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Sakuramoto H, Kuribara T, Ouchi A, Haruna J, Unoki T. Clinical practice competencies for standard critical care nursing: consensus statement based on a systematic review and Delphi survey. BMJ Open 2023; 13:e068734. [PMID: 36697042 PMCID: PMC9884938 DOI: 10.1136/bmjopen-2022-068734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES A clear development process and scientifically validated clinical practice competencies in standard critical care nursing (SCCN) have not yet been developed in Japan. Thus, this study aimed to develop a consensus-based set of SCCN competencies to provide a framework for critical care nursing education, training and evaluation. DESIGN Multistep, modified Delphi study (a systematic review, focus group interviews, a three-round web-based Delphi survey and an external validation process). PARTICIPANTS A systematic review of 23 studies, focus group interviews by 12 experts, a Delphi survey by 239 critical care experts (physicians, nurses and physical therapists) and an external validation by 5 experts (physicians and nurses). RESULTS A systematic review identified 685 unique competencies. The focus group interviews resulted in the addition of 3 performance indicator items, a synthesis of 2 subdomains and 10 elements. Of the 239 participants, 218 (91.2%), 209 (98.9%) and 201 (96.2%) responded in rounds 1, 2 and 3 of the Delphi survey, respectively. After round 3, 57 items were below the consensus level and were removed in the final round. External validation process feedback was received from experts after two revisions to ensure that the final competencies were valid, applicable, useful and clear. The final set of competencies was classified into 6 domains, 26 subdomains, 99 elements and 525 performance indicators. CONCLUSIONS This study found a set of SCCN competencies after a multistep, modified Delphi study. The results of this study are robust, and the competency framework can be used in multiple areas to improve clinical practice, including the assessment, training and certification of standard critical care nurses.
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Affiliation(s)
- Hideaki Sakuramoto
- Department of Critical care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Tomoki Kuribara
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Akira Ouchi
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan
| | - Junpei Haruna
- Intensive Care Unit, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
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Zakeri MA, Bazmandegan G, Ganjeh H, Zakeri M, Mollaahmadi S, Anbariyan A, Kamiab Z. Is nurses' clinical competence associated with their compassion satisfaction, burnout and secondary traumatic stress? A cross-sectional study. Nurs Open 2021; 8:354-363. [PMID: 33318843 PMCID: PMC7729795 DOI: 10.1002/nop2.636] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 11/18/2022] Open
Abstract
Aim The current study aimed to investigate the relationship between clinical competence and subscale of professional quality of life (ProQOL). Methods This cross-sectional study was conducted from November 2018 to May 2019 on 291 nurses working in public hospitals in south Iran (Rafsanjan). The nurses were selected by convenience sampling method. Data were collected using the ProQOL questionnaire that included three subscales: compassion satisfaction, secondary traumatic stress and burnout and the Competency Inventory for Registered Nurse (CIRN) that measured clinical competence. Results A significant positive relationship was observed between compassion satisfaction and clinical competence. A significant negative association was found between compassion satisfaction and secondary traumatic stress/burnout and also between secondary traumatic stress and clinical competence. The results of regression analysis indicated that compassion satisfaction was the best predictor of secondary traumatic stress (R2 = 65%), burnout (R2 = 40%) and clinical competence (R2 = 12%). Moreover, secondary traumatic stress was found to be the best predictor of compassion satisfaction (R2 = 53%).
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Affiliation(s)
- Mohammad Ali Zakeri
- Non‐Communicable Diseases Research CenterRafsanjan University of Medical SciencesRafsanjanIran
| | - Gholamreza Bazmandegan
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
- Department of Family Medicine, Ali‐Ibn Abi‐Talib Hospital, School of MedicineRafsanjan University of Medical SciencesRafsanjanIran
| | - Hamid Ganjeh
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Maryam Zakeri
- Physiology‐Pharmacology Research Center, Research Institute of Basic Medical SciencesRafsanjan University of Medical SciencesRafsanjanIran
| | - Sekineh Mollaahmadi
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Ali Anbariyan
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Zahra Kamiab
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
- Department of Family Medicine, Ali‐Ibn Abi‐Talib Hospital, School of MedicineRafsanjan University of Medical SciencesRafsanjanIran
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Batt AM, Tavares W, Williams B. The development of competency frameworks in healthcare professions: a scoping review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:913-987. [PMID: 31797195 DOI: 10.1007/s10459-019-09946-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/23/2019] [Indexed: 05/27/2023]
Abstract
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.
