4 Steps to Kicking Off a Nursing Competency Management Program

Nursing home leaders can benefit more than ever from investing in nursing competency. But as shortages and rising costs of post-acute labor have pushed long-term care leaders to work with fewer full-time workers, reaping the full benefits has become more challenging. 

However, your organization can approach nursing competency differently. It’s possible to integrate your contingent staff into your competency management program—if you lay a sound foundation and include your contingency nursing professionals. 

Step 1: Outline the Possibilities of a Nursing Competency Initiative

Prioritizing competence in your nursing staff can have downstream impact that aligns with some of your most challenging goals. A strong example of how this works can be found in Taiwan, a country that has been facing significant growth in its elderly population, much like the US. 

Taiwan projected that by 2025, their population over aged 65 would have almost doubled in comparison to 2015, meaning the need for long-term care would increase significantly. In response, the country’s leaders focused on ways to improve the quality of care for their older population. A 2016 study of their results set out to explore LTC nurse competence in relation to knowledge, care intention, and practical experience. It found that nursing competence can be improved and that it would benefit the quality of care. 

For post-acute nursing leaders, this means that any initiative to improve care quality, star ratings, or patient outcomes should be founded on a culture that prioritizes nurse competence for both full-time and contingent nursing staff. 

To move forward, prioritize identifying the potential for quality improvement in your specific organization and where investment in competency could have a direct impact. 

Step 2: Leverage the CMS Nurse Assessment 

Your competence development initiative will have a greater chance of success if you first build a solid understanding of your baseline.

The Centers for Medicare & Medicaid Services (CMS) provides a useful Nursing Home Staff Competency Assessment that you can use as is or as a starting point for developing your own competency assessment protocol. Your assessment should help you and your team identify strengths, find areas of potential growth and learning needs, inspire professional development, and ultimately increase job satisfaction for your nurse professionals.

CMS’s assessment is comprised of three multiple choice sections of behavioral, technical, and resident-based questions. These questions should not be used against nurse professionals or shared with state officials, but instead for helping to build a culture that prioritizes quality care and ongoing improvement of nurse competence. You can review details of the assessment here.

Step 3: Review the ANA’s Leadership Competency Model

Building a successful competency program will require strong nurse leaders who feel confident that they can achieve the results your facility needs. The American Nurses Association (ANA) has invested in strengthening leadership competencies of nurse professionals by creating a leadership development model that incorporates evidence-based instructional design, along with leadership research and theories.

This model will be useful both as you develop leaders for your competency improvement program and for individual nurse professionals as they deepen their competence. Some of their recommendations include:

Choosing useful evaluation tools

Tools like the National Database of Nursing Quality Indicators (NDNQI®) are equipped to capture both objective and subjective data about an individual nurse’s knowledge base and actual performance. This applies to both a specific situation and the desired outcome of the competence evaluation.

Treating progressional development as both an art and a science

Nursing is a combination of using analytical frameworks of critical thinking and evidence with personal relationships and caring, which are critical when interacting with patients. This means that while professional practice and early nurse education supports clinical work, professional development and additional preparation are critical when looking to enhance the ability of nurse professionals to contribute as professionals in a fast-changing healthcare environment.

Outline your leadership competencies

The ANA presents a three-pronged framework for nurse leaders

  • Leading oneself: Through adaptability, initiative, integrity, learning capacity, and self-awareness
  • Leading others: Through effective communication, confronting conflict, leveraging diversity, and empowering employee development
  • Leading the organization: Through change management, decisiveness, and problem solving

Step 4: Pull in the right partners

Your competence improvement initiative should not be exclusive to your full-time staff. This is especially true if your organization has been using more contingent staff in recent years than they have in the past. 

Ideally, your contingent staffing partners should be just as dedicated to the advancement and education of individual nurses as you aim to be at your facility. They should support their nurses in specialized post-acute care training so that they are prepared for the clinical and professional challenges and opportunities they’ll encounter working with you and your patients.

While staffing agencies have left their nurse professionals on their own with this level of development or pushed the responsibility off onto their clients, IntelyCare takes pride in empowering our nurses with a wealth of courses and educational materials, on topics including communication, EMR-specific options, behavioral health, and fall prevention. To learn more about how you can leverage highly competent nursing professionals in your staffing strategy, start here.


Megan is a business writer with over 15 years of experience in healthcare enterprise technology. She holds an MBA and B.S. in Healthcare Administration. She now keeps an ongoing eye on the latest developments and successes in healthcare admin technology and the people who use it to build a better world for providers, patients, and their care communities.


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