A competency-based patient care program was developed to measure current levels in staff nurses. Use of evaluative tools designed on site has resulted in: 1) Development of a credentialing and privileging process which meets JCAHO requirements; 2) Planning of an educational calendar based on identified needs; 3) Strengthening the foundations of the nursing career ladder; 4) Overall team building which integrates nurses with other healthcare professionals; and 5) Improved patient care.