AWHONN Standards 8th Ed. 2019

STANDARDS
FOR PROFESSIONAL
NURSING PRACTICE
IN THE CARE OF
WOMEN AND NEWBORNS
EIGHTH EDITION
Association of Women’s Health, Obstetric and Neonatal Nurses

ABOUT AWHONN
Headquartered in Washington, D.C., the Association of Women’s Health, Obstetric and Neonatal Nurses
(AWHONN) is a leader among the nation’s nursing associations, serving more than 24,000 health care
professionals in the United States, Canada, and abroad and representing more than 350,000 nurses in our
specialty.
AWHONN advances the nursing profession by providing nurses with critical information and support to help
them deliver the highest quality care for women and newborns. Through its many evidence-based education and
practice resources, legislative programs, research, and coalition work with like-minded organizations and
associations, AWHONN has firmly established itself as the leading association for women’s health, obstetric, and
neonatal nurses.
AWHONN members strive to deliver superior health care to women and newborns in hospitals, home health,
and ambulatory care settings. The rich diversity of members’ skills and experience make AWHONN the voice
for women’s health and neonatal nursing. It is through their dedication, knowledge, skill, and expertise that we
create resources aimed at achieving our mission to promote the health of women and newborns.
©2019 by the Association of Women’s Health, Obstetric and Neonatal Nurses. All rights reserved. This
document is protected by copyright. This material may not be reproduced or transmitted in any form or by any
other means, electronic or mechanical, including photocopy recording without permission in writing from the
Association of Women’s Health, Obstetric and Neonatal Nurses.
Requests for permission to use or reproduce material from this book should be directed to
permissions@awhonn.org or mailed to:
Permissions, AWHONN
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Washington, DC 20036
STANDARDS FOR PROFESSIONAL
NURSING PRACTICE IN THE CARE OF
WOMEN AND NEWBORNS
EIGHTH EDITION
©2019 AWHONN. All rights reserved.

ACKNOWLEDGEMENTS
The eighth edition of AWHONN’s Standards for Professional Nursing Practice in the Care of Women and Newborns was
developed by the AWHONN Standards Revision Task Force, which included AWHONN staff, members from the
AWHONN Board of Directors, previous team members, and a 2017 AWHONN Emerging Leader. Their commitment,
insight, and diligent work to review and revise this edition is greatly appreciated. AWHONN gratefully acknowledges the
significant contribution of each of these individuals as well as those team members who have worked on the past editions of
this document.
2019 AWHONN STANDARDS REVISION TASK FORCE
Joan Edwards, PhD, RNC, CNS, FAAN, Team Leader

Catherine M. Hill, MSN, FNP-BC, AWHONN Project Manager
Cheryl Larry-Osman, MS, RN, CNM, AWHONN 2018 Board of Directors
Lisa Miller, JD, CNM, AWHONN 2018 Board of Directors
Sarah Patel, MSN, RN, C-EFM, 2017 AWHONN Emerging Leader
Catherine Ruhl, MS, CNM, AWHONN Director of Women’s Programs
2019 AWHONN STANDARDS REVIEWERS

AWHONN 2018 Board of Directors
Jeanne L. Alhusen, PhD, CRNP, RN

Jennifer L. Doyle, MSN, WHNP
Emily Drake, PhD, RN, FAAN
Robert Durkee, RN, MHA, FACHE
Cynthia “Cyndy” Krening, MS, RNC-OB, C-EFM, CNS
Susan A. Peck, RNC, MSN-APN
Kristine Rimbos, MS, CNS, RNC-OB, C-EFM
Cheryl Roth, PhD, WHNP-BC, RNC-OB, RNFA
Barbara S. Tewell, MSN, RNC-OB
Raquel “Kelly” Walker, DNP, RNC-MNN, RN-BC
Additional Reviewers
Susan Hale, DNP, RN, C-EFM, AWHONN Member

Jody Hoyos, MHA, AWHONN Vice President of Member Services and Operations
Elizabeth Rochin, PhD, RN, NE-BC, AWHONN Vice President of Nursing
ii STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION
The standards presented herein summarize what AWHONN believes is the nursing profession’s best judgment and optimal
practice based on current research and clinical practice. AWHONN believes that these standards will be helpful for all
nurses engaged in the functions described. However, as with most or all such standards, certain qualifications should be
borne in mind:
• These standards articulate general guidelines; additional considerations or procedures may be warranted
for particular patients or settings. The best interest of an individual health care consumer is always the
touchstone of practice.
• These standards represent optimal practice; although nurses should strive for optimal practice, full
compliance may not be possible at all times with all health care consumers in all settings.
• These standards are only one source of guidance. Nurses also must act in accordance with applicable law,
regulations established by individual state boards of nursing, organizational rules and procedures, and
established interprofessional arrangements concerning the division of duties.
• These standards serve as a guide for best practice. They are not designed to define standards of practice for
employment, licensure, discipline, reimbursement, legal, or other purposes.
• These standards may change in response to changes in research and practice.
• The glossary is used to define terminology used throughout these standards.
STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION iii
iv STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION
TABLE OF CONTENTS
ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
INTRODUCTION TO THE EIGHTH EDITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

The Foundation Of Women’s Health, Obstetric, And Neonatal Nursing Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Tenets Characteristic Of Nursing Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Evolution Of Evidence-Based Nursing Practice And The Eighth Edition Of Standards . . . . . . . . . . . . . . . . . . . . . . . . . 4
COMPONENTS OF THE STANDARDS OF PRACTICE, EIGHTH EDITION . . . . . . . . 5

STANDARD 1: ASSESSMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
STANDARD 2: DIAGNOSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
STANDARD 3: OUTCOMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
STANDARD 4: PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
STANDARD 5: IMPLEMENTATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
STANDARD 5a: COORDINATION OF CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
STANDARD 5b: HEALTH TEACHING AND HEALTH PROMOTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
STANDARD 6: EVALUATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
COMPONENTS OF THE STANDARDS OF PROFESSIONAL PERFORMANCE,

EIGHTH EDITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
STANDARD 7: ETHICS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
STANDARD 8: CULTURALLY CONGRUENT PRACTICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
STANDARD 9: COMMUNICATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
STANDARD 10: COLLABORATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
STANDARD 11: LEADERSHIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
STANDARD 12: EDUCATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
STANDARD 13: EVIDENCE-BASED PRACTICE AND RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
STANDARD 14: QUALITY OF PRACTICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
STANDARD 15: PROFESSIONAL PRACTICE EVALUATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
STANDARD 16: RESOURCE UTILIZATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
STANDARD 17: ENVIRONMENTAL HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
APPLICATION OF THE STANDARDS INTO CLINICAL PRACTICE . . . . . . . . . . . . 26

Introduction To The Clinical Ladder Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
AWHONN Sample Clinical Ladder Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28-30
GLOSSARY OF TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION v
PREFACE
Since the seventh edition Standards and Guidelines for Professional Nursing Practice in the Care of Women and Newborns
was published in 2009 (AWHONN, 2009), nursing practice has continued to evolve. The AWHONN Standards Revision
Task Force used the Nursing: Scope and Standards of Practice, Third Edition, developed by the American Nurses Association
(ANA) as the foundation for the eighth edition of AWHONN Standards (ANA, 2015c). The ANA developed Standards
collaboratively with specialty nursing organizations and groups. The ANA standards were chosen because they define and
guide the expectations of the professional role within which registered nurses practice. Those standards delineate the
unifying elements within nursing practice and provide women’s health, obstetric, and neonatal nurses with a clear
definition of the unique elements of nursing, regardless of the area of specialty.
The AWHONN Standards of Practice set forth in this eighth edition are intended to define the roles, functions, and
competencies of the nurse who strives to provide high-quality services to health care consumers. The Standards of
Professional Performance delineate the various roles and behaviors for which the professional nurse is accountable. Core
elements of women’s health, obstetric, and neonatal nursing practice are integrated into this edition of Standards for
Professional Nursing Practice in the Care of Women and Newborns. The goal for individuals practicing in the field of
women’s health, obstetrics, and neonatal nursing is to use the Standards of Practice and Standards of Professional
Performance to improve the health and well-being of self, individual health care consumers, communities, and populations.
STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION 1
INTRODUCTION TO THE EIGHTH EDITION
THE FOUNDATION OF WOMEN’S HEALTH, OBSTETRIC, AND NEONATAL NURSING

