of working to changes in the health care and social welfare services.
• Lifelong learning
• Work community skills
 

Information technology and documentation

1) Complies with the requirements and regulations governing data protection and information security in health care and social welfare services relating to the creation, use, storage and disposal of data.
• Information security and data protection and related legislation
• EU’s General Data Protection Regulation and Directive
• Data Protection Act
• Information security and data protection in different nursing environments of client/patient
• Management of the process of health care and social welfare data produced of the client, from collection to sharing and utilizing

2) Demonstrates knowledge of appropriate recording of the client’s /patient’s nursing care process, and is capable of evaluating whether data recorded in the patient data repository is up-to-date, correct and of good quality.
• Nursing interventions and nursing care process
• Structural nursing care data
• Significance of producing real time data in a client contact
• Evaluation and application of produced data
• Evaluation of the quality and significance of data

3) Documents the nursing care of client/patient according to the nursing care process; assesses the client’s/patient’s need for interventions (care) in accordance with the Finnish Care Classification (FinCC), plans and implements interventions using the Finnish Classification of Nursing Interventions (FiCNI), evaluates nursing outcomes using the Finnish Classification of Nursing Outcomes (FiCNO), as well as produces a summary of the nursing care.
• Client-centred decision-making, implementation and evaluation of nursing care
• Use of different categories in the classifications of nursing, and free text recording
• Finnish Care Classification (FinCC) – (FiCND, FiCNI, FiCNO)

4) Demonstrates knowledge of information technology, electronic databases and reporting tools used in health care services.
• Client and patient data repositories, nursing process documentation and enterprise resource planning (ERP) systems
• Interactive communication channels for remote care of the patient and communication between the staff
• Wellbeing and health care technology devices needed in nursing
• Different reporting tools, their use and exploitation
• Personal Health Record Kanta PRH

5) Complies with netiquette, regulations and practices regarding emails, and assumes the role of a health care professional in social media.
• Social media and network services from a professional’s point of view
• Safe use of electronic data services in health care
• Data protection legislation

Guidance and education competence and supporting self-care

1) Assesses the needs, resources and responsibility of the client/patient in planning guidance and self-care.
• Assessment and support of patient’s resources, and provision of assistance in their affairs
• Patient-centred approach
• Identification of persons in need of multiple services

2) Plans, implements and assesses individual and group guidance in cooperation with the patient/client, and other professionals.

• Requirements for implementation of patient guidance
• Knowledge-based, social and emotional guidance
• Significance of patient background in guidance
• Digital guidance
• Improving guidance competence

3) Uses client/patient-centred education and guidance methods.

• Patient-centred and diversified use of guidance methods; oral and written guidance, demonstration, telephone and audio-visual guidance, group guidance and individual guidance
• Guidance of various patients

4) Demonstrates ability to evaluate guidance outcomes together with the client /patient, their nearest ones and health care professionals.

• Impact, quality and sufficiency of guidance

5) Uses pedagogy and ethics in plans, implementation and evaluation of guidance supporting the client’s /patient’s self-care.

• Legislation supporting guidance
• Code of ethics in guidance
• Evidence-based contents of client guidance
• Evidence-based pedagogic methods in client guidance

6) Encourages the client /patient and their nearest ones commit to the care.

• Patient commitment to and inclusion in care
• Motivating the patient for self-care and strengthening the feeling of being in control
• Guidance of family members and friends in and into patient care
• Interaction as a means of support of client self-care

7) Demonstrates knowledge of the clinical pathway of the client/patient and masters the basics of service guidance.

• Service guidance as a process and an operational method in nursing care
• Systematic, target-oriented guidance

Clinical nursing

1) Responds to the needs of the client/patient by planning, implementing and assessing appropriate individual nursing care in cooperation with the client/patient, their family members, and other professionals in health care and social welfare services.

