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Central venous access devices. Issues for staff education and clinical competence.

This article reviewed some of the challenges facing nurses in an ever-increasing quality-minded, cost-effective health care environment. Documenting competency will remain a concern of high regard as healthcare faces an uncertain future. The call for competency comes from both outside and within the profession. The notion of quality care is being associated with competency directed at outcomes. Each professional nurse must continuously assess his or her level of competency and seek out education. Institutions are taking responsibility for providing competency education and training for their employees, including nurses, but employment is not a substitute for professional behavior. Ultimately, competency is an individual professional responsibility. This article discussed two different institutional-based programs for providing competency education to nurses caring for patients with CVADs. Although the approaches are different, each program supports skill development and competency documentation. The programs are presented to stimulate thinking and offer ideas for practice settings confronted with ensuring competent practitioners. The challenge for nurses is to maintain skill in specialty practices heavily influenced by technology. The challenge for institutions and agencies is to ensure competency while maintaining cost effectiveness.