Core competencies for family and community nurses: a European e-Delphi study

The Role of Family or Community Nurse in Dealing with Frail and Chronic Patients in Italy: A Scoping Review

Even though Family and Community Nurses (FCNs) were introduced into the Italian healthcare system in 2000, to date, there is a substantial knowledge gap regarding the implementation of these professional figures within the Primary Care (PC) system. This scoping review aims to provide a comprehensive picture of the role of FCNs in managing older adults and the elderly with chronic conditions within the Italian PC system. A search on Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, and Scopus was conducted including studies published until 7 April 2023. Among 141 potential articles, only 4 met our inclusion criteria. Each of these studies attributed their findings to the presence of FCNs. They reported a significant decrease in the prevalence of several behaviours among patients diagnosed with hypertension, a reduction in metabolic complications among frail patients receiving home enteral nutrition, a decline in hospital readmissions or emergency services utilization among patients >65 years of ages with at least one chronic disease, and, notably, a high level of effectiveness in detecting major cardiovascular events in patients with cardiac implantable electronic devices. Despite the effectiveness of interventions managed by FCNs, comprehensive information and research on the integration of this role within the PC setting are still lacking in the Italian healthcare system.

Ensuring Throughput: Development and Validation of Charge Nurse Competencies for United States Emergency Care Settings

INTRODUCTION

Charge nurses are shift leaders whose role includes managing nursing resources and facilitating appropriate patient care; in emergency departments, the charge nurse role requires both clinical and leadership skills to facilitate the flow of patients, while ensuring patient and staff safety. Literature on orientation and specific training is notably sparse. This study aimed to evaluate the content and process of core competency training and identify evaluation and implementation strategies necessary to improve charge nurse performance in United States emergency departments.

METHODS

A modified Delphi technique was used in phase 1 and a qualitative content analysis method was used in phase 2 to address specific aims of the study.

RESULTS

In total, 427 emergency nurse managers, directors, educators, and charge nurses responded to the initial survey to identify elements, teaching modalities, and evaluative processes; 22 participated in 1 of 2 focus groups to provide further information about the pedagogical approaches to teaching emergency charge nurse competencies. The top 5 competencies were identified as patient flow management, communication, situational awareness, clinical decision making, and nurse-patient assignment, with understanding that each competency overlapped significantly with the others. Low-fidelity simulation and gamification were identified as a preferred method of both training and evaluation.

DISCUSSION

These findings have the potential to support a standardized approach to emergency charge nurse training and evaluation focusing on communication skills, clinical decision making, and situational awareness to facilitate safe and effective nurse-patient assignment and emergency department throughput.

Development of a Core Outcome Set for Family and Community Nursing: Protocol for a Delphi Study

BACKGROUND

Family and community nurses (FCNs) play a crucial role in delivering primary care to patients within their homes and communities. A key aspect of their role involves various health interventions, which are influenced by their unique competencies, such as health promotion, advanced clinical knowledge, and strong interpersonal skills. However, it is essential to understand which specific health outcomes these interventions impact to better understand the relationship between FCNs' skills and the health results.

OBJECTIVE

This study aims to outline the steps we will take to develop a set of core outcomes. These outcomes will be particularly sensitive to the health interventions carried out by FCNs, providing a clearer picture of their practice's impact.

METHODS

A Delphi survey will be used for this research, conducted from January to December 2024. The process will involve 5 steps and input from 3 stakeholder categories. These stakeholders will help identify a preliminary list of outcomes that will form the basis of our core outcome set (COS).

RESULTS

This guideline will be beneficial for a wide range of stakeholders involved in COS development, including COS developers, trialists, systematic reviewers, journal editors, policy makers, and patient groups. As of January 2024, we have successfully completed the first stage of the study, with the stakeholder group approving the reported outcomes and assigning participant lists for each stakeholder group.

CONCLUSIONS

This study will provide a roadmap for identifying the key health outcomes influenced by the interventions of FCNs. The multistakeholder, multiphase approach will ensure a comprehensive and inclusive process. Ultimately, the findings will enhance our understanding of FCNs' impact on health outcomes, leading to more effective primary care strategies and policies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/51084.

Factors affecting the development of clinical nurses' competency: A systematic review

AIM

To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency.