PRACTICE
AWHONN’s Standards for Professional Nursing Practice in the Care of Women and Newborns, Eighth Edition, addresses the
care provided to health care consumers in the context of woman-, newborn-, and family- centered care and includes those
who do not self-identify as women, or exclusively as women, as well as all people parenting newborns. These standards
provide the foundation for professional nursing practice regardless of the setting or complexity of care.
Standards are an important benchmark against which registered nurses assess their professional practice and by which the
quality of practice, service, or education can be judged. Thus, Standards provides the means through which AWHONN
clearly describes nursing practice in the care of women, newborns, and families. The eighth edition of Standards reflects
AWHONN’s mission to promote the health of women and newborns within the framework of the organization’s CARING
Core Values (AWHONN, 2008):
• Commitment to professional and social responsibility
• Accountability for personal and professional contributions
• Respect for diversity of and among colleagues and clients
• Integrity in exemplifying the highest standards in personal and professional behavior
• Nursing excellence for quality outcomes in practice, education, research, advocacy, and management
• Generation of knowledge to enhance the science and practice of nursing to improve the health of women
and newborns
The eighth edition of Standards specifically addresses the practice of the registered nurse, including those with advanced
degrees. Competencies, called “measurement criteria” in past editions, are included with each standard. These competencies
are one means of evaluating how the nurse’s performance and practice meet the standard. Applicability of specific
standards and competencies depends on context. Additional competencies are also included in some standards, when
needed, and may apply to any nurse but are more likely applicable to nurses with advanced education, including those with
master’s and doctoral degrees, nurse educators, and advanced practice registered nurses (APRNs). The competencies are not
meant to be a comprehensive list and may change over time as new knowledge is acquired and expectations for nursing
practice change (ANA, 2015c).
APRNs who provide care to consumers in the context of woman-, newborn-, and family-centered care integrate into their
practice both the standards presented herein and the standards applicable to their advanced practice specialty. Compared
with registered nurses, APRNs generally demonstrate greater depth and breadth of knowledge and data synthesis, allowing
them to perform more complex clinical skills and interventions, and they generally have greater role autonomy than
registered nurses. In some health care settings, specific elements of the Standards may be applicable to licensed practical or
licensed vocational nurses as identified in state or provincial nurse practice acts, by regulatory agencies, or by relevant nurse
association guidelines.
The application of the Standards transcends care settings. Women, newborns, and families are cared for in a variety of
settings, including the community and hospitals, which range from small rural health care facilities to large urban medical
centers. Standards applies to registered nurses who provide preconception, interconception antepartum, intrapartum,
postpartum, and newborn care in high- and low-risk settings, sexual and reproductive health care, and care across the
woman’s life span.
2 STANDARDS FOR PROFESSIONAL NURSING PRACTICE IN THE CARE OF WOMEN AND NEWBORNS, EIGHTH EDITION
TENETS CHARACTERISTIC OF NURSING PRACTICE
The AWHONN Standards includes the five tenets characteristic of nursing practice similar to that of the ANA Standards
(adapted from ANA, 2015c, pp. 7–9):
1. Caring and health are central to the practice of the registered nurse.
AWHONN’s Core Values focus on caring (AWHONN, 2008). “Caring is a conscious judgment that manifests itself
in concrete acts, interpersonally, verbally, and nonverbally” (Gallagher-Lepak & Kubsch, 2009, p. 171). Caring for
women, newborns, families, health care consumers, and groups is a key focus of nursing practice. Throughout this
process, nurses should also participate in self-care activities as well as care of the environment and society (ANA,
2015c).
2. Nursing practice is individualized.

Nursing practice is individualized to meet the unique needs of each health care consumer in the context of
woman-, newborn-, and family-centered care. The registered nurse respects the woman’s and family’s goals,
preferences, and abilities regarding care and recognizes social, cultural, and ethical differences while also
complying with legal and institutional requirements. In addition, the registered nurse uses clinical judgment based
on education, experience, and evidence-based practice to determine appropriate interventions and expectations for
the woman, newborn, and family in each situation encountered (Stevens, 2013).
3. Registered nurses use the nursing process to plan and provide individualized health care for consumers.
The nursing process is a dynamic, interpersonal, collaborative process based on theoretical and evidence-based
knowledge of human experiences. The nursing process is used to collaborate with women and families to assess,
diagnose, identify outcomes, plan, implement, and evaluate care individualized to each health care consumer’s
needs. The nurse’s actions are intended to produce beneficial effects, contribute to quality outcomes, and do no
harm. Critical thinking is used through each step of the nursing process to solve problems and assist in
decision-making.
4. Registered nurses establish partnerships that enhance nursing practice to achieve desired outcomes.
Whenever possible, registered nurses provide and coordinate care in the context of advocacy and partnerships
formed with the woman, parents of the newborn, family members, or significant others (as defined by the woman)
and with other health care professionals. The registered nurse recognizes and accepts that the degree of
participation by the woman, parents of the newborn, other family members, and significant others will vary based
on needs, preferences, and abilities. The registered nurse seeks to be inclusive and recognizes the needs of a diverse
population (Schmidt, MacWilliams, & Neal-Boylan, 2017). The registered nurse interacts and collaborates with
other members, using effective in-person and electronic communications, which results in a high-functioning
interprofessional team. Collaborative interprofessional team planning is based on recognition of each individual
profession’s value and contributions, mutual trust, respect, open discussion, and shared decision-making (ANA,
2015c).
5. The professional work environment impacts the registered nurse’s ability to practice.
Registered nurses have an ethical responsibility to sustain and improve the health care environments in which they
work. A healthy work environment is one that is safe, satisfying, and empowering. All members of the health care
team are accountable to ensure safety for health care consumers and health care workers. The ability of the
registered nurse to demonstrate AWHONN’s standards depends in part on the employer providing an environment
that supports nursing practice, open communication, optimal staffing, collaborative decision-making, and
meaningful recognition (Morton, 2015). Organizational policies should address safe patient handling and mobility,
fatigue in nursing practice, workplace stress and violence, and optimal staffing (ANA, 2015b; AWHONN, 2010;
National Institute for Occupational Safety and Health, 2018).
EVOLUTION OF EVIDENCE-BASED NURSING PRACTICE AND THE EIGHTH EDITION OF
STANDARDS
AWHONN advances the nursing profession by providing nurses with critical information and support to help them deliver
the highest quality care for women, newborns, and their families. The eighth edition of Standards, like the two previous
editions, contains Standards of Practice and Standards of Professional Performance only and does not include clinical
practice guidelines.
Continued development and dissemination of AWHONN’s evidence-based clinical practice guidelines, practice
monographs, practice briefs, and position statements help to ensure that perinatal, obstetric, neonatal, and women’s health
nurses have access to clinical practice recommendations that are based on the best available evidence. Incorporating
information from evidence-based guidelines, practice monographs, position statements, practice briefs, and other
AWHONN resources into clinical practice can promote collaborative practice among health care professionals. Basing
nursing practice on the best available scientific evidence can provide a foundation for research, continuing education,
curriculum, facility policy development, outcomes evaluation, and quality improvement.
COMPONENTS OF THE STANDARDS OF
PRACTICE, EIGHTH EDITION
The Standards of Practice for women and newborns describe a competent level of nursing care and consist of the six
components of the nursing process: assessment, diagnosis, outcomes, planning, implementation, and evaluation (ANA,
2015c). Standard 5: Implementation has additional subcomponents, 5a: Coordination of Care and 5b: Health Teaching and
Health Promotion, that are new to this edition and consistent with ANA’s Standards, Third Edition. Each component and
subcomponent is presented with a goal statement and a list of competencies specific to the health care of women and
newborns in the context of woman-, newborn-, and family-centered care. The goals and corresponding competencies reflect
the values and priorities of AWHONN and relate broadly to the nurse’s responsibility to the health care consumer.
STANDARD 1: ASSESSMENT
The registered nurse collects pertinent health data in the context of woman-, newborn-, and family- centered care.
Competencies
THE REGISTERED NURSE:
1. Collects data relative to the consumer’s situation in a systematic, ongoing process with compassion and respect
for the inherent dignity, worth, and unique attributes of every individual. These data include but are not limited
to the following:
• demographics social determinants of health, including health disparities
• physical, functional, psychosocial, emotional, and cognitive conditions
• sexual, cultural, age-related, environmental, and economic factors
• spiritual/transpersonal considerations
a. Prioritizes data collection based on the immediate condition of the woman or newborn and the need for
health promotion, maintenance, or restoration.
b. Uses evidence-based assessment techniques, instruments, tools, and available data and information relevant
to the situation during data collection to allow for identification of patterns and variances.
c. Involves the woman and, when appropriate, the family, significant others, and interprofessional members of
the health care team to enhance holistic, culturally sensitive data collection.
2. Incorporates, when appropriate, assessment parameters identified by the World Health Organization (WHO);
Healthy People 2030, and other organizations that influence nursing practice (Office of Disease Prevention and
Health Promotion, 2018).
a. Includes global and environmental factors in the assessment process.
b. Elicits the consumer’s values, preferences, needs, and knowledge of the health care situation during the
assessment process.
c. Seeks to minimize or eliminate the impact of their own personal values, biases, and beliefs on the assessment
process.
d. Includes assessment of the impact of family dynamics on the health and wellness of women and newborns.
3. Recognizes barriers to communication based on psychosocial, financial, cultural, and literacy considerations.
4. Recognizes consumers as the authority on their own health and honors their health care preferences (within legal
and institutional boundaries).
5. Applies ethical and privacy guidelines and policies to the collection, maintenance, use, and dissemination of data
and information.
6. Documents relevant data accurately and in accordance with policies and guidelines in a retrievable form accessible
to other health care providers with appropriate protection of consumer confidentiality.
Additional competencies may include:

A. Initiates diagnostic tests and procedures relevant to the consumer’s current and ongoing status.
STANDARD 2: DIAGNOSIS
The registered nurse analyzes assessment data to determine actual or potential diagnoses, problems, and issues
relevant to the health of women and newborns.
Competencies
1. Uses assessment data, standardized classification systems, technology, and clinical decision support to identify
actual or potential problems, diagnoses, or health issues.
a. Identifies actual or potential risks or barriers to women’s and newborn’s health and safety.
b. Partners with the woman and family as needed to establish mutual goals regarding prioritization of
diagnoses, problems, and issues across the health–illness continuum.
2. Confirms the diagnoses, problems, and health issues with the woman and interprofessional colleagues and with
the family, group, or community as appropriate.
3. Facilitates determination of expected outcomes and plans of care through documentation of verified diagnoses,
problems, and issues while maintaining the consumer’s confidentiality.

