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In the world of hospital based nursing, there are far fewer standardized parameters surrounding assessment of competence.  From a purely regulatory standpoint The Joint Commission requires the following:

  • Staff are competent to perform their responsibilities

Elements of Performance:

  • Staff competence is assessed and documented once every three years or more frequently as required by hospital policy or in accordance with law and regulation.
  • The hospital uses assessment methods to determine the individual's competence in the skills being assessed.  (Note: Methods may include test taking, return demonstration, or the use of simulation)
  • An individual with the education background, experience, or knowledge related to the skills being reviewed assesses competence.  (Note: When a suitable individual cannot be found to assess staff competence, the hospital can utilize and outside individual for this task.  Alternatively, the hospital may consult the competency guidelines from an appropriate professional organization to make it's assessment.)
  • Staff competence is initially assessed and documented as part of orientation.
  • The hospital takes action when a staff member's competence does not meet expectations.

Each organization is left to develop their own competencies in what ever format they like.  

For AACN, as a specialty nursing organization, we are the standard setting organization for acute and critical care nurses.  We have contributed to the development of standardized content for competencies through a variety of mechanisms such as the AACN Procedure Manual for Critical Care, the Scope and Standards for Acute and Critical Care Nursing Practice, etc.  Additionally, we have a Certification Corporation that offers several certifications for acute and critical care nurses.  Renewal of these certifications is currently accomplished by either re-testing or by obtaining a certain number of continuing education credits in specific categories AND by having  a certain number of clinical practice hours specific to that certification.  We are looking more and more closely at the assessment of continued competence for certificants but no action plan for that at the moment.  

Mary Pat Aust

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