Non-Clinical Topics   /   News

Lack of Documented Nurse Competency Could Put VA Patients at Risk

By U.S. Medicine

By Stephen Spotswood

WASHINGTON — Gaps in VA’s nurse-competency practices might be putting patients at risk, according to an investigation by VA’s Office of the Inspector General (OIG). The report found that nurses went years without being assessed for their proficiency on equipment, and, many times, when they failed to demonstrate competency, VA hospitals took no action.


A dialysis unit at VA Healthcare Upstate New York, VISN 2. Making sure nurses are trained on equipment has been a local issue. Photo from VISN 2 website.

Using data from a Combined Assessment Program (CAP) review conducted between April 2011 and September 2011, OIG investigators analyzed how VA hospitals assess the competency of their registered nurses (RN), how they define competency and how they respond when nurses fail to meet one of the requirements.

This most recent review builds upon previous reports on VA RN competency. A review in 2009 found that 24% of facilities evaluated did not meet Joint Commission competency requirements and lacked documentation of annual assessment and validation of registered nurse (RN) RN competencies.

A healthcare inspection found that nursing staff were not competent in the use of telemetry-monitoring equipment to ensure that correct patient parameters were set and that alarms would sound to alert staff to problems. Another inspection found that lack of RN competency on a cardiac-monitoring unit was known by hospital managers, who had no system in place to correct the problem.

Another review in 2010 found that, of 168 RN competency records reviewed, 19% did not have evidence of competency evaluation. Other reviews identified RN competency issues in dialysis, mental healthcare, long-term care, spinal-cord injury, endoscopy-procedure areas, the operating room and the cardiac-catheterization laboratory.

This most recent review found VA facilities still out of compliance with RN competency-assessment guidelines.

RNs are required to be assessed and validated at least every three years or more frequently, if required by local law or policy. Although all of the VA facilities investigated had policies in place for RN assessment, it was not always clear who had the responsibility to conduct the assessments on a timely basis. Also, methods and documentation requirements were not always addressed.


Related Articles

Shulkin Ousted, White House Physician Nominated for VA Secretary

WASHINGTON — After several weeks of speculation regarding his future in the Trump Administration, VA Secretary David Shulkin, MD’s tenure came to an abrupt end on March 28.

Congress Seeks More Oversight of VA EHR Program

WASHINGTON — Legislation under consideration by Congress would increase oversight of VA’s adoption and implementation of its forthcoming electronic health record (EHR) system. The VA announced last year that it would adopt the same Cerner... View Article


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

Shulkin Ousted, White House Physician Nominated for VA Secretary

WASHINGTON — After several weeks of speculation regarding his future in the Trump Administration, VA Secretary David Shulkin, MD’s tenure came to an abrupt end on March 28.

Department of Veterans Affairs (VA)

Congress Seeks More Oversight of VA EHR Program

BRONX, NY — For patients with chronic kidney disease (CKD), living more than 30 miles from their nephrologist is associated with many unfavorable outcomes. They have lower rates of clinic visit adherence, more limited access... View Article

Department of Veterans Affairs (VA)

Congress, VSOs Have Wait-and- See Position on Jackson Nomination

BRONX, NY — For patients with chronic kidney disease (CKD), living more than 30 miles from their nephrologist is associated with many unfavorable outcomes. They have lower rates of clinic visit adherence, more limited access... View Article

Department of Veterans Affairs (VA)

VA Vows to Meet Deadline for Revamp of Veteran Claims Appeal Process

BRONX, NY — For patients with chronic kidney disease (CKD), living more than 30 miles from their nephrologist is associated with many unfavorable outcomes. They have lower rates of clinic visit adherence, more limited access... View Article

Department of Veterans Affairs (VA)

Vets With Respiratory Disease More Responsive to ‘Quit’ Programs

BRONX, NY — For patients with chronic kidney disease (CKD), living more than 30 miles from their nephrologist is associated with many unfavorable outcomes. They have lower rates of clinic visit adherence, more limited access... View Article

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up