Are Your Nurses Ready for Revalidation?
What is Revalidation?
About 6 months ago all the talk was about nurse revalidation, what it was and what nurses had to do. From April 2016 all nurses and midwives will have to demonstrate that they practice safely and effectively. The new process allows nurses to maintain their registration with the NMC but they will have to revalidate every three years. Revalidation includes the existing renewal requirements but introduces new elements which encourage nurses to reflect on the role of the code in their practice and demonstrate that they are meeting the standards.
What is required?
In order to provide safe and effective practice in line with the Code nurses must provide evidence for the following eight categories:
- Practice hours:
- 450 practice hours, or 900 hours if revalidating as both a nurse and midwife over the three year period since the registration was last renewed or they joined the register.
- Helps to maintain safe and effective practice while keeping skills up to date.
- 35 hours of continuing professional development (of which 20 must be participatory).
- Reduces professional isolation through engagement while increasing skills and awareness.
- Practice-related feedback:
- Five pieces of practice-related feedback, including notes of the content of the feedback and how it was used to improve practice.
- Helps to become more responsive to the needs of patients which will improve practice.
- Written reflective accounts:
- Five written reflective accounts that explain what was learnt from CPD activity and/or feedback and/or an event or experience in practice, how it changed or improved their work as a result, and how this is relevant to the Code.
- Helps to identify changes or improvements to make and become familiar with the Code.
- Reflective discussion:
- A reflective discussion form which includes the name and NMC Pin number of the NMC-registered nurse or midwife that took part in the discussion with as well as the date of the discussion.
- Cultivates a sharing reflective culture that focuses on improvement.
- Health and character:
- This declaration is part of the online revalidation application.
- Satisfies the Registrar of capable of safe and effective practice.
- Professional indemnity arrangement:
- Evidence to demonstrate there is appropriate indemnity arrangement in place whether it is through the employer, membership of a professional body or through a private insurance arrangement.
- Is a legal requirement for providing care?
- A confirmation form signed by a confirmer.
- Provides assurance, increases support and engagement between nurses and midwives and their confirmers.
What is the process?
If it’s over three years since the last renewal or when the nurse joined the register they need to meet the range of revalidation requirements, listed above, designed to show that they are keeping up to date and maintaining safe and effective practice. In the 12 months up to the renewal date they will need to discuss their revalidation with a confirmer. As part of this confirmation discussion they will demonstrate that they have complied with all of the revalidation requirements, except professional indemnity arrangement and health and character. Nurses will be asked to apply for revalidation every three years using NMC Online.
The NMC will notify nurses at least 60 days before their application is due, either by email if they have set up an NMC Online account, or by letter sent to their registered address. Once the nurse has received their notification they will need to go online and complete the application form. As part of that application, they need to declare to the NMC that they have complied with the revalidation requirements. Finally, following submission of the revalidation application each year the NMC will select a sample of nurses and midwives to provide them with further information to verify the declarations they made as part of their revalidation application. Nurses selected for this verification will not have their registration renewed until this process is completed.
There have been many roadshows and workshops provide for nurses to explain revalidation, what it is, what the process involves and how to prepare. Four key top tips include:
- Understand key terms: Including the registration process, the fee expiry date, the revalidation application date, the renewal date.
- Keep a portfolio: Keep evidence in a portfolio that the revalidation requirements have been met, this doesn’t necessarily need to be an e-portfolio.
- Conflicts of interest and perceptions of bias: Nurses must be mindful about any personal or commercial relationship between themselves, their confirmer and their reflective discussion partner for example, it wouldn’t be appropriate for a family member or person with whom the nurse has a close personal relationship to undertake any of those roles.
- Appraisals: The revalidation process is designed so that it can be undertaken as part of a regular appraisal and, where possible, the confirmation discussion should form part of the annual appraisal.
Things to be aware of
In order to meet the requirements nurses can only count practice hours that they undertook whilst they were registered, they cannot count unregistered practice towards the practice hours requirement. They must also meet their practice hours in a role where they rely on their skills, knowledge and experience of being a registered nurse. As a professional, all nurses have a duty to keep their professional knowledge and skills up to date through a continuous process of learning and reflection, it isn’t down to the practice.
Nurses should try to obtain feedback from a variety of sources including from patients, colleagues, complaints and serious event reviews, practice performance reports and feedback received through their annual appraisal. Reflective accounts could include a particular topic which may have arisen through some feedback received following an event, such as consent and confidentiality and identify how that relates to the Code. Nurses must discuss their written reflective accounts with an NMC-registered nurse or midwife as part of a reflective discussion. Line managers are an appropriate confirmer and a line manager does not have to be an NMC-registered nurse or midwife. In meeting the revalidation requirements and keeping evidence, the nurse must not record any information that might identify an individual, whether that individual is alive or deceased, this includes patients, service users, colleagues or other individuals.
The NMC website has all the guidance and tools that nurses need for revalidation www.nmc.org.uk/standards/revalidation, including information for employers.
Alison Lowerson – QCS Expert GP Practice Manager Contributor
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