A. Analyzes diagnostic practice patterns of nurses and other members of the interprofessional health care team using
information and communication technologies.
B. Articulates diagnoses, problems, and issues of all consumers and organizational systems using aggregate-level data
analysis.
C. Formulates a differential diagnosis based on the assessment, history, physical examination, and
diagnostic test results of the consumer.
STANDARD 3: OUTCOMES
The registered nurse identifies expected outcomes for the consumer and creates an individualized plan in the
context of woman-, newborn-, and family-centered care.
Competencies
1. Engages the woman, parents of the newborn, interprofessional team, and others in partnership to identify
expected outcomes derived from assessments and diagnoses, problems, or issues.
a. Collaborates with the woman and family to integrate individual values, culture, and ethical considerations
into expected outcomes.
b. Identifies health risks, benefits, costs, or the expected trajectory of the condition using evidence-based
practice and clinical expertise.
c. Identifies outcome measures that are attainable in relation to resources available and accessible to the woman,
newborn, and family.
2. Provides a direction for continuity and coordination of care through outcome measures and generates a timeframe
for the attainment of expected outcomes.
3. Modifies outcome measures to reflect ongoing data collection and reevaluation of the woman’s or newborn’s
condition or situation.
4. Documents and evaluates actual outcomes in comparison with expected outcomes, as well as safety and quality
standards, in a retrievable form accessible to other health care providers with appropriate protection of consumer
confidentiality.

A. Defines expected outcomes that align with those identified by members of the interprofessional team,
incorporating cost-effectiveness and clinical effectiveness.
B. Differentiates outcomes that require system-level actions from those requiring care process interventions.
C. Advocates for outcomes reflecting the woman’s and family’s cultural considerations, values, and ethical concerns.
STANDARD 4: PLANNING
The registered nurse develops a plan that includes interventions and alternatives to attain expected, measurable
outcomes for women and newborns in the context of woman-, newborn-, and family-centered care.
Competencies
1. Develops an individualized, holistic plan to support the health promotion, maintenance, or restoration needs of
the women and newborn.
a. Develops a plan based on principles of woman-, newborn-, and family-centered care.
b. Develops a plan in partnership with the interprofessional team and, when appropriate, family members and
the community.
c. Ensures personal beliefs and biases do not impact the planning process.
d. Uses evidence-based practice strategies to address each of the identified diagnoses, problems, or issues.
e. Identifies costs, economic implications, and environmental influences related to the plan.
f. Ensures the plan reflects compliance with current statutes, rules and regulations, and applicable standards.
g. Integrates a timeline for implementation with consideration for continuity of care.
2. Establishes the plan priorities with the woman, family, and the interprofessional team based on the level of risk
and safety needs.
3. Minimizes unwarranted or unwanted treatment or suffering by advocating for responsible and appropriate use of
interventions.
4. Incorporates ongoing assessment of the woman’s and newborn’s status and other outcome indicators to modify the
plan as needed.
5. Documents the plan using standardized language or recognized terminology in a retrievable form accessible to
other members of the interprofessional health care team, with appropriate protection of consumer confidentiality.

A. Leads the design and development of interprofessional processes to address the identified diagnoses, problems, or
issues.
B. Designs and incorporates innovative nursing practices.
C. Actively participates in the development and continuous quality improvement of systems that support the planning
process.
STANDARD 5: IMPLEMENTATION
The registered nurse implements the identified plan to promote woman-, newborn-, and family-centered care in a
safe and timely manner.
Competencies
1. Uses critical thinking and technology solutions to implement the nursing process while maintaining consistency
with the established plan of care.
a. Integrates principles of safety and quality into interventions.
b. Delegates care consistent with evidence-based nursing practices and with accepted guidelines for care,
statutes, rules, and regulations.
c. Uses community resources and systems with established interventions to promote coordination of care across
the continuum.
2. Uses therapeutic interventions in collaboration with nursing colleagues and interprofessional members of the
health care team to develop professional, caring relationships with women and families.
3. Promotes holistic and culturally competent care for diverse populations, focused on mutually accepted goals, to
advocate and address needs of women, newborns, and families.
4. Documents implementation and modifications of the identified plan in a retrievable form accessible to other
health care providers with appropriate protection of consumer confidentiality.
5. Uses leadership skills to promote the nursing process, ethical practices, and critical reasoning.

A. Translates evidence and theoretical practices to impact organizational or system change.
B. Acts as a consultant to health care consumers and other health care providers.
C. Directs and prescribes care consistent with state and federal regulations.
D. Coordinates the integration of traditional and complementary treatments with the interprofessional team and
consistent with cultural preferences.
E. Uses systems, organizations, and community resources to lead effective change.
STANDARD 5a: COORDINATION OF CARE
The registered nurse coordinates care delivery to promote woman-, newborn-, and family-centered care within their
scope of practice.
Competencies
1. Collaborates with the woman and family to establish and implement a mutually agreed-upon plan of care for
desired outcomes.
2. Coordinates implementation of the plan.
3. Promotes the woman’s self-care to achieve her identified goals.
4. Advocates for the delivery of dignified and holistic care by the interprofessional team.
5. Collaborates with consumers, interprofessional team members, and community resources to promote safe
transitions in the continuum of care.
6. Documents the coordination of the care in a retrievable form accessible to other health care providers with
appropriate protection of consumer confidentiality.

A. Manages diverse consumer groups and populations.
B. Appropriately leads interprofessional teams to deliver safe, equitable, and effective woman-, newborn-, and
family-centered care.
C. Serves as a primary care provider and coordinator of health care services as regulated by state and federal laws and
regulations.
D. Synthesizes data and information to prescribe and provide necessary system and community support measures,
including modification of environments.
STANDARD 5b: HEALTH TEACHING AND HEALTH PROMOTION
The registered nurse employs health teaching strategies that promote, maintain, or restore health within the context
of a safe environment for woman-, newborn-, and family-centered care.
Competencies
1. Provides health promotion and teaching in collaboration with the woman and family that addresses such topics
as disease prevention, healthy lifestyles, risk-reducing behaviors, developmental needs, activities of daily living,
and preventive self-care.
a. Incorporates principles of safety, consumer values, and beliefs in health teaching and health promotion.
b. Uses health promotion and health teaching methods appropriate to the situation and the consumer’s
developmental level, learning needs, readiness, ability to learn, language preference, socioeconomic status,
spirituality, and culture.
c. Provides anticipatory evidence-based guidance to women and families to promote health and prevent or
reduce the risk of negative outcomes.
d. Uses technology to facilitate health promotion and disease prevention strategies for consumers.
2. Seeks opportunities for feedback and evaluation of the effectiveness of the strategies used.
3. Promotes mutual decision-making by providing the woman and family with information regarding the plan of
care.
4. Advocates with professional organizations to support activities in health teaching and health promotion for
women, newborns, and families.
5. Documents health teaching and health promotion activities in a retrievable form accessible to other health care
providers with appropriate protection of consumer confidentiality.

A. Synthesizes empirical evidence on risk behaviors, gender roles, and theoretical frameworks (e.g., learning,
motivational, translation, and epidemiological frameworks) to design health education and health promotion
information and programs.
B. Evaluates health information resources regarding women and newborns for applicability, accuracy, readability, and
comprehensibility to assist with access to high-quality educational materials for women and families.
STANDARD 6: EVALUATION
The registered nurse evaluates the progress toward attainment of expected outcomes in the context of woman-,
newborn-, and family-centered care.
Competencies
1. Conducts an evaluation that is holistic, equitable, systematic, ongoing, and criterion-based, relative to the
elements of consumer care, established timelines, and expected outcomes.
a. Evaluates the effectiveness of the planned strategies in relation to consumer responses and the attainment of
the expected outcomes.
b. Uses ongoing assessment data to revise diagnoses, problem lists, plans of care, interventions, and outcomes,
as needed.
c. Involves the woman, parents of the newborn, and, when appropriate, family members, significant others, and
other health care providers in the evaluation process.
d. Appropriately leads the interprofessional team through a systematic evaluation to revise the plan of care, as
needed.
2. Shares evaluation data and intervention outcomes with the woman and family, in accordance with federal and
state regulations.
3. Documents the revisions in diagnoses, problem lists, plans of care, and evaluation of outcomes in a retrievable
form accessible to other health care providers with appropriate protection of consumer confidentiality.

