Clinical competency assessment in intravenous therapy and vascular access: part 1

Nurse training and education programmes have changed in recent years, moving from a 'learning on the job' process of training and learning to a much more structured and academic approach. As professionals in health, we must continually update and refresh our knowledge and skills (Mann et al, 2009), a view supported by Fry et al (2003) who highlight that nurses are now encouraged to continue with lifelong learning. The Nursing and Midwifery Council (NMC) Code of Conduct 40 states: 'You must keep your knowledge and skills up to date throughout your working life'. Code 41 states: 'You must take part in appropriate learning and practice activities that maintain and develop your competence' (NMC, 2010). Within the hospital setting, most patients will receive some form of intravenous therapy (IV) treatment (Peterson, 2002: cited by RCN, 2010). Infusion therapy has therefore become an integral part of professional practice for most nurses, who must learn the initial skills in IV therapy and vascular access and achieve clinical competence. Education and clinical training by specialist teams in organisations must be delivered to ensure safe skills are learnt (RCN, 2010). This education and training must incorporate both theoretical and practical elements, with appropriate means of assessment. The delivery methods should be diverse, recognising that individuals have different approaches to learning. Clinical competency assessment frameworks are widely used within nurse education. But are they the most appropriate method of assessment, or can other methods be used? An in-depth literature review in this paper will highlight different approaches to learning, assessment and clinical competence.