Nursing competencies: personal characteristics contributing to effective nursing performance

Exploring the core competencies of clinical nurses in chinese tertiary hospitals: a qualitative content analysis

BACKGROUND

With the changes in social and medical environments and people's health needs, the nursing core competency should be updated and developed promptly. This study aimed to explore the core competencies of nurses in Chinese tertiary hospitals under the new health development strategy.

METHODS

Descriptive qualitative research was conducted using qualitative content analysis. 20 clinical nurses and nursing managers from 11 different provinces and cities were interviewed via purposive sampling.

RESULTS

Data analysis revealed 27 competencies, which were grouped into three major categories according to the onion model. These categories were motivation and traits (responsibility, enterprise, etc.), professional philosophy and values (professionalism, career perception, etc.), and knowledge and skills (clinical nursing competency, leadership and management competency, etc.).

CONCLUSION

Based on the onion model, core competencies for nurses in Chinese tertiary hospitals were established, revealing three layers of core competencies and giving a theoretical reference for nursing managers to conduct competency training courses based on the competency levels.

Bibliometric analysis of core competencies associated nursing management publications

AIMS

This study aimed to identify high-impact papers on global nursing to determine and analyze the publication of articles on core competencies in nursing-related journals and the research trends in the era of globalization.

BACKGROUND

Bibliometrics has been shown to be an effective method for analyzing publications. Through bibliometrics, nursing managers and researchers can understand the trends of high-impact international nursing core competencies research, identify mainstream research directions, and obtain relevant knowledge and information, thereby facilitating the translation of research outcomes into nursing management practice.

EVALUATION

The study adopted bibliometric analysis and the VOSviewer software to explore dynamic publication trends and analyze the current situation of nursing research from a comprehensive development perspective, which was realized by searching for nursing core competencies papers in the Web of Science (WoS) database, calculating citations, and determining the trends of the most influential papers.

RESULTS

Nursing core competencies research grew rapidly between 1997 and 2022. Countries with the most core competencies publications were the United States, England, Australia, and Canada. The Journal of Nursing Management has attracted substantial attention from researchers worldwide. Education, Management, and Nurses were the most frequently used keywords in the study. A total of 534 papers were retrieved from the WoS database with the main research fields, including nursing, business economics, public environmental occupational health, and health care science services.

CONCLUSION

Equipping nursing graduates with core competencies has always been an important goal of global medical and nursing education. This study analyzed papers across 35 years, most of which were published in the Journal of Nursing Management. In addition, the study identified some of the main research topics of nursing management, such as the integration of education with nursing management and the cultivation of nurses' core competencies. The study also provides a fresh review of highly cited articles. The results of the study show that high-quality articles play the role of improving both the quality and the quantity of related research. By analyzing the trends of the research on core competencies, this study lays a bibliometric foundation for researchers regarding international journals, hot topics, and relevant fields. In addition, the highly cited articles reveal new perspectives for the nursing field, providing inspiration for nursing management and education researchers.

IMPLICATIONS FOR NURSING MANAGEMENT

This study provides scholars and managers with an overview of the current situation of nursing management research and the development of benchmark journals. The study provides researchers not only with a better understanding of various international journals, allowing them to transition out of traditional thinking in the era of science and technology, but also with innovative thinking by combining research with nursing management. The results of this study invite nursing managers to study relevant topics of core competencies and integrate information technology to education, management, and nurses, thereby contributing to nursing management and educational research.

Validity and Reliability of the Korean Version of the Holistic Nursing Competence Scale

This methodological study aimed to verify the validity and reliability of the Korean version of the Holistic Nursing Competence Scale (HNCS), which comprises five dimensions and 36 items. The English version of the HNCS was forward and backward translated and administered to 251 participants with more than a year of work experience in a general hospital. Data were analyzed using SPSS WIN 24.0(Chicago, IL, USA), and AMOS program was used for confirmatory factor analysis. Additionally, the “Task Performance Evaluation Instrument for Clinical Nurses” was used for concurrent validity. Reliability assessed using Cronbach’s α was 0.969. Convergent, discriminant, and concurrent validity were good. Average variance extracted and construct reliability ranged from 0.845 to 0.932 and 0.980 to 0.987, respectively. The model was suitable with the chi-square value being 1216.563 (df = 584, p < 0.001), and Q value being less than three. Goodness-of-fit index, root mean square residual, and root mean square error of approximation were 0.784, 0.066, and 0.066, respectively. Moreover, comparative fit index, Tucker−Lewis index, and incremental fit index were 0.913, 0.906, and 0.913, respectively. Thus, this study verified the validity and reliability of the Korean version of the HNCS. Our findings suggest that the scale is helpful in measuring and developing the holistic nursing competence of clinical nurses.

Psychometric evaluation of the Ethical Caring Competency Scale in nursing

BACKGROUND

An ethical competence list for nurses could guide educators and managers in the field of health care to both support the development of ethical conduct and improve the assessment of ethical competence in health care.

AIM

This study aimed to verify the reliability and validity of the Ethical Caring Competency Scale (ECCS) and to obtain suggestions for its use as an evaluation form in rubric format among a sample of Japanese nurses.

RESEARCH DESIGN

This research employed a descriptive and cross-sectional design.