A. Synthesizes data to evaluate the effectiveness of care for consumers, communities, populations, and organizations
or health care systems.
B. Promotes the creation or revision of guidelines, policies, or protocols based on evaluation data.
COMPONENTS OF THE STANDARDS OF
PROFESSIONAL PERFORMANCE, EIGHTH EDITION
The Standards of Professional Performance outline the expectations of the professional role within which all nurses
practice and describe a competent level of professional behavior (ANA, 2015c). According to ANA “… nurses are
expected to engage in professional role activities, including leadership, appropriate to their education and position.
Registered nurses are accountable for their professional actions to themselves, their health care consumer, and their
peers and ultimately to society” (ANA, 2015c, p. 5).
The eleven Standards of Professional Performance in the eighth edition are as follows:
• Ethics
• Culturally congruent practice
• Communication
• Collaboration
• Leadership
• Education
• Evidence-based practice and research
• Quality of practice
• Professional practice evaluation
• Resource utilization
• Environmental health
The AWHONN Standards of Professional Performance in this edition reflect the ANA’s Standards, Third Edition. These
standards include two new standards: culturally congruent practice, which focuses on caring for diverse populations
(Marion et al., 2016), and environmental health, which focuses on a safe work environment (ANA, 2007). Several of the
AWHONN Standards of Professional Performance were renamed in this edition to achieve congruence with the content
in the ANA’s Standards, Third Edition:
• Resource utilization was previously part of the standard titled “Resources and Technology.”
• Evidence-based practice was previously titled “Research.”
• Collaboration was previously part of the standard titled “Collaboration and Communication.” The seventh
edition standard titled “Collegiality” is now subsumed into the collaboration standard in this edition.
• Communication was previously part of the standard titled “Collaboration and Communication.”
STANDARD 7: ETHICS
The registered nurse’s decisions and actions on behalf of women, fetuses, and newborns are determined in an
ethical manner and guided by a sound framework for ethical decision-making.
Competencies
1. Uses the ANA Code of Ethics for Nurses with Interpretive Statements (ANA, 2015a) and other applicable resources
to guide practice and formulate ethical decisions related to the care of women, fetuses, newborns, and their
families.
a. Practices with compassion and respect for the inherent dignity, worth, and unique attributes of all people.
b. Demonstrates professional accountability and responsibility for nursing practice.
c. Maintains competence through continued personal and professional development.
d. Demonstrates commitment to self-reflection and self-care.
e. Advances the profession through scholarly inquiry, professional standards development, and generation of
policy.
f. Articulates nursing values to maintain personal integrity and the integrity of the profession.
2. Contributes to the establishment and maintenance of an ethical framework that supports safe, high-quality health
care.
3. Contributes to the resolution of ethical issues for women and their fetuses, people caring for newborns, newborns,
or family members within health care services or systems (e.g., through family meetings, ethics rounds, or ethics
committee participation).
4. Advocates for health care consumers’ rights for health and safety through informed decision-making, self-
determination, and self-advocacy.
5. Maintains therapeutic relationships while recognizing personal and professional boundaries.
6. Maintains confidentiality and protects the privacy of health care consumers’ information and data consistent with
ethical, legal, and regulatory parameters.
7. Collaborates with other health professionals and the public to protect human rights, promote health diplomacy,
enhance cultural sensitivity and congruence, and reduce health disparities.
8. Integrates principles of social justice into nursing practice.
STANDARD 8: CULTURALLY CONGRUENT PRACTICE
The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles when
caring for women, newborns, and families.
Competencies
1. Demonstrates respect, equity, and empathy in action and interactions with all health care consumers and
colleagues.
a. Reflects upon their own values, beliefs, and biases.
b. Identifies the culturally specific meaning of interactions, terms, and content.
c. Identifies the consumer’s knowledge, patterns of needs, and engagement in health care practices.
d. Delivers care in a nondiscriminatory, nonjudgmental way while respecting consumer decisions that may be
based on age, traditions, beliefs, lifestyle, or family influence.
e. Applies knowledge of variations in health beliefs, practices, and communication patterns while ensuring the
health care consumer is addressed by self-identified terminology in all clinical and professional encounters.
2. Participates in lifelong learning to understand cultural preferences, worldview, choices, and decision-making
processes of consumers.
3. Considers the effects and impact of discrimination and oppression of practice within and among cultural groups
for both consumers and colleagues.
4. Uses skills, tools, and resources, including medical interpreters and translators that are appropriately vetted for the
culture, literacy, and language of the population served and in accordance with consumer preference.
5. Advocates for organizational and legislative policies and programs that promote health and reflect respect, equity,
and inclusion among culturally diverse, underserved, and underrepresented consumers.
6. Promotes equal and appropriate access to services, tests, interventions, health promotion programs, enrollment in
research, education, and other health care-related opportunities.
7. Educates colleagues about cultural similarities and differences among women, newborns, their families, groups,
communities, and populations.

A. Engages consumers, key stakeholders, and others in designing and establishing internal and external cross-cultural
partnerships.
B. Conducts research and participates in evidence-based practices to improve health care and outcomes for culturally
diverse health care consumers.
C. Develops recruitment and retention strategies to achieve a multicultural workforce that reflects the population
served.
D. Promotes shared decision-making solutions in planning, prescribing, and evaluating processes when the health
care consumer’s cultural preferences and norms may differ from current evidence-based practices.
STANDARD 9: COMMUNICATION
The registered nurse communicates with women, families, health care providers, and the community in providing
safe and holistic care.
Competencies
1. Assesses their own communication style, skills, and effectiveness.
a. Uses verbal and nonverbal communication styles and methods that demonstrate caring, respect, deep
listening, authenticity, and trust.
b. Demonstrates continuous improvement of communication skills.
c. Demonstrates cultural sensitivity when communicating.
2. Communicates to women, families, health care providers, and the community about the nurse’s role in the
provision of care.
3. Assesses the health care consumer’s communication ability, literacy, health literacy, resources, and preferences to
inform the interprofessional team.
a. Uses language access services (e.g., interpreters, translators), whenever available, to seek effective
communication.
b. Incorporates effective communication strategies for women, family members, or interprofessional team
members who have visual, speech, language, or communication barriers.
4. Maintains continuity of care by conveying accurate and timely information to women, families, and the
interprofessional team.
5. Communicates clinical, nonclinical, and interpersonal risk events to the appropriate level.
6. Incorporates accurate documentation as a communication tool.
7. Uses social media in a responsible manner that fosters a respectful interface with other professionals while
protecting consumer and organizational confidentiality.
STANDARD 10: COLLABORATION
The registered nurse collaborates with women, families, health care providers, and the community in providing safe
and holistic care.
Competencies
1. Participates in guiding nursing actions and collaborating with other health care providers while caring for
diverse populations.
a. Collaborates in creating a comprehensive documented plan, focused on outcomes and decisions related to
care and delivery of services.
b. Exhibits dignity and respect when interacting with others and when giving and receiving feedback.
c. Uses effective group dynamics, member expertise, and strategies to enhance team performance and outcome
achievement.
d. Uses appropriate tools and techniques, including information systems and technologies, to facilitate
discussions and team functions in a manner that protects privacy and confidentiality.
e. Partners with others to effect change resulting in high-quality care and positive outcomes through knowledge
of the woman, the family, and the situation.
2. Promotes engagement through consensus building and conflict management.
3. Participates in interprofessional activities to enhance knowledge, team performance, and outcomes.

A. Provides leadership for establishing, improving, and sustaining collaborative relationships to achieve safe,
high-quality care for women, newborns, and families.
B. Employs effective collaborative skills in the development and implementation of practice models, peer review,
practice guidelines, health policy, and standards of care to improve outcomes.
STANDARD 11: LEADERSHIP
The registered nurse should seek to serve as a role model, change agent, consultant, and mentor to women, families,
health care consumers, and other health care professionals.
Competencies
1. Models professionalism to women, families, health care consumers, and other health care professionals.
a. Displays teamwork, creativity, communication, and flexibility throughout conflict and times of change.
b. Contributes to the establishment of an environment that supports and maintains respect, trust, dignity, and a
passion for high-quality work.
c. Accepts responsibility for decisions and openly discusses ways to improve performance.
d. Provides mentorship to colleagues for the advancement of nursing practice and professional growth.
e. Demonstrates a commitment to continuous, lifelong learning for self and others.
2. Strives to create or maintain healthy work environments in local, regional, national, or international communities.
a. Inspires loyalty through valuing of people as the most precious asset in an organization.
b. Directs or participates in the coordination of care across settings and among caregivers, including oversight
of licensed and unlicensed personnel in assigned or delegated tasks.
c. Serves in key roles in the work setting by participating on committees, councils, and administrative teams
appropriate to their designated role.
d. Encourages innovation in practice and role performance to attain personal and professional plans, goals, and
vision.
3. Displays the ability to define a clear vision, associated goals, and a plan to implement and measure progress and
outcomes.
4. Promotes advancement of the profession through participation in professional organizations.
5. Develops, evaluates, and provides leadership for health care policy that impacts women, newborns, and families.
6. Advocates for social justice, equity, and ethical policies for women, newborns, and families.

