Continuing Competence
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Submission of Evidence

Licensees are only to submit evidence of continuing competence if specifically notified by the Board.

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.

Licensees seeking renewal or reinstatement must attest to having completed the chosen learning activity and be prepared to submit evidence of completion if requested by the Board upon random audit.

Last Changed 2-Mar-2020

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