Transcript Introduction to 12-Lead ECG Interpretation

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 goals
 Safety and infection control
 Cultural diversity and sensitivity
 Patient’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
 Based
& measurable
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 performance
 Meet regulatory standards
 Address problematic issues
 Enhance 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 statement
 Skill list
 Self-assessment
 Evaluation method
 Age-specific skills
New Graduate Orientation
 Start with the orientation checklist
provided by the School of Nursing
 Same checklist, but lengthen the time
 Steady preceptor
Floating Nurse
 Standardize processes between floors
 Documentation
 Admission process/paperwork
 Discharge process/paperwork
 Medication 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
 Equipment
 Fax
 Pager
system
 Xerox
 Phone Etiquette
 Unit 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.
Initial Competency Sample
ER
OR RR
ICU Total
% of
100
Competency
#1 #2
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%
Disciplinary Actions
 Switch preceptors
 Provide avenue for retraining or
lengthened orientation process
 Consider other work locations more
suitable for the staff member skills
 Set policy guidelines for dismissal
On-going Assessment
 New machines
 Low volume, high risk procedures
 Evidence based changes in practice
 Changes in policy
 Sentinel events
 New patient populations
 Problematic issues
On-going Competency Sample
Competency
Jul Aug Sep Oct Nov Dec Total
Blood Culture
15
Medication
Administration
Zoll
Defibrillator
20
30
10
35
10
19
50
25
25
% of
100
75
75%
64
64%
100
100%
On-going Assessment
 Focus on proficiency
 What skills make a difference
 Performance
improvement initiatives
 New procedures/technologies
 New 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.