Explain each of the Institute of Medicine’s five core competencies and describe ways in which nursing practice can meet each of these. Identify at least one obstacle for each and explain in detail how it can be overcome.

I. Provide patient-centred care This core competency entails identifying and respecting patients’ values, differences and attending to their varying needs. The competence requires that clinical decisions should be guided by the patient values and preferences. Nurses can meet this core competence by listening  6 to the patient concerns, respecting their preferences and expressed needs, involving them in the decision-making process and focusing on patients’ population health. The major obstacle towards the provision of patient-centred care is staffing constraints such as high staff workloads, fatigue and pressure (Roberts, 2016). Fixing staffing issues requires a coordinated effort between the government and healthcare institutions. The government needs to invest more in learning institutions that offer nursing training to expand their capacity. This way, more nurses will be trained to match the ever-increasing demand for nursing services. Nurses also need to be given a conducive working environment that protects them from mental illness (Roberts, 2016). II. Work in interdisciplinary teams This core competence requires nurses to apply an interdisciplinary approach in their practice. It entails working with different teams from different disciplines to meet a common goal by sharing responsibilities and resources. Nurses can meet this core competence by collaborating, communicating and cooperating with other practitioners (Roberts, 2016). They can also meet it by integrating care to ensure that the services provide are reliable and continuous. One major obstacle to working in interdisciplinary teams is the lack or absence of clearly stated and shared goals or purpose. When a team does not have a common knowledge of their destination, they tend to work in conflicting ways. The solution to this obstacle is to set a clear goal or purpose for the organization. The set goal or purpose must be understood by all members, and it should be measurable. Establishing progress periodically helps in tracking the process towards achieving the organization’s goal (Roberts, 2016). III. Employ evidence-based practice

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