competency: an overview of resources diane l. paulson, rn, msn, maj (ret)
TRANSCRIPT
Competency: An Overview of Resources
Diane L. Paulson, RN, MSN, MAJ (Ret)
Competency is…
“A determination of an individual’s skills, knowledge, and capability to meet defined expectations”
Joint Commission says…
HR1.2 – Define and verify HR2.1 – Orientation
Mission and goalsSafety and infection controlCultural diversity and sensitivityPatient’s rights and ethics
Joint Commission says…
HR 2.2 – Patient & environmental safety HR 2.3 – On-going education HR 3.1 – Competency assessment
Systematic & measurableBased on:
Evaluations Performance improvement Needs assessments
Joint Commission Intent
Orient staff BEFORE they provide direct care Base evaluations on job descriptions Tailor age-specific knowledge and skills Utilize professional associations Prioritize initial competencies
HIGH-RISK and PROBLEM-PRONE processes Reassess
Per hospital policy Based on learning needs
Joint Commission Reference
Assessing Hospital Staff Competence (2007) www.jcinc.com/889/
The Joint Commission Guide to Staff Education (2002) ISBN: 0-86688-725-3 Order Code: SEG-100ACF Price: $55
Managing Performance Measurement Data in Health Care Order Code: SITHC-01ACF Price: $55
Goals of Competency Assessment
Evaluate individual performanceMeet regulatory standardsAddress problematic issuesEnhance performance review process
Assessment Strategies
Orientation Newcomer’s Orientation Department of Nursing Orientation Unit Specific Orientation
On-going assessment Skill Fairs Online programs Self-study packets Unit specific requirements
New Hire Assessment
License and certifications verification Samples of orientation packets
RNS incorporated (www.rnsonline.com) Emergency Services Specific Competency
(www.ena.org) 3W Generic plus RN & LPN CBO’s
([email protected]) Madigan Army Medical Center Competency
Verificaton Record – DEM ([email protected])
Format Possibilities
Definition statementSkill listSelf-assessmentEvaluation methodAge-specific skills
New Graduate Orientation
Start with the orientation checklist provided by the School of Nursing
Same checklist, but lengthen the timeSteady preceptor
Floating Nurse
Standardize processes between floorsDocumentationAdmission process/paperworkDischarge process/paperworkMedication schedules
Focus on high-risk, problem-prone issues for each floor
Provide time for orientation prior to need
Agency Nurse Joint Commission on orientation
HR.3.10 The hospital needs to provide orientation to the
organization and any department specific and job specific information and training
Joint Commission on competency Letter from contractor Information from past and current employers Peer recommendations Validating specialty certifications Ongoing performance data collection Skills observation
Clerks/Administrative Staff
EquipmentFaxPager systemXerox
Phone EtiquetteUnit management
Competency Databases
PBDS www.pmsi-pbds.com EmpTrack www.empxtrack.com
Dumpe, M., Kanyok, N., & Hill, K. (2007). Use of an Automated Learning Management System of Validate Nursing Competencies. Journal of Nurses in Staff Development. July/August, 23 (4): 183-185.
Competency #1 #2 ER OR RR ICU Total% of 100
Orientation 15 10 15 10 15 10 75 75%
BLS 15 20 10 9 6 5 64 64%
Zoll Defibrillator 15 20 20 15 15 15 100 100%
Initial Competency Sample
Disciplinary Actions
Switch preceptorsProvide avenue for retraining or
lengthened orientation processConsider other work locations more
suitable for the staff member skillsSet policy guidelines for dismissal
On-going Assessment
New machinesLow volume, high risk proceduresEvidence based changes in practiceChanges in policySentinel eventsNew patient populationsProblematic issues
Competency Jul Aug Sep Oct Nov Dec Total% of 100
Blood Culture 15 20 30 10 75 75%
Medication Administration 35 10 19 64 64%
Zoll Defibrillator 50 25 25 100 100%
On-going Competency Sample
On-going Assessment
Focus on proficiencyWhat skills make a difference
Performance improvement initiativesNew procedures/technologiesNew policies
Based on survey results
Verification Methods Test/exam Return Demonstration Evidence of daily work Case Studies Exemplars Peer Review Self Assessment Discussion/reflection groups Presentations Mock events/Surveys Quality improvement monitors
Competency: More than a checklist
Include Joint Commission specifics Based on job description Skill development Skill maintenance Remediation Redevelopment
Resources Books
Joint Commission – Assessing Hospital Staff Competence (www.jcrinc.com)
Competency Management for the Medical-Surgical Unit (www.hcmarketplace.com)
Wright, Donna – The ultimate Guide to Competency Assessment in Health Care (www.amazon.com)
Systems Critical Check Lists (www.decisioncritical.com or
www.4nursingmanagers.com ) NurseTesting (www.nursetesting.com or
www.4nursingmanagers.com) Orientation to Emergency Nursing (www.ena.org) PBDS (www.pmsi-pbds.com)
References
www.jointcommission.org Whelan, L. (2006) Competency Assessment
of Nursing Staff. Orthopaedic Nursing, May/June 2006, 25(3), pp. 198-202.
Wright, D. (2005) The Ultimate Guide to Competency Assessment in Health Care, 3rd ed. Creative Health Care Management, Inc., Minneapolis, MN.