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Affiliation(s)
- Alan M Batt
- Department of Paramedicine, Monash University, Building H, McMahons Road, Frankston, VIC, 3199, Australia.
- Fanshawe College, 1001 Fanshawe College Blvd., London, ON, N5Y 5R6, Canada.
| | - Walter Tavares
- The Wilson Centre, Department of Medicine, University of Toronto/University Health Network, 200 Elizabeth Street, 1ES‑565, Toronto, ON, M5G 2C4, Canada
- Post‑MD Education (Post‑Graduate Medical Education/Continued Professional Development), University of Toronto, Toronto, ON, Canada
| | - Brett Williams
- Department of Paramedicine, Monash University, Building H, McMahons Road, Frankston, VIC, 3199, Australia
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Bell CAF, McCurry M. Opioid use disorder education for acute care nurses: An integrative review. J Clin Nurs 2020; 29:3122-3135. [PMID: 32533719 DOI: 10.1111/jocn.15372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/17/2020] [Accepted: 05/24/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to explore opioid use disorder (OUD) education programmes presented to practicing nurses working in medical-surgical settings and identify the methods used to evaluate their effectiveness. BACKGROUND Health professionals often express negative attitudes towards patients with OUD which can lead to suboptimal care. Education decreases negative attitudes of healthcare workers. Despite this, few educational programmes are offered to promote knowledge among acute care nurses who work in medical-surgical settings and provide care to patients with OUD. DESIGN An integrative review. METHODS The framework by Whittemore and Knafl was used to examine empirical literature between 1995-2019 to answer the research questions, (a) What types of education do acute care nurses receive regarding OUD? (b) What methods are used for measuring educational intervention effectiveness? CINAHL, ERIC, PsycINFO and MEDLINE were searched using combinations of search terms and PRISMA guidelines. The initial 394 articles were narrowed to nine from the United States and Australia that met the search criteria and purpose of the review. RESULTS Educational programmes used to promote knowledge included interactive workshops, case studies, online modules, simulation sessions, real-time coaching and in-service trainings. Methods used to measure effectiveness of educational interventions were self-assessment tools that measured pre/postknowledge, attitude surveys, alcohol and drug scales and individual researcher-developed instruments. CONCLUSIONS Additional research is needed to determine best teaching strategies for increasing knowledge of OUD and OUD patient care. Valid and reliable methods for measuring effectiveness of OUD educational interventions are inadequate. RELEVANCE TO CLINICAL PRACTICE Knowledge of OUD has been linked to positive patient outcomes and nurses would benefit from up-to-date educational offerings. Opioid use disorder is a growing global concern. Translation of current OUD nursing science to acute care nurses would promote health equity in practice for individuals with OUD.
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Affiliation(s)
| | - Mary McCurry
- University of Massachusetts Dartmouth, Dartmouth, MA, USA
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Zhang X, Meng K, Chen S. Competency framework for specialist critical care nurses: A modified Delphi study. Nurs Crit Care 2019; 25:45-52. [PMID: 31373155 DOI: 10.1111/nicc.12467] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/28/2019] [Accepted: 07/05/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The specialist critical care nurse plays a vital role in the delivery of evidence-based practice, and specific competency guidance has been established to facilitate critical care nursing practice and education development in many developed countries. However, no research has been conducted to develop a competency framework for specialist critical care nurses in China. AIMS AND OBJECTIVES To construct a competency framework specific to specialist critical care nurses in China. DESIGN AND METHODS A two-phased procedure was implemented. In phase 1, a literature review and four focus groups were used to develop the initial competency framework, which consisted of 101 statements. During phase 2, three rounds of a modified Delphi process were conducted and involved a national panel of 30 experts, including physicians, specialist critical care nurses, managers, and educators, who responded to the survey using a 5-point Likert-type scale to indicate their level of agreement with the competency framework. A 75% threshold for each competency was used to achieve panel consensus. RESULTS Experts in the field of critical care responded to rounds 1 (n = 29), 2 (n = 28), and 3 (n = 28). Seventy-eight competencies were agreed upon after round 1, increasing to 88 after round 2 and 92 after round 3. The final competency framework was classified into six domains: evidence-based practice, complex decisions, professionalism, communication and co-operation, education and development, and leadership. CONCLUSION The output of this study is an expert consensus competency framework that provides a sound foundation for the assessment and training of specialist critical care nurses. RELEVANCE TO CLINICAL PRACTICE The proposed competency framework should be used to assess nursing performance, promote continuing professional development, and further improve the delivery of quality health care and optimal patient outcomes.