A. Influences decision-making bodies to improve the professional practice environment and health care outcomes of
women and newborns.
B. Promotes advanced practice nursing and role development by interpreting the role for health care consumers and
policy makers.
STANDARD 12: EDUCATION
The registered nurse acquires and maintains knowledge and competencies that reflect current evidence-based
nursing practice for women, newborns, and families.
Competencies
1. Acquires knowledge, experiences, or skills reflective of current evidence-based practice to provide care to women
and newborns on a local or global scale.
2. Maintains licensure and certification as mandated by state licensing boards, health care facilities, and accrediting
agencies.
a. Participates in and maintains professional records of educational activities required to provide evidence of
competency.
b. Obtains and maintains specialty certification as appropriate within the area of practice.
c. Maintains a professional portfolio to provide evidence of individual competency and lifelong learning.
3. Demonstrates a commitment to lifelong learning through self-reflection and inquiry, including educational
activities related to evidence-based practice, knowledge acquisition, safety, and professional issues.
a. Identifies learning needs to assume the various nursing roles to promote the care of women and newborns.
b. Acquires knowledge of relevant practice parameters and guidelines of other organizations that focus on the
delivery of health care services to women and newborns.
c. Seeks experiences to maintain and advance current knowledge, skills, abilities, attitudes, and judgment in
practice.
4. Participates in formal consultations or informal discussions to address issues in nursing practice as an application
of educational findings, experiences, and ideas.
5. Mentors nurses (e.g., those who are new, experienced, or changing roles) by role modeling, encouraging, and
sharing pertinent information about the care of women and newborns.
6. Ensures an inclusive work environment supportive of ongoing education in support of the care of women,
newborns, and families.
7. Identifies modifications and accommodations needed in the delivery of education specific for women, newborns,
and their families.
STANDARD 13: EVIDENCE-BASED PRACTICE AND RESEARCH
The registered nurse generates or integrates evidence to identify, examine, validate, and evaluate interprofessional
knowledge, theories, and varied approaches in providing care to women and newborns.
Competencies
1. Articulates the values of evidence-based research and its application relative to the health care setting and practice.
2. Uses evidence-based practice, which includes the best available evidence, clinical judgment, and consumer
preferences, to guide practice decisions.
3. Participates in research activities appropriate to their position, education, and practice environment, including but
not limited to the following:
a. Identifies questions in the health care setting and practice that can be answered by research.
b. Incorporates evidence as a basis for learning and practice.
c. Appraises the clinical significance and application of evidence-based research findings for optimal women’s
health, obstetric, and newborn practice and outcomes.
d. Shares peer-reviewed evidence-based research findings with colleagues to accelerate the integration of
knowledge into nursing practice.
e. Participates in nursing unit, interprofessional, organizational, or community research programs.
f. Conducts and promotes research, scientific inquiry, and practice consistent with ethical guidelines.
g. Participates in data collection.
h. Evaluates the effect of nursing practice on outcomes.
i. Uses evidence-based findings for application in the development or revision of policies, procedures, and
guidelines for consumer care.
j. Participates as a member of funding groups, review panels, committees concerned with human subjects’
protection and review, or organizational review boards (e.g., institutional review boards [IRBs]).

A. Uses critical thinking skills to connect theory and research to practice.
B. Contributes to nursing knowledge by conducting or synthesizing research and other evidence that discovers,
examines, and evaluates current practice, knowledge, theories, criteria, and creative approaches to improve health
care outcomes locally, nationally, and globally.
C. Performs rigorous critique of evidence derived from databases to generate meaningful evidence for nursing
practice.
D. Promotes a climate of collaborative research and clinical inquiry.
E. Disseminates research findings through activities such as presentations, publications, consultation, and journal
clubs.
STANDARD 14: QUALITY OF PRACTICE
The registered nurse systematically practices, evaluates, and, if indicated, implements new measures to improve the
quality of nursing practice for women and newborns.
Competencies
1. Fosters quality nursing practice that is safe, effective, efficient, equitable, timely, and consumer-centered as
appropriate to their position, education, and practice environment (Institute of Medicine, 1999, 2001).
a. Identifies barriers, opportunities, and strategies to improve quality of practice.
b. Collects and analyzes data to monitor quality and safety and to improve nursing practice.
c. Uses creativity and innovation to enhance nursing care.
d. Participates in quality improvement initiatives.
e. Identifies aspects of practice important for quality monitoring.
f. Integrates the best available evidence into quality, safety, and effectiveness indicators, as appropriate, when
monitoring nursing practice.
g. Develops, implements, or provides at regular intervals critical review, revision, and evaluation of evidence-
based practice guidelines, policies, and procedures.
h. Participates in efforts to improve health care efficiency, such as ways to minimize costs and unnecessary
duplication, without compromising quality of care.
i. Formulates recommendations to improve nursing practice and consumer outcomes.
j. Engages in formal and informal peer review processes.
k. Collaborates on interprofessional teams that evaluate clinical practice and safety related to provision of health
services and that implement quality improvement plans and interventions, as indicated.
l. Documents nursing practice in a manner that supports quality and performance improvement initiatives.
m. Achieves professional certification, when available.
2. Uses the findings of quality-of-care activities to initiate and implement changes in practice with the goal of
enhancing quality, safety, and effectiveness of nursing practice and the health care system.
3. Protects the privacy of consumer information used to evaluate the quality of care, consistent with organizational
policy and state and federal laws.
4. Evaluates the influence of cultural factors on the quality of practice.
5. Promotes a practice environment that supports evidence-based, high-quality health care.
6. Contributes to nursing and interprofessional knowledge through scientific inquiry.

A. Engages in comparison evaluations of the effectiveness and efficacy of diagnostic tests, clinical procedures and
therapies, and treatment plans, in partnership with health care consumers, to optimize health and health care
quality.
B. Designs quality improvement studies, research, initiatives, and programs to improve health outcomes in diverse
settings.
C. Uses data and available benchmarks as a means to evaluate practice at the individual, departmental, or
organizational level.
STANDARD 15: PROFESSIONAL PRACTICE EVALUATION
The registered nurse evaluates their own nursing practice and participates in the evaluation of others in relation to
current evidence-based consumer care information, professional practice standards and guidelines, statutes, rules,
and regulations.
Competencies
1. Adheres to guidance about professional practice as specified in the ANA’s Nursing: Scope and Standards of
Practice, Third Edition (ANA, 2015c), and the ANA’s Code of Ethics for Nurses with Interpretive Statements (ANA,
2015a).
a. Adheres to nursing practice that is consistent with regulatory requirements pertaining to licensure, relevant
statutes, rules, and regulations.
b. Uses organizational policies and procedures to guide professional practice.
2. Engages in self-reflection and performance appraisal on a regular basis, identifying areas of strength as well as
areas where professional development would be beneficial.
a. Obtains formal and informal constructive feedback regarding their own practice from health care
consumers, peers, professional colleagues, supervisors, and others, consistent with established organizational
evaluation processes.
b. Takes action to achieve goals identified during performance appraisal.
c. Provides rationales for practice decisions and actions as part of the evaluation process that reflect current
evidence-based knowledge and professional practice standards and guidelines, laws, and regulations.
3. Provides peers and others with formal and informal constructive feedback regarding their practice or role
performance, as appropriate.
4. Influences organizational policies and procedures to promote interprofessional evidence-based practice.
STANDARD 16: RESOURCE UTILIZATION
The registered nurse considers resource factors related to safety, effectiveness, technological advances, and fiscal
responsibility when planning and delivering care to women and newborns.
Competencies
1. Assesses health care consumer needs, potential for harm, complexity of tasks, and resources available to achieve
desired outcomes.
a. Assists the woman and her family in identifying and securing appropriate and available interprofessional,
organizational, and community resources and services to address health-related needs across the health care
continuum.
b. Assists the woman and her family in becoming informed consumers and making decisions regarding
resources, factoring in the options, costs, risks, and benefits of treatment and care.
2. Evaluates factors such as safety, effectiveness, availability, cost and benefits, efficiencies, and impact on practice
when choosing practice options and resources.
3. Incorporates the most current technology in providing care and safety, documentation, and communication
whenever possible.
a. Advocates for resources that support and enhance nursing practice.
b. Integrates telehealth and mobile health technologies into practice to promote positive interactions between
health care consumers and care providers.
4. Assigns or delegates tasks based on evaluation of the needs and acuity of the woman or newborn, potential for
harm, stability of the consumer’s condition, complexity of the task, predictability of the outcome, and the
knowledge, skill, and scope of practice of the care provider.
5. Addresses discriminatory health care practices and the impact on resource allocation.

