Nurses' core emergency competencies for COVID-19 in China: A cross-sectional study

Current Status and Factors Influencing Emergency Response Capability of Shared Nurses in the Internet + Nursing Service Model: A Descriptive Cross-Sectional Study

Aim

To evaluate the existing level of emergency capabilities among shared nurses and analyze the factors influencing these capabilities.

Methods

An descriptive cross-sectional survey was conducted from September to October 2023, a purposive sampling method was employed to select 340 shared nurses as the subjects for investigation in Nanchang and Ganzhou cities of Jiangxi Province, as well as Wenzhou city in Zhejiang Province. A self - designed questionnaire on the emergency capabilities of shared nurses was utilized for data collection.

Results

This investigation encompassed the collection of 340 valid questionnaires, assessing the overall emergency response proficiency of shared nurses. The cumulative score amounted to (170.81±24.62), averaging (4.27±0.62). It is noteworthy that the dimension scoring the highest was preparedness (4.33±0.68), whereas the recovery capability dimension received the lowest score (4.17±0.75). Through multiple linear regression analysis, it was determined that marital status, participation in emergency capability training, and experience in home nursing services significantly influenced the emergency capabilities of shared nurses (P<0.05).

Conclusion

Shared nurses in China demonstrate a moderately high level of emergency response capability. The marital status, participation in emergency capacity training, and on-site nursing service experience are pivotal factors influencing the emergency capabilities of shared nurses. Nursing administrators should prioritize the development of emergency capacity training and team building for shared nurses, establishing a scientifically standardized mechanism for training, assessment, and management. The implementation of performance evaluation mechanisms for shared nurses is crucial to enhance professional awareness within the workforce.

Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis

AIMS AND OBJECTIVES

The COVID-19 pandemic has caused an increase in the workload of nurses and changes in working conditions. Stress and the increase in workload during the COVID-19 pandemic had a negative effect on nurses' intention to leave. This study aimed to determine the current rate of intention to leave the job among nurses during the COVID-19 outbreak by conducting a rapid systematic review and meta-analysis.

METHODOLOGY/METHODS

The review procedure was conducted by the PRISMA criteria. The researchers searched PubMed and Web of Science databases for studies providing the rate of nurses' intent to leave, published until 31 December 2021. Heterogeneity was assessed using the I2 test, and publication bias was measured by Egger's test.

RESULTS

The estimated overall intent to leave the profession among nurses during the COVID-19 pandemic was 31.7% (95% CI: 25%-39%) with significant heterogeneity (Q test: 188.9; p = 0.0001; I2 : %95.2; Tau2 : 0.225). Additionally, Egger's regression test suggested no publication bias for estimating the pooled rate of nurses' intent to leave during the COVID-19 outbreak.

NO PATIENT OR PUBLIC CONTRIBUTION

Since the research is a meta-analysis study, a literature review model was used. Ethics committee approval was not obtained because the literature review did not directly affect humans and animals.

CONCLUSION

This study showed that approximately one-third of nurses working during the COVID-19 pandemic had thoughts about intending to leave their job. The findings indicate the need for strategies involving precautions and solutions to minimise the psychological impacts of COVID-19 among nurses.

RELEVANCE TO CLINICAL PRACTICE

In this period when the global nurse crisis exists, it is of great importance for institutions to retain their nurse workforce. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for intention to leave could be a significant weapon giving nurses and healthcare systems the ability to response in a better way against the following COVID-19 waves in the near future.

Higher Vocational Nursing Students' Clinical Core Competence in China: A Cross-Sectional Study

Introduction

Understanding the clinical core competence of nursing students in higher vocational colleges is crucial for adjusting the nursing core curriculum and training of nursing professionals. However, little is known about the level of clinical core competence of higher vocational nursing students in China.

Objective

To investigate nursing students' clinical core competence in the school of nursing and health at a vocational and technical college in Guangdong, China.

Methods

The Core Competency Scale for Registered Nurses in China was used to evaluate the clinical core competence of higher vocational nursing students from February to March 2022. Data were analyzed by descriptive statistics, Mann-Whitney U test and Kruskal-Wallis test.

