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Niu A, Ma H, Chen Z, Zhang S, Deng J, Luo Y. Exploring the competencies of Chinese critical care nurses in mobile medical teams based on the onion model: A qualitative study. Nurs Crit Care 2024; 29:868-879. [PMID: 37743055 DOI: 10.1111/nicc.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND With frequent conflicts, natural disasters, and public health emergencies globally, mobile medical teams (MMTs) are becoming increasingly critical. Importantly, the competency of critical care nurses in MMTs can substantially affect the effectiveness and quality of its rescue efforts. Yet, these nurses' competencies are not well understood. AIM This study examined the competencies of critical care nurses in MMTs using the Onion Model. STUDY DESIGN A qualitative descriptive method was used to describe the competencies of Chinese MMT critical care nurses. From April to May 2022, a convenience sample of 18 participants (14 critical care nurses and 4 surgeons) from 10 MMTs was recruited for semi-structured interviews. Deductive and inductive coding methods were combined for content analysis. RESULTS In total, 29 competencies were identified, which were grouped into four major domains using the Onion Model. From the outer to inner layers, these domains were knowledge and skills, professional abilities, professional quality, and personal traits. Several novel competencies emerged, including field medical equipment operation skills, on-site hazard identification and safety prevention skills, triage knowledge, and field survival skills. CONCLUSIONS Using the Onion Model, this study furthers the understanding of the competency of critical care nurses in MMTs, especially by revealing the novel competencies. Further, the results can be used to recruit, evaluate, and train critical care nurses for MMTs. RELEVANCE TO CLINICAL PRACTICE Understanding MMT critical care nurses' competencies can help managers plan and provide relevant training and education before deployment, which can improve nurses' performance, and especially reduce the mortalities and disabilities from trauma.
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Affiliation(s)
- Aifang Niu
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Huijuan Ma
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Zhe Chen
- Army Health Service Training Base, Third Military University/Army Medical University, Chongqing, China
| | - Suofei Zhang
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Jing Deng
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Yu Luo
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
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Almarwani AM, Alzahrani NS. Factors affecting the development of clinical nurses' competency: A systematic review. Nurse Educ Pract 2023; 73:103826. [PMID: 37951064 DOI: 10.1016/j.nepr.2023.103826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
AIM To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency. BACKGROUND Nursing competence affects not only patients but also nurses themselves. Competent nurses contribute to patient safety. Prioritizing clinical competency enables nurses to deliver high-quality care. Clinical nursing competency is influenced by various factors including education and training, experience, professional development, clinical judgment, decision-making skills and communication. DESIGN This was a systematic review. METHODS This study utilized an extensive literature search of online databases, including SCOPUS, Web of Science and PubMed. This review followed the guidelines provided by the Effective Practice and Organization of Care (EPOC) Cochrane Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS This systematic review provided 20 valuable articles, with a total of 6273 participants across the 20 studies, including 18 cross-sectional studies and two descriptive-correlational studies, predominantly using quantitative research methods. The analysis revealed several key factors that significantly affect nurses' clinical competency. These factors included years of experience, workplace environment, theoretical knowledge and educational level, marital status, clinical training, job satisfaction, turnover intention, job stress and critical thinking. CONCLUSIONS Understanding and addressing these factors are crucial for enhancing nurses' clinical competence and ultimately improving patient outcomes. Further research and interventions should be directed towards promoting supportive work environments, continuous education and the development of critical thinking skills among nurses to optimize their clinical competencies.
