CNS Population-Based Competencies - Update Catherine Ruhl, MS, CNM Director, Women's Health Programs Association of Women's Health, Obstetric and Neonatal Nurses 4/27/20151©2012 Association of Women’s Health, Obstetric and Neonatal Nurses

© 2012 Association of Women’s Health, Obstetric and Neonatal Nurses 2 APRN Regulatory Model

Women’s health/gender specific CNS competencies Build a foundation for use by educators and certifiers Articulate the unique contribution of the CNS in the care of women across the lifespan and their infants 4/27/2015©2011 AWHONN3

Women’s health CNS Competencies for women’s health CNS in process Writing group is joint task force of AWHONN and NACNS Task force began work March, 2012 Modeled on CNS competencies 4/27/2015©2011 AWHONN4

© 2012 Association of Women’s Health, Obstetric and Neonatal Nurses 5 Women’s health in the U.S. High rates of chronic illness: heart disease, diabetes Obese/overweight: 63% of women, million women ages uninsured 16.7 million effectively uninsured

Rates of chronic hypertension 4/27/2015©2011 AWHONN6

Maternal and infant health Half of pregnancies unplanned Severe obstetric complication rates 27% increase 1998 to 2005 U.S. 50th in world for maternal mortality U.S. 30th in world for infant mortality Wide racial disparities maternal and infant mortality 1 in 8 infants are premature 4/27/2015©2011 AWHONN7

Cesarean birth rate 4/27/2015©2011 AWHONN8

Maternal mortality 4/27/2015©2011 AWHONN9

Population definition (draft) The women’s health CNS provides advanced direct and indirect care to women to address gender-related issues that may impact health and wellness across the lifespan, in the context of the woman’s multiple social roles, circumstances and family as she defines family. 4/27/2015©2011 AWHONN10

Population definition (draft) This includes, but is not limited to, reproductive health, starting in adolescence; childbearing, newborn and family adaptation, perimenopausal, menopausal, and post- menopausal health, and healthy aging for women. 4/27/2015©2011 AWHONN11

CNS spheres of influence Patient Nurse/Nursing Practice Organization/System 4/27/2015©2011 AWHONN12

Core competency domains Direct care Consultation Systems leadership Collaboration Coaching Research Ethical Decision-Making, Moral Agency and Advocacy Competency 4/27/2015©2011 AWHONN13

Unique WH CNS role The pressing women’s health issues of our time require nurses who are advanced practice clinicians and systems leaders at every level and setting to provide direct care, coordinate healthcare teams, improve processes and promote healthier outcomes for women across the lifespan and for their families, and communities. 4/27/2015©2011 AWHONN14