Results

A total of 1,120 nursing students were investigated, 1,069 were valid questionnaires, and the response rate was 95.4%. The total score of core competence score of higher vocational nursing students was 176.55 ± 43.95, only 43.3% of students obtained an overall score more than 178, and 47.7% of students scored between 116 and 178 scores. The lowest score was on critical thinking and scientific research (2.72 ± 0.77) following by clinical nursing (2.85 ± 0.80), which had differences in gender, category of students, and years of study. There were differences in the total average score of core competence in terms of gender and category of students. Leadership and interpersonal relationships differ significantly by gender, while professional development, teaching, and coaching differ significantly by category of student.

Conclusions

The findings revealed the core competence of higher vocational nursing students is at a medium level. Moreover, critical thinking and scientific research, and clinical nursing ability are significantly insufficient.

Common domains of nurses' competencies in public health emergencies: a scoping review

BACKGROUND

A public health emergency can cause large numbers of deaths in a short period, with devastating social, economic and health consequences. Nurses are the main healthcare providers during such emergencies, and their competencies affect the control and outcomes of the situation. Studies on nurses' competencies in public health emergencies vary between countries and healthcare systems. Therefore, we conducted a scoping review to identify the common domains of nurses' competencies in public health emergencies worldwide.

METHODS

We searched the PubMed, CINHAL, Scopus, Web of Science, Science Direct, Embase, Cochrane Library, WanFang and ECRI databases from their inception to 2023. All published articles on nurses' competencies in public health emergencies that were published in English and Chinese were included. We mainly analyzed and synthesized nurses' competencies, assessment instruments and the training described in the included studies.

RESULTS

A total of 27 competency domains were identified following an analysis and summary. The most frequently cited domains were communication skills, self-protection skills, basic knowledge of a public health emergency, laws and ethics and the capacity for organizational collaboration. The Disaster Preparedness Evaluation Tool and the Emergency Preparedness Information Questionnaire were the most commonly used tools for assessing competencies. Most training was conducted online and the content that was covered varied by country.

CONCLUSIONS

Given the significant roles and responsibilities of nurses in public health emergencies, knowing the domains of their competencies is essential to evaluating, developing, and conducting clinical training.

The analysis of reliability and validity of a competency evaluation model for front-line nursing staff during the outbreak of major infectious diseases

BACKGROUND

Outbreaks of major infectious diseases represent a tremendous threat to people's health, safety and property, yet little is known about the competence of front-line caregivers in such situations.

AIM

To construct a model for evaluating the competency of front-line nursing staff during major infectious disease outbreaks and to test the model's reliability and validity.

STUDY DESIGN

This was a cross-sectional study that took place between November and December 2021, in Chinese hospitals. The model was constructed through literature reviews, descriptive qualitative research, the Delphi method and the analytic hierarchy process. To evaluate the model's validity and reliability, 550 front-line nurses were selected to complete a questionnaire survey, and six experts were invited to conduct a content validity evaluation. Cronbach's α coefficient was used to test the model's reliability, while an exploratory factor analysis was used to measure the structural validity of the model.

RESULTS

The model included 57 items. The Cronbach's α coefficient of the model was 0.983, and the content validity index was 0.958. Six common factors were produced by exploratory factor analysis. The cumulative variance contribution rate was 66.718%. After discussion, the original four dimensions were maintained.

CONCLUSION

The model for evaluating the competency of front-line nursing staff during an outbreak of major infectious diseases has strong reliability and validity and can be used as a tool to assess the competency level of front-line nursing staff.

RELEVANCE TO CLINICAL PRACTICE

This model can provide a useful reference for care managers to accurately evaluate, train and select caregivers during an epidemic.

[Disaster Literacy Status and the Influencing Factors: A National Survey of 107997 Chinese Nurses]

Objective

To study the level of disaster literacy among nurses in China and the influcing factors and to provide scientific basis for developing effective interventions to improve the disaster literacy among Chinese nurses.

Methods

Between September 2021 and October 2021, an online survey was conducted among nurses from health care institutions in eastern, central, western, and northeastern China by using a cross-sectional survey design and convenience sampling. The content of the survey included the surveyed nurses' sociodemographic characteristics, occupational characteristics, disaster relief characteristics, self-efficacy, and disaster literacy level. A disaster literacy model developed previously was used to assess the nurses' disaster literacy.

