Continuing Competence
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Continuing Competence Requirements

(One of the following is required)
  • 15 Contact Hours of continued education and 640 hours of active practice within previous 2 years. Active practice is defined as activities performed, either for compensation or without compensation, consistent with the scope of practice for each level of licensure, RN or LPN [21 NCAC 36 .0120(5)].
  • National Certification or Re-certification by a National Credentialing Body recognized by the Board
  • 30 Contact Hours of continued education
  • Completion of a Board-Approved Refresher Course
  • Completion of a minimum of two (2) semester hours of post-licensure academic education related to nursing practice
  • 15 Contact Hours of continued education and completion of a nursing project as Principal Investigator or Co-Investigator to include statement of problem, project objectives, methods, date of completion and summary of findings
  • 15 Contact Hours of continued education and Authoring or Co-Authoring a nursing-related article, paper, book or book chapter
  • 15 Contact Hours of continued education and developing and conducting a nursing continuing education presentation or presentations totaling a minimum of five contact hours, including program brochure or course syllabi, objectives, date and location of presentation, and approximate number of attendees

Renewal – If a nurse cannot demonstrate meeting the continuing competence requirements, the license will be placed on INACTIVE STATUS starting at 12:01 a.m. on the first day after a nurse’s renewal date until compliance with the Continuing Competence requirement is met.

Reinstatement – License will not be issued until all Continuing Competence requirements have been met.


The Board sends out random audit notifications via the Nurse Gateway when renewal notifications are released. It is each licensee’s responsibility to make sure their correct email address and mailing address is on file with the Board. Notice of random audit will also be provided at the time the online renewal application is accessed.

Submission of Evidence

Public awareness has been raised about the need for regulatory boards to assure continuing competence of licensees. The Task Force on Healthcare Workforce Regulations of the Pew Health Professions Commission released in 1995 their recommendations for changing how health care professions, including nursing, were regulated. They recommended determining continuing competence as a regulatory board function. The Citizens Advocacy Center, a public policy organization located in Washington, D.C., has also given similar advice. In 2000, the Institute of Medicine published a report, To Err is Human, which included a recommendation for health professional licensing bodies to determine licensees’ competence and knowledge.

The Board of Nursing determines minimum competency to practice nursing upon entry into practice. Entry-level competence is met by successful completion of an approved program of education and passing the national licensure exam (NCLEX). 

Definition of Continuing Competence:

Continuing Competence is the ongoing application of knowledge and the decision-making, psychomotor, and interpersonal skills expected of the licensed nurse within a specific practice setting resulting in nursing care that contributes to the health and welfare of clients served.

The process of determining continuing competence is based on the following assumptions:

  • The Board of Nursing has an interest in ongoing competence based on the board’s legislative mandate to ensure minimum standards of competency and to provide the public safe nursing care.
  • Nurses desire to be competent in their practice.
  • There are a variety of mechanisms that can be used to determine continuing competence.
  • Determining continuing competence is:
    • An evaluative process carried out by the nurse, employer, and Board of Nursing; and
    • A self-directed and ongoing process carried out by the individual nurse, for purposes of licensure renewal.

The Board of Nursing has approved and endorsed the reflective practice approach to continuing competence.

  • Reflective Practice is defined as a process for the assessment of one’s own practice to identify and seek learning opportunities to promote continuing competence. Inherent in this process is the evaluation and incorporation of this learning into one’s practice.
  • A pilot demonstration project was completed in 2003, followed by a statewide educational approach preparing licensees, key stakeholders, and the public for implementation of continuing competence as part of licensure renewal.
  • The North Carolina General Assembly passed G.S. § 90-171.23 (b) (20) , the Continuing Competence requirement, into law in July 2005.
  • Continuing competence requirements for licensee renewal or reinstatement became effective July 1, 2006. The criteria are specified in rule 21 NCAC 36.0232 .
  • Using a reflective practice approach, the licensed nurse must carry out a self assessment of her/his practice, and develop a plan for maintaining competence. This assessment is individualized to the licensed nurse’s area of practice. There are a wide variety of options/methods through which the nurse can choose to maintain continuing competence. Taking or passing an examination is not a requirement.
Last Changed 4-Aug-2023

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