A. Designs innovative solutions to use resources effectively and maintain quality.
B. Creates evaluation strategies that address cost effectiveness, cost benefit, and efficiency factors associated with
nursing practice.
C. Assumes complex and advanced leadership roles to initiate and guide change.
D. Engages organizational and community resources to formulate and implement interprofessional plans.
STANDARD 17: ENVIRONMENTAL HEALTH
The registered nurse practices in an environmentally safe and healthy manner when planning and delivering care to
women, newborns, and families.
Competencies
1. Promotes a safe, healthy, and professional practice environment in the workplace.
a. Uses environmental health concepts when providing care.
b. Assesses the environment for risk factors impacting women and newborns.
c. Reduces environmental health risks to self, colleagues, women, and newborns.
d. Communicates information about environmental health risk and exposure reduction strategies in a timely
manner.
e. Advocates for safe and judicious use and disposal of products in the workplace.
f. Uses products and treatments consistent with evidence-based practice and recommended standards to reduce
environmental risk.
2. Incorporates technological use and advancement to promote safe practice environments.
3. Participates in the development of strategies to promote healthy communities and practice environments for women
and newborns.

A. Analyzes the impact of social, political, and economic influences on the global environment and health experience
for women and newborns.
B. Creates partnerships to promote sustainable global policies to prevent environmental hazards for women,
newborns, and families.
APPLICATION OF THE STANDARDS INTO
CLINICAL PRACTICE
The standards for professional nursing practice help to promote and guide clinical practice as well as provide an
evaluation tool to ensure clinical proficiency, clinical safety, and professional growth for registered nurses and
APRNs. Professional nursing standards are used to provide a framework for developing clinical competency
checklists and proficiency evaluations. However, professional standards may also be used as criteria of
achievement within a clinical ladder program.
Many health care organizations have developed clinical ladder programs as a way to recognize professional
advancement as well as to provide financial incentives, increase job satisfaction and staff morale, and aid in
recruitment and retention (Hespenheide, Cottingham, & Mueller, 2011; Zehler et al., 2015). Using tools provided
in these programs helps nurses to improve decision-making skills that may influence consumer outcomes and
contribute to professional growth and a healthy work environment (Fardellone & Click, 2013). Some studies
show that clinical ladders can be a roadmap to developing nurse leaders within the organization (Adeniran,
Bhattacharya, & Adeniran, 2012; Fardellone & Click, 2013).
INTRODUCTION TO THE CLINICAL LADDER TEMPLATE

To clearly illustrate how the AWHONN Standards for Professional Nursing Practice in the Care of Women and
Newborns, Eighth Edition, can be used in a health care organization’s or system’s clinical ladder, a template
including each standard’s competencies has been developed to reflect leveling throughout a clinical ladder tool.
This template may be downloaded and adapted to reflect an organization’s individual clinical ladder program.
The competencies identified at each level in the template may be adjusted to support the clinical and professional
expectations of the facility. The 2019 AWHONN Standards Revision Task Force used the following descriptions to
develop the clinical ladder template:
Clinical Nurse I: A clinical nurse I is an entry-level nurse who is learning to apply newly acquired knowledge and
skills to a multitude of clinical situations. Those practicing at the clinical nurse I level initially draw on learned facts
and rules to organize care and guide practice. As they gain experience, they are increasingly able to recognize the
uniqueness of each situation and modify care to meet individual health care consumers’ needs.
Clinical Nurse II: A clinical nurse II is a competent professional nurse who demonstrates the ability to recognize
patterns in clinical practice and uses this knowledge to make clinical decisions. Those practicing at this level
routinely draw on learned facts and experience as well as an understanding of outcomes when designing a plan of
care. They have confidence in their own decisions and abilities, personalize care for each health care consumer, and
act as resources to colleagues and strong advocates for health care consumers.
Clinical Nurse III: A clinical nurse III is a proficient professional nurse who demonstrates an in-depth knowledge
about the care of a particular population and an appreciation for the many factors that influence care. In caring for
each health care consumer, nurses at this level frequently consider what is most likely to happen given the clinical
and organizational factors at hand and tailor their care to ensure the best outcomes. The clinical nurse III values
the contributions of peers and colleagues in other disciplines and routinely consults with and serves as a resource to
others.
Clinical Nurse IV: A clinical nurse IV is an expert professional nurse who demonstrates exquisite foresight in
planning care. Nurses at this level are recognized as experts in their areas of specialization and are adept at
negotiating conflict and collaborating with others. They are able to respond intuitively to the needs of the health
care consumers they serve and to comfortably engage in clinically sound risk taking. Skilled at creative problem
solving and in working with others, they routinely lead efforts to strengthen the many organizational systems that
support care.
Based on these criteria, the task force identified key clinical and professional requirements that might be achieved
at each level. The competencies from each Standard of Practice or Standard of Professional Performance were
added into the appropriate level of the template. In addition, examples of certifications and educational programs
were added. It is important to note that all items in the previous level must be achieved in addition to the items in
the level for which the registered nurse is applying.
Many facilities use portfolios with a peer review process as a way for clinical nurses to demonstrate their
achievements and for application into a clinical ladder program. Registered nurses may easily adapt the
information from the AWHONN clinical ladder template into a portfolio by using certificates, memberships,
reviews, written clinical narratives, and other items. Implementing the AWHONN standards into a clinical ladder
program can help nurses recognize the skills required to contribute to high-quality care, enable healthy work
environments, and support the nursing profession.
AWHONN SAMPLE CLINICAL LADDER TEMPLATE
CLINICAL NURSE I (CNI) CLINICAL NURSE II (CNII) CLINICAL NURSE III (CNIII) CLINICAL NURSE IV (CNIV)
(Novice) (Competent) (Professional) (Expert)
All Components of CNI All Components of CNII All Components of CNIII
Education and Experience Education and Experience Education and Experience Education and Experience
• Entry level with diploma, associate’s, • Associate’s or bachelor’s degree, at a • Bachelor’s or master’s degree, at a • Bachelor’s or master’s degree, at a
or bachelor’s degree minimum minimum minimum
• Accumulates a minimum of 8 contact • 2 or more years of clinical experience • 4 or more years of clinical experience • 6 or more years of clinical experience
hours per year • Accumulates a minimum of 10 contact • Accumulates a minimum of 12 contact • Accumulates a minimum of 15 contact
hours per year hours per year hours per year
• Planning for or achieves national • Achieves national certification in area of
certification in specialty area specialty
Examples of course completion, if Examples of course completion, if Examples of course completion, if Examples of course completion, if
applicable to clinical setting applicable to clinical setting applicable to clinical setting applicable to clinical setting
• Basic Life Support (BLS) • The S.T.A.B.L.E. Program (STABLE) • AWHONN Advanced Fetal Heart • Ιnstructor Simulation Training
• Neonatal Resuscitation Program (NRP) • AWHONN Critical Care Obstetrics (CCOB) Monitoring Course • AWHONN Fetal Heart Monitoring Advanced
• AWHONN Introduction To Fetal Heart • AWHONN Maternal Fetal Triage Index • AWHONN Fetal Heart Monitoring Instructor course
Monitoring Course (MFTI) Educational Course Intermediate Instructor Course • AWHONN Fetal Heart Monitoring Instructor
• AWHONN Intermediate Fetal Heart • Advanced Life Support in Obstetrics • AWHONN Obstetric Patient Safety Trainer
Monitoring Course (within 6 months of (ALSO) Instructor Program
practice) • AWHONN Obstetric Patient Safety
• AWHONN Perinatal Orientation and Program (OPS)
Education Program (POEP) or Neonatal
Orientation and Education Program
(NOEP)
*Any suggested course may be replaced by a similar type of course, based on organizational requirements.
28
STANDARDS OF PRACTICE STANDARDS OF PRACTICE STANDARDS OF PRACTICE STANDARDS OF PRACTICE
1. Assessment: 1, 1a, 1b, 1c, 2b, 2d, 4, 1. Assessment: 2, 2c, 3 1. Assessment: 2a 1. Assessment: Additional A
5, 6 2. Diagnosis: 2 2. Diagnosis: Additional A 2. Diagnosis: Additional B, C
2. Diagnosis: 1, 1a, 1b, 3 3. Outcomes:1b, 2, Additional A 3. Outcomes: Additional C 3. Outcomes: Additional B
3. Outcomes: 1, 1a, 1c, 3, 4 4. Planning: 1c, 1f, 1g, 2, 3 4. Planning: 1e, Additional B 4. Planning: Additional A, C
4. Planning: 1, 1a, 1b, 1d, 4, 5 5. Implementation: 1c, 5 5. Implementation: Additional A 5. Implementation: Additional B, C, D, E
5. Implementation: 1, 1a, 1b, 2, 3, 4 5a. Coordination of Care: 5 5a. Coordination of Care: Additional B 5a. Coordination of Care: Additional A, C, D
5a. Coordination of Care: 1, 2, 3, 4, 6 5b. Health Teaching & Promotion: 1c 5b. Health Teaching & Promotion: 4, 5b. Health Teaching & Promotion:
5b. Health Teaching & Promotion: 1, 1a, 6. Evaluation: 1d Additional B Additional A
1b, 1d, 2, 3, 5 6. Evaluation: Additional B 6. Evaluation: Additional A
6. Evaluation: 1, 1a, 1b, 1c, 2, 3
Clinical Requirements Clinical Requirements Clinical Requirements Clinical Requirements
• Demonstrates entry-level nursing skills • Demonstrates mastery of technical skills • Acts as a resource to colleagues in • Is recognized as an expert in area of
• Seeks out and uses resources and • Is adaptable and flexible in managing relation to a particular consumer interest or specialization
colleagues to validate information to clinical situations population • Demonstrates foresight in anticipating and
maintain the standards of care • Begins to take clinically sound risks • Initiates independent learning based on planning regarding consumer and family
• Recognizes responsibility and their needs problems and concerns
• Supports and participates in orienting
accountability for their own practice new staff • Is adaptable and flexible in managing • Applies and shares relevant research with
unexpected clinical situations colleagues
• Recognizes the challenges of and
develops strategies for prioritizing and • Feels comfortable in taking clinically • Critically evaluates own decision making
organizing care sound risks and judgments
• Demonstrates a spirit of inquiry as it • Understands the impact of illness on the • Consistently takes clinically sound risks
relates to clinical practice (wants to know lives of the consumer and family • Independently seeks out opportunities to
why) learn, teach, and influence
Achieved = Achieved at previous levels
29
STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL

