RSSArchive for February, 2008

Merging competency validation and performance evaluation

A new way to look at competencies, from the pages of our Briefings on Long-Term Care newsletter:

Making sure nurses are competent in their skill sets is one of the most important responsibilities of a director of nursing. But as the need for validation goes beyond technical skills and focuses on professional development as a whole, the traditional methods of assessing competencies need to be examined in a new light.

“It has always been important to validate competencies, but how some institutions are choosing to look at it is taking a different spin,” says Sheila St. Cyr, MS, RN-BC, OCN, performance-based development system coordinator at the University of Oklahoma (OU) Medical Center in Oklahoma City. “Now we’re not just looking at technical skills, we’re validating interpersonal skills as well. It used to be more about the technical skills checklist. And that’s just not how it should be.”

With the recent shift in focus, directors of nursing must arm themselves with the necessary tools and information to think beyond simply validating skill sets.
St. Cyr says there are two main areas of assessment on which to focus: competency validation and performance evaluation. Recently, the shift has been to combine the two efforts rather than have an instructor simply check off that a nurse is able to complete a particular skill.

Developing a definition of competency validation for your facility must take place prior to any assessments, says Diana Swihart, PhD, DMin, MSN, CS, APRNBC, clinical nurse specialist in nursing education at the Bay Pines (FL) VA Healthcare System.

When you begin working with staff members to validate competencies, St. Cyr says one of the best strategies toward education is to play the what-if game. “Use a questioning technique with staff members,” she says. Give your nurses a scenario, then ask the following questions:

  • What complications can happen?
  • What are the signs or symptoms?
  • Would you need to call the doctor?
  • What assessments would you need to make?

Other methods for validation, adds Swihart, can include:

  • Case studies, which can help measure critical thinking
  • Quality improvement monitors, which are a strong determinant of competency because they reflect an individual’s overall performance
  • Mock events, which are useful in measuring cognitive knowledge

What methods are used at your organization?

Learning Management Systems: Their place in healthcare

By Diane M. Billings, EdD, RN, FAAN

Following our discussion during today’s audioconference, we realized that one big component of implementing new classroom technology includes bringing in a Learning Management System (LMS). Basically, an LMS includes software tools designed to manage learning. Many LMSs are Web-based and are able to facilitate “anytime, any place, any pace” access to administration and learning content. LMSs are especially relevant in healthcare as compliance training remains essential. Characteristics of LMSs often include:

  • The ability to manage users, courses, and instructors
  • The inclusion of a course calendar
  • Access to messaging learners
  • The chance to display scores and transcripts

There are many different types of LMSs that are available, including Blackboard Inc., Saba Software, and ATutor. What have your experiences been with using LMSs, and which ones have you found to be most effective (or ineffective) in your educational endeavors?

A great idea for teambuilding!

Purchase a puzzle large enough for each staff member to have a piece. Give each one a piece of the puzzle (during a staff meeting, in their mailbox, etc.). Explain that you need everyone’s participation to make the team fit together. Have a designated place for staff to begin working the puzzle until it’s completed.

Kick It Up A Notch: Leave a few pieces out, but give them to ancillary staff (RT, PT, CM, etc.). After a time of having “holes” in the finished picture, ask the other disciplines to fit their pieces into the picture. You could even have someone glue the puzzle and ask engineering to hang it–as a reminder that we cannot work together without everyone’s input.

“Whoever does not love his work cannot hope that it will please others.” (unknown)

“Leaders must be close enough to relate to others, but far enough ahead to motivate them.” (John Maxwell)

Lessons learned from my first class

When the Leader’s Lounge was born, I started the blog with my decision to return to school in my mid-50s. What was I thinking? It is hard to believe that my first course has already ended, and that I am preparing for the next one. Wondering how it went?

Better than I expected.

I took the one course that was only for two credits, as I knew the load would be less and I could plan from that for the other three- and four-credit course loads. I found out today I received an “A” (I never read so much in such a short time period; eat lots of carrots!) and found the overall experience was good. Getting a good grade certainly helped with that perception. I would prefer to be in a live classroom as I thrive on that interaction, but “life” gets in the way of that. Online courses can be interactive in their own way, but I miss the voices, tones, and facial expressions. Call me a product of my generation compared to the younger ones who don’t use the phone much (they text message).

I learned a great deal from my first course on Issues in Health Care Informatics. Along with the acquired knowledge of real substantial material that I can use, I learned how to study at an airport with people around you talking (shouting) into their blackberry’s, I learned how to scan articles for what I have to read, and mostly, I learned that my nursing experience, every bit of it, is relevant.

Additionally, because this was a two-credit course, it did not take nearly the time away from my home life as I thought it would. Being able to do a great deal of the work while on the road, left little time taken away once I was home.

Are you still on the edge about going back to school? What’s holding you back?

Shhh! We’re preventing medication errors here!

A creative way to prevent medication errors from the pages of our Briefings on Patient Safety newsletter:

Citizens Medical Center in Victoria, TX, took a creative approach to cut down on medication errors when it created a “no-talk zone.”

“Distractions were definitely becoming an issue with medication errors,” says Gail Martin, MBA, RN, quality analyst at Citizens Medical Center. The main problem was that two of the facility’s busiest and most critical floors had Pyxis medication dispensing machines located out in the open-next to the coffee pot and across from the nurses’ station, says Martin.

Though the obvious solution was to relocate the Pyxis machines, it was not feasible at that time, says Martin.

“That costs money. And we’re a county hospital, so it wasn’t happening,” she says. “It is in our future plans, but for the immediate future, we needed to do something.”

So, Martin’s team brainstormed different signage asking staff and hospital visitors not to disturb anyone using a Pyxis machine, especially in a busy area. They eventually settled on a simple “no-talk zone” sign much like a “no smoking” sign. The lettering is black, and the symbol is red. The sign is displayed on the floor in front of the Pyxis machine, kind of like a mat slicked on the floor, says Martin.

The “no-talk zone” has been in place for a year and has paid dividends. Since the start of 2007, five medication errors have been attributed to frequent interruptions, lighting, or noise level; this is a decrease from the entire year of 2006, in which 23 medication errors were attributed to the same causes, according to Martin.

What does your organization do to prevent medication errors? Do you think something like this “no-talk zone” would work where you are?