PARTICIPANTS AND RESEARCH CONTEXT

A self-administered questionnaire was distributed to 1157 nurses working in two hospitals in Japan. The contents of the survey were demographic data, a draft of the ECCS consisting of 22 competencies from four core competencies, questions regarding experience in learning about medical/nursing ethics, and the Work Motivation Measurement Scale for Nurses. Three levels of difficulty for the 22 items were established using relative comparisons of the mean scores within the four core competencies. Three groups, namely, an expert group, a middle group, and a beginner group, were categorized according to the quartiles of the total ECCS score.

ETHICAL CONSIDERATIONS

This study was approved by the Clinical Research Ethics Committee of Hamamatsu University School of Medicine (Decision no. 18-267). The ethical principles of voluntary participation, anonymity, and confidentiality were considered.

FINDINGS

A total of 962 valid responses were analyzed. The ECCS scores for the three levels of difficulty were significantly different from each other. Stability was confirmed by the test-retest of the total ECCS scores (r = .900, p < .0001). The total ECCS scores for the three groups showed significant differences in all pairs. The Cronbach's α coefficient ranged from .72 to .89 for each core competency, and internal consistency was confirmed.

CONCLUSION

The reliability and validity of the ECCS as a scale were statistically verified, and we were able to obtain suggestions for its application as a form of evaluation in rubric format.

Exploration of Mental Readiness for Enhancing Dentistry in an Inter-Professional Climate

Competencies required for dentistry go far beyond the academic or scientific spheres. They incorporate important mental readiness concepts at its core with an appropriate balance of operational readiness (i.e., technical, physical, mental readiness). The aim of this exploratory study was to investigate the importance of mental readiness for optimal performance in the daily challenges faced by dentists using an Operational Readiness Framework. One-on-one interviews were conducted with a select group of seasoned dentists to determine their mental readiness before, during and after successfully performing in challenging situations. Quantitative and qualitative analyses of mental readiness were applied. Study findings were compared with a Wheel of Excellence based on results from other high-performance domains such as surgery, policing, social services and Olympic athletics. The analysis revealed that specific mental practices are required to achieve peak performance, and the balance between physical, technical and mental readiness underpins these dentists' competency. Common elements of success were found-commitment, confidence, visualization, mental preparation, focus, distraction control, and evaluation and coping. This exploration confirmed many similarities in mental readiness practices engaged across high-risk professions. Universities, clinics and hospitals are looking for innovative ways to build teamwork and capacity through inter-professional collaboration. Results from these case studies warrant further investigation and may be significant enough to stimulate innovative curriculum design. Based on these preliminary dentistry findings, three training/evaluation tools from other professions in population health were adapted to demonstrate future application.

Relationship between Personal Values, Work Experience and Nursing Competencies among Cancer Care Nurses in Malaysia

Oncology nurses are an essential component of cancer care teams. Nurses play a vital role in ensuring that cancer patients comply with their cancer treatment. In the cancer care nursing context, competency is not merely being skilled, but also implies the characteristic of being able to perform effectively. In addition to the need for competence, nursing is a discipline rich in values including human dignity, caring, humanity, and respect for personal privacy. Research from a variety of disciplines indicates that values often influence human behaviour in professional and work settings. It is often believed, therefore, that nurse' values and work experience influence and contribute to their work performance. Few studies have attempted to examine these relationships, particularly in the context of cancer care nursing. The purpose of this study was to determine the relationship between personal values, work experience and competency among cancer care nurses in Malaysia. Quantitative surveys were used to collect the data. A total of 845 cancer care nurses from 38 public hospitals in Peninsular Malaysia participated in the study. Descriptive statistics and Pearson Product-Moment Correlations were used to analyse the data. The findings revealed positive and significant relationships between personal values and competency (r = 0.59, p < 0.01) and work experience and competency (r = 0.11, p < 0.047). The findings support the assertion that Malaysian nurses' values and work experience are related to performance-related competency.
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Developing Capabilities From the Scope of Emotional Intelligence as Part of the Soft Skills Needed in the Long-Term Care Sector: Presentation of Pilot Study and Training Methodology

The article presents the results of the preliminary survey and pilot application of the methodological toolkit for the improvement of certain competencies, which are part of the soft skills of professionals in the long-term care sector in Bulgaria. Based on the survey the authors define 2 target competencies, namely conflict management and empathic interaction. These skills are considered a part of the scope of emotional intelligence and its constituent dimensions and authors use Daniel Goleman's ability-based model as a base for their conceptual frame and theoretical explanations. In order to present their thesis, the authors perform a soft skill analysis of the long-term care sector; define the construct emotional intelligence and justify their choice of a theoretical model for the subsequent survey. On this basis, they develop a training design for the development of these skills and present the results achieved through its pilot application. The study includes 62 participants randomly divided into a test and control groups. The level of targeted skills is measured (before and after) and the authors report a significant increase in those skills (empathic interaction, net effect 1.87; conflict management, net effect 1.75). In conclusion, the authors open a discussion on the importance of emotional management as an essential part of any profession related to health care and underline its importance for the quality of caregiving services.

