Why is competency testing so difficult and elusive?
External forces pushing for better tools
Part of the problem with competency testing is a lack of uniform standards and universally accepted measurement tools, says Georgiann Homuth, RN, MS, CCRN, a clinical nurse specialist and competency assessment expert at Swedish American Health System in Rockville, IL.
Although there are helpful resources available to hospitals, such as nursing certification exams and published research, there are no widely used or accepted guidelines in critical care, she says.
Technology is another factor. Critical care is extremely technology-driven, and many nurses can’t stay abreast of new protocols or developments in the field. As a result, many competency tests don’t necessarily reflect the best evidence-based practice, nurses say.
However, the field is changing. "Accredita-tion bodies such as the Joint Commission on Accreditation of Health Care Organizations are demanding stronger proof of staff competencies," says Sara Moore, RN, MSN, CCRN, a critical care nurse for the Department of Veterans Affairs Medical Center (VA) in West Palm Beach, FL, who developed the hospital’s competency assessment tool.
State laws are also requiring that providers demonstrate nurse competencies. Local regulatory agencies are using demonstrated clinical competence as a benchmark for patient safety and quality assurance.
In fact, the certification program for clinical nurse specialist sponsored by the American Association of Critical Care Nurses Certification Corp. (AACNCC) in Aliso Viejo, CA, reflects the trend among states demanding more evidence of skills-based performance from ICU nurses.
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