PERFORMANCE PERFORMANCE PERFORMANCE PERFORMANCE
7. Ethics: 1, 1a, 1b, 1d, 2, 4, 5, 6 7. Ethics: 1c, 3, 7. Ethics: 1e, 1f, 8 7. Ethics: 7
8. Culturally Congruent Practice: 1, 8. Culturally Congruent Practice: 2, 3, 7 8. Culturally Congruent Practice: 5 8. Culturally Congruent Practice: 6,
1a, 1b, 1c, 1d, 1e, 4 9. Communication: 2 9. Communication: Achieved Additional A, B, C, D
9. Communication: 1, 1a, 1b, 1c, 3, 3a, 10. Collaboration: 1c, 1d, 2 10. Collaboration: 1e, Additional A 9. Communication: Achieved
3b, 4, 5, 6, 7 11. Leadership: 1a, 1d, 1e, 2b 11. Leadership: 2c, 2d, 3, Additional A 10. Collaboration: Additional B
10. Collaboration: 1, 1a, 1b, 3 12. Education: 1, 2b, 5 12. Education: 2c, 3b, 4, 7 11. Leadership: 5, 6, Additional B
11. Leadership: 1, 1b, 1c, 2, 2a, 4 13. EBP & Research: 3b, 3d, Additional A 13. EBP & Research: 3c, 3e, 3h, 3i, 12. Education: Achieved
12. Education: 2, 2a, 3, 3a, 3c, 6 14. Quality of Practice: 1c, 1e, 1f, 1m, 2, 5 Additional E 13. EBP & Research: 3f, 3j, Additional B, C, D
13. EBP & Research: 1, 2, 3, 3a, 3g 15. Professional Practice Evaluation: 2c, 3 14. Quality of Practice: 1b, 1g, 1h, 1i, 1k, 14. Quality of Practice: 6, Additional A, B
14. Quality of Practice: 1, 1a, 1d, 1j, 1l, 16. Resource Utilization: 1a, 1b, 4 Additional C 15. Professional Practice Evaluation:
3, 4 17. Environmental Health: 1e 15. Professional Practice Evaluation: 4 Achieved
15. Professional Practice Evaluation: 1, 16. Resource Utilization: 2, 5, Additional 16. Resource Utilization: 3b, Additional C
1a, 1b, 2, 2a, 2b A, B, D 17. Environmental Health: Additional A, B
16. Resource Utilization: 1, 3, 3a 17. Environmental Health: 3
17. Environmental Health: 1, 1a, 1b, 1c,
1d, 1f, 2
Professional Requirements Professional Requirements Professional Requirements Professional Requirements
• Completes the orientation process • Actively supports or participates in the • Actively participates in the orientation • Assists and guides new preceptors in the
• Demonstrates safe consumer care orientation of new personnel of new personnel preceptor role
based on organizational policies and • Contributes to the nursing profession by • Completes preceptor education • Contributes to the nursing profession by
procedures, where applicable demonstrating membership to at least program demonstrating membership to at least two
• Supports unit-based quality improve- one professional nursing organization • Contributes to the nursing profession by professional nursing organizations
ment indicators. • Participates in unit-based product demonstrating membership to at least −− Attends at least two professional
evaluation or practice change one professional nursing organization. meetings per year or participates in a
−− Attends at least one professional committee or task force for a professional
• Participates in at least one health-related
meeting per year (local, regional, or nursing organization
activity (e.g., consumer health fair)
national) • Participates in at least one hospital-based
• Shares information gained from an committee
internal or external education program • Identifies departmental or hospital-wide
through an in-service activity or in-house quality issues and collaborates with others
publication toward resolution
• Actively participates in at least one • Actively participates in the research
quality improvement project or EBP process
effort (e.g., unit-based practice change)
30
GLOSSARY OF TERMS
Advanced practice registered nurse (APRN): A nurse who has obtained additional education, credentialing, expertise
beyond that of the registered professional nurse. The role of the APRN includes clinical nurse specialists, nurse practitioners,
nurse midwives, and nurse anesthetists. As a group, APRNs provide care across the spectrum of women’s health, obstetric,
and neonatal nursing.
Advocacy: The process of actively supporting the cause of, speaking or writing in favor of, or defending or interceding on
behalf of a person (case advocacy) or group (class advocacy). Action to ensure the best possible services for or intervention
in the service system on behalf of an individual or group. Advocacy may include providing information and tools for self-
empowerment in consumers’ health and social care and helping them obtain needed services.
Aggregate-level data: Data combined from several measurements. When using aggregate-level data, groups of observations
are replaced with summary statistics based on those observations.
ANA’s Code of Ethics: A list of nine provisions that serves as the ethical framework for nursing practice with descriptive
statements focusing on the primary goals, values, and obligations of the profession (ANA, 2015a).
Assessment: A systematic, dynamic process by which the nurse—through interaction with women, newborns, families,
significant others, and health care providers—collects, monitors, and analyzes data. Data may include the following
dimensions: psychological, biotechnological, physical, sociocultural, spiritual, cognitive, developmental, and economic, as
well as functional abilities and lifestyle.
Caring: The moral ideal of nursing consisting of human-to-human attempts to protect, enhance, and preserve humanity
and human dignity, integrity, and wholeness by assisting a person to find meaning in illness, suffering, pain, and existence
(Watson, 2012).
Collaboration: A professional health care partnership grounded in a reciprocal and respectful recognition and acceptance of
the following: (a) each partner’s unique expertise, power, and sphere of influence and responsibilities; (b) the commonality
of goals; (c) the mutual safeguarding of the legitimate interest of each party; and (d) the advantages of such a relationship
(ANA, 2015c, p. 86).
Competence: Having requisite qualities, knowledge, or abilities.
Competency: A measurable level of nursing performance that integrates knowledge, skills, abilities, and judgment based on
established scientific knowledge and expectations for nursing practice.
Complementary treatments: Treatments used alongside conventional medicine to complement the established plan of care.
These may include the use of natural products or therapies involving mind and body medicine.
Consumer: Any actual or potential recipient of health care, such as a patient or family member. (See also health care
consumer.)
Continuity of care: An interprofessional process that includes health care consumers’ families and other stakeholders in
the development of the coordinated plan of care. This process facilitates the transition between settings and health care
providers, based on changing needs and available resources (ANA, 2015c, p. 86).
Glossary Of Terms (Continued)
Continuum of care: The delivery of health care for women, newborns, families, and groups over a period of time.
Cultural congruence: The application of evidence-based nursing that is in agreement with the preferred cultural values,
beliefs, worldviews, and practices of the health care consumer and other stakeholders.
Cultural sensitivity: The ability to be appropriately responsive to the attitudes, feelings, or circumstances of groups of people
that share a common and distinctive racial, national, religious, linguistic, or cultural heritage (Office of Minority Health,
2001, p. 131).
Data: Discrete information that is described objectively without interpretation.
Delegate: The transfer of responsibility for the performance of a task to another individual while retaining accountability for
the outcome.
Diagnosis: A clinical judgment about the health care consumer’s response to actual or potential health conditions or needs.
Diagnoses provide the basis for determination of a plan of nursing care to achieve expected outcomes.
Diversity: A set of evolving attributes that encompasses but is not limited to age, class, culture, special health care needs,
education level, ethnicity, family structure, gender, gender diversity, ideologies, political beliefs, race, religion, sexual
orientation, lifestyle, and values.
Environmental health: A combination of factors that comprise those aspects of human health, including quality of life, that
are determined by physical, chemical, biological, social, spiritual, and psychosocial influences.
Equity: The absence of avoidable or remediable differences among groups of people, whether those groups are defined
socially, economically, demographically, or geographically (WHO, 2018).
Equitable health care: Accessible health care for all individuals that is affordable, high in quality, culturally sensitive, timely,
and linguistically appropriate.
Ethical framework: A set of codes in which nurses and providers base their practice. Major principles of ethics include the
following (ANA, 2015b):
• Autonomy: The right of health care consumers to make decisions about their medical care without their health care
provider trying to influence the decision.
• Confidentiality: The right of an individual to have personal, identifiable medical information kept private.
• Nonmaleficence: An intention to avoid harm or injury that can arise through acts of commission or omission.
• Beneficence: Taking actions that serve in the best interest of the health care consumer and family.
• Justice: A concept involving fairness, equality, and equitable treatment.
• Fidelity: Keeping commitments based on caring and virtue.
• Principles of totality and integrity: Taking the time to consider the entire person when deciding which therapies,
medications, or procedures should be offered or used in treatment.
Evaluation: The process of determining the health care consumer’s progress toward attainment of expected outcomes and
the effectiveness of nursing care.
Evidence-based practice: A lifelong problem-solving approach that integrates the best available evidence from well-
designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health
care consumer’s history and condition; available resources; and the health care consumer, family, group, community, and
population preferences and values (ANA, 2015c, p. 87).
Expected outcomes: Response to nursing interventions that are measurable, observable, and most often desirable.
Family: A unit of interacting individuals whom the woman or health care consumer recognizes as significant and perceives
as important.
Guideline: A framework developed through experts’ consensus and review of the literature, which guides health-care-
consumer-focused activities that affect the provision of care.
Health: An individual’s experience that is often expressed in terms of wellness and illness and may occur in the presence or
absence of disease or injury.
Health care consumer: A person, client, family, group, community, or population who is the focus of attention and to whom
the registered nurse is providing services as sanctioned by state regulatory bodies (ANA, 2015c, p. 88).
Health diplomacy: The chosen method of interaction between stakeholders engaged in public health and politics for the
purpose of representation, cooperation, resolving disputes, improving health systems, and securing the right to health for
vulnerable populations (Lee & Smith, 2011).
Health literacy: The degree to which individuals have the capacity to obtain, process, and understand basic health
information and services needed to make appropriate health decisions.
Health care provider: Individuals with expertise who provide health care services or assistance to health care consumers.
Holistic care: A system of comprehensive health care that considers the physical, emotional, social, economic, and spiritual
needs of the person; their response to illness; and the effect of the illness on actualization of human potential.
Illness: The subjective experience of discomfort, disharmony, or imbalance.
Implementation: The process of taking action by intervening, delegating, teaching, monitoring, providing counsel, or
coordinating. Women, newborns, families, significant others, or health care providers may direct the implementation of
interventions within the plan of care.
Interprofessional team: A group of diverse health care professionals possessing unique characteristics yet sharing
complementary knowledge, experiences, skills, or attitudes for the purpose of achieving a common goal or outcome, usually
specific to the health care consumer.
Nursing: The protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation
of healing; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of
individuals, families, groups, communities, and populations (ANA, 2015c, p. 88).
Nursing practice: The collective professional activities of nurses, characterized by interrelations of human responses, theory
application, nursing actions, and outcomes (ANA, 2015c, p. 88).
Nursing process: A critical thinking model used by nurses in providing care to health care consumers that integrates the
following components: assessment, diagnosis, outcomes identification, planning, implementation, and evaluation.
Oppression: When a dominant group develops a series of norms and regards outsiders as inferior, oppression may be
characterized by unfair behavior, ignoring others’ rights, or disrespecting their dignity.
Oppression of practice: When registered nurses and APRNs are not allowed to practice to the fullest extent of their
education and license.
Plan of care: A comprehensive outline of the components that need to be addressed to attain expected or desired outcomes.
Quality: The degree to which health services for women, consumers, families, groups, and communities increase the
likelihood of desired outcomes and are consistent with current professional knowledge (ANA, 2015c, p. 89).
Registered nurse: A health care professional who has successfully completed a nursing education program and licensure or
registration process approved by a province, territory, or state. For the purpose of this document, the term nurse refers to the
registered nurse.
Scope of nursing practice: The range of roles, functions, responsibilities, and activities that a registered nurse is educated,
competent, and has authority to perform. The scope of nursing practice may vary by state and is defined by individual state
boards of nursing and institutional rules.
Social justice: The fair and proper administration of laws conforming to the natural law that all persons, irrespective of
diversity (e.g., ethnic origin, gender, economic status, race, religion, sexual orientation, age, language, literacy), are to be
treated equitably and without prejudice.
Standard: Authoritative statement defined and promoted by the profession and by which the quality of practice, service, or
education can be evaluated.
Standards of practice: Authoritative statements that describe competent clinical nursing practice for women, newborns, and
families demonstrated through assessment, diagnosis, outcome identification, planning, implementation, and evaluation.
Standards of professional performance: Authoritative statements that describe competent behavior in the professional
role, including activities related to quality of practice, education, professional practice evaluation, ethics, collegiality,
collaboration, communication, research, use of resources and technology, and leadership.
Traditional treatments: The sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences
indigenous to different cultures, whether explicable or not, used in the maintenance of health and the prevention, diagnosis,
improvement, or treatment of physical and mental illness (WHO, 2013).
Worldview: The way people look at the universe and form a picture or value about their lives and the world around them
(Leininger, 1995, p. 105).
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STANDARDS FOR PROFESSIONAL NURSING PRACTICE
IN THE CARE OF WOMEN AND NEWBORNS
EIGHTH EDITION
ASSOCIATION OF WOMEN’S HEALTH, OBSTETRIC AND NEONATAL NURSES
1800 M STREET NW, SUITE 740S • WASHINGTON DC 20036