Left Amygdala and Putamen Activation Modulate Emotion Driven Decisions in the Iterated Prisoner's Dilemma Game

Although economic decision-making is commonly characterized as a purely rational phenomenon, it is clear that real-world decision-making is influenced by emotions. Yet, relatively little is known about the neural correlates of this process. To explore this issue, 20 participants underwent fMRI scanning while engaged in the Prisoner's Dilemma game under partner-directed sympathy, anger and neutral emotion conditions. Participants were most and least likely to cooperate after sympathy and anger induction, respectively, with the neutral condition eliciting intermediate cooperation rates. Moreover, the sympathy condition elicited quicker responses for cooperation than defection choices, whereas this pattern was reversed in the anger and neutral conditions. Left amygdala activation showed a positive correlation with cooperation rates and self-reports of partner directed sympathy in the sympathy condition. In the anger condition, left putamen activation was positively correlated with cooperation rates and negatively correlated with self-reports of partner directed anger strength. These findings indicate that while the left amygdala activation may be indicative of emotion enhancement and increase of cooperative behavior, the left putamen may help to suppress an emotion to overcome anger and engage in cooperation.

Relationship between knowledge sharing and job satisfaction: a systematic review

Purpose

The purpose of this study was to systematically collect and review the English language studies that provided empirical evidence for the existence of relationship between knowledge sharing (KS) and job satisfaction (JS) and their impact on each other.

Design/methodology/approach

A systematic review of the literature was conducted searching Google Scholar, LISTA, ISI Web of Knowledge, Scopus and ProQuest Dissertation and Theses. Searches were completed through March 2017. Language limit was applied; and manual searching from review articles and some key studies using backward and forward citation from Google Scholar was also completed. Studies determining the relationship or correlation between KS and JS were included and books were excluded in this review. Data extraction and critical appraisal were performed to determine the risk of bias of each study.

Findings

The findings clearly reveal that these two variables had a significant relationship with and were influenced by each other. It is concluded that KS had a positive impact on JS and, similarly, JS had strong effect on KS among the individuals working in different organizations.

Originality/value

This review is first to examine the relationship between KS and JS and their impact on each other by systematically collecting and reviewing the English language studies. This study has theoretical and practical implications for managers and HR departments.

Grieving as an Internal Factor of Nurse-Patient Interaction in a Dialysis Unit

Introduction: The quality of the nurse-patient interaction is one factor that affects the patient adherence, but a study that provides an overview of factors in the nurse-patient interaction in improving or maintaining dialysis patient adherence has not been found. The aim of this study was to provide an overview of the various factors involved in the interaction process between nurses and patients undergoing dialysis in relation to their adherence to fluid and dietary restrictions.Methods: A qualitative research design with an interpretive phenomenology approach was used in this study. The researcher intends to interpret the findings of the research, in this case the activity of the dialysis patients, in order to get a picture of the various factors involved in the process of interaction between nurse and dialysis patient. The unit of analysis used in this study was the disclosure or exposure of the internal factors of the nurse-patient interaction process, especially in relation to fluid and dietary restrictions. There were 15 participants who were selected based on the inclusion criteria. In-depth interviews, with field notes, were used in this study as the data collection method.Results: The analysis of the theme based on the goal of the research includes grieving, needs and values/morals, but in this article, the researchers only describe one theme - grieving.Conclusion: This result provides an overview of the findings on nurse-patient interaction factors that can serve as baseline data for the development of nursing care, both in nursing assessments and interventions aimed at improving dietary adherence and the fluid restriction of dialysis patients.

Does Preceptorship improve confidence and competence in Newly Qualified Nurses: A systematic literature review

AIM

A systematic literature review to assess whether preceptorship improves confidence and competence in Newly Qualified Nurses.

BACKGROUND

Preceptorship was introduced into nursing in the United Kingdom in 1991 with the original aim to improve competence and confidence. This systematic review was undertaken to review the evidence of the impact of preceptorship on confidence and competence of nurses in their first year post qualifying.

DATA SOURCES

A comprehensive search of The British Nursing Index, CINAHL, Embase, Medline, PsycInfo, PyscArticles, Campbell Collaboration; Cochrane, HMIC, ERIC, ASSIA, Web of Science, Scopus, Scopus Conference, Web of Science Conferences; NHS Evidence, OpenGrey, National Technical, NINR, Opendoar, SSRN, Kings College London and the RCN was conducted.

METHODS

A PRISMA structured systematic review was carried out, 14 papers 4 mixed methods, 8 qualitative, 1 scoping review and 1 service development, published between 1996 and 2013 were critically reviewed, and data extracted using thematic analysis.

RESULTS

Four themes were identified from a thematic analysis: measurement, knowledge and experience, support, and structure.

CONCLUSION

While one-to-one preceptorship does influence confidence and competence, Preceptorship Programmes has greater impact than the individual preceptor. Due to limited empirical research there is no concrete evidence that Preceptorship has a direct impact on confidence or competence. Further research into team preceptorship/choice of preceptors and what impacts on Newly Qualified Nurses confidence and competence is required.

Linking knowledge sharing, competency development, and affective commitment: evidence from Indian Gen Y employees

Purpose

The present study aims to explore knowledge sharing to evoke affective commitment of Gen Y employees through competency development.

