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How To Measure and Assess Nurse Competency

Because hiring is a pressing concern for hospitals and health systems, leaders might shift focus away from nurse competency. Competing with other healthcare organizations to fill nurse vacancies creates a sense of urgency to hire, regardless of whether you’re selecting the most highly competent applicants.

But instead of lowering your standards, now is the time to ensure that the nurses you hire and train are performing at their highest levels. Ideally, every clinician will bring as much value to your organization as possible. To enable this, you must be able to measure and assess nurse competency accurately, consistently, and efficiently.

Top reasons for assessing nurse competency

Prioritizing nurse competency is important for many reasons. Employing effective strategies and tools to maximize resources and performance has several major benefits:

  • Evaluating competency provides a complete picture of your staff utilization. You can learn where every team falls in terms of skills and performance and determine where they could improve.
  • More nurses performing at the top of their practice means more productivity and effectiveness from your existing resources. Don’t depend solely on the addition of new staff to bring productivity gains when your experienced teams have untapped potential.
  • Your staff wants to develop and improve. They also want to see their organization excel. Rewards of high competency include heightened employee engagement and greater organizational success.

With these benefits in mind, leaders should work to improve staff competency levels through the measurable improvement of knowledge and skills.

Don’t depend solely on the addition of new staff to bring productivity gains when your experienced teams have untapped potential.

Factors for assessing nurse competency

Nurse competency — or the attainment of targeted proficiencies — varies by role, specialty, and experience. Different healthcare disciplines have their own corresponding competency frameworks.

For example, the Academy of Medical-Surgical Nurses (AMSN) provides a framework that encompasses definitions, scope of skills and knowledge, related competencies, and professional development steps. Regardless of specialty area, the following tactics apply to all healthcare competency assessment processes.

Identify knowledge and skill gaps

Whether you’re assessing a newer nurse or an experienced one, a quality competency assessment measures the nurse’s knowledge and skills against a professionally endorsed rubric outlined by trusted industry experts or your own organization. Consider any identified gaps as valuable insights for improvement.

Standardization is key for your reporting to be accurate and reliable. Measure the same skills, according to the same criteria, for every nurse. Consistency ensures that your results provide a clear measure of where each nurse stands in terms of capabilities and deficits. Using a robust tool ensures that every assessment is complete, uniformly executed, and recorded for reference and reporting.

Conduct pre-hire assessments

Evaluating nurse competency begins with a pre-hire (or predictive) assessment for new nurses. Employers typically screen an applicant’s education and experience, but it is equally important to measure aptitude and fit in statistically valid and reliable ways. The additional data will strengthen your hiring decisions and provide candidate information necessary to support successful onboarding.

A pre-hire assessment not only provides critical information during the recruitment process. It also increases success on the job. Providing the right training from the start engages your new employees and develops them in the areas they need most to become valued contributors. A research study found that a good onboarding process has a very strong influence on a nurse’s progress.

Review your onboarding process

To ensure that you begin with accurate metrics for every nurse, confirm that your onboarding process includes a thorough competency evaluation soon after hiring. Additional assessments should then recur regularly using consistent criteria so that you can measure improvement.

Initially, you’ll need to assess readiness to practice with the goal of preparing your new nurses to provide a high standard of safe patient care as soon as possible. Knowing the exact competency areas to address within a personalized onboarding process avoids wasted time and keeps your new hires engaged and focused on skill acquisition.

Look for leadership skills

Even with the help of a robust assessment tool, healthcare leaders and administrators can’t take on the responsibility of raising nurse competency on their own. Especially in a large healthcare system with many nurses, raising competency levels must be an organizational effort. Once you’ve identified high-performing nurses using your competency tool, leverage their skills to help elevate others.

Highly competent nurses can help mentor nurses who need more training. Working together in teams, your team leaders will know who needs assistance in a particular area to become more proficient. Create a culture of learning where employees commit to a shared vision, system thinking, personal mastery, and team learning.

Track nurse satisfaction

Our 2022 Nurse Salary Research Report revealed that nurse competency and job satisfaction are related. Satisfaction indicators included high rankings by survey participants for educational opportunities, the ability to exercise “the full scope of their nursing practice,” and other factors that supported their ability to practice confidently and competently.

