Development of competency inventory for registered nurses in the people's republic of china: Scale development

Nursing core competencies and educational needs in the low- and middle-income country: A cross-sectional study

BACKGROUND

The government of the Kyrgyz Republic is committed to improving healthcare worker education, and as nurses comprise the majority of healthcare workers, improving nursing education and competency is a critical policy strategy. However, insufficient understanding of nurses' duties and competencies, low levels of professional education and motivation, and the poor reputation of the profession have negatively impacted the development of nursing in the Kyrgyz Republic.

AIM

This study aimed to identify the core competencies of nursing that are necessary for improving healthcare in the Kyrgyz Republic.

DESIGN

The research design was a cross-sectional study.

SETTING

The study was conducted from June to November 2022 across the Kyrgyz Republic.

PARTICIPANTS

A total of ten focus group interviews were conducted with 54 participants, and 289 individuals responded to the survey.

METHODS

A job analysis was conducted to identify nursing core competencies, followed by focus group interviews. Educational needs were assessed and analysed for importance and performance using the Competency Inventory for Registered Nurses and the Borich Needs Assessment Model.

RESULTS

Of the 289 participants, 97.9 % were female, the mean age was 43.22, and the mean nursing career length was 19 years. Eleven duties were identified as nursing core competencies. Educational needs were highest for teaching-coaching, followed by clinical care and critical thinking and research aptitude, with interpersonal relations being the lowest. Critical thinking and research aptitude, clinical care, and professional development were identified as topics with high importance and educational needs.

CONCLUSIONS

The nursing core competencies reflect the emphasis on primary health care in the Kyrgyz Republic, while the educational needs were related to international nursing standards and national nursing education characteristics. The findings can be used to develop a bachelor's-level nursing curriculum in the Kyrgyz Republic to improve nursing care and contribute to improving the health status of the population.

Development of entrustable professional activities for novice nurses: A modified Delphi study

AIM

This study aimed to develop a tailored EPA framework for novice nurses to support their integration and performance in hospital settings.

BACKGROUND

Novice nurses often struggle with the transition from education to practice due to the gap between theoretical knowledge and practical skills. EPAs help bridge this gap by defining and assessing key competencies, but a framework specific to novice nurses is needed to address their unique challenges.

DESIGN

A modified Delphi method was used.

METHODS

Conducted from October 2023 to March 2024, the study followed a four-stage process: team formation, identification, revision and evaluation of EPAs. Initial EPAs were identified through literature reviews, clinical guidelines and focus groups, then refined using the EQual rubric. Two Delphi rounds were conducted for validation. Experts rated the importance of EPAs in the first round, followed by online discussions, with the second round focusing on dimensions including Focus, Observable, Realistic, Generalizable and Multiple competencies.

RESULTS

The final framework included 12 EPAs: 1) Manage Admission and Discharge, 2) Provide Basic Care, 3) Collect Specimens, 4) Administer Medications, 5) Perform Non- Medication Therapies, 6) Monitor Conditions, 7) Respond to Emergencies, 8) Educate Patients, 9) Prevent Adverse Events, 10) Conduct Handovers, 11) Document Care and 12) Operate Equipment.

CONCLUSION

This EPA framework integrates theory and practice to improve training and assessment. Future research should focus on its implementation and refinement in diverse clinical settings to ensure broader applicability.

Comparison of the Achieved and Expected Competence Level of New Graduate Nurses: Two Cross-Sectional Studies

AIM

To explore and compare the self-perceived competence level of new graduate nurses with the expected competence level that nurse managers believe new graduate nurses should have in general.

DESIGN

Two cross-sectional empirical studies.

METHODS

Two independent cross-sectional studies were carried out in 12 tertiary hospitals in September 2020 and November 2021, respectively. Participants were 1017 new graduate nurses with less than 2 years of work experience and 306 nurse managers who completed an online survey.

RESULTS

The score of self-perceived nursing competence of new graduate nurses was 74.77 ± 14.35, and the expectation of nurse managers was 74.21 ± 15.04. The values of 18 items were significantly different between the two of them (p < 0.05), and there were only three items showed higher expectations of nurse managers than the self-rated values of new graduate nurses. Results of latent profile analysis revealed that this cohort of new graduate nurses could be divided into three subgroups, named risky competent (11.1%), medium competent (46.0%) and advanced competent (42.9%). When comparing, the nurse managers' expected competence level was between the value of 'medium competent' group and 'advanced competent' group.

CONCLUSIONS

Our study adopted a dual perspective comparison of nurse managers and new graduate nurses, which broke through the limitations of the previous single perspective study of new graduate nurses' nursing competence.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This study highlights the importance of the consistency in new graduate nurses' nursing competence from the perspectives of new graduate nurses and nurse managers.

IMPACT

This study showed a generally good match of actual nursing competence level of new graduate nurses and the expected level from nurse managers. While there was significant individual heterogeneity in the competence score of new graduate nurses, three subgroups were identified through the individual-centred analysis of latent profile analysis. Therefore, Nurse managers need to systematically adjust the standardized training programs and teaching methods for new graduate nurses according to the population characteristics and take precise interventions to improve nursing competence of new graduate nurses.

REPORTING METHOD

We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Construction of learning objectives and content for emergency triage nurses in tertiary general hospitals: A Delphi study

AIM

To construct learning objectives and educational content for emergency triage nurses based on core competencies.

BACKGROUND

The core competencies of emergency triage nurses has an impact on the quality of medical services and patient treatment outcomes. However, research on learning objectives and educational content aimed at cultivating the core competencies of emergency triage nurses is limited.

DESIGN

A Delphi study.

METHODS

To develop a draft of the teaching objectives and content for emergency triage nurses based on core competencies, a literature review, semistructured interviews and expert group meetings were conducted. Then, 24 experts were invited to provide feedback on the draft and suggest revisions through two rounds of Delphi consultation.

RESULTS

Consensus was reached on six core competencies, 30 learning objectives and 43 educational contents. The response rate for the two rounds of expert questionnaires was 100 %, with 79.2 % and 54.2 % of the experts providing feedback in the first and second rounds, respectively. The judgement coefficient (Ca) was 0.910, the familiarity coefficient (Cs) was 0.917 and the authority coefficient (Cr) was 0.914. The Kendall's W coefficients for the two rounds of expert inquiry were 0.321 and 0.334, indicating a statistically significant difference (P<0.05).

CONCLUSIONS

Constructing learning objectives and educational content for emergency triage nurses based on core competencies is scientific and reliable and can provide a reference for the training and management of emergency triage nurses.

Influence of information anxiety on core competency of registered nurses: mediating effect of digital health literacy

BACKGROUND

In the information age of health care, nurses often face information overload, leading to negative emotions, e.g., anxiety that may impede the adoption of evidence-based practice and clinical decision-making process. Nurses with higher digital health literacy can effectively process and manage information. Despite this, no research has explored the relationship between information anxiety, digital health literacy, and core competency among nurses. Therefore, this study aims to investigate the mediating effects of digital health literacy on information anxiety and core competency among nurses.

METHODS

From July to October 2023, the data for this cross-sectional study were collected. The study surveyed a total of 608 nurses from three tertiary hospitals in Fujian Province, and the survey instruments included a sociodemographic information questionnaire, Chinese revision version of the Digital Health Literacy Instrument (CR-DHLI), Information Anxiety Scale (IAS), and Competency Inventory for Registered Nurses (CIRN). Descriptive statistics and Pearson correlation analysis were conducted using SPSS 29.0, and the mediating effect of digital health literacy was examined using Mplus.

