Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting CATHY HENNERBY MSc 1 and PAULINE JOYCE EdD 2 1 Director of Services, St Paul’s Services, Mater Hospital, Dublin and 2 Director of Academic Affairs, Institute of Leadership, Royal College of Surgeons in Ireland, Dublin, Ireland Introduction The primary work arrangement held by nurses for the last century has been predominantly long term, perma- nent employment. However, a shift towards the use of agency nurses as contract staff (Hass et al. 2006) has become the norm in many hospital settings. Yet, concern regarding their organizational value, quality of work and professional competency has been raised (Hoque et al. 2008). There is a paucity of research carried out on the competency of agency nurses. According to Manias et al. (2003) and Hass et al. (2006) professional devel- opment of agency nurses is viewed as the responsibility of agency nurses as contract staff themselves. However, these nurses are more likely to undertake continuing education and development if they are supported by their managers (Lemow 2004). With agency nurses contracted to work part-time this support is not a given Correspondence Pauline Joyce Royal College of Surgeons in Ireland RCSI Reservoir House Ballymoss Road Sandyford Dublin 18 Ireland E-mail: pjoyce@rcsi.ie HENNERBY C. & JOYCE P. (2011) Journal of Nursing Management 19, 237–245 Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting Aim This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. Background The increased number of registered general agency nurses working in an acute childrenÕs hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about Ônear missesÕ, parental dissatisfaction, perceived competency weaknesses and rising cost associated with their use. Method [YoungÕs (2009) Journal of Organisational Change, 22, 524–548] nine- stage change framework was used to guide the implementation of the competency assessment tool within a paediatric acute care setting. Implications for Nursing Management The ongoing success of the initiative, from a nurse managerÕs perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managersÕ persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail. Keywords: agency, change, competency, nurses, paediatric Accepted for publication: 14 December 2010 Journal of Nursing Management, 2011, 19, 237–245 DOI: 10.1111/j.1365-2834.2011.01223.x ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd 237