SAN DIEGO — Knowledge should not be confused with competency when assessing skilled nursing staff, a nursing expert warned Tuesday.
“Knowledge is you have information floating around in your head,” explained Amy Stewart, RN, DNS-MT, QCP-MT, RAC-MT, Curriculum Development Specialist at the American Association of Directors of Nursing Services. “But competency-based education is a measurable pattern of knowledge, skills, abilities, behaviors, and characteristics that an individual needs to perform work roles or occupational roles.”
Stewart spoke during an American Health Care Association education session titled “How to Competently Address Staff Competencies.” She told how a bear threatened her sister-in-law near her rural home, and Stewart reached for her gun.
While she was able to scare the bear off by shooting the weapon, she said she also realized she had no business using the gun again without more hands-on training. Similarly, skilled nursing staff have to be taught how to perform skills such as putting in a catheter, she noted. People generally retain only 10% of what they read, 20% if what they hear 30% of what they see, but the figure rises up to 90% of what they’ve seen demonstrated and are given the opportunity to practice, she said.
“Having competent staff means they have the knowledge and skills, and that knowledge goes to the hands,” Stewart said. “And it means you are getting the intended outcomes.”
Directors of nursing might consider skills fairs, which can include demonstration stations, she said. Boosting competency also may include learning management systems, a lecture followed by a test, on-the-spot training, demonstration and orientation. Staff also must be able to use communication and advocacy skills on behalf of patients and residents.
If it sounds like a lot, Stewart reminded attendees that Phase 2 requirements include F-Tag 838, which demands that SNFs must conduct and document an annual facility-wide assessment. Per the Centers for Medicare & Medicaid Services, that is defined as ”what resources are necessary to care for its residents competently during both day-to-day operations and emergencies.”
One place to start, Stewart said, is to categorize which diseases are prevalent among residents. For example, if two-thirds of residents are diabetic, competency education could focus on monitoring for hypo/hyperglycemia and subcutaneous injections. If a third have depression, the education may focus on the adverse effects of antidepressants.
Investing in teaching staff can help increase tenure and reduce turnover, Stewart added.
“Competency is more than a number,” she observed. “It’s about having the right people.”