RESULTS

The mean score of nurses' information anxiety, digital health literacy, and core competency was 3.03 ± 0.91, 2.46 ± 0.56, 2.72 ± 0.88, respectively. And the mediation model of information anxiety on core competency for nurses showed a good model fit index (χ²/df = 2.207, CFI = 0.985, TLI = 0.982, RMSEA = 0.045, SRMR = 0.035). Digital health literacy was positively correlated with nurses' core competency but negatively correlated with information anxiety. The results of path analysis revealed that information anxiety had negative and significant direct effects on NCC (β = -0.119, P = 0.004) and DHL (β = -0.297, P < 0.001). DHL had a positive effect on NCC (β = 0.306, P < 0.001). Digital health literacy played a partial mediating role, accounting for 43.54% of the relationship between information anxiety and nurses' core competency.

CONCLUSIONS

Information anxiety among nurses was at relatively high levels, which had a negative impact on the core competency of nurses. This issue requires attention from nursing managers. The mediating role of digital health literacy in the relationship between information anxiety and core competency among nurses has been established. Nursing managers should strengthen the evaluation of nurses' DHL and devise effective support strategies to enhance DHL, thus improving the core competence of nurses in information age.

Comparison of professional competency and anxiety of nursing students trained based on two internship models: a comparative study

BACKGROUND

Improving the professional competency of nursing students during the internship is critical. This study aimed to compare the professional competency and anxiety of nursing students trained based on two internship models.

METHODS

This is a two-group posttest-only quasi-experimental design study. One hundred nursing students who passed internship models A (a previous internship model) and B (an intervention with more educator support and a more planned and programmed process) were randomly enrolled in this study. Internship model groups A and B were conducted for the students in semesters 7 and 8. The outcomes assessed in both groups were "The Competency Inventory for Registered Nurses" and Spielberger "State-Trait Anxiety Inventory". T-test and MANOVA were used to analyze the data.

RESULTS

The mean scores of competency were 134.56 (SD = 43.23) and 160.19 (SD = 35.81) for the nursing students in the internship model groups A and B, respectively. The mean scores of nursing students' anxiety were 92.14 (SD = 15.36) and 80.44 (SD = 18.16) in the internship model groups A and B, respectively. MANOVA test showed a significant difference between the groups regarding professional competency (F = 10.34, p = 0.002) and anxiety (F = 11.31, p = 0.001).

CONCLUSIONS

The internship model group B could improve the professional competency of nursing students to a great extent and they experienced mild anxiety; it is suggested that this intervention should be done for nursing students. Conducting more studies to evaluate the effect of this model on the nursing students' competency and anxiety after graduation and as a novice nurse is suggested.

A scale for measuring nursing digital application skills: a development and psychometric testing study

BACKGROUND

The adoption of digitization has emerged as a new trend in the advancement of healthcare systems. To ensure high-quality care, nurses should possess sufficient skills to assist in the digital transformation of healthcare practices. Suitable tools have seldom been developed to assess nurses' skills in digital applications. This study aimed to develop the Nursing Digital Application Skill Scale (NDASS) and test its psychometric properties.

METHODS

The Nursing Digital Application Skill Scale was developed in three phases. In Phase 1, an item pool was developed based on previous literature and the actual situation of nursing work. Phase 2 included 14 experts' assessment of content validity and a focus group interview with 30 nurses to pretest the scale. In phase 3, 429 registered nurses were selected from March to June 2023, and item analysis, exploratory factor analysis, and confirmatory factor analysis were used to refine the number of items and explore the factor structure of the scale. Additionally, reliability was determined by internal consistency and test-retest reliability.

RESULTS

The final version of the NDASS consisted of 12 items. The content validity index of NDASS reached 0.975 at an acceptable level. The convergent validity test showed that the average variance extracted value was 0.694 (> 0.5) and the composite reliability value was 0.964 (> 0.7), both of which met the requirements. The principal component analysis resulted in a single-factor structure explaining 74.794% of the total variance. All the fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the single-factor structure contributed to an ideal model fit. The internal consistency appeared high for the NDASS, reaching a Cronbach's alpha value of 0.968. The test-retest reliability was 0.740, and the split-half coefficient was 0.935.

CONCLUSION

The final version of the NDASS, which possesses adequate psychometric properties, is a reliable and effective instrument for nurses to self-assess digital skills in nursing work and for nursing managers in designing nursing digital skill training.

Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study

OBJECTIVES

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

DESIGN

A cross-sectional study.

METHODS

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

RESULTS

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=-0.151, p=0.026; β=-0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.

CONCLUSIONS

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses' core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.

Development and Psychometric Testing of Task and Contextual Performance Scales for Clinical Nurses

Background and Purpose: This study aims to develop a task performance scale and a contextual performance scale for clinical nurses and to test the scales psychometrically. Methods: This study was carried out in two phases in a private hospital group. During the first phase, the initial scales were developed, and then the validity and reliability of the scales were analyzed; 154 nurses participated in the second phase. Results: The task performance scale consisted of two factors (total variance explained: 75.87%); the contextual performance scale consisted of three factors (total variance explained: 74.05%). The content validity indexes of both scales were 0.99. The Cronbach's alpha coefficients of both scales were 0.98. The test-retest reliability and inter-rater agreement of the scales were also good. Conclusions: The scales can contribute to nursing literature and hospital managers in assessing the performance of clinical nurses.

Professional Values and Self-Reported Clinical Competence of Acute Care Nurses in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Professional values are the foundation of nursing practice. Current research evidence on the influence of professional values on clinical competence among acute care nurses in the clinical area is lacking.

PURPOSE

The purpose of this study was to examine the professional values and self-reported clinical competence among acute care nurses.

METHODS

This quantitative study used a cross-sectional, correlational design. A convenience sample of 403 nurses was recruited to answer the survey utilizing the Nurses Professional Values Scale-3 and the Nurse Competence Scale. The Pearson correlation coefficient was computed to test the relationship between study variables, and a stepwise multiple regression analysis was then performed to investigate the predictors of nurses' professional values and clinical competence.

RESULTS

The professional value of "caring" received the highest mean score, followed by "professionalism", while the factor "activism" was rated the lowest. Education was a significant predictor of all three factors of professional values. For clinical competence, "managing situations" was rated as the highest dimension, while "ensuring quality" was rated as the lowest. Moderate positive correlations were revealed between the three factors of professional values and all dimensions of nurses' clinical competence. Area of practice and "activism" were the only significant predictors of the nurses' clinical competence.

CONCLUSIONS

Nurses perceived all three factors of professional values with high importance in influencing their clinical competence. These findings can contribute to the development of educational interventions to improve and sustain professional values and clinical competence among acute care nurses.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study

BACKGROUND

Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts.

METHODS

A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished.

RESULTS

A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies.