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Affiliation(s)
- Xiaoning Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Kun Meng
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Shuang Chen
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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Häggström M, Bergsman AC, Månsson U, Holmström MR. Learning to manage vasoactive drugs-A qualitative interview study with critical care nurses. Intensive Crit Care Nurs 2017; 39:1-8. [PMID: 28108169 DOI: 10.1016/j.iccn.2016.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/14/2016] [Accepted: 09/17/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. AIM To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. RESEARCH METHODOLOGY/SETTING Twelve critical care nurses from three hospitals in Sweden were interviewed. Qualitative content analysis was applied. RESULTS The theme "becoming proficient requires accuracy, practice and precaution" illustrated how critical care nurses learn to manage vasoactive drugs. Learning included developing cognitive, psychomotor, and effective skills. Sources for knowledge refers to specialist education combined with practical exercises, collegial support, and accessible routine documents. The competence required to manage vasoactive drugs encompassed well-developed safety thinking that included being careful, in control, and communicating failures. Specific skills were required such as titrating doses, being able to analyse and evaluate the technological assessments, adapting to the situation, and staying calm. CONCLUSION Learning to manage vasoactive drugs requires a supportive introduction for novices, collegial support, lifelong learning, and a culture of safety.
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Nobahar M. Competence of nurses in the intensive cardiac care unit. Electron Physician 2016; 8:2395-404. [PMID: 27382450 PMCID: PMC4930260 DOI: 10.19082/2395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 03/01/2016] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Competence of nurses is a complex combination of knowledge, function, skills, attitudes, and values. Delivering care for patients in the Intensive Cardiac Care Unit (ICCU) requires nurses' competences. This study aimed to explain nurses' competence in the ICCU. METHODS This was a qualitative study in which purposive sampling with maximum variation was used. Data were collected through semi-structured interviews with 23 participants during 2012-2013. Interviews were recorded, transcribed verbatim, and analyzed by using the content-analysis method. RESULTS The main categories were "clinical competence," comprising subcategories of 'routine care,' 'emergency care,' 'care according to patients' needs,' 'care of non-coronary patients', as well as "professional competence," comprising 'personal development,' 'teamwork,' 'professional ethics,' and 'efficacy of nursing education.' CONCLUSION The finding of this study revealed dimensions of nursing competence in ICCU. Benefiting from competence leads to improved quality of patient care and satisfaction of patients and nurses and helps elevate nursing profession, improve nursing education, and clinical nursing.
