Patient deaths at VA hospitals in Denver and New York City, as well as an overall indictment of nurse competency and processes at Veterans Health Administration facilities in general, are reminders of the critical need for not only training—but retraining—nurses.
Moreover, a report suggests that merely having training requirements on paper isn't enough. Instead, facilities need to have processes in place to make sure that the training actually happens and happens when it's supposed to.
A report issued in late April by the Department of Veterans Affairs Office of Inspector General finds that although all 29 of its facilities included in the evaluation had RN competency assessment and validation policies/processes in place, they varied by location and were not consistently followed.
For example, the report points to one RN whose last documented telemetry use competency training was 13 years ago, "despite facility annual competency requirements."
In another case, there was no ongoing process to assess and validate RNs cardiac monitoring competencies, and managers knew that their RNs lacked the related skills.
At each of the facilities in the examples above, patients died. Although inspections couldn't prove that nurses' skill deficiencies were directly to blame for the patient deaths, deficiencies were found nonetheless.