CONCLUSIONS

We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

Influence of psychological capital on core competency for new nurses

BACKGROUND

The development of core competency is crucial for the success of new nurses, enabling them to deliver high-quality care. Psychological capital (PsyCap), encompassing self-efficacy, optimism, hope, and resilience, significantly influences individuals' abilities and achievements across various professions. However, limited research has specifically examined the impact of PsyCap on the core competency of new nurses. This study aims to bridge this gap by investigating the relationship between PsyCap and core competency development in new nurses, providing valuable strategic insights for improving PsyCap and promoting core competence acquisition.

METHODS

142 new nurses were chosen for the investigation using a convenient cluster sampling method. The questionnaire included components on socio-demographic characteristics, the Competency Inventory for Registered Nurses (CIRN), and the PsyCap Questionnaire-24 (PCQ-24). The t-test, One-Way ANOVA, Pearson correlation analysis and hierarchical multiple regression were used for statistical analysis.

RESULT

The number of valid questionnaires was 138, and the effective return rate was 97.2%. The overall mean score for core competencies was 171.01 (SD 25.34), and the PsyCap score was 104.76(SD 13.71). The PsyCap of new nurses was highly correlated with core competency, with a correlation coefficient of r = 0.7, p < 0.01. Self-efficacy of PsyCap is a significant independent predictor of core competency (adjust R2 = 0.49).

CONCLUSION

Self-efficacy in PsyCap is an important predictor of new nurses' core competency. Nursing managers should pay sufficient attention to the cultivation and development of new nurses' PsyCap, with particular emphasis on enhancing self-efficacy to improve their core competency.

Psychometric testing of the nurse professional competence scale Arabic version: An exploratory and confirmatory factor analyses

AIM

To translate the Nurse Professional Competence Scale-Short Form English version into Arabic and psychometrically validate its properties among Saudi citizen nurses.

BACKGROUND

Evaluating nurses' professional competence is vital in delivering safe, cost-effective care and developing healthcare systems. However, psychometrically reliable and validated nurse competence scales in Arabic-speaking countries remain scant.

DESIGN

A descriptive cross-sectional design adhering to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

METHODS

Participant nurses (n = 598) were conveniently recruited from four government-owned hospitals and completed the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form. We used Spearman's rank-order correlation, exploratory factor analysis, Kaiser-Meyer-Olkin test, and confirmatory factor analysis to analyze the data.

RESULTS

After exploratory factor analysis and reliability analyses, several items of the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form were omitted due to high inter-item correlations and low factor loading difference. The Arabic version of the Nurse Professional Competence Scale-Short Form was reduced to 21 items, consisting of a three-factor structure: Professional Care Pedagogics, Holistic Value-Based Care, and Direct Nursing Care. Results also demonstrated that the revised three-factor structure had good overall scale reliability, good subscale internal consistencies, and acceptable construct validity using the confirmatory factor analysis.

CONCLUSION

The 21-item Nurse Professional Competence Scale-Short Form Arabic version is a useful scale, having demonstrated construct validity and reliability. Therefore, nurse managers in Arabic-speaking nations could assess their nurses' professional competence using the 21-item Nurse Professional Competence Scale-Short Form Arabic version to develop proactive programs that enhance professional competence.

Emotional intelligence as a mediator between spiritual care-giving competency and core competencies in Chinese nursing interns: a cross-sectional study

BACKGROUND

The development of nursing interns' fundamental competencies should be a top focus because they represent an essential reserve for nursing professionals. The objective of this study is to investigate the relationship between spiritual care-giving competency (SCG) and nursing core competencies (NCC) among Chinese nursing interns, adopting a competency-based education (CBE) perspective, additionally, the study aims to examine how emotional intelligence (EI) serves as a mediator in this relationship.

METHODS

A nationwide online survey was completed by 1811 Chinese nursing interns at vocational colleges between June and July 2022 as part of a multi-site, cross-sectional, web-based study. Participants completed a demographic questionnaire and competencies inventory for the registered nurse questionnaire (CIRN), the Chinese version of the spiritual care-giving scale questionnaire (C-SCGS), and the Chinese version of the Wong and Law EI scale questionnaire (WLEIS-C). Means, standard deviations, t-tests, one-way ANOVA analysis, and Pearson's production correlation coefficients were calculated using IBM SPSS25.0 software. Mediated effect tests and studies utilizing the process plug-in SPSS developed by Hayes.

RESULTS

The NCCs of college nursing interns were related to whether working as student leaders, whether have a better self-learning evaluation level, whether a college nursing intern with good interpersonal relationship, and whether they intend to engage in the nursing profession in the future. The scores of NCC, EI, and SCG were (156.43±23.14), (61.55±9.10), and (167.64±20.52) respectively. There were positive correlations among SCG (r = 0.402), EI (r = 0.506), and NCC. The partial mediating effect of EI between SCG and NCC was 0.127, accounting for 36.29% of the total results.

CONCLUSION

The average levels of Chinese college nursing interns' NCC and SCG were at a moderate level. EI is mediating between SCG and NCC in Chinese nursing interns. This new perspective shows that developing and improving SCG and EI may improve NCC. We suggest modifying the nurse curriculum and instruction to strengthen NCC and integrating SCG and EI management into the nursing curriculum.

Competency in nursing practice: a concept analysis

OBJECTIVE

Competency denotes the ability to execute a certain task or action with the necessary knowledge. Competency definitions and measurements are challenging for nursing and other professions due to their multidimensional aspects. This study aimed to clarify the concept of competency in nursing practice and propose an accurate definition.

DESIGN

Walker and Avant's approach was used to elucidate the concept of competency in nursing practice.

DATA SOURCES

ScienceDirect, PubMed, ProQuest, Scopus and CINAHL were searched from 1 January 2000 to 31 December 2021.

ELIGIBILITY CRITERIA

We included studies with the keywords: "concept analysis", "competence", "competency" and "nursing". The search was limited to full-text studies written in English that used theoretical and empirical approaches.

DATA EXTRACTION AND SYNTHESIS

We extracted the concept's uses, defining attributes, and the consequences and antecedents of the concept.

RESULTS

60 articles were identified from the search process; after excluding duplicates and works unrelated to the study aim and context following the full-text screening, 10 articles were included in this concept analysis. The common defining attributes of competency were knowledge, self-assessment and dynamic state. Competency in nursing practice had many reported positive consequences that include but are not limited to improved patient, nurse and organisational outcomes.

CONCLUSIONS

Nurses can benefit from the result of this analysis in practice to implement professional care, in particular clinical contexts and situations to enhance patients' health.

Core competencies of healthcare professionals in Oman: Research and evidence-based practice needs attention

AIM

The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency.

DESIGN

A cross-sectional design.

METHODS

Healthcare Professional Core Competency Instrument, consisting of 11 sub-scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t-test, ANOVA and linear regression were used for data analysis.

RESULTS

Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence-based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts.

Workflow interruption and nurses' mental workload in electronic health record tasks: An observational study

BACKGROUND

Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human-machine interactions in nursing care, but few studies have examined interruptions and nurses' mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses' mental workload and performance in EHR tasks.

METHODS

A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1^st to October 31^st, 2021. An observer documented nurses' EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses' mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model.

RESULTS

In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload.

CONCLUSIONS

Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses' mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload.

Healthcare professionals' digital health competence and its core factors; development and psychometric testing of two instruments

BACKGROUND

Healthcare professionals' digital health competence is an important phenomenon to study as healthcare practices are changing globally. Recent research aimed to define this complex phenomenon and identify the current state of healthcare professionals' competence in digitalisation but did not include an overarching outlook when measuring digital health competence of healthcare professionals.