Results

A total of 107997 nurses were covered in the survey and their disaster literacy score was found to be 255.62±53.92. According to the findings of multiple linear regression, the protective factors for disaster literacy among Chinese nurses included the following, being based in Eastern region (non-standardized regression coefficient [ B]=2.365, 95% confidence interval [ CI]: 1.647-3.082), male sex ( B=9.418, 95% CI: 7.892-10.944), bachelor's degree or higher level of education ( B=3.822, 95% CI: 3.195-4.450), tertiary-level hospitals ( B=3.569, 95% CI: 3.000-4.138), military/local public hospitals ( B=2.606, 95% CI: 1.750-3.463), emergency department ( B=2.921, 95% CI: 2.149-3.694), intermediate professional title ( B=2.918, 95% CI: 2.209-3.627), senior professional title ( B=5.801, 95% CI: 4.448-7.155), participation in disaster rescue ( B=5.566, 95% CI: 5.020-6.112), the institution being previously involved in disaster emergency rescue ( B=3.257, 95% CI: 2.429-4.084), the institution having set up disaster rescue team ( B=5.967, 95% CI: 5.103-6.831), having received nursing education in disaster preparedness in school ( B=6.205, 95% CI: 5.621-6.790), having received on-the-job disaster preparedness education and training ( B=8.776, 95% CI: 8.027-9.525), and self-efficacy ( B=5.117, 95% CI: 5.069-5.165).

Conclusions

In China, disaster literacy among nurses is at a medium to low level and needs to be improved. For the next step, efforts should be focused on nurses with the following features, being based in the central and western regions, female sex, having completed junior college education or less, no nursing education in disaster preparedness in school, having junior professional titles, being from gynecology, pediatrics, and auxiliary departments, working in grassroots medical and health institutions and primary and secondary-level hospitals, neither the individual respondent nor her institution having any experience in disaster rescue, the institution having no disaster rescue team, not having any on-the-job nursing education and training in disaster preparedness, and having low self-efficacy. Measures should be taken to improve their disaster literacy level.

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak

BACKGROUND

Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic.

METHODS

We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered.

RESULTS

The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic.

CONCLUSION

The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Structural Equation Modelling of Professional Values and Competency of Nurses During the COVID-19 Pandemic

Background

The COVID-19 pandemic is a global health crisis that affected nurses’ professional values and competence.

Aim

Our study examined the relationship between nurses’ professional values and competence in Saudi Arabia during the COVID-19 pandemic.

Methods

This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data.

Findings

The emerging model showed acceptable model fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong, direct effect on activism. Justice had a moderate, direct impact on trust, while activism had a weak, direct impact on trust. Professionalism and caring had strong, indirect effects on professional competence by mediating the dimension of activism.

Discussion

The study’s findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence.

Conclusion

This study provides a structural model of the interaction between nurses’ professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses’ professional values and competence.

Nursing skills required across natural and man-made disasters: A scoping review

AIMS

To map the nursing skills required for different types of disasters.

DESIGN

This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute.

DATA SOURCES

A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review.

REVIEW METHODS

The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized.

RESULTS

We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills.

CONCLUSION

This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing.

IMPACT

This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.

Clinical competency and psychological empowerment among ICU nurses caring for COVID-19 patients: A cross-sectional survey study

Aim

This study aimed to determine clinical competency and psychological empowerment among ICU nurses caring for COVID‐19 patients.

Background

Nurses need clinical competency (skills pertaining to knowledge, reasoning, emotions and communication) and psychological empowerment (regard for one's organisational role and efforts) to deliver quality care.

Methods

This cross‐sectional study was conducted with 207 nurses working in ICUs in Iran. A clinical competency survey instrument consisting of basic demographic questions and the Spreitzer psychological empowerment questionnaire was completed online. Descriptive and inferential statistics were used to analyse the data in SPSS software version 13 to address the primary research question.

Results

There was a significant positive relationship between clinical competency and psychological empowerment (r = .55, p < .001). Clinical competency had a significant positive relationship with work experiences (r = .17, p = .01).

Conclusion

Clinical competency has been tied to nurse health and quality of care. Given the significant positive relationship between clinical competency and psychological empowerment, attention must be given to ways to psychologically empower nurses.

Implications for Nursing Management

Nursing managers can consider the promotion of psychological empowerment related to its significant positive relationship to clinical competency. Psychological empowerment can be bolstered through the promotion of servant leadership, organisational justice and empowering leadership practices.