• Nursing care process (defining needs, nursing care diagnostics, nursing care planning, implementation of interventions and evaluation of outcomes)

2) Demonstrates ability to use diverse nursing care methods in psychosocial support of the client /patient.
• Nursing care methods
• Psychosocial methods

3) Masters the knowledge and skills needed for key nursing interventions as a part of holistic
care of the client /patient.
• The most common interventions in clinical nursing

4) Masters the knowledge and skills of key nursing diagnostics as a part of holistic
care of the client/patient.
• The most common diagnostics in clinical nursing

5) Masters the principles of infection prevention and puts their knowledge into practice in the implementation of infection prevention.
• Microbiology
• Asepsis
• Hand hygiene and routine safety precautions
• Safety precaution categories

6) Applies knowledge of anatomy and physiology, pathophysiology, applied pharmacology and medication to the planning, implementation and assessment of medication for treatment of different diseases.
• Basics of pharmacology (pharmacokinetics, pharmacodynamics and toxicology)
• Major groups of drugs, their uses, mechanisms of action and administering
• Therapeutic effects, side effects and interaction with other medicaments, interaction mechanisms of medicaments
• Monitoring of the effects, recording, control and evaluation of medication
• Implementation of medication using different administration routes

7) Applies knowledge of anatomy and physiology, pathophysiology and applied pharmacology to the planning, implementation and assessment of safe medication of different client/patient groups.
• Applied pharmacology (medication of different patient groups, patients of different age)
• Self-medication
• Blood transfusion
• Medication technology
• Medication calculation

8) Demonstrates knowledge of legislation governing medication and information guidance.
• Regulations governing medication
• Nurse’s role, duties and responsibility regarding medication
• Medication plan

9) Demonstrates knowledge of structure, functions and regulations of the human organ systems and factors affecting them.
• Human anatomy and physiology

10) Understands disease mechanisms and their effects on the human organ systems.
• Pathology and pathophysiology

11) Applies nutrition and care recommendations for different age and target groups for prevention and treatment of national diseases.
• National nutrition and food recommendations for different age groups
• Application of nutrition and food recommendations to the patient’s/client’s everyday choices of foods and meals
• Implementation of nutritional care and preventive nutritional guidance

12) Demonstrates the ability to integrate nutritional care and guidance in holistic nursing care in collaboration with a network of multidisciplinary professionals.
• Significance and systematic implementation of nutritional care in the client’s /patient’s nursing care
• Identification of the need for nutritional care
• Major special diets
• Assessment of the patient’s/ client’s need for energy and nutrients

13) Evaluates nutrition of customer client/patient and identifies a client/patient at a risk of malnutrition.
• Weight monitoring data as a part of holistic
• care
• Interpretation, and application to care, of tests measuring the state of nutrition
• The patient’s nutrient intake, monitoring of consumption of food and liquids, and an individual assessment of needs
• Individual assessment of the need for energy and proteins, as well as food supplements and protective nutrients

14) Demonstrates knowledge of the principles of wound treatment and is able to apply their knowledge in treatment of chronic wounds
• structure, function and blood circulation as well as wound healing process of the skin
• types of chronic wounds
• aetiology and prevention of wounds
• local treatment, healing and evaluation of wounds

15) Identifies, assesses and manages the client’s /patient’s pain
• Pain mechanism
• Identification of pain
• Assessment of pain intensity and techniques used in the assessment of pain
• Techniques for alleviation of pain (with or without medication)

16) Applies knowledge about the most frequent internal diseases) to the practical nursing care.
• Major internal diseases (general medicine and specialties in medicine

17) Masters key nursing interventions and nursing methods used in the nursing care of internal medicine patients.
• Interventions and methods used in the nursing care of an internal medicine patient

18) Applies their knowledge of major cancers to the nursing care.
• Major cancers

19) Demonstrates ability to manage key interventions in the nursing care of a patient with cancer.
• Interventions and methods in the nursing care of a cancer patient

20) Applies their knowledge of key conditions requiring surgical intervention in different phases of perioperative nursing care of a patient.
• Major conditions requiring surgical intervention (surgery and surgical specialties)
• Pre-, intra- and post-operative nursing care

21) Competent in key nursing interventions used in the nursing care of a perioperative patient.

