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Competency is a key component to achieving patient safety and quality patient outcomes. Through many reports since 1999, the Institute of Medicine (IOM) has increased attention to factors that promote quality and safety of patient care and recommended solutions (IOM, 1999, 2001, 2004, 2007, 2011). As a result, outcomes of patient care have be - come increasingly important. Compe tencies identified by the IOM and addressed by the Quality and Safety Edu cation for Nurses (QSEN) include patient-centered care, teamwork and collaboration, evidencebased practice, quality improvement, safety, and informatics (Sherwood, 2012).
Competence indicates sufficiency of knowledge and skills that enable someone to act in a wide variety of situations. Because each level of responsibility has its own requirements, competence can occur in any period of a person's life or at any stage of his or her career.
In a study by Rhodes, Morris, and Lazenby (2011), nursing students overwhelmingly acknowledged intelligence as a major factor in nursing competence. Three distinct areas describing intelligence included saving lives, understanding disease processes and preventing mistakes, and patient surveillance. Students depicted saving lives in comments such as "knowledge saves lives." Students used the words "life or death" in describing the importance of competence in nursing. Respondents acknowledged that nursing "mistakes can be fatal," indicating that knowledge is required to prevent untoward patient outcomes. Students explained the importance of intelligence regarding patient surveillance in explaining that nurses "make assessments" and "use the knowledge and expertise for a positive outcome."
Continuing professional nursing competence is ongoing professional nursing competence, according to level of expertise, responsibility, and domains of practice as evidenced by behavior based on beliefs, attitudes, and knowledge matched to and in the context of a set of expected outcomes, as defined by nursing scope of practice, policy, the code of ethics, standards, guidelines, and benchmarks that assure safe performance of professional activities (American Nurses Association, 2000).
Responsibility for Assuring Competence
Nurses are individually responsible for maintaining their continued competence. Nephrology registered nurses must continually reassess their competencies and identify needs for additional knowledge, skills, personal growth, and integrative learning experiences (Gomez, 2011)....