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Affiliation(s)
- Abdulaziz Mofdy Almarwani
- Department of Psychiatric Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia.
| | - Naif S Alzahrani
- Department of Medical-Surgical Nursing, College of Nursing, Taibah University, Medina 42353, Saudi Arabia
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Tan X, Ning N, Hua N, Wiley J, Sun M. Determining the core competencies for international postgraduate nursing students in internship programs: A delphi study. Nurse Educ Pract 2023; 70:103654. [PMID: 37146479 DOI: 10.1016/j.nepr.2023.103654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/26/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
AIM To determine the core competencies of clinical internships for international postgraduate nursing students undertaking a two-year professional program in China. BACKGROUND Clinical internship is an important part of nursing education and is the cornerstone for the future training of nursing professionals. However, in terms of providing a basis for the training and assessment of international postgraduate nursing students undertaking a two-year professional program in China, their core competencies of clinical internships have not yet been sufficiently determined. METHODS Focus group interviews and a two-round Delphi method were conducted. The preliminary list of core competencies was determined based on a scoping review and focus group interviews. Subsequently, experts provided suggestions for modifications to the core competencies in two rounds of the Delphi survey. The response rate (RR), composite reliability (Cr), coefficient of variation and Kendall coefficient of indices were calculated. RESULTS Twenty experts completed two rounds of Delphi expert consultation and reached consensus on five first-level indices and 13 s-level indices with 27 connotations. The RR values for the two rounds of consultation were 100 %, the Cr values were 0.853 and 0.873 and the Kendall coordination coefficients were 0.134-0.250 (p < 0.05). CONCLUSION The core competencies identified in this research can provide a basis for further training international postgraduate nursing students undertaking a two-year professional program in China through internship programs. This research also provides a reference for effectively evaluating and improving clinical programs.
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Affiliation(s)
- Xiangmin Tan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ni Ning
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Nan Hua
- Xiangya School of Nursing, Central South University, Changsha, China
| | - James Wiley
- School of Nursing, University of California, San Francisco, CA 94118, USA
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China.
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Endacott R, Scholes J, Jones C, Boulanger C, Egerod I, Blot S, Iliopoulou K, Francois G, Latour J. Development of competencies for advanced nursing practice in intensive care units across Europe: A modified e-Delphi study. Intensive Crit Care Nurs 2022; 71:103239. [DOI: 10.1016/j.iccn.2022.103239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 12/21/2022]
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Assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement. An integrative review. Nurse Educ Pract 2021; 58:103258. [PMID: 34847502 DOI: 10.1016/j.nepr.2021.103258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/30/2021] [Accepted: 11/14/2021] [Indexed: 11/20/2022]
Abstract
AIM To provide an overview of assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement and to identify recommendations for future assessment methods. BACKGROUND The purpose of postgraduate critical care nursing education is to educate professional, competent and caring critical care nurses and high-quality assessment strategies in clinical placement are of most importance. DESIGN An integrative review following Whittemore and Knafl's framework and Prisma 2020 guidelines for systematic reviews. METHODS Systematic searches were performed in June 2020 with an update in April 2021 using the following: Academic Search Premier, British Nursing Index, CINAHL, MEDLINE, SveMed+, Web of Science and the Joanna Briggs Institute databases. The systematic literature search and hand search yielded 380 studies. After screening and checking for eligibility, fifteen studies published between 2005 and 2020 were included in this review. The included studies were critically appraised using the Mixed Methods Appraisal Tool for empirical studies and the Joanna Briggs Institute Critical Appraisal tool for literature reviews. RESULTS Four qualitative, six quantitative, three mixed-methods and two literature review studies were included in this review. We identified that competence in postgraduate critical care nursing is a multidimensional concept and it is recommended to use a combination of assessment methods like self-assessment, observation and mentor evaluation. It is necessary to have discussions and reflections between the student, preceptor and lecturer, as well as written self- and mentor evaluation to provide formative and summative feedback to the students. The need to provide consistency and objectivity resulted in the development of competency assessment tools and they were mostly developed and validated as a collaboration between clinical sites and educational institutions. Most of the assessment tools consisted of domains reflecting holistic nursing, including both technical and non-technical skills. Domains reflecting evidence-based nursing practice were less common. CONCLUSIONS We need valid and reliable instruments to assess postgraduate critical care nursing student's competence in placement. Innovation and further research regarding effective and accessible assessment methods, such as digital assessment tools, are needed to meet future needs. This may also stimulate collaboration to improve the international inconsistency in critical care nursing educations. We should be working towards common, international educational competence descriptions and assessment tools that are in line with the ever-changing critical care environment, including holistic nursing and continuous learning.