MAIN 1-800-673-8499 • 1-800-245-0231 (CANADA)
FAX 202-728-0575 • WWW.AWHONN.ORG

AWHONN Standards 8th Ed. 2019

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STANDARDS

Association of Women’s Health, Obstetric and Neonatal Nurses

©2019 AWHONN. All rights reserved.

2019 AWHONN STANDARDS REVISION TASK FORCE

Joan Edwards, PhD, RNC, CNS, FAAN, Team Leader

2019 AWHONN STANDARDS REVIEWERS

Jeanne L. Alhusen, PhD, CRNP, RN

Susan Hale, DNP, RN, C-EFM, AWHONN Member

INTRODUCTION TO THE EIGHTH EDITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

COMPONENTS OF THE STANDARDS OF PRACTICE, EIGHTH EDITION . . . . . . . . 5

COMPONENTS OF THE STANDARDS OF PROFESSIONAL PERFORMANCE,

APPLICATION OF THE STANDARDS INTO CLINICAL PRACTICE . . . . . . . . . . . . 26

THE FOUNDATION OF WOMEN’S HEALTH, OBSTETRIC, AND NEONATAL NURSING

2. Nursing practice is individualized.

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

Additional competencies may include:

INTRODUCTION TO THE CLINICAL LADDER TEMPLATE

All Components of CNI All Components of CNII All Components of CNIII

STANDARDS OF PRACTICE STANDARDS OF PRACTICE STANDARDS OF PRACTICE STANDARDS OF PRACTICE

Clinical Requirements Clinical Requirements Clinical Requirements Clinical Requirements

Achieved = Achieved at previous levels

STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL STANDARDS OF PROFESSIONAL

Professional Requirements Professional Requirements Professional Requirements Professional Requirements

Competence: Having requisite qualities, knowledge, or abilities.

Data: Discrete information that is described objectively without interpretation.

Illness: The subjective experience of discomfort, disharmony, or imbalance.

Schmidt, B. J., MacWilliams, B. R., & Neal-Boylan,

Spector, N., & Kappel, D. (2012). Guidelines for using

Stevens, K. (2013). The impact of evidence-based practice

Warman, G.-A., Williams, F., Herrero, A., Fazeli, P., &

Watson, J. (2012). Human caring science: A theory of nursing

World Health Organization. (2013). WHO traditional

World Health Organization. (2018). Health systems: Equity.

ASSOCIATION OF WOMEN’S HEALTH, OBSTETRIC AND NEONATAL NURSES

1800 M STREET NW, SUITE 740S • WASHINGTON DC 20036

FAX 202-728-0575 • WWW.AWHONN.ORG

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