OBJECTIVES

The purpose of this study was to develop and psychometrically validate two self-assessed instruments measuring digital health competence and factors associating with it.

METHODS

The study followed three phases of instrument development and validation: 1) conceptualisation and item pool generation; 2) content validity testing and pilot study; and 3) construct validity and reliability testing. The conceptual background of the instruments was based on individual interviews conducted with healthcare professionals (n = 20) and previous systematic reviews. A total of 17 experts assessed the instrument's content validity. Face validity was evaluated by a group of healthcare professionals (n = 20). Data collection from 817 professionals took place in spring-summer 2022 in nine organisations. Construct validity was confirmed with exploratory factor analysis. Cronbach's alpha was used to assess the internal consistency of the instruments.

RESULTS

The instrument development and validation process resulted in two instruments: DigiHealthCom and DigiComInf. DigiHealthCom included 42 items in 5 factors related to digital health competence, and DigiComInf included 15 items in 3 factors related to educational and organisational factors associated with digital health competence. The DigiHealthCom instrument explained 68.9 % of the total variance and the factors' Cronbach alpha values varied between 0.91 and 0.97. The DigiComInf instrument explained 59.6 % of the total variance and the factors' Cronbach alpha values varied between 0.76 and 0.88.

CONCLUSIONS

The two instruments gave valid and reliable results in psychometric testing. The instruments could be used to evaluate healthcare professionals' digital health competence and associated factors.

Development and psychometric evaluation of the trauma nurse core competency scale

Background

Trauma, especially severe trauma, has become a significant public health problem worldwide. This postulates higher requirements on the core competence of trauma nurses. However, limited scales exist to assess it validly and reliably. This study aims to develop and evaluate the psychometric properties of the Trauma Nurse Core Competency Scale (TNCCS).

Methods

This study included three stages. First, scale development was based on a broad literature review and two rounds of Delphi expert consultation. Then, a pre-investigation was conducted with 106 trauma nurses, and a formal scale was formed. Finally, scale evaluation of reliability and validity, based on a cross-sectional study, was tested with 1,107 trauma nurses. Content validity and structure validity were used to evaluate the validity of TNCCS. The Cronbach's α coefficient and the split-half reliability coefficient were used to evaluate the reliability of TNCCS.

Results

The final scale contained 46 items under three dimensions, which were Knowledge and skills (21 items), Comprehensive literacy (20 items), and Professionalism & physical and mental health (5 items). The Content Validity Index (CVI) of the total scale was 0.980. The goodness-of-fit indices (χ²/df = 3.547, RMSEA = 0.065, GFI = 0.929, CFI = 0.912, NFI = 0.904, IFI = 0.929) signified a good fit for this model. The Construct Reliability (CR) ranged from 0.89 to 0.98, and the Average Variance Extracted (AVE) ranged from 0.62 to 0.69. The Cronbach's α coefficient of the scale was 0.99, ranging from 0.90 to 0.98 for the subscales. The split-half reliability coefficient was 0.84.

Conclusions

The TNCCS demonstrated good validity and reliability, and it could be used to assess the core competency of trauma nurses. The present study has valuable implications for nursing managers to take corresponding measures to train and improve the core competence of trauma nurses.

Status and influencing factors of nursing and midwifery professionals' core competence- a cross sectional study

OBJECTIVES

This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under-five nursing in China.

BACKGROUND

Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low- and middle-income countries like China, due to the overwhelming COVID-19 crisis.

METHOD

The 890 nurses and midwives from 12 hospitals were investigated in this cross-sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses.

RESULTS

The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P < .05).

CONCLUSIONS

The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence.

IMPLICATIONS FOR NURSING MANAGEMENT

Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners.

Construction on teaching quality evaluation indicator system of multi-disciplinary team (MDT) clinical nursing practice in China: A Delphi study

AIM

To construct an evaluation indicator system for nursing multi-disciplinary team (MDT) clinical practice in China and to provide quantifiable indicators for MDT clinical teaching courses.

METHODS

Based on relevant literature retrieval and analysis, a evaluation indicator system of nursing MDT clinical teaching quality was preliminarily constructed using the Donabedian. Structure-Process-Outcome model as theoretical guidance. Then, a final indicators content was formed after two rounds of expert consultation and Analytic Hierarchy Process (AHP) was used to determine the weight of indicators at all levels.

RESULTS

The effective response rate of the questionnaires in two rounds were 95.23% (20/21) and 100% (20/20) respectively, the expert authority coefficient (Cr) were 0.838 and 0.853 respectively and the Kendall's coefficient of concordance (Kendall's W) of indicators at all levels were 0.137-0.612 (P < 0.05). The final evaluation index system consisted of three one-class indicators, 8 s-class indicators and 28 third-class indicators.

CONCLUSION

The study constructed a comprehensive set of evaluation indicator system of nursing MDT clinical practice, which was scientific and reliable and provides reference for the clinical teaching quality evaluation of MDT nursing.

The Development and Psychometric Assessment of a Coping Inventory for Intimate Partner Violence Among Abused Iranian Women

Helping abused Iranian women better cope with intimate partner violence (IPV) requires measuring their coping strategies. The review of literature on the subject showed that there is no context-based instrument for measuring coping with IPV among abused Iranian women. The present study was thus conducted to develop and perform the psychometric assessment of a coping inventory for intimate partner violence (CIIPV) in abused Iranian women.In this methodological study, two consecutive studies were carried out for the development and psychometric assessment of CIIPV. In the first study, the inventory items were designed based on the results of a previous qualitative study that was conducted to identify the coping strategies used for IPV among abused Iranian women. In the second study, the inventory's validity and reliability were examined. The face validity, content validity, construct validity, and convergent validity of the inventory were also evaluated. Moreover, to assess the reliability of the inventory, its internal consistency was estimated using Cronbach's alpha coefficient.A total of 58 items were designed in the first study and then psychometrically assessed. The final version of the inventory comprised 29 items and 6 factors, including negotiation, instrumental action, help-seeking, positive cognitive restructuring, spiritual support-seeking, and distraction. The content validity index of the entire inventory was 1. The extracted factors explained 75.44% of the variance. The convergent validity of the CIIPV was confirmed with a medium positive relationship between the conceptually similar subscales in the two instruments CIIPV and the Ways of Coping Questionnaire. Furthermore, the Cronbach's alpha coefficient of the entire inventory was 0.86, indicating its suitable reliability. Given the results, the CIIPV is a valid and reliable domain-specific tool to measure the coping strategies used for IPV among abused Iranian women.

The Role of Fundamental Nursing Practices Simulation on Students’ Competencies and Learning Satisfaction: Repeated Measured Design

Few studies have examined the simulation of fundamental nursing practices regarding nursing competencies and learning satisfaction via repeated measured methods. Objectives: To evaluate a simulation of fundamental nursing practices on nursing students’ competencies and learning satisfaction in three time points: before (T1), immediately after (T2), and one month after simulation (T3), and to examine nursing students’ competency predictors to learning satisfaction, immediately after conducting the simulation and one month after. Methods: The study design was a one-group, repeated measures study. Ninety-three undergraduate nursing students were convenience sampled and conducted a simulation of fundamental nursing practices. The students completed a questionnaire at T1, T2, and T3. The Competency Inventory for Registered Nurses questionnaire was distributed, and question about the level of learning satisfaction were asked. Results: All nursing competencies and learning satisfactions increased significantly. Only the legal/ethical practice competency succeeded in predicting the learning satisfaction in T2 and in T3 after conducting simulations. Conclusions: This study has established that a simulation of fundamental nursing practices is effective not just immediately after performing the simulation but also one month after the simulation. Therefore, it is recommended to implement a pedagogical structure of simulations of fundamental nursing practices in other nursing education areas.

