Nursing competency is the ability of a nurse to demonstrate personal traits, professional attitude, his/her values, and the set of knowledge and skills applicable in fulfilling professional responsibility in practice. My organization uses the Performance-Based Development System (PBDS) to assess nurses based on their interpersonal skills in relation to evidence-based practice (Bezemek, 2017). Therefore, this assessment focuses on the nurse’s conflict management abilities, clinical reasoning, communication skills, and teamwork in terms of his/her stimulus and response (Lasater & Nielsen, 2009). For instance, information about a patient’s scenario like diagnostic and lab reports are presented before the nurse. Thereafter, lead-in questions follow to trigger responses from the nurse. He/she must demonstrate the ability to identify the patient’s problem and provide recommendations about the best interventions to solve the problem in order of priority. In this case, the nurse’s competency will be based on his/her clinical reasoning skills and critical thinking capacity that will depend on the patient’s unique needs and the environment of care. Therefore, the organization evaluates the responses to the questions based on a standardized qualitative analysis procedure. From the assessment results, it becomes easier to rate the level of nurse’s competency.
Formal tool
The organization uses professional/ethical practice and holistic approaches to care and the integration of knowledge, which are the two formally accepted tools within the context of domains of competence. The former evaluates if the nurse applies ethical principles and considers the implications of those guidelines for nursing practice. Additionally, it looks into compliance with the policies, procedures, and standards in providing safe, effective, and efficient care. Similarly, professional/ethical practice determines the levels of nurse’s ability to recognize his/her limits of competence based on the dissemination of knowledge and skills development in trying to fulfill nurse’s roles. The second formal tool, holistic approaches to care and the integration of knowledge, will depict the ability of the nurse to implement and utilize the correct patient assessment framework safely and accurately. For instance, it will determine if the nurse can identify the needs of the patient and provide a rationale for the findings.
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Can we observe “competency”, or can we measure it in another way?
Competency can be observed although direct observation is subject to bias and requires the assessor to familiarize him/herself with the clinical and practical setting during evaluation. This implies that the reliability of the results is questionable. Therefore, competency can also be measured by the use of portfolios. This tool involves a collection of evidence that depicts the nurse’s skills, knowledge, attitudes, and achievements over a given duration. For example, portfolios provide adequate evidence regarding the ability of the nurse to demonstrate self-regulation, writing skills, and critical reflection capacity.
Suggestions for improving quality and consistency of care
Improving quality and consistency of care should be based on the use of evidence-based practice and working in interdisciplinary teams. Notably, evidence-based practice facilitates redesigning of care to ensure that service provision is effective, safe, and efficient (Rubenfeld & Scheffer, 2015). This will be possible since evidence-based practice will integrate the best research with clinical expertise by prioritizing patient values. Consequently, nurses will provide optimum care as they conduct further research to improve care. Additionally, working in interdisciplinary teams will promote cooperation, collaboration, and effective communication whilst integrating care among team members. Therefore, nurses will provide continuous, reliable, and quality care to patients. Collective goal-setting, decision making, and sharing resources to accomplish specific objectives will improve consultations among team members and also ensure better patient outcomes and continuous patient satisfaction. However, both evidence-based practice and working in interdisciplinary teams will depend on nurse’s levels of critical thinking skills. This is because critical thinking tactics will help them identify the folly in solving problems based on linear thinking (Robert, & Peterson, 2013). Therefore, the two suggested core competencies will improve nurses’ critical thinking capabilities and ensure that they deliver top-notch care consistently.
References
Bezemek, R. (2017). Leading the Way. Assessing nurses’ competency to achieve highly reliable care. American Nurse Today. https://www.americannursetoday.com/wp-content/uploads/2016/12/ant1-Competency-1213.pdf
Lasater, K, & Nielsen, A. (2009). Reflective journaling for clinical judgment development and evaluation. Journal of Nursing Education , 48(1). 40-44.
Robert, T., & Peterson, S. (2013). Critical thinking at the bedside: Providing safe passage to patients. MedSurg Nursing , (22), 2, 85-91.
Rubenfeld, M. G., & Scheffer, B.K. (2015). Chapter 4: Critical thinking TACTICS for nurses: Achieving the IOM competencies (3rd ed.). Sudbury, MA: Jones and Bartlett.