Design/methodology/approach

The research uses cross-sectional survey to collect primary data. A questionnaire is developed based on extensive review of literature. A sample was obtained from Gen Y employees (born between 1980 and 2000) working in software organizations in India. In total, 582 completely filled, usable questionnaires were obtained.

Findings

Results indicate that knowledge sharing has a positive effect on competency development of Gen Y employees, which in turn, positively predicts affective commitment. Furthermore, this would result in the enhancement of employee competencies and eventually, the generation of affective commitment.

Research limitations/implications

This study was limited to the software development professionals working in Indian organizations Therefore, researchers should test the research model further in other industries preferably in a different country.

Practical implications

The more knowledge assets are shared in the organization, the higher the enhancement of employee competencies will become. To evoke emotional attachment of Gen Y employees, an organization must implement learning and development interventions

Originality/value

This study contributes to knowledge management literature, particularly knowledge sharing by exploring its possible linkage with employee attitudinal outcomes through empirical data. This also happens to be an empirical study to investigate Gen Y employees’ commitment in Indian context.

Moral competency: meta-competence of nursing care

Introduction

To follow the progress of technology and increasing domain of nurses’ duties, ethical challenges can be observed more than ever. Therefore, the growing and dynamic system of nursing requires nurses with professional and ethical competence who can provide optimal care. The aim of the present study was to define and explain dimensions of moral competency among the clinical nurses of Iran.

Methods

This qualitative content analysis study was carried out in the years 2014 and 2015 in Iran. Data were collected through in-depth semistructured interviews and field notes. The resulting data were analyzed by Graneheim and Lundman’s method of conventional content analysis. The participants were 12 clinical nurses who were selected using purposive convenient sampling and continued interviews until data saturation.

Results

Themes obtained in the present study were posited in three main categories of “moral character,” with subcategories of altruism, search for meaning, be pioneering, perfectionism, self-control, honesty, and forgiveness; “moral care” with subcategories of dignified care, safe care, fair care, and holistic care; and “moral decision-making” with subcategories of moral sensitivity, moral thinking, moral reasoning, and moral courage.

Conclusions

Findings of the present study suggest that nurses’ moral competency is an adorable character with a wide range that includes moral virtues and character, moral decision-making, and ultimately providing moral care; therefore, moral competency is a meta-competence in the field of nursing. Because there are many competencies in different fields.

Nurses' perceptions of personal attributes required when working with people with a learning disability and an offending background: a qualitative study

WHAT IS KNOWN ON THE SUBJECT?: Learning disability nursing in the area of people with a learning disability and an offending background has developed considerably over recent years, particularly since the publication of the Bradley (). There has been limited work into the competencies nurses require to work in this area, and even less about the personal attributes of learning disability nurses. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Learning disability nursing's specific contribution to the care of this population lies in their knowledge of the interaction between the learning disability, an individual's, sometimes abusive, personal history and an understanding of the subsequent offending behaviour. The knowledge base of nurses working with people with learning disabilities and an offending background needs to reflect the changing service user group. This is particularly in relation to substance misuse, borderline personality disorder, and mental health and the way such factors inter-relate with the learning disability. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further research is required into the relationship among decision making, risk taking or reluctance to do this, and the personal attributes required by nurses to work in secure learning disability care. Learning disability secure services are likely to continue to undergo change as circumstances alter and the offending population demonstrate greater complexity; nursing competencies and personal attributes need similarly to adapt to such changes. Mental health nursing has a great deal to contribute to effective working with this population, specifically with regard to developing strong relationships when concerns around borderline personality disorder or substance misuse are particularly in evidence.

ABSTRACT

Aim To identify and discuss the personal attributes required by learning disability nurses to work effectively with people with an offending background in secure and community settings. Background This study was part of a larger research investigation into the nursing competencies required to work with people with an offending background. There are few existing studies examining the personal attributes necessary for working with this group. Design A qualitative study addressing the perceptions of nurses around the personal attributes required to work with people with learning disabilities and an offending background. Methods A semi-structured interview schedule was devised and constructed, and 39 individual interviews were subsequently undertaken with learning disability nurses working in high, medium, low secure and community settings. Data were collected over 1 year in 2010/11 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced three categories of personal attributes, named as looking deeper, achieving balance and connecting, each of which contained a further three sub-categories. Conclusion Nursing of those with a learning disability and an offending background continues to develop. The interplay among personal history, additional background factors, nurses' personal attributes and learning disability is critical for effective relationship building.

Performance Measurement of Nursing Care

Concerns about nurse staffing in hospitals, nursing's influence on patient safety and health care outcomes, and nurses' work environment (e.g., equipment failures, documentation burden) have led to increased interest in measuring and reporting nursing's performance. This article reviews recent efforts and issues involved in identifying a set of nursing-sensitive performance measures. Sustaining and strengthening current efforts requires developing measures that address all the domains of nursing, addressing technical issues needed to analyze the impact of nursing on patient safety and health care outcomes, developing data systems that provide the information needed to implement the model system, regularly improving the set of endorsed standards to reflect the most current science and empirical evidence, and persuading all health care stakeholders that measurement and reporting nursing-sensitive standards make a difference in the care and quality that are delivered. Each of these tasks requires substantial development work and construction and maintenance of the infrastructure to sustain the performance measurement efforts.

