Are Competencies Really Necessary
By Brenda Miller, Trish Wackler, Stephanie Hisey, and Angi Deere
A competent nurse contributes to patient safety and satisfaction. Competencies are important because they provide a method of measurement to validate an individual has an ability or a skill. At Premier Health, competencies are measured utilizing several different methodologies. A few examples are OnSomble-OnRole, the Donna Wright Competency Assessment Model, and Resuscitation Quality Improvement (RQI). This article will describe each of the various methods.
OnSomble - OnRole is a measurement tool that facilitates nursing workforce competency and professionalism. This allows clinical and nursing leaders throughout the organization to assess themselves against a predefined set of professional behaviors (role competency). Some of the benefits of this measurement tool are:
· Uses novice to expert scale for measurement
· Identifies strengths and opportunities
· Peer review: a 360-degree evaluation that allows the individual to compare his/her self-assessment against assessments completed by peers and their immediate supervisor
· Provides data to support individualized development plans for continual professional growth
· Supports the Premier Health Professional Practice Model
The Donna Wright Competency Assessment Model validates clinical skill and/or professional behavior. It is utilized across Premier Health for annual competency evaluation. Currently, each facility determines the timeframe for competency assessment. In addition, each nursing unit’s members determine which competencies will be completed for the given year. The competency determination is done through collaboration with the nursing staff, the unit educator, and the nursing manager. These groups enter topics into a worksheet that divides potential competency topics into four categories:
New products, policy changes, initiatives, equipment
Changes in procedures, policies, initiatives
High-risk aspects of the job
Problematic aspects of the job
The suggested topics are then reviewed and determined to be a high, medium or low priority. Based on these determinations, the topics are selected, and the verification methods are created. Ms. Wright has identified 11 different verification methods that can be utilized. Employees are given the opportunity to choose the verification method they prefer and complete this by the due date. The educator then determines if the employee has met the competency requirements. This model creates a culture of success focused on the mission of the organization and positive employee behavior.
Resuscitation Quality Improvement (RQI) is a collaborative program between the American Heart Association (AHA), Laerdal, and Healthstream. The premise of this program is to provide a platform for ongoing education and skills training to create a maintenance of competency (MOC). Evidence clearly supports that skills not used frequently will decay rapidly over a period of about 3-6 months. The key points of this competency are:
· A more efficient, practical, flexible, and modern program that meets our clinical leaders’ schedules and patient needs
· Modules replacing the classroom component are placed on the employees’ Healthstream account annually and can be completed in small increments over the course of the calendar year
· The hands-on skills required for CPR and ACLS are demonstrated quarterly through 24/7 access to the mannequin-skills carts
· Successful completion of the mannequin activity generates an e-card which extends the expiration date of the certification by 3 months
· Supports staff accountability by visually being able to see expiration/due dates
Competencies are more than a checklist. They support better outcomes, an engaged workforce, and a positive patient experience. They are the interweaving threads that connect the different components of the nursing model at Premier Health, which ultimately leads to the building of healthier communities.
Wright, D. (2005). The Ultimate Guide to Competency Assessment in Health Care (3rd. ed.). Minneapolis, MN: Creative Health Care Management, Inc.
Meaney, P. A. et. al (2013). CPR Quality: Improving cardiac resuscitation outcomes both inside and outside the hospital: A consensus statement from the American Heart Association. Circulation; doi: 10.1161/cir/0b013e31829d8654.