Nursing Practice: Demonstrating Continuing
Competency - Protecting the Public
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Chuck Cumiskey, BSN, MBA RN
Nursing Practice Advisor,
Nursing Care Quality Assurance Commission
February 1, 2011
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Identify the purpose of continuing competency requirements for all registered and licensed
practical nurses in Washington State.
Define the requirements for active practice and continuing education to maintain an active
registered and licensed practical nursing license in Washington State.
Explain active practice and acceptable documentation of active practice requirements.
List and describe options available to nurses not meeting active practice requirements:
inactive license, expired license, and approved refresher courses.
Describe the audit process and how to meet audit requirements.
Describe technical assistance available to nurses not meeting continuing competency
requirements.
Describe the timeline of events implementing the continuing competency requirements and
how this timeline will impacts licensure renewal.
Explain continuing competency requirements to coworkers, supervisors, human resource
personnel, and colleagues.
Refer coworker, supervisors, human resource personnel, and colleagues to the Nursing Care
Quality Assurance Commission’s Website with resources and frequently asked questions on
continuing competency.
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It is the purpose of the NCQAC to regulate the
competency and quality of professional health care
providers under its jurisdiction by establishing,
monitoring, and enforcing qualifications for
licensing, consistent standards of practice,
continuing competency mechanisms, and
discipline. (RCW 18.79.010)
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Competency is the ongoing ability of a nurse to
maintain, update, and demonstrate sufficient
knowledge, skills, judgment, and qualifications
necessary to practice safely and ethically in a
designed role and setting in accordance with the
scope of nursing practice. WAC 246-840-202(3)
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Continuing competency is achieved:
 Self-directed
program that includes:
active practice, self assessment and
reflection, and continuing nursing
education WAC 246-840-202(3)
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531 hours over a three-year review period (paid or
unpaid) starting in 2011 on your birthday
Wide interpretation of nursing practice
◦ Nursing license is required or
◦ Nursing knowledge is necessary to do the job
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Examples
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CEO of Sisters of Providence SW Washington Service Area
Regulatory Nurse or Patient Safety Officer
Staff Nurse, Nurse Manager, or Nurse Executive
Faculty member
Consultant
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Inactive license
◦ Personal choice to move from active practice
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Expired license
◦ Let your license expire and reactivate within three years;
you will be audited and must provide documentation of 177
active practice hours and 15 hours of CE upon renewal.
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Approved refresher courses required for expired
licenses of 3 yr or more:
◦ http://www.doh.wa.gov/hsqa/professions/Nursing/document
s/refresher.pdf
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Philosophy, purpose, and objectives:
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Philosophy, purpose, and objectives of the course shall be clearly stated and
available in written form. They shall be consistent with the definition of nursing as
outlined in chapter 18.79 RCW.
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Objectives reflecting the philosophy shall be stated in behavioral terms, and
describe the capabilities and competencies of the graduate.
Faculty:
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Must hold a current license to practice as a RN in Washington State.
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Must be qualified academically & professionally for their respective areas of
responsibility.
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Must be qualified to develop and implement the program of study.
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Must be sufficient in number to achieve the stated program objectives.
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The maximum faculty to student ratio in the clinical area shall be 1 to 12.
Exceptions shall be justified to and approved by the Commission.
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W-2 or pay-stub
 Log book signed by employer
 Attestation signed by manager
 WAC 246-840-203 (2) Failure to complete the
attestation every 3 years may be grounds to
deny the license or place the license on expired
status according to WAC 246-12-010 (11)(b)
and Chapter 34.05 RCW.