• Interventions and methods used in the nursing care of perioperative patient

22) Applies their knowledge of major diseases of children/adolescents in nursing care.
• Paediatric nursing and paediatric diseases
• Interventions and methods used in the nursing care of children and adolescents

23) Demonstrates knowledge of the principles of family work and is able to put them into practice.
• Family nursing care and interventions

24) Demonstrates ability to promote the sexual health of client and patient
• Promotion of sexual health

25) Understands the normal process and monitoring of pregnancy, delivery and puerperium.
• Normal pregnancy, delivery and puerperium

26) Demonstrates ability to apply their knowledge of key mental health disorders and psychiatric conditions in nursing care.
• Major mental health disorders and psychiatric conditions

27) Demonstrates knowledge of key interventions used in the nursing care of patients with mental health disorders and psychiatric conditions.
• Interventions and methods used in nursing care of mental health disorders and psychiatric conditions

28) Demonstrates knowledge of key methods of early intervention in nursing care of substance abusers.
• Alcohol, surrogate alcohol, mixed use, tobacco, drugs
• Working with substance abusers and early intervention
• Prevention of substance abuse and dealing with related damage, health risks and problems
• Mini-intervention

29) Demonstrates ability to support a person in acute crises.
• Acute crisis and crisis care

30) Applies their knowledge of changes related to ageing to nursing care.
• Care of the elderly and geriatrics
• Changes occurring with ageing

31) Demonstrates knowledge of interventions and methods of assessment and maintenance of health, functional capacity and resources of the aged.
• Functional capacity and assessment of resources
• Risk factors predicting weakening of functional capacity
• Gerotechnology

32) Applies in practice their knowledge of memory disorders, nursing care of and services for patients with memory disorders.
• Memory disorders
• Nursing care of persons with memory disorders

33) Applies in practice their knowledge of major developmental disabilities and becoming disabled in their nursing care of persons who have developmental disabilities or who have become disabled.
• Major developmental disabilities
• Becoming disabled
• Interventions in the nursing care of the disabled
• Supporting the functional capacity of persons with developmental disorders or having become disabled

34) Identifies the need of a patient for palliative or end-of-life care.
• Palliative care and end-of-life care; key concepts, values and principles
• Identifying the need for palliative or end-of-life care
• Encountering a patient with terminal condition
• Role of a nurse in palliative care and end-of-life care

35) Draws up a nursing care plan for the last phase of a patient’s life in collaboration with the patient, his or her family members, physician in charge and other members of the multidisciplinary team.
• Palliative care and end-of-life care; legal bases
• Key elements of a nursing care plan for the last phase of life, living will

36) Implements symptomatic and humane palliative care and end-of-life care.
• Addressing suffering and related symptoms
• Pain relief
• Symptoms in airways, gastrointestinal tract, mouth, dehydration, fading away and anorexia, exceptional fatigue, itching and other skin symptoms, sweating, delirium, anxiety and depression

37) Encounters and implements nursing care of a dying patient and supports the family members.
• Encountering a dying patient and his or her family members and friends
• Recognition and anticipation of changes in communication caused by the disorder
• Existential support
• Psychosocial support
• Signs of impending death
• Support and consideration of family members and friends

38) Uses various methods to support the psychosocial and conviction needs of patients and their nearest ones
• Identification of the need for spiritual support
• Professional assistance and how to arrange it

39) Assesses the need for emergency care of a critically ill patient.
• ABCDE protocol
• Assessment of the need for emergency care

40) Demonstrates ability of systematic assessment of the need for emergency care, and takes immediate action in situations requiring emergency care.
• NEWS
• PEWS
• Intervention in situations requiring immediate care and in emergencies
• PPE+D
• Resuscitation

41) Demonstrates ability to initiate immediate rescue services and to implement interventions in situations of crises and disaster.
• Action in an accident situation
• Crises and disasters
• Action in situations involving chemical hazard, biological risk, radiation or nuclear accident

Evidence-based practice, utilization of research knowledge and decision-making

1) Understands that work of a nurse is evidence-based and commits to it.
• Evidence-based practice
• Role of the nurse in evidence-based practice

2) Demonstrates ability to plan, implement and evaluate evidence-based nursing safely.
• Planning, implementation and evaluation of evidence-based nursing
• Knowledge produced by nursing science as the basis of nursing care

3) Participates in developing evidence-based practices in their own work.
• Identification and critical assessment of used practices
• Consistent practices

4) Demonstrates ability to search information in major databases of health sciences and to read scientific publications critically.
• Use of major databases of health sciences
• Reading and critical evaluation of scientific publications

