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Weekly Q&A: Credentialing and privileging clinical skills and competencies

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, January 3, 2006

This week,a reader asks for insight about what types of activities require formal credentialing and privileging methods. Read the response below from our advisor, Suzanne C. Beyea, RN, PhD, FAAN, director of nursing research, Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, NH.

Q: In the ANCC's Application Manual, Force 14, source of evidence 10 states, "Identify clinical skills and/or competencies recognized by nursing as requiring formal credentialing and privileging mechanisms." We do credential our APNs and have competencies for our regular staff, but unless I assume that competency is our form of credentialing for the staff nurse, I am at a loss to identify what skills or activities would require formal credentialing and privileging. Can you share some insight?

A: I believe reviewers are looking for organizations to have a defined process to ensure that APNs are credentialed and that staff nurses maintain competencies for their current assignment. This is similar to the expectations that the Joint Commission on the Accreditation of Healthcare Organizations places on institutions. Some healthcare organizations actually credential staff nurses to administer moderate sedation, or to serve in the role as a registered nurse first assistant, whereas other organizations generally address these issues as competency validation. Regardless, an organization needs to be compliant with its own policies regarding these issues and ensure that there are adequate resources for nurses to maintain their expertise and competence.

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