Psychometric evaluation of the perceived perioperative competence scale-revised among the Chinese operating room nurses: a methodological research

Background

Perioperative competence is necessary to evaluate operating room nurses. The Perceived Perioperative Competence Scale-Revised (PPCS-R) is the only available tool developed specifically for the perioperative setting. However, there is a lack of research on the reliability and validity of this scale among Chinese nurses. Thus, the aim of this study is to translate, culturally adapt, and evaluate the psychometric properties of the Perioperative competence Scale-Revised (PPCS-R) among operating room nurses in China.

Methods

Instrument cultural adaptation was carried out through forward translation, back translation, expert panel evaluation and pretesting. The psychometric properties (content validation, item analysis, construct validation, and reliability coefficient) of the Chinese PPCS-R (C-PPCS-R) were examined. An online survey was completed from June to August 2020 by operating room nurses (N = 480) in five third-grade class-A hospitals in Beijing.

Results

The item analysis identified six items for scale reduction. Exploratory factor analysis showed the remaining 34 items loaded on six factors, which were named in accordance with the original scale. The six-factor model showed a good fit through confirmatory factor analysis. The item content validity index for the C-PPCS-R items ranged from 0.857 to 1.000, and that for the total scale was 0.875. Cronbach’s alpha was showed 0.787. Together, the six factors explained 68.62% of the variance.

Conclusions

The 34-item C-PPCS-R showed good validity and reliability to measure perceived competence among operating room nurses in the Chinese context. The scale can assist nurse managers to identify operating room nurses’ perceived competence, and provides evaluation criteria for career planning, performance appraisal, job assignment, and continuing education.

Extending the description of the clinical research nursing workforce

Background

The role of Clinical Research Nurses across the globe has not been evaluated to identify similarities or differences among specific activities.

Aims

This study's aims were to determine differences in Clinical Research Nurses most frequently performed activities, if these activities are reflective of those previously described in the literature, and job titles Clinical Research Nurses use to self-identify.

Methods

An online cross-sectional survey distributed via snowball sampling through email, social media, and research nurses' networks included questions on frequency of activities performed and information related to job titles. Pearson's chi-square test is analyzed for associations between the groups.

Results

Respondents returned 252 questionnaires, 233 were eligible for analysis. Research nurse activities performed internationally showed both similarities and differences. Any between country comparisons will be limited to the United States and the United Kingdom. The three most common tasks reported were recruitment 120 (51.5%), monitoring the research participant for potential adverse events 187 (80.2%) and providing nursing leadership within the interdisciplinary team 169 (72.5%).

Conclusion

Considering the context and range of activities of the original Clinical Research Nursing Domain of Practice, broadening the framework to include the leadership domain will better serve as a foundation for the specialty practice.

Validation of a clinical competence evaluation tool for community service nurses in North West province, South Africa

Background

Little has been done to evaluate clinical competence of community service nurses (CSNs) during the 12-month compulsory community service in South Africa. Evaluating clinical competence of CSNs would be of benefit as it might improve quality patient care and promote patient satisfaction. It therefore became of paramount importance for the researcher to establish some method of evaluating the CSNs’ clinical competence during their compulsory service in the North West province (NWP), South Africa.

Aim

To evaluate the clinical competence evaluation tool (CCET) for CSNs for reliability and validity.

Setting

A selected regional level 2 hospital.

Methods

Ten experts participated in the validation process. The tool was tested at one of the public hospitals in the NWP and 11 out of 13 CSNs participated in this process. Statistical Package for the Social Sciences version 25 was employed and the reliability of the tool was measured using Cronbach’s alpha.

Results

This tool’s content validity index has exceeded 0.80 and is indicated at 0.98, which reflects excellent content validity. The higher the content validity ratio score the greater the agreement amongst the experts. The Cronbach’s alpha coefficients in the six competencies are all greater than 0.7 implying that the tool developed in this study is reliable. All the experts indicated that the tool is clear, simple, general, accessible and important.

Conclusion

From the above-mentioned results, a CCET for CSNs was proven to be valid and reliable.

Contribution

This was the first tool to be developed in NWP of South Africa.

Psychometric evaluation of Nurse Professional Competence Scale-Short-form Chinese language version among nursing graduate students

Aim

The aim of the study was to determine the psychometric properties, construct validity and internal consistency of the Chinese language version of the Nurse Professional Competence scale short form.

Design

A methodological design was used.

Methods

Questionnaire data from 260 nursing students nearing graduation from 2 universities in China were analysed using confirmatory factor analysis, known‐group validity and internal consistency.

Results

The confirmatory factor analysis revealed that the model was acceptable, and the analyses for known‐group validity revealed statistically significant differences in all factors and the total scale of the Nurse Professional Competence scale short form. Internal consistency revealed that Cronbach's alpha values exceeded 0.70 for all factors and the total scale. The Chinese language version of the Nurse Professional Competence scale short form has acceptable construct validity and good internal consistency.

Core competency scale for operating room nurses in China: Scale development, reliability and validity evaluation

AIMS

To develop a competency scale for operating room nurses and test its reliability and validity.

BACKGROUND

The existing Chinese Registered Nurse Competency Scale and the core competency scale for operating room nurses developed abroad cannot fully meet the capacity needs of Chinese operating room nurses.

METHODS

The scale was developed based on the results of qualitative interview and the Delphi method. Ten experts were selected for expert consultation, and 300 operating room nurses were recruited by convenience sampling for a cross-sectional survey to test the reliability and validity of instrument.The reliability and validity of the scale was assessed based on internal consistency reliability, test-retest reliability and confirmatory factor analysis. Data collection was conducted between March to July, 2015.

RESULTS

An initial scale with 42 items was confirmed, and 36 items remained. The internal consistency Cronbach's α was 0.97 for the overall scale and 0.88-0.94 for the subscales. The retest reliability ranged from 0.55-0.96. Five factors were extracted by exploratory factor analysis, and they explained 66% of the total variance. The fitting indices of the confirmatory factor analysis were as follows: χ2/df = 3.47, CFI = 0.83, TLI = 0.81, SRMR = 0.06 and RMSEA = 0.09.

CONCLUSIONS

The core competency scale for operating room nurses with 5 components and 36 items had acceptable reliability and validity. The scale could continue to be optimized in the future.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BACKGROUND

Transition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown.

OBJECTIVES

The aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses.

DESIGN

A descriptive, cross-sectional design.

SETTINGS

Six tertiary hospitals in the southeast of mainland China.

PARTICIPANTS

Newly graduated registered nurses undertaking their professional role in the first year.

METHODS

Convenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019.

RESULTS

The nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = -0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency.

CONCLUSIONS

Educational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.

