My small hospital has an oncology infusion room with 12 treatment chairs. We have an inpatient medicine floor with 32 beds. We have a high turnover of nursing staff due to the nature of our facility. All nurses new to our hospital must complete their initial skills competency, which includes implanted port access, deaccess and lab draw. Our hospital does not treat acute leukemics. It is very unusual for a patient admitted to inpatient medicine to have a port, in fact there are so few that these nurses must go to outpatient oncology's treatment room for a day to get signed off for their port access competency. It is very likely that the average nurse on inpatient medicine will never access a port for the year after they are deemed competent. This question may not actually be about port competency, but about competencies in general. What does this list think about documenting competency for a skill that will hardly ever be used, especially a skill that if done incorrectly, could seriously injure a patient? What would be the minimum frequency for port access to maintain the skill?
You have 2 options.
1. Designated these infrequent procedures to be performed ONLY by a small group of nurses so they can get the experrience required to maintain their competency. This is one of the basic concepts of an infusion team and proven in many other industries - practice with any task or procedure improves the knowledge and skill about that specific tasks. It works for building cars and in healthcare as well.
2. Conducting ongoing competency validation more frequently for these infrequent tasks. In other words, assessing the knowledge and skill every 3-6 months instead of every year. This would be time consuming and costly, so an infusion team doing these tasks is the best method in my opinion.
Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861