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 45
CE contact hours in 3 years
 Continuing education hours should relate
to the nurse's area of professional
practice, or areas identified through selfassessment and reflection for professional
growth and development. WAC 246-840-203 (ii)
(B)
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The 3-year review period starts on your
birthday month in 2011 and you become
qualified for audit on your birthday month in
2014 (up to 5% of RNs and LPNs will be
audited)
 Have an accounting system to track, log, &
store practice hours worked (paid and unpaid)
 Have an accounting system to track, log, &
store CE hours
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You will go through the annual renewal process
◦ Pay fee
◦ Sign attestation stating that you are in compliance
with continuing competency rules
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Starting in 2014, in your birth month after your license
has been renewed, the audited nurse will receive a letter
from the Commission stating that he/she has been
chosen for random audit
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Technical assistance will be provided to the
audited nurses who do not meet compliance
standards
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Technical assistance includes: mentoring and
guidance so that the nurse can comply with the
standard
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 Proof
of 531 hours of active practice
◦ (paid or unpaid)
 Proof of 45 CE contact hours
 You do not submit your self assessment
and reflection
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http://www.doh.wa.gov/hsqa/professions/Nursing/conti
nuecomp.htm
http://listserv.wa.gov/cgi-bin/wa?SUBED1=nursingqac&A=1
Continuing Competency Web-link
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Tools for tracking hours and CEs
Examples of self assessment and reflection tools
Links to continuing education offerings
Checklist of program essentials as audit preparation
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List:
 Location of active practice
 Category of active practice
 Dates and hours of active practice
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List:
 Continuing Education Topic or Title
 Category of Continuing Education (class,
courses, publications, independent study,
mentorship, presentations, specialty
certification)
 Dates and Hours of Continuing Education
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Be familiar with current laws and rules relating to the nursing profession.
Take responsibility for gaining new knowledge and skills to advance
your nursing practice.
Participate in professional activities that contribute to your nursing
knowledge and skills.
Incorporate new knowledge into your practice and evaluate its impact on
your nursing practice.
Support and help to create an environment in which learning,
professional growth, cooperation, and mutual respect can occur.
Make patient safety a priority for patients and patient populations.
Incorporate patient-specific risk-factors and standardized approaches to
reduce the risk of adverse outcomes: fall-reduction programs, “hand-off”
communication, and infection control techniques.
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Use evidence such as research findings & current standards of
practice to base decisions relevant to practice.
Encourage active involvement of patients in their own care as a
patient safety strategy.
Promote effective communication among caregivers; use data
gathered from all members of the team to optimize patient
outcomes.
Promote the assessment of education needs of patients & families;
make sure appropriate education is incorporated into plans of care.
Use techniques to reduce the risk of health care-associated
infections; ensure good hand-washing techniques for all.
Identify alternate approaches to overcome obstacles & maximize
health outcomes for patients.
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Understand your duty to report unsafe or substandard nursing practices to the
Nursing Commission; know mandatory reporting includes unprofessional conduct,
boundary violations, and criminal convictions.
Promote a patient’s right to privacy by protecting confidential information; use
patient information only for legitimate healthcare purposes.
Review the Uniform Disciplinary Act (UDA) and nursing law related to boundary
violations and sexual misconduct; your relationships with patients and clients
should be therapeutic and professional.
Understand your responsibility to restrict your practice if you are not able to
perform essential functions safely, including physical, emotional, or mental
conditions, or other stressors.
Seek advice when you are unsure if actions expected exceed your legally
recognized scope of practice.
Be familiar and know how to use the Nursing Commission’s Scope of Practice
Decision Tree.
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Why is the Commission doing this?
What is the 3-year practice requirement?
What is the 3-year CE requirement?
When does the 3-year timeframe begin?
When is the earliest an RN or LPN will be audited?
If audited what must be submitted?
What happens if you do not comply with the audit?
How many nurses will be audited annually?
If you let your license expire, when must you take a
refresher course?
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Chuck Cumiskey BSN, MBA, RN
Nursing Practice Advisor
Washington State Department of Health
Nursing Care Quality Assurance Commission
310 Israel Road SE, Tumwater, WA 98501
Chuck.Cumiskey@doh.wa.gov
360-236-4725
Fax 360-236-4738
 For more “Practice Information” please see our website at:
 http://www.doh.wa.gov/hsqa/professions/Nursing/default.htm
 Please sign-up for the Nursing Commission list-serve: http://listserv.wa.gov/cgibin/wa?SUBED1=nursing-qac&A=1
 "Public Health - Always Working for a Safer and Healthier Washington”
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