Developing measuring and maintaining competence in new nursing roles, skills and advanced practice

Ann Close , Care Quality Commission

May 26th 2009

• Development of competencies• Factors leading to the development of new roles,

skills and advanced practice• Identifying competencies• Achieving and maintaining competency• Measuring competence• Why is it important?

Overview

Development of competencies

What makes a good nurse?• Presence of mind• Gentleness of heart• Accuracy of memory• Observation• Forethought

Hints for Hospital Nurses 1877

Defining competency

‘Ability to assess plan, implement and evaluate care’ (UKCC 1983)

‘Combination of skills, knowledge, attitudes values and abilities that underpin effective and/ or superior performance in a professional/ occupational area (ANMC 2000)

‘Combination of attributes enabling performance of a range of professional tasks to the appropriate standard’ (Gonczi et al 1990)

Factors in new role development

• Darzi’s 6 challenges

• Demands for safe, effective, personalised care

• Practitioners fit for purpose, more productive and efficient

• Demand for greater accountability

• Drive for quality and safety

• Policy changes

Identify what competencies are required

• Context

• Outcomes – what does someone do

• Clearly defined standards to measure performance

• At a particular point in time

• Knowledge, skills and abilities

Indentifying competencies

• Service being provided

• Relevant NSF, clinical guidelines

• Professional head

• AFC and KSF national profiles

• NMC guidance

• Rcn / Rcm guidance

• Regulator reports

Achieving and maintaining competence

• Joint responsibility• Understand expectations• Learning opportunities • Appraisal / review• Supervision• Coaching• Mentoring• Involvement in professional activities• Self motivation

Measuring competence

• Self assessment

• Peer review

• Review of patient / user satisfaction• Evaluation of patient / user outcomes • Audit of practice• Benchmarking• Review of incidents

• Makes contribution explicit• Offers basis for judgement of practice

improvement• Alerts to where action is required• Provides evidence and assurance of quality /

improvement• Supports revalidation / accreditation and

registration• Supports lifelong learning and development

improvement

Benefits

And finally….

• Using competencies to measure performance is helpful….

• If you don’t know how you are performing then its difficult to make improvements….

• Continuous improvement is essential for maintaining high standards of effective and safe care

Thank you