Investigating perceived core disaster competencies of nurses in Iran: A case study of northwest hospitals

AIM

This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023.

BACKGROUND

Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters.

METHODOLOGY

This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%.

RESULTS

The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05).

CONCLUSIONS

The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters.

Perceived competence and related factors affecting the development of the clinical competence of nursing students at two university sites in Namibia: a cross-sectional study

BACKGROUND

Ensuring that nursing students graduate with the required clinical competence in nursing is a global challenge. To address this challenge, several studies have looked at various aspects of competency and competency development, however there is scanty evidence on factors affecting development of clinical competency in nursing students. Therefore the, purpose of this study was to investigate nurses' perceived competence and related factors affecting the development of clinical competence of nursing students at two university sites in Namibia.

METHODS

A cross-sectional design was utilised. Simple random sampling was applied and 272 nursing students at two university campuses in Namibia were selected. An online questionnaire was used. Data were collected between April and May, 2022, over a period of six weeks, and were analysed using Statistical Package of Social Sciences (SPSS) version 27. Chi-square and Spearman correlations were used to assess the associations and correlations, respectively, among the variables. Logistic regression was used to assess the factors associated with the development of clinical competence using a p-value < 0.05 confidence interval.

RESULTS

Forty-seven percent (47%) of the students were found to be competent while more than half (53%) were not. A Chi-square test found a statistically significant difference between students studying at different campuses and between different year levels (p =  < .05). A regression analysis showed that nursing educators' competence (β = .128; p = .36) had a positive influence on nursing students' competence levels, unlike the mode of learning (β = -.140; p = .013), which negatively predicted the development of clinical competence. No significant relationship was found between the development of clinical competence and teaching approaches, assessment, feedback, constructive alignment, theory-practice gap and reflective practice (p = ˃.05).

CONCLUSION

Educator's competence levels and the mode of learning were the two major factors that were more likely to influence the development of clinical competence among nursing students. Therefore, it is recommended that nursing training institutions prioritise the development of educators' competence and apply various modes of learning to enhance development of nursing students' competence.

A scoping review of advanced pharmacy practice experience readiness assessment measures across schools of pharmacy

BACKGROUND

The development and implementation of Advanced Pharmacy Practice Experience (APPE) readiness assessments has been an area of increased interest to the academy since the publication of the Accreditation Council for Pharmacy Education (ACPE) standards in 2016. This scoping literature review aims to provide an updated summary of current APPE readiness assessment practices among ACPE-accredited institutions in the United States (US).

METHODS

A literature search was conducted between 2022 and 2024 using the terms "APPE student readiness," "APPE readiness assessment," "APPE preparedness," "APPE student preparedness," "pharmacy" AND "readiness assessment", "pharmacy" AND "practice readiness," and "pharmacy" AND "student practice readiness" in Pubmed and Embase. The websites for the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning were also searched using these terms. Abstracts for all results were reviewed. Abstract only and poster presentations were excluded, as well as articles centered on non-US and/or non-ACPE-accredited institutions. Data was collected regarding the outcomes assessed, type of assessment activity, and how the assessment was implemented. Results were reviewed by a second author to ensure consistency in reporting.

RESULTS

A total of 289 unique abstracts were reviewed by author pairs for inclusion based on relevance to the review objectives. A total of 13 articles were included in the final analysis. Each institution measured different knowledge areas, abilities, and entrustable professional activities (EPAs). Most programs had a summative component, with APPE readiness being primarily assessed in the final didactic year of the pharmacy curriculum. Most programs report at least one source of validity.

IMPLICATIONS

Given the lack of specific APPE readiness assessment requirements in the ACPE Standards 2016, the different assessment methods among programs were not surprising. However, the commonalities identified can be leveraged with the release of the Curricular Outcomes and Entrustable Professional Activities (COEPA) 2022 to promote a standardized definition of APPE readiness. Future research should focus on formative assessment methods embedded throughout the didactic curriculum to identify "at-risk" students prior to a "high-stakes" summative assessment at the end of the didactic curriculum that impedes student progression to the APPE year.

Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study

BACKGROUND

The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care.

AIM

The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience.

METHODS

A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data.

RESULTS

The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses.

CONCLUSIONS

The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern.

Comparison of self-competency and executive (charge) nurse competency assessments of clinical nurses

AIM

This study compared nurses' self-competency assessments and their managers' nurse competence assessments.

