The Importance of Continued Clinical Competency in Nursing Practice

Avoiding Liability Bulletin – October 1, 2016

Continued clinical competency is a topic that has gained much attention in nursing in recent years.  Debates and comments as to how competency is measured in any nursing practice, how competency can be improved, and what approaches are best to increase and maintain competency abound in all forms of nursing literature.

One definition of competence is the potential ability to function in a given situation while competency is the actual performance in a given situation.¹  Continuing competence has been defined by 2 nurse authors as “the on-going commitment of a registered nurse to integrate and apply the knowledge, skills, and judgement with the attitudes, values and beliefs required to practice safely, effectively and ethically in a designated role and setting.”²

Although the above definition of clinical competence specifically refers to registered nurses (RNs), it can also be applied to all levels of nursing practice. Whether you are an R.N. assessing a newly admitted patient to your unit, a nurse’s aide feeding a patient or a student in a nursing education program, continued clinical competence is essential.

The definition of clinical competence clearly refers to individual competence.  However, competence of the nursing team is also essential.³ As a result, all team members must constantly maintain and improve their individual and collective proficiencies.

An aspect of continued clinical competency includes accountability and responsibility, not only for your clinical practice, but also when you may not be clinically competent to perform a new procedure, practice in a new practice setting (e.g., from a medical-surgical staff nurse to an ED staff nurse), or feel you are not practicing safely due to your own personal reasons.

Not being clinically competent affects not only patient safety and good nursing outcomes, it can result in a suit against you alleging professional negligence or a disciplinary action by the state regulatory board for a violation of the applicable practice act.

How can you ensure that you maintain and continue clinically competent practice?  Some suggestions include:

1. Obtain additional formal education in your area of clinical practice;
2. Obtain and maintain formal certification in your area of clinical practice;
3. Attend accredited continuing education programs, courses, and conferences that expose you to the latest updates in your clinica area;
4. Regularly review your state practice act and regulatory body for definitions of clinical competency, standards of practice, and changes that may take place;
5. Consider membership on your facility’s Quality Improvement Committee or, at a minimum, provide regular input to the Committee on competency practice issues of concern to you; and
6. Whatever the reason, never attempt to provide patient care or treatment when not competent to do so.

FOOTNOTES

1. Pam Dickerson and Kathy Chappell (2016), “Principles of Evaluating Nursing Competence”, 1. Available at: https://www.td.org/Publications/Magazines/TD-Archive/2016/02/Principles-of-Evaluating-Nursing-Competence.
2. Bette Case di Leonardi and Melissa Biel (2012), “Moving Forward With A Clear Definition of Continuing Competence”, 43(8) Journal of Continuing Education In Nursing.
3. Dickerson and Chappell, supra note 1, at 3.

THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK SUCH ADVICE FROM A COMPETENT PROFESSIONAL.