BACKGROUND

Nursing competence affects not only patients but also nurses themselves. Competent nurses contribute to patient safety. Prioritizing clinical competency enables nurses to deliver high-quality care. Clinical nursing competency is influenced by various factors including education and training, experience, professional development, clinical judgment, decision-making skills and communication.

DESIGN

This was a systematic review.

METHODS

This study utilized an extensive literature search of online databases, including SCOPUS, Web of Science and PubMed. This review followed the guidelines provided by the Effective Practice and Organization of Care (EPOC) Cochrane Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

This systematic review provided 20 valuable articles, with a total of 6273 participants across the 20 studies, including 18 cross-sectional studies and two descriptive-correlational studies, predominantly using quantitative research methods. The analysis revealed several key factors that significantly affect nurses' clinical competency. These factors included years of experience, workplace environment, theoretical knowledge and educational level, marital status, clinical training, job satisfaction, turnover intention, job stress and critical thinking.

CONCLUSIONS

Understanding and addressing these factors are crucial for enhancing nurses' clinical competence and ultimately improving patient outcomes. Further research and interventions should be directed towards promoting supportive work environments, continuous education and the development of critical thinking skills among nurses to optimize their clinical competencies.

Construction of an evaluation index system of core competencies for critical care blood purification nurses in China: A Delphi study

AIM

The purpose of this study was to construct a core competencies evaluation index system for critical care blood purification nurses in China.

BACKGROUND

While nursing is an integral part of critical care blood purification treatment, there are no established indicators to evaluate the core competencies of critical care blood purification nurses.

DESIGN

A Delphi study.

METHODS

An initial draft of the competencies evaluation index system for critical care blood purification nurses was developed through a literature review and semi-structured interviews. From February 2023 to March 2023, a two-round Delphi survey was conducted to consult with 18 experts in the field of critical care blood purification from eight provinces in China to rate the importance of each item and propose modifications to the evaluation index system.

RESULTS

The effective questionnaire recovery rates in two rounds of expert consultation were 94.4 % and 94.1 % and the average expert authority coefficients were 0.88 in both rounds. The core competencies evaluation index system of critical care blood purification nurses consisted of 39 items in five domains, namely theoretical knowledge, practical skills, professional development capability, critical thinking ability and personal qualities and attributes. The Kendall's W coefficients for the first- and second-level indicators were.21 and.20 in the first round and.23 and.25, respectively, in the second round of consultations (p < .01).

CONCLUSION

The core competencies evaluation index system of critical care blood purification nurses is scientific and reliable and can provide references for the recruitment, training and management of critical care blood purification nurses.

Integrative nursing in Europe - A competency profile for nursing students validated in a Delphi-study

BACKGROUND

Integrative nursing is a framework for providing holistic care and includes complementary therapies and non-pharmacological interventions. There is no common European approach on how to educate healthcare professionals on complementary therapies and non-pharmacological interventions for symptom management. Nurses report a lack of formal education as the main barrier to applying integrative nursing.

OBJECTIVES

The aim of this study is to develop and validate integrative nursing learning outcomes in a competency profile for bachelor nursing students.

METHODS

A two-round Delphi study was conducted with experts on integrative nursing and/or nurse education from eight European countries. The expert panelists rated their level of agreement with learning outcomes in relation to "Knowledge, Skills, Responsibility and Autonomy" on a nine-point Likert scale (1 = strongly disagree/9 = strongly agree) and were invited to add comments in an open text field. The Rand manual's description of levels of appropriateness was used, and experts' suggestions were analyzed thematically and used for reformulating or adding learning outcomes.

RESULTS

In the first round, 19 out of 23 experts participated, versus 18 in the second round. In all, thirty-five learning outcomes within the three areas Knowledge, Skills and Responsibility/Autonomy were rated. After two Delphi rounds, twenty-four included learning outcomes were classified as appropriate, with median levels of appropriateness between 7 and 9; none had been classified as inappropriate. The learning outcomes include general knowledge about selected complementary therapies and non-pharmacological interventions, safety, national rules and regulations, communication and ethical skills and competencies for self-care actions and for applying simple evidence-based complementary therapies and non-pharmacological interventions in nursing practice.

CONCLUSIONS

The competency profile consist of validated competencies; the high degree of consensus from the expert panelists makes the learning outcomes relevant for structuring a teaching module for nursing students about integrative nursing.