What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study

BACKGROUND

The core competencies of new graduate nurses (NGNs) have significant health outcomes in the clinical environment. However, these nurses experience a theory-practice gap, which creates a barrier in the transition process when they first enter the clinical workplace.

OBJECTIVE

To understand the general overview of the transition of the core competencies of NGNs to clinical practice in China and the influencing factors.

DESIGN AND SETTING

A cross-sectional study design consisting of a multi-stratified grounded random sample from 31 hospitals in seven regions nationwide.

PARTICIPANTS

2400 NGNs were recruited by email.

METHODS

The Competencies Inventory for Registered Nurse (CIRN) was applied to evaluate NGNs' core competencies.

RESULTS

NGNs performed best on leadership and worst on critical thinking or research aptitude. Core competencies were predicted by depressive symptoms, worked for two-three years, having a nurse-in-charge title, professional values, department, happiness, etc. Besides, the preceptor program also has significant to core competencies.

CONCLUSION

The average level of Chinese NGNs' core competencies was at a moderate level, which wasn't well optimized. It is recommended to adopt appropriate interventions to support NGNs. With an increase in work years and the accumulation of more work experience, the corresponding core competencies of NGNs will also improve. Preceptor institutions, limiting first-degree recruitment, and early ICU or operating room department rotations can be carried out by nursing educators to improve core competencies.

Competence-based human resource management to improve managerial competence of first-line nurse managers: A scale development

AIM

This study aimed to develop and psychometrically test a competence-based human resource management scale to improve managerial competence of first-line nurse managers in public hospitals.

BACKGROUND

To ensure the high competence of the first-line nurse managers, the competence-based human resource management should be evaluated using the best-fit instrument. However, no instrument has been identified in the hospital setting.

METHODS

This methodological study consists of three main steps: (1) generating scale items based on literature review and expert interviews, (2) pilot testing of face and content validity and (3) evaluating psychometric properties with 300 first-line nurse managers from 16 public hospitals in Indonesia selected using a multistage sampling. Data were collected from May to December 2017. Principal component analysis and Cronbach's α were used for construct validity and internal consistency reliability.

RESULTS

The final scale consists of 30 items in five dimensions, which explained 65.48% of the total variance. The dimensions include 'training and evaluation, career planning and development, rewards scheme, recruitment and selection, and appraisal system'. Cronbach's α for the scale was .89, with a range of .85 to .88.

CONCLUSION

The competence-based human resource management scale is reliable and valid to use in public hospital settings.

SUMMARY STATEMENT

What is already known about this topic? The concept of competence-based human resource management has been applied worldwide in every organization, and it is applicable to use for developing managerial competence of first-line nurse managers. Therefore, the effectiveness of this management system should be assessed via a valid and reliable instrument. Several instruments to measure competence-based human resource management have been developed, but no instrument has been identified to measure competence-based human resource management specifically in hospital settings. What this paper adds? This study developed a scale designed to measure competence-based human resource management to support improvement of first-line nurse managers' managerial competence in public hospitals. The scale demonstrated sound psychometric properties with acceptable internal consistency reliability, content validity and construct validity. The scale consists of 30 items in five dimensions: training and evaluation, career planning and development, rewards scheme, recruitment and selection, and appraisal system. The implications of this paper: This study expands the basic knowledge of competence-based human resource management as a concept with five dimensions that can be used in nursing organizations, and it can be used in quality assurance systems in public hospitals settings in Indonesia. The scale can be used as a feedback for first-line nurse managers to see the impact of competence-based human resource management framework on their competence and helps to identify which dimension of human resource management needs further improvement. With further research, the scale may be of use in other countries and settings.

A systematic review of healthcare professionals' core competency instruments

While technical and profession-specific competencies are paramount in the delivery of healthcare services, the cross-cutting core competencies of healthcare professionals play an important role in healthcare transformation, innovation, and the integration of roles. This systematic review describes the characteristics and psychometric properties of existing instruments for assessing healthcare professionals' core competencies in clinical settings. It was guided by the JBI methodology and used the COSMIN checklist (Mokkink et al., User manual, 2018, 78, 1) to evaluate the methodological quality of the included studies. A database search (CINAHL, Scopus, and PubMed) and additional manual search were undertaken for peer-reviewed papers with abstracts, published in English between 2008 and 2019. The search identified nine studies that were included in the synthesis demonstrating core competencies in professionalism, ethical and legal issues, research and evidence-based practice, personal and professional development, teamwork and collaboration, leadership and management, and patient-centered care. Few instruments addressed competencies in quality improvement, safety, communication, or health information technology. The findings demonstrate the reviewed tools' validity and reliability and pave the way for a comprehensive evaluation and assessment of core competencies into clinical practice.

Development of the Role Performance Scale for Middle-Aged Generalist Nurses in Japan

AIM

The aim of this study was to develop a self-assessment tool, the Role Performance Scale for Middle-aged Generalist Nurses in Japan and confirm its reliability and validity.

METHODS

Scale items were extracted from interviews, and item and scale-level validity were rated by nursing management researchers and middle-aged generalist nurses. The resulting 36-item questionnaire was administered to clinical generalist nurses (middle-aged nurses, n = 837; young nurses, n = 800) in Japan. Exploratory and confirmatory factor analyses were performed, and the tool's internal consistency and construct validity were analyzed.

RESULTS

Valid responses obtained from 504 middle-aged and 311 young generalist nurses were included in the analysis. The final scale was composed of 25 items, which were divided into five factors: "backing up head nurses," "instructing young nurses on practices as an informal mentor," "providing young nurses with mental support," "providing empathic support to patients and their families," and "coordinating team medical care." In the confirmatory factor analysis, the indices of fitness supported these results. The Cronbach's alpha coefficient was .94 for the total scale and ranged from .72 to .91 for the five factors. The five factors explained a cumulative variance of 65.4%.

CONCLUSIONS

The five-factor, 25-item Role Performance Scale for Middle-aged Generalist Nurses in Japan was confirmed to have sufficient reliability and validity. Middle-aged generalist nurses can use this tool to self-assess their nursing behavior. In addition, head nurses can use it to assess the role performance of middle-aged generalist nurses and aid in their continual education.

Job burnout and its influencing factors among newly graduated nurses: A cross-sectional study

BACKGROUND

Burnout affects the quality of work and health of newly graduated nurses, increases the turnover rate among newly graduated nurses and leads to a shortage of nurses. Reducing job burnout among newly graduated nurses is critical. However, the factors that impact burnout among newly graduated nurses are currently not well known.

OBJECTIVE

This exploratory study aims to identify the factors that influence burnout among newly graduated nurses in China.

METHODS

We conducted a cross-sectional study of newly graduated nurses from 15 cities in 13 provinces in China. We used online questionnaires to conduct the survey and obtain the results in this study. A STROBE checklist was used to report the results.

RESULTS

Of the 2400 questionnaires distributed, 2071 (86.29%) were returned. Job satisfaction, professional rank, hospital level, professional values and core competence were negatively correlated with burnout, while negative emotions were positively correlated with burnout. Women were more prone to burnout than men.

CONCLUSIONS

Burnout among newly graduated nurses was divided into three dimensions based on the Maslach Burnout Inventory Scale. Our findings provided new evidence that newly graduated nurses had average levels of emotional exhaustion and depersonalisation and low levels of personal accomplishment. Job satisfaction, professional rank, hospital level, gender, professional values, negative emotions and core competence were predictors of job burnout among NGNs in China.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should pay attention to burnout management, standardise training about professional values, core competence and coping mechanisms and promote mental health and job satisfaction among newly graduated nurses.

