Competency Days Help Ensure Nursing Knowledge

"Each year, we look at what's been going on in the hospital and decide where we want to focus across the board," says Siddell. For example, the hospital purchased smart pumps in 2007 and found some knowledge gaps in the equipment at first, so they made competency training a requirement for everyone. Other years, there may be a type of medication error that needs to be focused on. Restraints are often a focus point.

"When we first went to the department about the steering committee, we asked, 'How do we define competency?' There wasn't any defined method of doing that in the department," says Urban. "What we did was made a definition, created a mission statement, developed a policy with human resources on competency, and determined who is responsible for what."

The steering committee meets with educators, managers, and representation from HR, and the group looks globally at what nurses need to be validated on to have their core competencies covered.

To keep requirements reasonable, the committee determined that there would be no more than 10 core competencies covered to avoid overwhelming the staff. These 10 can be made up of a combination of core competencies required globally, as well as those for individual units. This year, for example, the steering committee decided on six core competencies, leaving four additional competencies to be identified for individual units.

Those requirements are identified after the core competencies, when educators go back to speak with managers to discuss what areas they feel nurses need to be validated in to ensure competency.

Scheduling challenges
Timing and resources are everything when planning a competency day. Making sure you have the resources to man the stations and identifying the number of offerings you need to have can be a challenge.

"It takes time," says Freeland-Wasel. "We needed to go back to see how many could go through the fair at the same time."

"One of our struggles at first was scheduling; the mandatory nature of it," says Siddell. "We were setting up approximately three days a month, and during the first part of the year, they were not well attended."

Then, when staff members realized they still needed to attend a competency day, attendees would swell to unmanageable numbers. The education department went back to examine exactly how many attendees it could handle at once. It then went back to managers to organize the number of staff who would be scheduled to attend each fair.

"Doing this helped us push the issue about being more proactive about how they were scheduled," says Siddell.

Another issue was that Saint Francis originally scheduled some point-of-care testing during the competency days, and it was a struggle at first to get managers and staff to plan accordingly.

The hospital has seen a massive jump in staff finishing their competencies since taking on a more structured scheduling process, says Urban.

"We probably had around 40% finishing their competencies at first, and now we have over 90%," not including nurses on maternity leave, leaves of absence, or other excused absences, says Urban.

It all ultimately ties into the MRP journey, Siddell says. With St. Francis' focus on revamping the shared governance structure and some of these core processes, the ultimate goal in mind is the highest quality education and training.

One piece of advice for a hospital just starting to revamp its competency training: Don't go at it alone.

"I would say to someone starting from scratch: Talk to a hospital that is already doing it," says Urban. "Starting from square one, it took us from 2005. It's a process."