Nurses who have higher levels of satisfaction are more likely to excel. Review data from your employee engagement surveys and other personnel insights for additional perspectives on competency levels. If a nurse expresses dissatisfaction, dig deeper to understand the causes.

Overcoming challenges to nursing competency

External factors can affect an organization’s ability to achieve and maintain nurse competency. The Online Journal of Issues in Nursing reported that healthcare organizations have experienced a decline in the initial competency of new registered nurses. The authors theorized that the decline is the result of current education systems not keeping up with the competencies needed to succeed in modern healthcare environments.

Constantly evolving practices

Health care is constantly changing due to medical and technological innovation. It is estimated that medical knowledge doubles every 73 days. With such a rapid pace of change, healthcare educators must teach the skill of adaptive learning, which enables clinicians to see themselves as “knowledge workers” always acquiring new learning — and even new ways of learning — such as smart devices, virtual reality, video, multimedia, and artificial intelligence. Nurses must be lifelong learners.

Mass workforce exits

The persistent issue of staffing shortages requires creative and strategic approaches to safeguard the well-being of your staff. As you simultaneously improve competency levels while working to fill staff vacancies, conveying strong shared values can help unite and elevate your organization.

Employ frequent and transparent communication with your teams to acknowledge staffing challenges, and make sure your people know that you value them. Enlist their help and support in the joint effort of creating an ideal workplace that enriches those who are there and attracts new talent.

Although the COVID-19 pandemic has subsided, a new health crisis could emerge. Part of being ready for another major global health event is to anticipate further staffing challenges and create contingency plans. Is disaster planning and preparedness one of your organization’s competencies?

High turnover rates

Despite your best efforts, high turnover may continue. Adapt your processes to this new reality. Rather than hold firm to an outdated expectation of staff longevity, embrace an agile mindset that anticipates and accommodates high turnover rates.

Strategies that accept rather than fight inevitable staff departures could include increasing your cross-training efforts so that nurses can shift to alternate roles or responsibilities within your organization quickly. Increased versatility also benefits your organization as needs and roles change with new technology, mergers, or emerging community health needs.

Limited training opportunities

Don’t let training limitations hold your nurses back from attaining maximum competency levels. Education is an investment that pays for itself in the capabilities of your nursing teams and their ability to surmount obstacles. Offering an array of learning opportunities empowers nurses who need and want more knowledge. Lack of access to learning should not be a limiting factor.

Research has shown that organizations outperform others due to factors in their environment rather than differences in aptitude. Your organization has the potential to elevate the care you provide if employees have the education they need to succeed.

How to improve competency

As discussed above, numerous factors can support nurse competency, and significant obstacles can hinder it. The commonality among these factors is being able to harness data from nurse assessments and competency evaluations. Without data, it is difficult to understand where your nurses stand in terms of current competencies and where they need to be.

Access to competency data and targeted education can also help mitigate factors that hinder competency efforts. Monitoring skill gaps and providing needed training can protect your organization from risks.

Ensure nurse competency with education

When assessing nurse competency, all paths lead to education. Assessing and improving knowledge and skills helps develop new nurses, equips experienced nurses for success in a quickly and constantly evolving field, and enables leaders to prepare for industry shifts and emerging demands.

The definition of competence is “the ability to do something successfully or efficiently.” Competency is also the word used by organizations such as the American Nurses Credentialing Center (ANCC) to describe success: a nurse’s ability to “provide competent care” and demonstrate continuing competence. Competency is indeed the foundation of nursing excellence.


Competency Management: Evaluating Knowledge, Skills, and Abilities Gaps To Increase Staff Competencies

Elevating organizational competence efficiently has never been as important as it is today. Higher numbers of experienced clinicians are leaving the profession, and new ones need to ramp up quickly. Leaders must address knowledge, skill, and ability (KSA) gaps and then provide the right learning opportunities. Watch our recent webinar to learn about a streamlined, efficient, and effective way to evaluate, track, and report on role-based competencies.

Watch the webinar →

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