The development of competency frameworks in healthcare professions: a scoping review

Competency frameworks serve various roles including outlining characteristics of a competent workforce, facilitating mobility, and analysing or assessing expertise. Given these roles and their relevance in the health professions, we sought to understand the methods and strategies used in the development of existing competency frameworks. We applied the Arksey and O'Malley framework to undertake this scoping review. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) using keywords related to competency frameworks. We screened studies for inclusion by title and abstract, and we included studies of any type that described the development of a competency framework in a healthcare profession. Two reviewers independently extracted data including study characteristics. Data synthesis was both quantitative and qualitative. Among 5710 citations, we selected 190 for analysis. The majority of studies were conducted in medicine and nursing professions. Literature reviews and group techniques were conducted in 116 studies each (61%), and 85 (45%) outlined some form of stakeholder deliberation. We observed a significant degree of diversity in methodological strategies, inconsistent adherence to existing guidance on the selection of methods, who was involved, and based on the variation we observed in timeframes, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. We observed significant variation within the conduct and reporting of the competency framework development process. While some variation can be expected given the differences across and within professions, our results suggest there is some difficulty in determining whether methods were fit-for-purpose, and therefore in making determinations regarding the appropriateness of the development process. This uncertainty may unwillingly create and legitimise uncertain or artificial outcomes. There is a need for improved guidance in the process for developing and reporting competency frameworks.

Factors Related to the Clinical Competence of Registered Nurses: Systematic Review and Meta-Analysis

PURPOSE

To determine the factors associated with the clinical competence of registered nurses.

METHODS

Systematic review and meta-analysis was used. The search strategy was limited to 10 years, ranging from January 2009 to December 2019, in Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Google Scholar. A meta-analysis was performed using R Studio with the metafor package (Boston, MA, USA; https://rstudio.com/products/rstudio/older-versions/).

RESULTS

A total of 22 studies were included, representing 33,961 nurses. There were 28 factors associated with clinical competence. Of those, 13 factors were significantly supported and included for meta-analysis, grouped into (a) individual-related factors, (b) job satisfaction, (c) bullying, (d) burnout, and (d) specific knowledge. The effect size of those factors ranged from -0.14 to 0.50.

CONCLUSIONS

Among individual-related factors, salary has the largest effect size on competence and is considered important. Clinical competence is positively affected by job satisfaction, but negatively influenced by bullying and burnout. Although specific knowledge has a large effect size, it does not significantly affect the clinical competence of registered nurses.

CLINICAL RELEVANCE

It is critical to understand factors related to the clinical competence of registered nurses to maintain quality care and patient outcomes in clinical settings. The findings serve as data to help nurse managers find effective ways to improve the knowledge, skill, attitudes, and performance of registered nurses.

The Core Knowledge and Skills of Nursing Competency Regarding Mealtime Assistance for Hemiplegic Patients in China

PURPOSE

Hemiplegic patients often experience malnutrition and feeding risks due to disabilities and inadequate nursing support; nursing roles regarding mealtime assistance remain unclear in China. Therefore, this study aimed to clarify the core knowledge and skills of nursing competency regarding mealtime assistance for hemiplegic patients in China.

METHODS

A cross-sectional survey of self-administered questionnaire to 640 nurses (response rate: 57.7%) from two tertiary teaching hospitals and two sanatoriums was conducted. Survey content included 25 items regarding the mealtime assistance competency plus 6 items on demographic characteristics. The factor structure of the 25 items was explored and verified by exploratory and confirmatory factor analysis. Its reliability was confirmed by Cronbach's alpha.

RESULTS

Three factors including 22 items with a cumulative rate of 60.9% were identified: "Assistance knowledge and skills for acute period", "Knowledge about assistance and guidance for recovery period," and "Professional basic knowledge regarding hemiplegia." Its reliability was ensured with Cronbach's alpha ranging from .86 to .96. In addition, evidence for its construct validity was obtained, as structural equation modeling revealed a good fit to the data within the allowable range based on various fit indices.

CONCLUSION

This study clarified the core knowledge and skills regarding mealtime assistance competency for hemiplegic patients, with "Assistance for acute period" most concerned, followed by "assistance and guidance for recovery period," and "Professional basic knowledge," and the latter two need more attention. Obtained results can provide useful evidence for competent nursing practice to improve the quality of mealtime assistance for hemiplegic patients in China.

Factors associated with core competencies of emergency-room nurses in tertiary hospitals in China

AIM

Quantitative studies using validated questionnaires on core competencies of emergency nurses in China are rare and the baseline core competencies must first be evaluated before improvizations to the competencies can be implemented. This study aimed to investigate the factors potentially involved in the level of core competencies of emergency nurses from tertiary hospitals in northwest China.

METHODS

In this cross-sectional study, male and female emergency nurses (n = 277) from tertiary hospitals of northwest China were enrolled to complete the Competency Inventory for Registered Nurses (CIRN) questionnaire comprising of a total of seven dimensions with 58 items. General self-efficacy and perceived stress were also evaluated. Pearson correlation test and multivariate stepwise linear regression analysis were performed to assess the association between various factors associated with core competencies.

RESULTS

Senior nurses had higher CIRN scores than junior nurses (p < .001). Married and widowed nurses had higher CIRN scores than unmarried and divorced nurses (p = .008). Nurses satisfied with their career had better CIRN scores than those who were dissatisfied (p < .001). CIRN scores were correlated with age (r = .356, p < .001), working years (r = .374, p < .001), and the general self-efficacy scale (r = .547, p < .001). Multivariable stepwise linear regression analysis showed that higher professional titles and job satisfaction were independently associated with higher CIRN scores (both p < .001).

CONCLUSIONS

Emergency nurses from tertiary hospitals of northwest China with senior titles and job satisfaction had high CIRN scores which necessitates empowering the junior nurses by way of education and training programs to gain higher core competencies in order to deliver better nursing care to patients.

Students’ Self-assessed Competence Levels during Nursing Education Continuum – A Cross-sectional Survey

During nursing education, nursing students are required to develop their competence to be able to fulfill their duties safely as Registered Nurses. The aims of this study were to explore 1) nursing students’ self-assessed competence levels during education 2) the relationship with competence and frequency at which competencies are utilized in clinical practice, and 3) factors related to competence levels. 841 (response rate 67.6 %) nursing students responded to the Nurse Competence Scale in a cross-sectional study. The self-assessed overall competence levels were improving during the education continuum (VAS-means 1st 56.6; 2nd 58.3; 3rd 59.8 and 3.5th -year students 68.4). Every group revealed a significant positive correlation with competence and frequency at which competencies are utilized in clinical practice in clinical placement. Risk factors for low competence were also identified. Systematic multimethod competence evaluations with longitudinal designs are needed to monitor outcomes of nursing education.

Exploration of Factors Influencing Nurse Competence Through Nursing Profile Analysis

BACKGROUND

Nurse competence is a combination of knowledge, performance, skills, and attitudes that are required in fulfilling one's role as a nurse. So far, few comprehensive studies have explored the influencing factors of nurse competence.