Long term care nursing competence and related factors among Taiwanese nurses: A national survey for those who completed the LTC training course

The aim of this study was to explore Taiwanese nurses' LTC competence and to examine its relationship with their LTC-related knowledge, care intention, and practical experience. The total sampling was selected from nurses who participated in a 2013 LTC course offered by the Ministry of Health and Welfare. Participants in this study (n = 122) voluntarily provided email addresses and responded to an online survey. A self-developed scale with acceptable reliability and validity was used for data collection. Findings from this study showed median high levels of LTC nursing competence, which was found to be positively correlated with LTC knowledge, care intention, practical experience, continuing education, and marital status. The study revealed that through on-the-job training, nurses' LTC knowledge, care intention, practical experience and nursing competence can be improved, which will benefit the quality of care for LTC clients.

The impact of personality on person-centred care: a study of care staff in Swedish nursing homes

AIM AND OBJECTIVE

In this study, we explore how personal and situational factors relate to the provision of person-centred care (PCC) in nursing homes. Specifically, we focus on the relationship between the care staff's personality traits and provision of PCC and to what extent perceptions of the working environment influences this relationship.

BACKGROUND

The ultimate goal of elderly care is to meet the older person's needs and individual preferences (PCC). Interpersonal aspects of care and the quality of relationship between the care staff and the older person are therefore central in PCC.

DESIGN AND METHODS

A cross-sectional Swedish sample of elderly care staff (N = 322) completed an electronic survey including measures of personality (Mini-IPIP) and person-centred care (Individualized Care Inventory, ICI). A principal component analysis was conducted on the ICI-data to separate the user orientation (process quality) of PCC from the preconditions (structure quality) of PCC.

RESULTS

Among the five factors of personality, neuroticism was the strongest predictor of ICI user orientation. ICI preconditions significantly mediated this relationship, indicating the importance of a supportive working environment. In addition, stress was introduced as a potential explanation and was shown to mediate the impact of neuroticism on ICI preconditions.

CONCLUSIONS

Personality traits have a significant impact on user orientation, and the perception of a supportive and stress free working environment is an important prerequisite for achieving high-quality person-centred elderly care.

IMPLICATIONS FOR PRACTICE

Understanding how personality is linked to the way care staff interacts with the older person adds a new perspective on provision of person-centred elderly care.

Moral Competence in Nursing Practice

This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, compassion, sympathetic joy, equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand.

Developing Ethical Competence in Health Care Organizations

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

The effect of an enrolled nursing registration pathway program on undergraduate nursing students' confidence level: A pre- and post-test study

BACKGROUND

In the latter half of the 20th century, registered nurse education moved to university degree level. As a result, there has been a reduction in access for students to clinical experience. In numerous studies, nursing graduates have reported that they do not feel prepared for practice. The importance of maximising every learning opportunity during nursing school is paramount. At Edith Cowan University, a program was initiated that allows students to become enrolled nurses at the midway point of their degree to enable them to work and therefore gain experience in the clinical practice setting during their education. This study investigated the effect of the program on the nursing students' perception of their clinical abilities and explored their ability to link theory to practice.

METHODS

The research design for this study was a quasi-experimental, prospective observational cohort study. The study included 39 second-year nursing students not enrolled in the program (Group 1), 45 second-year nursing students enrolled in the program (Group 2), and 28 third-year nursing students who completed the program and are working as enrolled nurses (Group 3). Participants were asked to complete a Five Dimension of Nursing Scale questionnaire.

RESULTS

The quantitative analyses showed that students in Group 1 had statistically significant higher pre-questionnaire perceived abilities across all domains, except in two dimensions when compared to Group 2. The post-questionnaire analysis showed that Group 1 had statistically significant lower perceived abilities in four of the five dimensions compared to Group 2. Group 1 also had significantly lower abilities in all dimensions compared to Group 3. Group 3 had a significantly higher perception of their clinical abilities compared to Group 2.

CONCLUSION

This study highlights the value of meaningful employment for undergraduate nursing students by providing opportunities to increase confidence in clinical abilities.

Preceptors' experiences of using a competence assessment tool to assess undergraduate nursing students

The purpose of this study was to explore Irish preceptors' experience of using a competence tool to assess undergraduate nursing students' clinical competence. This study used a mixed methods design. This study was conducted in two phases, the qualitative phase involved six focus group interviews to ascertain preceptors' experiences of using an assessment tool to assess clinical competence. The quantitative phase involved a descriptive survey measuring preceptors (N = 843) attitudes linked with the use of the assessment tool. The key themes that emerged from qualitative analysis were challenges of using the assessment tool, recognising competence and valuing adult learners. The challenges of using the tool included negotiating complex language and time constraints in completing assessments. Recognising competence revealed the use of intuition and subjectivity. While valuing adult learners acknowledged the reciprocal learning process between the preceptor and the learner. These findings reveal the inherent skills of preceptors to intuitively and subjectively recognise competence. The quantitative findings revealed merits and challenges for the preceptors using the assessment tool. In particular the complexity of the language was highlighted as an issue. A key recommendation from this research is the need to revise the assessment tool to support objective and subjective measurement of competence.

