Completing annual competency requirements can be a tiresome task for both staff nurses and nurse educators, especially in the busy intensive care unit (ICU) and emergency department (ED) practice settings. At St John Medical Center, Tulsa, Okla, new nurses hired in the ICUs and ED are closely precepted and monitored for initial competency completion. However, because of the high patient census and acuity in these areas, completing the high-risk, low-frequency, problem-prone competencies11 required of incumbent nursing staff as well as ancillary unit staff is difficult. Using Alspach’s competency suggestions,11 St John managers and educators created written forms to verify initial and annual competencies. Nevertheless, they often were frustrated by the numerous attempts to complete these annual requirements.

Now, cluster-specific ICU and ED clinical instructors who are responsible for tracking annual competency completions have devised a...

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