BACKGROUND

Nurse competence is important for nursing care quality and patient safety. Executive (charge) nurses play a main role in the nurse competency assessment.

METHODOLOGY

In this study conducted at a university hospital between January and December 2020, the self-efficacy evaluations of nurses (n = 162) working in services other than the emergency department, operating room, and outpatient clinics of the university hospital were compared with the evaluations of nurse executives (charges) on these nurses (n = 21). Data were collected using the personal information form and the Nurse Competence Scale. A cross-sectional study design was used. The Strengthening the Reporting of Observational Studies in Epidemiology guideline was used for reporting.

RESULTS

Service nurses' self-assessments and nurses treating charge's assessment of clinical nurses evaluated the competence levels as excellent in both groups. The self-competency assessments of the nurses were higher than the charge nurses' competency assessments.

DISCUSSION

In this study, the lower competence assessment of nurses by the charge nurses was may be due to their ability to observe nurses in their teams in general and that they have more experience in evaluation.

CONCLUSION

It is suggested that professional development and competence programs be created to further develop the competencies of nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nurse competency assessments support planning to ensure patient safety. Patient care burden and planning of risky patients according to the nurse competency level will provide safe patient care.

Iranian nurses' perceptions of core competencies required for disaster risk management

BACKGROUND

With an increase in the incidence and severity of disasters, disaster risk management receives an important priority in the health system. Nurses at all levels of healthcare play an important role in disaster risk management and they must have core preparation and competencies to respond to disasters. This study aimed to evaluate Iranian nurses' core competencies required for disaster risk management.

METHODS

This cross-sectional study was conducted on 277 nurses working in three hospitals affiliated to Kerman University of Medical Sciences in 2022. The demographic information questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) were used to collect data, and SPSS21 was used to analyze data.

RESULTS

Nurses' competencies in disaster risk management were favorable (3.67 ± 0.77), with the subscales of technical skills and special diagnostic skills receiving the highest (3.91 ± 0.65) and the lowest mean scores, respectively (3.46 ± 0.87). The results found a significant difference between the scores of nurses' competencies in disaster risk management in terms of education level, age, work experience, employment status, participation in training courses related to disaster risk management, work experience in incidents and disasters.

CONCLUSION

The study results suggested nurses' high level of competency in disaster risk management, but indicated gaps in their core competencies. The study results recommend authorities provide various training courses related to disaster risk management for all nurses.

The Arabic Nurse Professional Competence-Short Version Scale (NPC-SV-A): Transcultural Translation and Adaptation with a Cohort of Saudi Nursing Students

BACKGROUND

There is broad consensus that assessing and improving the competence of nurses is a crucial element of nursing education and practice. Numerous national and international nursing research studies have used the 35-item Nurse Professional Competence Scale (NPC-SV) to measure the self-reported competence of nursing students and registered nurses. To increase its usage in Arabic-speaking nations, however, a culturally adapted Arabic version of the scale with the same level of quality was necessary.

OBJECTIVES

The study aimed to develop a culturally adapted Arabic version of the NPC-SV and evaluate its reliability and validity (construct, convergent, and discriminant types).

METHODS

Methodological descriptive cross-sectional design was utilized. A convenience sampling technique was employed to recruit 518 undergraduate nursing students from three Saudi Arabian institutions. The translated items were appraised by a panel of experts, who considered the content validity indexes. The structure of the translated scale was examined using exploratory and confirmatory factor analysis, structural equation modelling, and the Analysis of Moment Structure method.

RESULTS

When utilized with nursing students in Saudi Arabia, the Arabic short version of the Nurse Professional Competence Scale (NPC-SV-A) was shown to be reliable and valid in terms of its content, construct, convergent, and discriminant validity. Cronbach's alpha for the entire NPC-SV-A scale was 0.89 and varied from 0.83 to 0.89 for each of the six subscales. Exploratory factor analysis (EFA) revealed six significant factors with 33 items that accounted for 67.52 percent of the variance. The scale was congruent with the suggested six-dimensional model, as confirmed by confirmatory factor analysis (CFA).

CONCLUSION

The Arabic version of the NPC-SV, which was reduced to 33 items, showed good psychometric properties, with a six-factor structure accounting for 67.52% of the total variance. When used alone, this 33-item scale can allow for more in-depth evaluations of self-reported competence among nursing students and licensed nurses.