Impact of the Empathic Understanding of People and Type D Personality as the Correlates of Social Skills of Primary Health Care Nurses: A Cross-Sectional Study

Efficient functioning at work depends on social skills. The aim of this study was to assess the relationship among empathy, type D personality traits, and the level of social skills among Primary Health Care (PHC) nurses. A cross-sectional study was carried out involving 446 PHC nurses. In the multidimensional model, after taking into account disruptive variables (age, place of residence, postgraduate education and self-assessment of health), as in one-dimensional models, respondents with a higher level of empathic understanding of other people were found to have a higher level of social skills (b = 0.76; SE = 0.11; p < 0.001), while a lower level of social skills was observed among respondents with traits which are characteristic of type D personality (b = −11.86; SE = 2.28; p < 0.001). The results of the study show that personal predispositions, such as empathy or type D personality, may support or hinder the shaping of social skills of nurses. Therefore, it is essential to create an individualised approach when nurses are undergoing social skills training.

Advancing nursing in Italy through the development and evaluation of an innovative postgraduate programme in Family and Community Nursing - A pilot study

INTRODUCTION

Due to the impact on the public health systems of the ageing and the increasing frailty of the population, the European Union and the World Health Organisation have emphasised how family and community nurses (FCNs) could play an important role in supporting the ageing process through prevention, promotion, and protection in the territory.

METHODS

This study describes the first experience in Italy of a one-year postgraduate blended-learning master course divided into 5 modules for FCNs piloted as part of the EuropeaN curriculum for fAmily aNd Community nursE (ENhANCE) 2018-2020 project, funded by the European Commission. The 5 modules focused on: Epidemiology and Prevention (14 ECTS); Fundamentals of care (19 ECTS); Organisational Models and Priority Health Problems (12 ECTS); Communication Models and Continuity of Care (5 ECTS); and Nursing Research (10 ECTS). Participants included a total of 45 students and 23 lecturers and a team of clinical tutors.

RESULTS

The Italian pilot course for the FCNs proved to be a successful example of innovative teaching methods using blended didactic methods, which enabled participants to achieve high-standard learning outcomes and competencies in the field of family and community nursing.

CONCLUSIONS

The pilot course is well suited to preparing competent family and community nurses to meet the growing healthcare needs of the population. Therefore, we have planned to replicate this course to increase the workforce of family and community nurses, who through their healthcare services aimed at prevention, promotion and protection, will ensure high quality services to the public and consequently relieve the burden on acute hospitals.

Core competencies for a biomedical laboratory scientist - a Delphi study

BACKGROUND

After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist.

METHODS

A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary.

RESULTS

The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality.

CONCLUSIONS

We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.

Competency assessment for community health nurses: a focus group expert panel discussion

Background

General Practice setting in the Primary Health Care Services are the utmost visited by the public. It is important that the nurses’ competencies in this area be assessed to ensure provision of safe and quality services.

Aim/objective

To explore perceptions and experiences of competencies assessment tool for community health nurses working at the General Practice setting in the Primary Health Care Services.

Methods

An exploratory qualitative study utilizing focus group discussions were conducted on purposive sample of 12 officers with expertise in competency assessment and community health nursing from higher nursing education institutions, the Nursing Training and Development Centre, the Nursing Board and the Community Health Nursing Services in Brunei Darussalam. The existing competencies assessment tool was revised, the participants were divided into two groups of expert panel review team and two focus group discussions were held with each team. The focus group discussions encompassed components and methods of assessment; methods of grading; and overall organization and structure of the revised competency assessment tool.

Findings

Four themes emerged: 1) International equivalent core competencies components; 2) Multi-methods approach to assessment; 3) Definitive guidelines as framework for assessment; and 4) Understanding and acceptability of the competency assessment tool.

Conclusions/implications to practice

The expert panel reviews provide practical input that were inculcated in the preliminary developed competencies assessment tool. Identification of eligible assessors were recommended based on standardized criteria, and socialization and training held to set direction and guidance for implementing the utilization of the competencies assessment tool. Further studies are deemed important to critically evaluate and validate the preliminary competencies assessment tool for development of a more robust assessment instrument.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00898-y.