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Okumura M, Ishigaki T, Mori K, Fujiwara Y. Personality traits affect critical care nursing competence: A multicentre cross-sectional study. Intensive Crit Care Nurs 2021; 68:103128. [PMID: 34391627 DOI: 10.1016/j.iccn.2021.103128] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 06/11/2021] [Accepted: 07/25/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the relationship between personality traits and critical care nursing competence among critical care nurses. RESEARCH METHODOLOGY/DESIGN Multicentre cross-sectional survey using a self-report questionnaire and path modelling, from August 2017 to December 2018. SETTING Six intensive care units in Japan. MAIN OUTCOME MEASURES We assessed relationships among the Big Five personality traits and four critical care nursing competencies in nurses. FINDINGS We included 211 nurses (77.7% women, 59.2% in their 20 s); 62.6% had 1-5 years' critical care nursing experience. Among the four competencies, principles of nursing care had a direct positive effect on decision-making (0.77, p < 0.001); decision-making had a direct positive effect on collaboration (0.74, p < 0.001) and nursing interventions (0.77, p < 0.001). The personality traits openness to experience, agreeableness, and extraversion had a significantly positive effect (0.17, p < 0.05; 0.43, p < 0.001; 0.29, p < 0.01; respectively) on principles of nursing care, the key competency. The personality trait neuroticism had a direct or indirect negative effect on all four nursing competencies. CONCLUSION Nursing competence in the critical care setting is affected by personality traits. Our findings can be applied in nursing education to improve competence based on individual personality traits.
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Affiliation(s)
- Masatoshi Okumura
- Department of Anesthesiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Tomonori Ishigaki
- Department of Business Administration, Nanzan University, 18 Yamazato-cho, Showa-ku, Nagoya, Aichi 466-8673, Japan.
| | - Kazunao Mori
- Division of Nursing, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yoshihiro Fujiwara
- Department of Anesthesiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
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Egerod I, Kaldan G, Nordentoft S, Larsen A, Herling SF, Thomsen T, Endacott R. Skills, competencies, and policies for advanced practice critical care nursing in Europe: A scoping review. Nurse Educ Pract 2021; 54:103142. [PMID: 34265667 DOI: 10.1016/j.nepr.2021.103142] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy. REVIEW METHOD We performed a scoping review including papers published in 1992-2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin). DESIGN AND DATA SOURCES Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search. RESULTS The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking. CONCLUSIONS This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. Task-shifting from physician to nurse needs to be more clearly defined and patient outcomes described. Given the scarcity of papers in our target area, we believe it might be too early to conduct a systematic review at this time.
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Affiliation(s)
- Ingrid Egerod
- Department of Intensive Care, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Gudrun Kaldan
- Department of Neurology, Copenhagen University Hospital Rigshospitalet Glostrup, Denmark.
| | - Sara Nordentoft
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Denmark.
| | - Anders Larsen
- The University Hospitals Centre for Health Research, UCSF, Copenhagen University Hospital Rigshospitalet, Copenhagen Denmark.
| | | | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit (Herlev-ACES), Copenhagen University Hospital Herlev-Gentofte, Denmark.
| | - Ruth Endacott
- School of Nursing and Midwifery, Plymouth University, UK.