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Affiliation(s)
- Monir Nobahar
- Associate Professor, Nursing Care Research Center, Faculty of Nursing and Allied Health, Semnan University of Medical Sciences, Semnan, Iran
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Lakanmaa RL, Suominen T, Perttilä J, Ritmala-Castrén M, Vahlberg T, Leino-Kilpi H. Basic competence in intensive and critical care nursing: development and psychometric testing of a competence scale. J Clin Nurs 2013; 23:799-810. [PMID: 23331409 DOI: 10.1111/jocn.12057] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To develop a scale to assess basic competence in intensive and critical care nursing. In this study, basic competence denotes preliminary competence to practice in an intensive care unit. BACKGROUND There is a need for competence assessment scales in intensive care nursing practice and education. The nursing care performed in the intensive care unit is special by its nature and needs to be assessed as such. At this moment, however, there is no tested, reliable and valid scale in this field. DESIGN A multi-phase, multi-method development and psychometric testing of the scale was conducted. METHODS The scale was developed in three phases. First, following a literature review and Delphi study, the items were created. Second, the scale was pilot tested twice by nursing students (n1 = 18, n2 = 56) and intensive care nurses (n1 = 12, n2 = 54), and revisions were made. Third, reliability and construct validity were tested by graduating nursing students (n = 139) and intensive care nurses (n = 431). RESULTS The Intensive and Critical Care Nursing Competence Scale (ICCN-CS-1) is a self-assessment test consisting of 144 items. Basic competence is divided into patient-related clinical competence and general professional competence. In addition, basic competence is comprised of knowledge base, skill base, attitude and value base and experience base. ICCN-CS-1 is a reliable and tolerably valid scale. CONCLUSIONS The ICCN-CS-1 is a promising scale for use among nursing students and nurses. Future research is needed to evaluate its construct validity further and to assess its suitability for completion during intensive care unit's orientation programmes and nursing students' clinical practice in an intensive care unit. RELEVANCE TO CLINICAL PRACTICE The ICCN-CS-1 can be used for basic competence assessment in professional development discussions in intensive care units, in mentor evaluation situations during nursing students' clinical practice and in intensive care nursing education.
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Affiliation(s)
- Riitta-Liisa Lakanmaa
- Department of Nursing Science, Finnish Post-Graduate School in Nursing Science, University of Turku, Turku, Finland
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Gill FJ, Leslie GD, Grech C, Latour JM. A review of critical care nursing staffing, education and practice standards. Aust Crit Care 2012; 25:224-37. [DOI: 10.1016/j.aucc.2011.12.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 12/12/2011] [Accepted: 12/16/2011] [Indexed: 10/14/2022] Open
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Lakanmaa RL, Suominen T, Perttilä J, Puukka P, Leino-Kilpi H. Competence requirements in intensive and critical care nursing--still in need of definition? A Delphi study. Intensive Crit Care Nurs 2012; 28:329-36. [PMID: 22534494 DOI: 10.1016/j.iccn.2012.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 02/19/2012] [Accepted: 03/12/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Empirical studies in competence are lacking in the field of intensive and critical care nursing. OBJECTIVE To identify competence requirements, by soliciting the views of intensive care unit nurses and physicians. METHODS Two rounds of the Delphi method were used in 2006 in Finland. Data were analysed by content analysis and with descriptive statistics. RESULTS Competence requirements in intensive and critical care nursing can be divided into five main domains: knowledge base, skill base, attitude and value base, nursing experience base and personal base of the nurse. Four of these domains can be found in the existing requirements and one new domain - personal base of the nurse - was identified. CONCLUSIONS Competence requirements are multidimensional. Earlier descriptions of competence are not sufficient; more comprehensive and cohesive descriptions are needed. The personal base of a nurse should also be included in the competence requirements in intensive and critical care nursing.
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Affiliation(s)
- Riitta-Liisa Lakanmaa
- Department of Nursing Science, University of Turku, Betaniankatu 12 B 26, 20810 Turku, Finland.
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Hadjibalassi M, Papastavrou E, Lambrinou E, Tsangari H, Athini E, Georgiou E, Nicolaou E, Merkouris A. Development of an instrument to determine competencies of postgraduate ICU nurses in Cyprus. Nurs Crit Care 2012; 17:255-64. [DOI: 10.1111/j.1478-5153.2012.00503.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aäri RL, Tarja S, Helena LK. Competence in intensive and critical care nursing: a literature review. Intensive Crit Care Nurs 2008; 24:78-89. [PMID: 18206373 DOI: 10.1016/j.iccn.2007.11.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Revised: 10/30/2007] [Accepted: 11/28/2007] [Indexed: 10/22/2022]
Abstract
This literature review defines and describes the concept of competence in adult intensive care nursing, with special reference to clinical and professional competence. The aim was to see whether and how the studies reviewed defined or described the concept of competence, and which domains of competence have been investigated in intensive and critical care nursing research. The review focuses on empirical studies retrieved from the COCHRANE and MEDLINE (1994-2005) databases. The final analysis comprised 45 studies. The studies were analysed by inductive content analysis. Very few (n=7) of the studies offered any definitions or descriptions of the concept of competence. Clinical and professional competence in intensive and critical care nursing can be defined as a specific knowledge base, skill base, attitude and value base and experience base of intensive and critical care nursing. Clinical competence can be divided into three and professional competence into four constituent domains. In clinical competence, these are the principles of nursing care; clinical guidelines; and nursing interventions. In professional competence, the domains are ethical activity; decision-making; development work; and collaboration. More empirical research is needed to examine competence in intensive and critical care nursing.