Factors associated with changes in students' self-reported nursing competence after clinical rotations: a quantitative cohort study

BACKGROUND

The quality of nursing care in different healthcare contexts can be associated with the level of available nursing competence. Physical assessment skills are vital in nurses' assessment of patient care needs. However, in nursing education, using physical assessment skills is challenging for nursing students who struggle to apply these skills comprehensively in a clinical rotation. Therefore, this study explores changes in nursing competence, factors associated with changes after clinical rotations, and whether a Suite of Mobile Learning Tools supports changes in confident use of basic physical assessment skills.

METHODS

A quantitative cohort study with an explorative pre-and post-test design. During autumn 2019 and spring 2020, 72 s-year nursing students and 99 third-year students participated in the study. The Nurse Professional Competence scale short form was used to investigate students' self-reported changes in nursing competence, and a study-specific questionnaire was used to investigate students' confidence concerning performing physical assessments. The students voluntarily used the Suite of Mobile Learning Tools for the learning of physical assessment. Linear regression analysis was used to identify factors associated with changes in nursing competence after clinical rotation. The STROBE guidelines for cohort studies were followed for study reporting.

RESULTS

After the clinical rotation, both student groups reported changes in nursing competence and confidence in performing physical assessment skills, with statistically significant moderate or large changes in all areas. The Suite of Mobile Learning Tools was evaluated as being useful for learning physical assessment. The regression analysis showed that confidence in performing physical assessment skills, the usefulness of the Suite of Mobile Learning Tools, and a higher nursing competence at the start of clinical rotation were positively associated with overall nursing competence.

CONCLUSION

Basic physical assessment skills are an important component of nursing competence and can be considered one of the pillars of person-centered care, as proposed by the Fundamentals of Care framework. Spaced repetition and access to digital resources are suggested pedagogical approaches to enhance student confidence in the use of assessment skills within academic and clinical contexts.

Self-perceived competence and its related factors in nursing students at graduation: the role of self-efficacy

OBJECTIVES

This study aimed to investigate the level of perceived competence and explore the predictors of competence in nursing students at graduation.

METHODS

This cross-sectional study was conducted with students at the point of graduation (n=239). A sociodemographic form and three different scales assessing students' competence, self-efficacy, and self-reflection and insight were used to collect data. Visual Analog Scale (VAS) was used to assess students' satisfaction (i.e., the role as nursing students in the nursing program), job-related stress (i.e., perceived stress related to nursing program), and coping behaviors. The data were analyzed using descriptive statistics and hierarchical linear regression.

RESULTS

The mean scores of perceived competence, self-reflection, insight, and self-efficacy were 5.25 ± 0.96 (range: 1-7), 54.51 ± 7.83 (range: 12-96), 33.36 ± 5.40 (range: 8-48), 84.13 ± 12.27 (range: 0-100), respectively. Self-efficacy was the most significant associated factor of the entire group of variables in competence.

CONCLUSIONS

Scores of perceived competence of students were optimistic. Self-efficacy was the most important factor affecting competence; that is, the greater the self-efficacy, the better the perceived competence.

PROFESSIONAL DEVELOPMENT AMONG NEWLY GRADUATED REGISTERED NURSES WORKING IN ACUTE CARE HOSPITAL SETTINGS ‐ A QUALITATIVE EXPLORATIVE STUDY

AIM

To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience.

BACKGROUND

Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care.

METHODS

An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings.

RESULTS

One theme emerged: 'Clarity and security in one's own nursing role despite facing challenges that hinder professional development' and three categories: 'Independency due to one's own efforts and experience', 'Well-functioning teamwork' and 'Challenges in the work situation'.

CONCLUSION

After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students.

IMPLICATION FOR NURSING MANAGEMENT

Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.

Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

Introduction: Healthcare systems increasingly move toward “value-based healthcare” (VBHC), aiming to further improve quality and performance of care as well as the sustainable use of resources. Evidence about healthcare professionals' contributions to VBHC, experienced job demands and resources as well as employee well-being in VBHC is scattered. This systematic review synthesizes this evidence by exploring how VBHC relates to the healthcare professional, and vice versa.

Method: Seven databases were systematically searched for relevant studies. The search yielded 3,782 records, of which 45 were eligible for inclusion based on a two-step screening process using exclusion criteria performed by two authors independently. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). Based on inductive thematic analysis, the Job Demands-Resources (JD-R) model was modified. Subsequently, this modified model was applied deductively for a second round of thematic analysis.

