NEW MEXICO CONSORTIUM FOR NURSING WORKFORCE DEVELOPMENT
Report: Role of the New Mexico Board of Nursing in Assuring Ongoing Competence
In the Nursing Workforce
June 21, 2003
A subcommittee was formed for the purpose of responding to the question as stated above, contained in the scope of work of the monies awarded to the Consortium.
The subcommittee consisted of:
Sheena Ferguson, MSN, RNSusan Fox, PhD, RN
Director, Clinical EducationAssociate Professor
University of New Mexico Hosp.College of Nursing
University of New Mexico
Marilyn Pase, MSN, RNJohanna Stiesmeyer, MSN, RN
Graduate Program ChairManager, Center for Clinical Excellence
Department of NursingLovelace-Sandia Health System
New MexicoStateUniversity
Judith Thomas, BSN, RNJulieWarren, MSN, RN, CCRN
Nursing EducationDirector of Nursing Practice
CrownpointIHSHospitalPresbyterian Healthcare Services
This subcommittee reviewed professional literature, previous discussion material from the New Mexico Board of Nursing, and material from ongoing discussion and actions from other states’ Boards of Nursing. As a result of this review and our discussions, the subcommittee would like to make the following recommendations:
- The Board’s main responsibility should remain licensing the nursing workforce ensuring competence at time of licensure. Continuing competence should remain a separate issue.
- The continuing education requirement is appropriate and should be left in place.
- Clinical agencies are required by various regulatory oversight bodies to ensure competence for the nursing workforce in their agency. Some agencies reported 32 online competencies required for RNs to be completed and updated yearly. Skills are then validated in a variety of ways. Some agencies have Performance Based Developmental Systems which evaluate knowledge and make clinical observations of skill abilities, or plans which match job expectations from job descriptions/profiles and identify gaps in individuals’ abilities, and then develop targeted growth plans for employees and resources to help them fill the gaps. The Subcommittee felt strongly that most clinical agencies have adequate ways to ensure ongoing competencies, as competence is closely tied to job performance.
- Based on the above, the Subcommittee recommends ongoing competence be evaluated in this fashion:
- Basic Licensed personnel:
- If employing agency has competency evaluation in place, no further monitoring required
- If no competency evaluation or individual is in independent practice or consultation, they will develop their own plan for ongoing improvement or growth in their practice
- The Board may audit this at any time
- The Subcommittee recommends expanding the options for “verifying” competency [in much the same manner as requirements for Nurse Midwifery are spelled out]; other options discussed included some credit allowed for activities currently designated “inservice education”, peer review activities, serving as preceptor for other nurses,portfolio activities, etc.
- Advanced Practice Nurses:
- If employing agency has competency evaluation plan in place, no further monitoring required
- If no competency evaluation or individual is in independent practice, a plan for ongoing improvement or growth in their practice and competencies must be submitted to the Board [in the same manner as the Formulary] and may be audited at any time.
- For a change in practice setting:
- Orientation must occur at the new setting, and expected competencies validated
In addition, the Subcommittee wished to recommend two additional resources:
- The proposed website for the Center for Nursing Excellence will be used to share best practices in ongoing competency assessment. Clinical agencies and individuals could then access examples of assessment programs that are successful and contact professionals who have used those programs.
- A White Paper regarding the role of the Board in regulating nursing systems recommended a task force with multiple stakeholders be convened to discuss how to proceed regarding this issue of regulating systems. This same task force could also address the continually evolving issue of how to evaluate continuing competency.
In all instances of lack of competency for nursing professionals, the Subcommittee felt the Board of Nursing would remain the determination body re: the veracity of the claim and the body which recommends next steps. Should additional monies be made available to address this system, the Subcommittee would like to see increased monitoring of all level of professionals and ways to assist agencies in developing methods, such as the Performance Based Developmental System discussed above, to continue to address the competency question and insure that the nursing workforce has the resources to attain growth for the individual and safety for the public.