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Affiliation(s)
- Riitta-Liisa Aäri
- University of Turku, Department of Nursing Science, 20014 Turku, Finland.
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Williams G, Schmollgruber S, Alberto L. Consensus forum: worldwide guidelines on the critical care nursing workforce and education standards. Crit Care Clin 2006; 22:393-406, vii. [PMID: 16893727 DOI: 10.1016/j.ccc.2006.03.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores the key themes, evidence, and arguments that inform the current position statements. It is acknowledged that future research, evidence, and practice experience may create the need to review and change these guidelines. Reform and refinement of the guidelines are inevitable; however, the current guidelines represent the best attempt yet to reach international consensus on what are appropriate standards to guide critical care nursing education and workforce requirements.
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Affiliation(s)
- Ged Williams
- School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 1, 723 Swanston Street, Carton Vic 3053, and Maroondah Hospital, PO Box 3135, East Ringwood, Victoria 3135, Australia.
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Hanley E, Higgins A. Assessment of clinical practice in intensive care: a review of the literature. Intensive Crit Care Nurs 2005; 21:268-75. [PMID: 16182123 DOI: 10.1016/j.iccn.2004.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2004] [Revised: 09/17/2004] [Accepted: 10/01/2004] [Indexed: 11/21/2022]
Abstract
Nursing is a practice-based discipline, with clinical practice forming the heart of any programme of study. The major goal of all programmes should be on facilitating students to develop the skills necessary for competent and compassionate practice. Assessment of clinical competence is a fundamental aspect of programme development and as such deserves attention during the curriculum design process. The literature on assessment of students in clinical practice suggests that the tools used have evolved through various stages, ranging from the use of simple check list and rating scale to the development of competence assessment tools. Each stage has been fraught with difficulties and has taxed nurse educators, clinical assessors and students alike. The literature also indicates that there is a limited range of research available on clinical assessment tools, especially with an intensive care context. In part one of this two-part paper, the literature on assessment of clinical practice is explored, with specific emphasis on the assessment of competence with the Intensive Care environment. Part two of the paper reports on the findings of a study on students perceptions on a clinical competence assessment tool, used in an Intensive Care environment.
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Affiliation(s)
- Elaine Hanley
- Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland.
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McLean C, Monger E, Lally I. Assessment of practice using the National Health Service Knowledge and Skills Framework. Nurs Crit Care 2005; 10:136-42. [PMID: 15918426 DOI: 10.1111/j.1362-1017.2005.00112.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Current difficulties in the assessment of practice of qualified nurses undertaking courses in critical care nursing are outlined and discussed. The evaluation and development of previously identified core competencies for intensive care nurses is discussed. The use of the National Health Service Knowledge and Skills Framework as a framework for the assessment of practice of nurses undertaking courses in intensive care nursing within one higher education Institution is presented and examined. The potential implications of these developments for practice and education are outlined.
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Affiliation(s)
- Christopher McLean
- School of Nursing and Midwifery, University of Southampton, Nightingale Building 67, University Road, Southampton, SO17 1BJ.
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Glen S. Healthcare reforms: implications for the education and training of acute and critical care nurses. Postgrad Med J 2005; 80:706-10. [PMID: 15579609 PMCID: PMC1743166 DOI: 10.1136/pgmj.2003.009456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.
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Affiliation(s)
- S Glen
- St Bartholomew School of Nursing and Midwifery, 20 Bartholomew Close, London.
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