5) Demonstrates ability to make evidence-based clinical decisions
• Critical thinking
• Evidence summaries, systematic reviews, evidence-based guidelines
• Significance of evaluation of the degree of evidence in clinical decision-making
• Implementation of evidence-based activities into clinical practice

6) Demonstrates ability to exploit scientific data in clinical decision-making
• Evidence-based guidelines and consistent practices in clinical nursing

Entrepreneurship and development

1) Understands the idea of intrapreneurship and commits to it in his or her work.
• Intrapreneurship

2) Has the basic qualities required for an independent entrepreneur in the sector.
• Working as an independent nurse entrepreneur
3) Masters the principles of cost consciousness in nursing and works cost-efficiently.
• Cost consciousness
• Cost-effective working

4) Reflecting with his or her work community, he or she is able to identify practices to be developed and things that need to be changed in their own work.
• Reflection as a tool in identifying needs for improvement in one’s own work
• Professional growth as a tool for developing one’s own work

5) Demonstrates ability to participate in development, innovation and research processes as a team member.
• Project management
• Innovations and quality improvement in nursing
• Research methods

Quality management

1) Evaluates the quality of nursing care in order to develop the client’s /patient’s care, and their own practices.
• Acts and decrees governing quality management, and information guidance
• Evaluation of nursing care quality
• Indicators and monitoring of quality and efficacy

2) Participates in quality management as a member of the work community.
• Nursing philosophy of the organization
• Quality of services and client satisfaction
• Recognition of targets in nursing to be developed and studied

3) Understands the impact of their own activities on the quality of the organization.
• Responsibility for own work

4) Understands the use of patient safety reports as a part of quality control of the organization.
• Hazardous situations reporting process and capitalizing on the outcomes
• Patient safety reports as a part of quality

Service system of health care and social welfare services

1) Understands how health care and social welfare services are produced and organized, and how they are controlled and monitored in Finland.
• Legislation and other means to control service provision
• Following current management plans in health care and social welfare services
• Quality and efficacy of service organization and control
• Assessment of the need for services and their monitoring
• Accessibility of client and patient data, and resource planning systems as tools in service provisions

2) Understands the roles of different action and service units as part of the care and service chain.
• Different service providers in health care and social welfare services and their collaboration
• Collaboration of different municipal service areas in the provision of services

3) Understands their personal role in promoting the organization’s reputation, brand and image, as well as in creating a positive service experience for the client.
• Assessment of the client’s service needs
• Role-based responsibility for the continuity of the patient’s care
• Timely provision of services close to the customer
• Informing clients of different services and helping them in the selection of services
• Role of patient safety in a successful service chain and experience
• Identifying issues in the nursing care process

4) Demonstrates competence in using digital services as a part of holistic
care of the client/patient.
• Digital services and their use.

5) Demonstrates ability to function in changing environments and to provide service guidance.
• Health care technology
• Centralized client and service guidance
• Informal carers and supporting persons caring for their nearest ones
• Social media in nursing care

Patient and client safety

1) Demonstrates knowledge of key factors regarding patient and client safety
• Patient safety legislation
• Ensuring patient safety
• Impact of systems and complexity of nursing care on patient safety
• Fields of patient safety: equipment safety, nursing care safety, safety of interventions, drug safety and medication safety
• Patient safety culture
• Radiation safety

2) Promotes patient safety and prevents patient safety incidents in every phase of the nursing process of the patient.
• Efficient team work to ensure patient safety
• Systematic efforts to guarantee patient safety
• Prevention of patient safety incidents in nursing
• Engagement and inclusion of patients and nursing staff in the promotion of patient safety.
• Human factors as risk to patient safety
• Stress management skills
• Learning from mistakes to prevent harm
• Open processing of mistakes

3) Communicates clearly to ensure patient safety.
• Methodical tool for structured reporting (ISBAR)

4) Takes immediate situation-specific action in a hazardous situation.
• Situation-specific action in hazardous situation
• Intervention in threatening situations involving risk to patient safety

5) Recognizes potential patient safety incidents and reports them.
• Obligation to report patient safety incidents
• Recognition of patient safety incidents
• Reporting a patient safety incident

6) Understands how a report on patient safety incident is handled.
• Handling process of the report of patient safety incident