METHOD

The competence levels of 160 RNs in a Chinese hospital were evaluated using a questionnaire method, and the relationship between competence results and nursing characteristics was analyzed.

RESULTS

The competence of participating nurses was at a medium level. Among all the characteristics, education and staffing levels were two main factors influencing nurse competence.

CONCLUSION

Quantity of nurses and quality of nursing service are two main issues facing the modern nursing system. The findings from this study provide useful information and suggestions on how to improve nurse competence to nurse industry personnel, including nurses, nursing employers, educators, and students. [J Contin Educ Nurs. 2019;50(12):572-580.].

The Components of Nursing Competence in Caring for Older People in Iranian Hospitals: A Qualitative Study

Background:

There is limited research on gerontological nursing competence in hospitals. However, there is no comprehensive and integrated description of the gerontological nursing competence requirements in hospitals. The purpose of this study was to explain the components of nursing competence in caring for older people in Iranian hospitals.

Materials and Methods:

This is a qualitative descriptive-exploratory study. The data were collected through a semi-structured interview with nurses, nurse managers, and clinical educators in teaching hospitals and nursing schools affiliated to Arak, Isfahan, and Tehran Universities of Medical Sciences in Iran from September 2015 to July 2016. Participants included 25 people who were selected by purposive and snowball sampling method. Sampling continued until data saturation. Data were analyzed using conventional content analysis method.

Results:

Data analysis generated three main categories including (1) Patient and family centered care; (2) Process-oriented care; and (3) Self-care and continuing professional development.

Conclusions:

Nurses should have competencies such as participation and empowerment of the patient and family; ease of comfort in the elderly; comprehensive geriatric assessment; development, implementation and evaluation of care plan; development of knowledge and clinical proficiency; and coaching so that they can work effectively during the care of the elderly. The results of this study can be used by nursing educators, nursing students, and nurses to develop their individual and professional skills in the field of gerontological nursing.

Improving the professional competency of psychiatric nurses: Results of a stress inoculation training program

It is essential to conduct cognitive-behavioral interventions on nurses' professional competency. The present study aimed to evaluate the impact of a stress inoculation training (SIT) on professional competency of psychiatric nurses. This was an experimental study, in which 70 psychiatric nurses were allocated to two intervention and control groups (35 in each group) using cluster random design. A SIT program was conducted for the intervention group. Data were gathered by competency inventory for registered nurse (CIRN) before and one month after SIT. The participants in the intervention group reported higher scores on professional competency and its dimensions compared to those in the control group one month after SIT. The increased scores of professional competency and its dimensions after using the SIT implied the effectiveness of this method in enhancing the professional competences of psychiatric nurses. The higher efficiency of SIT can be determined by its application in diverse domains of medical professions.

The effects of emotional labor and competency on job satisfaction in nurses of China: A nationwide cross-sectional survey

Objectives

This study aimed to explore the status of job satisfaction, emotional labour, core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurses in China.

Methods

Data were collected by using a self-designed general information questionnaire, a job satisfaction questionnaire (McCloskey/Mueller Satisfaction Scale), a nurse emotional labour questionnaire, the Competency Inventory for Registered Nurses questionnaire, and a nurse job stressor questionnaire. A total of 13,448 nurses from 92 hospitals across mainland of China were surveyed, and 11,337 respondents (84.3% response rate) completed the questionnaires.

Results

The survey results indicated that Chinese nurses had average job satisfaction (24.77 ± 5.23), moderate job stress (86.84 ± 21.12), moderate to high emotional labour experiences (55.08 ± 9.63) and high competency (195.77 ± 37.61). Multiple linear regression indicated that surface acting was negatively correlated with job satisfaction (P < 0.01), while deep acting (P < 0.01) and nurses’ core competence (P < 0.01) were positively associated with job satisfaction. Besides, The results also indicated job stress, geographical distribution, hospital category, gender, work shift, only children, parenting status, monthly salary, nursing experience, professional title, hospital area were the influencing factors of job satisfaction (P < 0.05).

Conclusion

The improvement of the emotional labour and competency of nurses may help enhance their job satisfaction.

Psychometric properties of self-assessment clinical competency questionnaire in baccalaureate nursing students

Background

One of the main challenges of nursing student education is the lack of clinical competence that reduces the quality of patients care. Measuring the clinical competency of undergraduate nursing students is effective in curriculum developing, planning, and learning evaluation.

Objective

To validate self-assessment clinical competence questionnaire of undergraduate nursing students.

Methods

This was a cross-sectional study at Baqiyatallah University of Medical Sciences in Tehran, Iran, 2015–2016. The original version of the self-assessment questionnaire for baccalaureate nursing graduates was translated to Persian by the World Health Organization’s (WHO) method. The psychometric evaluation of the questionnaire was conducted on 300 nursing students. The participants were selected by convenience sampling. The tool validity was confirmed by exploratory factor analyses. The reliability was investigated by internal consistency and test-retest.

Results

Cronbach’s alpha coefficient was 0.96 (0.82–0.91). Intraclass correlation coefficient (ICC) was 0.98 (0.88–0.99). Five factors were extracted by analysis of clinical competency tool of undergraduate nursing students. The factors included technical competence, advanced competence, ethical competence, care management and safety competence.

Conclusions

The Persian version of the clinical competence assessment tool has acceptable psychometric characteristics in the Iranian nursing students’ community. This questionnaire can be used as a valid tool in planning and research management areas.

Development and validation of health service management competencies

Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

Psychometric properties of the Persian version of the Intensive and Critical Care Nursing Competence Scale version-1 (ICCN-CS-1)

Background

Nursing competence is highly related to patient outcomes and patient safety issues, especially in intensive care units. Competence assessment tools are needed specifically for intensive care nursing.

Objective

This study was performed to determine psychometric properties of the Intensive and Critical Care Nursing Competence Scale version-1 between Iranian Nurses.

Methods

The present study was a methodological research in which 289 nurses of Intensive Care Units from nine hospitals in Shahid Beheshti University of Medical Sciences in Tehran were selected between 2015 and 2016. The original version of the scale was translated into Persian and back-translated into English, and the comments of the developer were applied. The validity of the scale was the determined quality (content validity and face validity) and quantity (confirmatory factor analysis). Reliability of the scale was reported by Cronbach’s alpha coefficient and Intra class Correlation Coefficient. SPSS-PC (v.21) and LISREL (v.8.5) were used to analyze the data.

Results

The intensive and critical care nursing competence scale version-1 is a self-assessment test that consists of 144 items and four domains which are the knowledge base, the skill base, the attitudes and values base and the experience base, which are divided into clinical competence and professional competence. Content and face validity was confirmed by 10 experts and 10 practitioner nurses in the intensive care units. In confirmatory factor analysis, all fitness indexes, except goodness of fit index (0.64), confirmed the four-factor structure of the ICCN-CS-1. The results of the factor analysis, load factor between 0.304 and 0.727 items was estimated; only 4 items out of 144 items, that were loaded were less than 0.3 due to high Cronbach’s alpha coefficient (0.984–0.986), all items were preserved, no item was removed and 4 subscales of the original scale were confirmed.

Conclusion

The results of this study indicated that the Persian version of “The Intensive and Critical Care Nursing Competence Scale version-1” is a valid and reliable scale for the assessment of competency among Iranian nurses, and it can be used as a reliable scale in nursing management, education and research.