A Home Healthcare Nursing Competency Tool Kit

As a result of the Affordable Care Act, increases in aging populations, and advances in technologies, there is a critical need for highly qualified, competent home healthcare nurses. According to the Joint Commission's Human Resource Standard, home healthcare nurses must demonstrate their competency at least every 3 years by participating in in-service education (). Unfortunately, not all home healthcare agencies (HHA) are accredited by the Joint Commissions. A review of several states healthcare regulatory rules-specifically California, New York, Nevada, and Virginia, reveals no mandates for home healthcare nurses to demonstrate competencies for skills specific for home healthcare nursing. There are many competency programs that focus on general nursing knowledge and skills; however, there is a gap in the literature regarding home healthcare nursing competencies. This article will discuss how a simulation tool kit can be the format by which HHA can enhance the knowledge and skills of their nurses, and promote effective health outcomes and protect the public from harm.

Development and Psychometric Evaluation of the Moral Competence Scale for Home Care Nurses in Japan

Purpose: The purpose of this study was to evaluate the validity and reliability of the Moral Competence Scale for Home Care Nurses (MCSHCN). Methods: A self-administered questionnaire that included the preliminary MCSHCN (90 items) was distributed to home care nurses (HCNs) in Japan. Usable data (from 1,961 questionnaires) were analyzed. Results: Item and exploratory factor analysis for the MCSHCN revealed 45 items that loaded on 5 factors. This 5-factor model showed reasonable fit to the data by confirmatory factor analysis (root mean square error of approximation [RMSEA] = 0.070). Thus, the model closely corresponded to the theoretical components of moral competence. Cronbach’s alpha ranged from .78 to .93. Conclusions: The construct validity and internal consistency reliability were supported. Further research is needed to refine this scale to increase the generalizability.

Nursing students' perspectives on the patient and the impact of the nursing culture: a meta-synthesis

AIM

To explore and interpret how nursing students develop their understanding of the patient as a human being.

BACKGROUND

Understanding the patient is the main characteristic of good, caring performance. In addition, nurse leaders play an active role in creating a culture in which nursing students can flourish and improve.

METHOD

This meta-synthesis was based on Noblit and Hare's meta-ethnography.

RESULTS

The overarching metaphor was interpreted as the nursing students' capacity for compassion. Two central metaphors were revealed, based on how nursing students developed their understanding of the patient as a human being. These central metaphors were labelled 'The open door', comprising seven key metaphors and 'The closed door' based on two key metaphors.

CONCLUSION

During practical training, the students observed both virtuous and unkind nurses. Virtue is a skill that can be taught, but not all students were able to learn it. Some students acquired the ability to reflect on ethical issues, while others did not. Therefore, good role models are of major importance.

IMPLICATION FOR NURSING MANAGEMENT

The nurse leader should function as a facilitator in the students' efforts to gain the capacity to face the suffering patient and to develop an understanding of the patient's situation.

Influence of Nurses' Performance with Critical Thinking and Problem Solving Process

PURPOSE

This study determined the correlation between nurses' critical thinking disposition; problem solving process; and nursing performance. It also examined the impact of critical thinking disposition and problem solving process on nursing performance.

METHODS

The data was collected from 419 nurses. Descriptive statistics, t-test, ANOVA, scheffe test, pearson correlation analysis and multiple regression analysis were performed.

RESULTS

Nursing performance showed that there were differences according to age, marital status, educational level, total number of years in the career and the length of employment in the present department. The problem solving process showed differences in the educational level. Critical thinking disposition showed differences according to age, educational level and total number of years in the career. Problem solving process and nursing performance showed a positive relationship whereas critical thinking disposition and nurses' performance showed a positive relationship. Factors affecting nursing performance, were nurses' age, duration of employment in the present department, problem solving process and critical thinking disposition. This model was statistically significant and showed 22.1% of the total variance.

CONCLUSION

The attention of nursing administrators should be drawn to the consideration that a certain amount of experience in the current department is positively related to nursing performance. Furthermore, in order to provide a improvement in professional nursing performance, educational programs towards nurses' critical thinking disposition and problem solving process should be provided.

Development of the Holistic Nursing Competence Scale

This study developed a scale to measure the nursing competence of Japanese registered nurses and to test its psychometric properties. Following the derivation of scale items and pilot testing, the final version of the scale was administered to 331 nurses to establish its internal consistency, as well as its construct and criterion-related validity. Using an exploratory and a confirmatory factor analysis, 36 items with a five-factor structure were retained to form the Holistic Nursing Competence Scale. These factors illustrate nurses' general aptitude and their competencies in staff education and management, ethical practice, the provision of nursing care, and professional development. The Scale has a positive correlation with the length of clinical experience. A Cronbach's alpha coefficient was 0.967. The Scale is a reliable and valid measure, helping both nurses and organizations to correctly evaluate nurses' competence and identify their needs for professional development.

Relationships between critical thinking ability and nursing competence in clinical nurses

AIM AND OBJECTIVE

To examine the relationships between critical thinking ability and nursing competence in clinical nurses.

BACKGROUND

There are few evidance-based data related to the relationship between critical thinking ability and nursing competence of clinical nurses.

DESIGN

A cross-sectional and correlation research design was used.