Association Between Clinical Competencies and Mental Health Symptoms Among Frontline Medical Staff During the COVID-19 Outbreak: A Cross-Sectional Study

Background

In China, mental health of frontline medical staff might be influenced by clinicians' ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians' competencies and mental health in this context. This cross-sectional study was to examine the prevalence of mental health symptoms among frontline medical staff that fought against the COVID-19 outbreak, and explore the associations between their competencies, and separate and concurrent depressive and anxiety symptoms.

Methods

A total of 623 frontline medical staff was included in this study. Competencies, depressive symptoms, and anxiety symptoms were assessed using a self-reported short form of the Chinese clinical physicians' competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to evaluate the associations between one SD increase in competency scores and the prevalence of mental health problems.

Results

The prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93, 31.78, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive [odds ratios (ORs) = 0.67, 95% confidence intervals (CIs): 0.55-0.81], anxiety (OR = 0.68, 95% CI: 0.56-0.83), and comorbid anxiety and depressive symptoms (OR = 0.69, 95% CI: 0.55-0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses.

Conclusion

The present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms.

Construction of an index system of core competence assessment for infectious disease specialist nurse in China: a Delphi study

Aim and objective

This study was to establish an index system for the evaluation of Chinese infectious disease specialist nurses’ core competence.

Background

The index system for the evaluation of infectious disease specialist nurses’ core competence has not been established.

Design

A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of infectious disease specialist nurses’ core competence.

Methods

The study adopted several research methods, including literature retrieval, theoretical analysis and qualitative research. Based on the above method, the draft of core competence evaluation index system of infectious disease specialist nurses was constructed. A Delphi survey was used for the study of 30 infectious disease experts from 8 provinces and cities around China. A modified recommendation for the Conducting and Reporting of Delphi studies (CREDES) was also used to guide this study. A STROBE checklist was used.

Results

The Core Competence Evaluation Index System of Infectious Disease Nurses is composed of 6 primary indicators, namely, Nursing Abilities for Infectious Diseases, Infection Prevention and Control Abilities, Responsiveness to Infectious Diseases, Professional Development Abilities, Communication and Management Abilities, and Professionalism and Humanistic Accomplishment, 16 secondary indicators and 47 tertiary indicators. The authority coefficient, judgment coefficient and familiarity degree of Delphi experts were 0.923, 0.933 and 0.913 respectively.

Conclusions

The evaluation index system of core competence of diseases specialist nurses is scientific and reliable. It can be reference for future training and assessment of Chinese infectious disease specialist nurses.

Relevance to clinical practice

Infectious disease specialist nurses are the main force for infectious disease nursing. Their core competence is related to the quality of infectious disease nursing and treatment. The core competence of the nurses is important for identification of training strategies and can be regarded as reference for nurse assessment and promotion. The construction of the index system is based on the consensus of infectious disease experts, which is not only helpful to standardize the training strategies and selection standards of infectious disease specialist nurses in the future, but also meet the society’s needs in clinical infectious disease nursing.

Nurses' core emergency competencies for COVID-19 in China: A cross-sectional study

Aim

To investigate nurses’ core emergency competencies for handling the coronavirus disease‐19 (COVID‐19) and analyse the factors associated with those competencies.

Background

COVID‐19 has become a major global public health event. Nursing staff have played an important role in COVID‐19 prevention and control. Understanding their emergency competencies for handling COVID‐19, and the potential disadvantages will help governments to develop targeted training policies and improve nurses’ capacities in relation to pandemics and emergency preparedness.

Introduction

COVID‐19 is a disastrous infectious disease, but the competencies of nurses in China to handle COVID‐19 have not been well documented.

Methods

We conducted a cross‐sectional survey on nurses from 22 provinces of China in February 2020. The scores of self‐report questionnaires were used to analyse their competencies for core emergency care, and linear regression analysis was used to explore influential factors.

Results

A total of 2570 nurses participated. The study revealed that nurses had a good grasp of COVID‐19 knowledge, but the majority of nurses lacked experience in isolation ward work and emergency training. We found that age, professional title, work department, major work content, total work time, disaster rescue history, emergency training and infectious disease training were associated with core emergency competencies.

Conclusions

Chinese nurses were qualified for handling COVID‐19 but still need to strengthen the accumulation of practical experience.

Implications for nursing

Nurses should actively participate in emergencies to strengthen their operational capacity, whether in training or actual practice.

Implications for nursing/health policy

Managers should improve relevant policies to ensure that nurses have more opportunities to participate in the practical training of health emergencies and explore effective training methods to improve the ability of nurses to respond to these.