An innovative way to revalidate cardiac nursing competency: An annual staff skills fair

Abstract

Background: The Cardiac Center at The Children's Hospital of Philadelphia is comprised of three separate units: the Cardiac Intensive Care Unit, The Cardiac Care Unit and The Cardiac Preparation Recovery Unit with over 250 staff members. Revalidating skills on an annual basis, as required by the Joint Commission, can be a challenge for a large center providing specialty services to a wide variety of patients. Methods: A skills fair committee was developed that included staff nurses, the clinical nurse specialist, the education nurse specialist and the nurse manager. Skills requiring revalidation were identified by analysis of: incident reports, Joint Commission Patient safety goals, institutional initiatives, and anecdotal data collected from patient rounds by the clinical nurse specialist. Critical high risk, low volume skills were also included. Eleven skill stations were identified through prioritizing patient care needs and matching nursing skills sets across all areas. Staff were identified to coordinate skills stations. Station coordinators met with designated clinical experts and designed the station with assistance of the nurse educator. Coordinators were responsible for training additional staff to be qualified observers for each station. The skills fair committee identified all clinician roles throughout the center and defined which skills each clinician was required to complete. The skills fair was offered over a 5 day period over a variety of shifts in an effort to accommodate patient care needs and individual nurses' schedules. Flexibility in scheduling was maintained so that nurses could attend the skills fair at a time convenient to their schedule. An online evaluation tool was created for staff to complete upon finishing the skills fair. Results: Two hundred and thirty five nurses completed the skills fair. The skills fair was open for a period of 60 hours and was staffed by 59 qualified observers. Survey results revealed that the majority of staff worked 4 hours of additional time to complete the stations. Qualified observers were provided with 8 hours of paid time within their status to teach and were asked to work a minimum of 12 hours. Conclusion: This is the fifth year that the Cardiac Center has run the skills fair. The skills fair is an effective way to revalidate annual competency. The skills fair builds teamwork and staff morale in the unit. Staff enjoy the atmosphere of sharing their expertise and learning from one another. To encourage completion, prize drawings were held at the end of each day and all nurses who completed the skills fair were given a Cardiac Center t-shirt commemorating the event. Each year we work at streamlining our process. This year improvements were seen in online evaluation, reduction in amount of stations taught and increased time paid to qualified observers to teach. Having paid time allowed for less qualified observers and increased the quality of teaching. The majority of the stations and teachers were rated in evaluations as "very good" to "excellent". The next step is to conduct a Strengths, Weaknesses, Opportunities & Threat (SWOT) analysis of each station to determine areas for further improvement.