METHODS

A total of 570 clinical nurses at a medical centre in southern Taiwan were recruited into this study. Two self-report questionnaires, the Watson-Glaser Critical Thinking Appraisal (WGCTA) and the Nursing Competence Scale (NCS), were used to collect data.

RESULTS

The critical thinking ability of clinical nurses was at the middle level. The highest score for the subscales of the WGCTA was 'interpretation ability' and the lowest was 'inference ability'. The nursing competence of clinical nurses was at the middle level and above. The highest score for the subscales was 'caring ability' and the lowest was 'research ability'. Critical thinking ability had a significantly positive correlation with nursing competence. Critical thinking, working years, educational levels and position/title were the significant predictors of nursing competence, accounting for 32·9% of the variance.

CONCLUSIONS

Critical thinking ability had a significantly positive correlation with nursing competence. The critical thinking ability of clinical nurses with a master's degree was significantly better than those with a bachelor's degree or a diploma and nurses with over five working years was significantly better than those with under five years.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study can further serve as a reference for nursing education to improve nursing curricula and teaching strategies for nurse preparation. It could also be a guideline for nursing administration personnel in on-the-job training and orientation programs for nursing staff.

What are the necessary practice competencies for two providers: dermal fillers and botulinum toxin type A injections?

There has been a steady increase in the number of individuals who undergo dermal fillers and botulinum toxin Type A injections. The majority of these procedures are performed by nurse providers. The purpose of this study was to collect national data on the current practice among nursing providers within the American Society of Plastic Surgical Nurses (ASPSN). The goal was to utilize the national data and develop a document of the necessary competencies to guide the practice of providers of dermal fillers and botulinum toxin Type A injections. A survey tool was developed and validated for content by expert nursing providers among the membership of the ASPSN and disseminated via e-mail to the membership of the ASPSN. In addition, data from investigator training, mentoring, and evidence from a review of the literature were also incorporated into the competency document utilizing the Competency Outcomes and Performance Assessment (COPA) model. Common core issues became apparent that included contraindications for the use of botulinum toxin Type A and dermal fillers, postprocedure complications as well as strategies in terms of managing complications. The data also revealed that there is no common method providers are taught to assess the aesthetic patient and a lack of a collaborative relationship in current practice. Overwhelmingly, the respondents supported the need for defined practice competencies. A competency document to guide the practice of providers of dermal fillers and botulinum toxin Type A has been developed for completion of this DNP project.

Psychological support and outcomes for ICU patients

AIMS AND OBJECTIVES

To critically review evidence on the effects of psychological support during intensive care unit (ICU) treatment on adult ICU patients' psychological and physiological outcomes. Evidence from intervention studies on imagery and relaxation has been included, as well.

BACKGROUND

Stress and negative emotions may have both immediate, as well as long-term effects on ICU patients' psychological and physical well-being, and they are linked to delayed physical recovery. DESIGN, METHODS: A narrative critical review methodology was employed. Databases searched included Medline, CINAHL, PubMed, PsychInfo and the Cochrane Library. Experimental, quasi-experimental or pretest-posttest peer-reviewed intervention studies published since 1970 were included.

RESULTS

Fourteen studies: seven on nurse led relaxation, three on guided imagery, one on nurse-patient interaction, two on physician-patient interaction and one correlational study on perceived social support were included. The results suggest significant improvements in patients' outcomes: improved vital signs, decrease in pain ratings, anxiety, rate of complications and length of stay, and improved sleep and patient satisfaction. Eight studies employed randomized experimental, four quasi-experimental and two descriptive correlational designs. Two studies explored effects on patients' sleep, and two on procedure-related pain.

CONCLUSIONS

The literature is limited in exploring the effects of nurse-patient interactions. The amount and quality of psychosocial support in the ICU, as well as imagery and relaxation techniques, are linked to short-term and long-term patients' outcomes.

RELEVANCE TO CLINICAL PRACTICE

ICU nurses need to engage in psychological support in a systematic way, and to acknowledge the high priority of support interventions.

The role of guidelines in ethical competence-building: perceptions among research nurses and physicians

The aim of the present study was to describe and explore the perception of ethical guidelines and their role in ethical competence-building among Swedish physicians and research nurses. Twelve informants were interviewed in depth. The results demonstrated that the informants had a critical attitude towards ethical guidelines and claimed to make little use of them in practical moral judgements. Ethical competence was seen primarily as character-building, related to virtues such as being empathic, honest and loyal to patients. Ethical competence was assumed to be learned through good examples, role models and practical experience, while ethical guidelines were not perceived as valuable in this process. In order to improve the staff's familiarity with and the usability of ethical guidelines, the workplace needs to provide opportunities for ethical dialogues. In such discussions, argumentation can improve, virtues can be developed and guidelines can be usefully invoked.

[Critical thinking disposition and clinical competence in general hospital nurses]

PURPOSE

This study was done to investigate the relationship between critical thinking disposition and clinical competence among nurses in general hospitals.

METHODS

This study was a descriptive-correlational study with a convenience sample of 560 nurses from 5 general hospitals. The data were collected by self-administered questionnaires. Critical thinking disposition was measured using the Critical Thinking Disposition Scale for Nursing Students. Clinical competence was measured using the Standardized Nurse Performance Appraisal Tool.