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Okumura M, Ishigaki T, Mori K, Fujiwara Y. Development of an easy-to-use questionnaire assessing critical care nursing competence in Japan: A cross-sectional study. PLoS One 2019; 14:e0225668. [PMID: 31774872 PMCID: PMC6881035 DOI: 10.1371/journal.pone.0225668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Critical care nurses need a high level of medical competence, especially with regard to patient safety. There are several tools to measure general and critical care nursing competence, but the usability of these tools is inadequate because they include large numbers of questions. To maintain quality and safety in intensive care units (ICUs), it is necessary to be able to easily measure and evaluate critical care nursing competence. The purpose of this study was to develop an easy-to-use questionnaire assessing critical care nursing competence related to patient safety. METHODS A cross-sectional, descriptive, explorative study was designed to collect data from nurses working in six ICUs in tertiary hospitals in Japan. Data were collected from August 2017 to December 2018. The Critical Care Nursing Competence Questionnaire for Patient Safety (C3Q-safety) is a 22-item instrument designed to assess nursing competence related to patient safety in ICUs. Items were developed based on previous work related to critical care nursing competence and were adjusted based on a pilot study. RESULTS A total of 211 nurses working in ICUs participated in this study. Through descriptive statistics and factor analysis, the number of questions was reduced from 24 to 22. The C3Q-safety had four factors: decision making, collaboration, nursing intervention, and principles of nursing care. Cronbach's alpha ranged from 0.73 to 0.83. The four factors showed positive correlations with each other (0.47 to 0.72). Nurses licensed as certified nurses in intensive care and those with longer ICU work experience showed significantly higher scores on all four factors. CONCLUSIONS We developed an easy-to-use questionnaire to assess critical care nursing competence related to patient safety. The C3Q-safety was able to detect four areas of competence. The C3Q-safety will make it possible to easily measure critical care nursing competence and can be utilized for efficient education.
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Affiliation(s)
- Masatoshi Okumura
- Department of Anesthesiology, Aichi Medical University, Nagakute, Aichi, Japan
- * E-mail:
| | - Tomonori Ishigaki
- Department of Business Administration, Nanzan University, Nagoya, Aichi, Japan
| | - Kazunao Mori
- Division of Nursing, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yoshihiro Fujiwara
- Department of Anesthesiology, Aichi Medical University, Nagakute, Aichi, Japan
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Wei W, Niu Y, Ge X. Core competencies for nurses in Chinese intensive care units: a cross-sectional study. Nurs Crit Care 2018; 24:276-282. [PMID: 30569548 DOI: 10.1111/nicc.12398] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 09/17/2018] [Accepted: 09/30/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Core competencies of intensive care unit (ICU) nurses were defined as the essential capability to influence patient safety and interdisciplinary collaboration; however, there has been no research conducted that relates to core competencies of ICU nurses at Chinese tertiary-A hospitals in Shanghai. AIMS AND OBJECTIVES To investigate the current state of core competencies and the factors that influence this key capability in ICU nurses in Chinese tertiary-A hospitals. DESIGN This was a multicentre, cross-sectional study. METHODS A convenient sampling method was used to investigate 451 ICU nurses at five tertiary-A hospitals in Shanghai. Data were collected using self-administered questionnaires. RESULTS The core competencies of ICU nurses were above average, and the scores of seven dimensions, ranked from first to last, were medical ethics, clinical practice, nurse-nurse co-operation, assessment and decision-making, personal and professional development, teaching and research and nurse-physician co-operation. Multivariate linear regression analysis showed that the factors exerting an influence on the core competencies of ICU nurses were title, role incumbent and ICU department. CONCLUSION This study showed an above-average level of core competencies among ICU nurses in tertiary-A hospitals in Shanghai; however, competencies related to nurse-physician co-operation and the translation of research into practice were underdeveloped. RELEVANCE TO CLINICAL PRACTICE Nursing managers should implement targeted interventions to improve nurse-physician co-operation and translate research into practice competencies, such as high-fidelity simulation, inter-professional education, scientific research training and innovative skills tutorials. Moreover, this study demonstrated the influencing factors that can be used to improve core competences of ICU nurses.