Results: Ten behaviors of healthcare professionals to enhance value in care were identified. These behaviors and associated changes in professionals' work content and work environment impacted the experienced job demands and resources and, in turn, employee well-being and job strain. This review revealed 16 constructs as job demand and/or job resource. Examples of these include role strain, workload and meaning in work. Four constructs related to employee well-being, including engagement and job satisfaction, and five constructs related to job strain, including exhaustion and concerns, were identified. A distinction was made between job demands and resources that were a pure characteristic of VBHC, and job demands and resources that resulted from environmental factors such as how care organizations shaped VBHC.

Conclusion and Discussion: This review shows that professionals experience substantial job demands and resources resulting from the move toward VBHC and their active role therein. Several job demands are triggered by an unsupportive organizational environment. Hence, increased organizational support may contribute to mitigating or avoiding adverse psychosocial factors and enhance positive psychosocial factors in a VBHC context. Further research to estimate the effects of VBHC on healthcare professionals is warranted.

Psychometric evaluation of Nurse Professional Competence Scale-Short-form Chinese language version among nursing graduate students

Aim

The aim of the study was to determine the psychometric properties, construct validity and internal consistency of the Chinese language version of the Nurse Professional Competence scale short form.

Design

A methodological design was used.

Methods

Questionnaire data from 260 nursing students nearing graduation from 2 universities in China were analysed using confirmatory factor analysis, known‐group validity and internal consistency.

Results

The confirmatory factor analysis revealed that the model was acceptable, and the analyses for known‐group validity revealed statistically significant differences in all factors and the total scale of the Nurse Professional Competence scale short form. Internal consistency revealed that Cronbach's alpha values exceeded 0.70 for all factors and the total scale. The Chinese language version of the Nurse Professional Competence scale short form has acceptable construct validity and good internal consistency.

The level of competence of graduating nursing students in 10 European countries-Comparison between countries

AIM

To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career.

DESIGN

An international cross-sectional evaluative design.

METHODS

Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically.

RESULTS

In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Aims and objectives

To explore newly graduated registered nurses' experiences and how they manage complex patient situations.

Background

Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages.

Design

Qualitative study design.

Methods

Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used.

Results

The analysis resulted in the overarching theme “Not being sufficiently prepared and supported to meet responsibilities and demands.” The theme included three categories: “Responsibility is not in proportion to competence,” “Lack of medical competence and experience complicates patient safety” and “Strives for control to manage and organise nursing care.”

Conclusion

The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised.

Relevance to practice

Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.

Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students

AIMS

To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme, and students' general self-efficacy (GSE).

DESIGN

A cross-sectional study combining survey data and results from a national examination.

METHODS

Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the GSE scale, and results from the National Clinical Final Examination. A two-step cluster analysis was used to identify competence profiles, followed by comparative analyses between clusters.

RESULTS

Three clusters were identified illustrating students' different competence profiles. Students in Clusters 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value, respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

CONCLUSION

The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

IMPACT

The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their GSE lower than other students. The findings illuminate the need for student-centred strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

Development and Validation of the Ambulance Nurse Competence Scale

INTRODUCTION

In recent decades, major competency shifts have taken place in prehospital care in Sweden because staffing ambulances with registered/specialized nurses has become a priority. The aim of this study was to develop and validate a new instrument to measure the self-reported professional competency of specialist ambulance nursing students and registered/specialist nurses working in prehospital care.

METHODS

This study used a quantitative cross-sectional design to evaluate psychometric properties of a new instrument. The sample included 179 registered/specialist ambulance nurses and 34 specialist ambulance nursing students.

RESULTS

The analyses resulted in the Ambulance Nurse Competence (ANC) scale, consisting of 43 items and covering 8 factors: Nursing Care (n = 8), Value-based Nursing Care (n = 5), Medical Technical Care (n = 5), Care Environment's Community (n = 4), Care Environment's Serious Events (n = 8), Leadership Management (n = 3), Supervision and Professional Conduct (n = 4), and Research and Development (n = 6). All factors except Leadership Management achieved a Cronbach's alpha value greater than 0.71, explaining 59.62% of the total variance.

DISCUSSION

The ANC scale was systematically tested and showed satisfactory psychometrical properties. The ANC scale can be used in the education programs of future registered/specialist ambulance nurses as a tool for self-reflected learning and could also be of potential use in identifying competence gaps in registered/specialist ambulance nurses, which could direct the design of introductory programs. The scale could also be used as an outcome measure together with other instruments.