RESULTS

The mean score for critical thinking disposition and clinical competence was 3.37 and 4.10 respectively on a 5 point scale. A statistically significant correlation was found between critical thinking disposition and clinical competence. A regression model explained 72.8% of clinical competence. Prudence is the most significant predictor of clinical competence (R(2)=.728).

CONCLUSION

Study findings suggest that nurses with a higher level of critical thinking disposition would have a higher level of clinical competence. Furthermore, prudence might be the most important predictor of clinical competence. In order to strengthen clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the college level and nurses should be encouraged to make a clinical decision with greater prudence.

The effects of potentiality education on potentiality and job satisfaction among psychiatric nurses in Taiwan

PURPOSE

This study evaluated the effects of a potentiality education program on potentiality and job satisfaction among psychiatric nurses.

DESIGN AND METHODS

This quasiexperimental study recruited 59 psychiatric nurses, of whom 26 were assigned to an experimental group, based on their interest in participating in the program, and 33 to a control group.

FINDINGS

The results indicated that the scores for job satisfaction were significantly higher in the experimental group than in the control group. Specifically, potentiality education promoted job satisfaction but had no significant influence on potentiality. PRACTICE APPLICATION: Increasing nurses' potentiality could help them to successfully cope with their large workload and the various challenges of their job.

Acute nursing episodes which challenge graduate's competence: perceptions of registered nurses

On successful completion of nurse education programmes new graduate nurses are expected to meet the requirements for registration as a professional practitioner. Nurse educators need to collaborate with clinical colleagues to be responsive to changes in health care. Identifying challenging acute nursing episodes (CANE) that nurses' encounter in clinical practice and the aspect of competence that new graduate nurses require to manage these episodes effectively can inform undergraduate nursing curricula. Thus a qualitative, descriptive design was employed when undertaking a study to identify challenging acute nursing episodes which new graduates will encounter in clinical practice. Six focus groups were conducted in three university teaching hospitals in Ireland where a total of 28 registered nurses were recruited. Thematic analysis was used to extract themes from the focus group data. The results of this study identified 41 challenging acute nursing episodes and 4 key aspects of competence namely; patient assessment, technical/clinical skills; interactions and communications and clinical decision making. Findings of this study identify both the episodes which challenge new graduates and aspects of competence required by new graduates. These findings provide evidence for nurse educators to develop and deliver curricular content which is congruent with the realities of current day nursing practice.

Communication in palliative care: philosophy, teaching approaches, and evaluation of an educational program for nurses

In this article is presented a post-graduate program in palliative care nursing focusing communication. The teaching plan was inspired by action learning, and the students' discovery processes necessitated a variety of teaching methods. The program was based on a holistic view of the human being and of inter-human communication. Neuro-motoric stimulation exercises were used to improve the students' focus of attention, sensory reception, and awareness of their corporeal and intellectual selves. Stimulation of relational skills, the discussion of ethical and difficult questions, and narratives helped students discover relationships between theoretical knowledge and palliative practice, and were used to explain and illustrate topics, and as backgrounds for discussions. During the program the students examined, challenged, and continuously reflected upon their explicit and unconscious praxis theories and their communicative habits. Although very different from educational programs they previously had experienced, this teaching/learning plan and the outcome thereof was positively evaluated. At the end of the year the students found themselves to be more knowledgeable, discerning and self-confident nurses. Even so, some found that they needed more time to digest what they had learned and for new knowledge and philosophies to become internalised.

Clinical oral examinations: assessment of competence in radiation therapy

Matching assessment strategies to learning outcomes in radiation therapy education is of the utmost importance. Assessing clinical competence requires that ‘competence’ be clearly defined prior to the start of any clinical programme. In this article, we report on our experience in using clinical oral examinations in assessing competence in second year undergraduate radiation therapy students. The shortcomings of clinical oral examinations such as ‘leaking’ of the agenda are addressed and more positive attributes, such as increased collaboration between academic and clinical radiation therapists are discussed.

Nurses' perceptions of leadership in an adult intensive care unit: a phenomenology study

The purpose of this research was to explore ICU nurses' perceptions of nursing leadership in the adult intensive care unit (ICU). The nursing profession needs leaders at all levels; ward, administration and executive and in an era in which there is a shortage of ICU nurses, nursing leadership is important, as positive leadership skills correlate with enhanced recruitment and retention of these specialist nurses. Six ICU nurses with at least 5 years experience in ICU nursing were recruited from a metropolitan hospital in Australia. Qualitative phenomenological methodology was used to depict the lived experiences of nurses' leadership in the adult ICU. Data were collected through individual semi-structured interviews using open-ended questions and analysed using Giorgi's [Giorgi A. Toward phenomenologically based research in psychology. J Phenomenol Psychol 1970;1:75-98] descriptive method for data analysis. Five themes emerged and these were all inter-related: leading by example, communication, ability to think outside the management square, knowing your staff and stepping up in times of crisis. These findings highlight the importance of nursing leadership in the adult ICU and the need to ensure that all current and future nursing ICU leaders are adequately prepared and educated for this role. This information may also be used to assist in the development of leadership skills in ICU nurses.