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Affiliation(s)
- Wanrui Wei
- Department of Nursing, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,School of Nursing, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yunchao Niu
- Circle Harmony Health, International Healthcare Network, Shanghai, People's Republic of China
| | - Xiaohua Ge
- Department of Nursing, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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DeGrande H, Liu F, Greene P, Stankus JA. Developing professional competence among critical care nurses: An integrative review of literature. Intensive Crit Care Nurs 2018; 49:65-71. [PMID: 30166231 DOI: 10.1016/j.iccn.2018.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 07/06/2018] [Accepted: 07/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Professional competence is the ability to base clinical decisions on prior experiences with particular clinical situations. METHODS An integrative review of the literature using the methodology of Whittemore and Knafl. The guiding question was: What is the extent and nature of the published literature on intensive care nurses developing professional competence? RESULTS This review analysed 21 peer-reviewed articles obtained from electronic databases. The three main domains of professional competence were managing situations, decision-making and teamwork. Three instruments, the Critical Care Competency Assessment instrument, the Self-Assessment Competence Tool, and the Intensive and Critical Care Nursing Competence Scale (intensive care unit), measure professional and/or clinical competence. Demographic factors are experience, education, age, figure tow near here certification status, gender and location. CONCLUSION Perception of self-competence, seeing beyond the technical aspects of care to the patient, and perceptions of and bonding with intensive care patients and their families are other facets of professional competence that warrant further study.
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Affiliation(s)
- Heather DeGrande
- Texas A&M University: CONHS, 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Fuqin Liu
- Texas Woman's University: CON, 304 Administration Dr., Denton, TX 76204, United States.
| | - Pamela Greene
- Texas A&M University: CONHS, 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Jo-Ann Stankus
- Texas Woman's University: CON, 304 Administration Dr., Denton, TX 76204, United States.
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Scholes J. What's in this issue? Nurs Crit Care 2015; 17:223-4. [PMID: 22897806 DOI: 10.1111/j.1478-5153.2012.00530.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lakanmaa RL, Suominen T, Ritmala-Castrén M, Vahlberg T, Leino-Kilpi H. Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:536724. [PMID: 26557676 PMCID: PMC4628747 DOI: 10.1155/2015/536724] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 04/23/2015] [Indexed: 11/25/2022]
Abstract
Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1-5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n = 431). Intensive care unit nurses' self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses' basic competence was their experience of autonomy in nursing care (F value 60.85, β 0.11, SE 0.01, and P ≤ 0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses' experienced autonomy in nursing.
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Affiliation(s)
| | - Tarja Suominen
- School of Health Sciences, University of Tampere and University of Turku, 33014 Tampere, Finland
| | - Marita Ritmala-Castrén
- Department of Anesthesiology and Intensive Care, Helsinki University Hospital, HUS, 00029 Helsinki, Finland
| | - Tero Vahlberg
- Biostatistics, University of Turku, 20014 Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Turku University Hospital, 20521 Turku, Finland
