It has been suggested that the maximum weight limit is 17 kg, above which muscle competency for maintenance of a functional and durable pseudarthrosis is unlikely to be established.
The American Boards of Internal and Emergency Medicine have a general requirement for staff training, initial competency evaluation and maintenance of competency in electrocardiography [8].
Interventions included: central line insertion checklist, demonstration of competencies for line maintenance and access, daily line necessity checklist, and quality rounds by nursing leadership, heightened staff accountability, follow-up surveillance by epidemiology with timely unit feedback and case reviews, and identification of noncompliance with evidence-based guidelines.
Ongoing ALS education influences maintenance of competency and avoids skill decay.
Future work in this area is needed to measure and track clinically meaningful patient outcomes resulting from simulation-based training, examine the use of simulation to assist physicians undergoing re-entry to practice, and to examine the use of procedural skills simulation as part of a maintenance of competency and life-long learning.
However, it is reasonable that practitioners and consumers alike view maintenance of competency as a basic element of ethical and responsible practice [ 3].
Given current concerns over medical errors [ 12] and the fact that many of these errors may be occurring in the critical care environment, documentation of procedure performance in training and during maintenance of competency programs is likely to gain importance.
Lysaght and Altschuld [ 10] suggest that factions develop when professional groups are mature, but are not engaged in processes related to maintenance of competencies.
Data from this survey reveal that many consultants, particularly from DGHs, have <1 PA devoted to paediatric practice each week and thus maintenance of competencies will be particularly difficult for them.
This survey has not explored the physiological problems encountered with RRT in these patients, but has highlighted that the maintenance of training, competency and logistical problems sometimes affects the consistent, direct availability of RRT to NICU patients.
