Clinical competence assessment

[Dutchstudents]

Hello,

We are two nursing degree students from the Netherlands. We have a question for everyone. How do you prove your clinical competence in skills such as cannulation, venapuncture? Are you assessed regularly and is it a legal requirement?

This is for a dissertation on skills assessment in clinical practice from an international perspective.

We'd also be grateful for any links or documents on the subject.

Many thanks in advance for your help.

[nev05]

Hello, I sent a private message !

[Carolynn E. Wilson]

My personal experience was 1) written directives, 2) rubber prosthetic arm practice, 3) assignment to ER for two weeks watching insertion on site by licensed personnel (after checking written order, gathering supplies, clean or sterile setups only- up to actual access- nobody will put up with a student in ER usually) and hoping they will sign you off on that skill- and 4) in-service training at the first job with whoever is assigned to mentor you. Did not have internet in 1971 using You Tube or disposable equipment. The best training I received was a month with an actual IV certified nurse and we practiced on each other.

So many nurses graduate without actually inserting an IV even one time. There is no legal requirements for ongoing assessment of skills sets in any venue I ever worked for (hospital, nursing home) likely due to the costs and time needed to perform every year or two. There is only a policy and procedure to follow and they vary with each employer. Some larger employers have a Nurse Educator on site, but her job is to make sure everyone is CPR certified every year, knows where the MSDS data sheets are located in case a surveyor asks you, and you offer proof of a pain CEU for your file. The State of MI requires about 24-26 CEU credits to maintain your license in anything you choose every two years. The Pain CEU is required in MI. but not all 50 states. Comes down to what your employer requires, or what you take the initiative to learn on your own, praying your first IV patient is in a coma, and another nurse will back you up if you fail the first time :>)

[Fiona59]

In my health authority (Canada) IV starts are minimally covered in school. The employer does inhouse training and certification. Spend time with Nurse Educator. Learn the sites, short written quiz, practice on the dummy arm. Three witnessed starts with the educator and then you are on your own. You can ask for a refresher with an educator if you feel you need it. Some units rarely have to do a start as the patients come to the unit from the OR with either a peripheral or PICC in situ.

Venipuncture is a sore issue. We have lab staff that go throughout the hospital doing all blood draws. They are certified technicians. Management is trying to add routine blood draws to our duties and we just don't have the time. There is a certification (inhouse) exam for nurses to write but most won't.