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Henao Castaño ÁM, Amaya MCDP. CEI-UCI: instrumento para evaluar el cuidado de enfermería individualizado de adultos en la UCI. AVANCES EN ENFERMERÍA 2015. [DOI: 10.15446/av.enferm.v33n1.38310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p>El propósito de este estudio fue diseñar el instrumento Cuidado de Enfermería Individualizado en Unidad de Cuidado Intensivo (CEI-UCI) para identificar las intervenciones de cuidado de enfermería individualizado en pacientes con ventilación mecánica invasiva en la UCI.</p><p><strong>Metodología:</strong> Estudio psicométrico, exploratorio-observacional, con <em>n</em> = 156 enfermeras que laboraban en la UCI con pacientes adultos en ventilación mecánica. Se diseñaron un total de 85 ítems para iniciar las pruebas. Para la validez facial se utilizó la V. Aiken por encima de 0,70. Para la validez de contenido se realizó el cálculo de Lawshe Modificado igual o mayor a de 0,58. La validez de constructo se obtuvo por medio del análisis factorial con ocho dominios nanda. La confiabilidad se reportó con test-retest para los días 1, 2 y 3 de estadía de los pacientes en UCI.</p><p><strong>Resultados:</strong> El CEI-UCI presentó una validez facial con rangos entre 0,75-0,82, con un CVI con rangos entre 0,58-0,90. La validez de constructo se confirmó con una varianza total explicada del 73% para cuatro factores. La confiabilidad por el test-retest entre los tres primeros días de aplicado el instrumento se presentó con un rango de 0,662 a 1,00.</p><p><strong>Conclusiones:</strong> El instrumento CEI-UCI posee 53 ítems y seis dimensiones con validez facial, aparente y consistencia interna. La validez de constructo derivada del análisis factorial<br />de cuatro factores se denominaron Dimensiones, a saber: F1, <em>Protección y seguridad</em> (17 ítems); F2, <em>Interacción fisiológica y social</em> (3 ítems); F3, <em>Roles y conexiones sociales</em> (13 ítems); y F4, <em>Autopercepción y nutrición</em> (11 ítems). Además, hubo dos dimensiones permanentes y centinelas: <em>Perceptual-Cognitivo</em> y el de <em>Confort</em>.</p>
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Gill FJ, Leslie GD, Grech C, Boldy D, Latour JM. Developing and Testing the Standard of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT) for Critical Care Nursing Practice. J Contin Educ Nurs 2014; 45:312-20. [PMID: 24972098 DOI: 10.3928/00220124-20140620-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 04/16/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nurses working in critical care often undertake specialty education. There are no uniform practice outcomes for critical care programs, and consumer input to practice standards has been lacking. METHODS A structured multiphase project was undertaken to develop practice standards and an assessment tool informed by critical care nursing stakeholders as well as patients and families-the Standards of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT). RESULTS Testing of the SPECT revealed adequate content validity index (CVI), domain CVI (range, 0.772 to 0.887), and statement CVI (range, 0.66 to 1.00). Reliability was adequate in terms of internal consistency (Cronbach's α > 0.864) and test-retest Spearman rank correlation (range, 0.772 to 0.887); intra-rater kappa agreement was significant for 102 of 104 statements with moderate agreement for 94.2% of statements. CONCLUSION The SPECT appears to have clinical feasibility, preliminary validity and reliability, and provides a clear definition for the expected practice level for graduates of a critical care education program.
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Gill FJ, Leslie GD, Grech C, Boldy D, Latour JM. Development of Australian clinical practice outcome standards for graduates of critical care nurse education. J Clin Nurs 2014; 24:486-99. [DOI: 10.1111/jocn.12631] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Fenella J Gill
- Faculty of Health Science; School of Nursing and Midwifery; Curtin University; Perth WA Australia
- Child & Adolescent Health Services; Princess Margaret Hospital for Children; WA Australia
| | - Gavin D Leslie
- Critical
Care Nursing; Joint Appointment Royal Perth Hospital; Perth WA Australia
- Faculty of Health Science; School of Nursing & Midwifery; Curtin Health Innovation Research Institute; Curtin University; Perth WA Australia
| | - Carol Grech
- School of Nursing & Midwifery; University of South Australia; Adelaide SA Australia
| | - Duncan Boldy
- Faculty of Health Science; School of Nursing and Midwifery; Curtin University; Perth WA Australia
| | - Jos M Latour
- Faculty of Health, Education and Society; School of Nursing and Midwifery; Plymouth University; Plymouth UK
- Department of Pediatrics; Intensive Care Neonatology; Erasmus MC - Sophia Children's Hospital; Rotterdam The Netherlands
- Faculty of Health Science; School of Nursing and Midwifery; Curtin University; Perth WA Australia
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