A project to establish a skills competency matrix for EU nurses

Development and validation of a tool for competence assessment of the insert of the intrauterine device

Abstract Objectives:. to develop and validate an instrument to assess the professional competence of nurses in the insertion of the intrauterine device (IUD) Methods: methodological study, developed in three stages: 1) tool development (Theoretical procedures); 2) evaluation of the tool by experts and judgment of the initially proposed items (Appearance validation and content validation); 3) test of the version resulting from the assessment by experts and assessment of internal consistency (Analytical procedures). Ten judges participated in the face and content validation, among obstetric nurses and gynecologists/obstetricians from the Sofa Feldman Hospital in Belo Horizonte (MG), while 38 nursing residency students were evaluated using the test tool, in the last stage of the study. Calculations of the Content Validity Index (CVI) and Cronbach’s alpha coefficient were performed as psychometric measures. Results: the initial tool covered 39 items. No item obtained CVI<0.8; however, through suggestions from the judges, items were merged, totaling 34 items. The total Cronbach’s alpha coefficient for this version was 0.828. Conclusion: the tool developed is valid and reliable. It is believed that the implementation of this tool will contribute to the training of professionals and the improvement of knowledge, behaviors, and skills in nursing consultations with a focus on reproductive planning with an emphasis on the insertion of the IUD.

Factors Affecting Clinical Nursing Competency: A Cross Sectional Study

Background

The purpose of this study was to elucidate the factors which affect the achievement of clinical nursing competency.

Methods

A survey was conducted on 717 nurses using an anonymous self-administered questionnaire. Their clinical nursing competency was assessed using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). This study examined the factors affecting clinical nursing competency using regression analyses. A simple regression analysis was performed with the CNCSS as the objective variable. A multiple regression analysis was performed using the items for which the relationship was clarified as explanatory variables.

Results

The factors affecting the "basic nursing competency" were age, ease of taking time off, workplace with a clear vision, and good interpersonal relationships. The factors affecting the "competency in providing assistance commensurate with the patient's health status" were total years of experience, workplace with a clear vision, ease of taking time off, and use of acquired certifications. The factors affecting the "coordinating care environment and teamwork" were total years of experience, workplace with a clear vision, use of acquired certifications, and ease of taking time off. The factors affecting the "ability for professional growth in nursing practice" were use of acquired certifications, workplace with a clear vision, total years of experience, and ease of taking time off.

Conclusion

For improvement of clinical nursing competency, the factors elucidated to be necessary were accumulation of experience as a nurse, a clear vision of goals, and a work environment with good interpersonal relationships and ease of getting days off. The way nurses make their nursing practice experience meaningful contributed toward their growth as nurses. It is important to train nurses through basic education and continued education with awareness of achievement and improvement of clinical nursing competency. Basic education should promote the ability to make clinical training experience meaningful and continuing education should enable nurses to continue to grow independently through reflection.

Nurse Competence Scale: a systematic and psychometric review

AIM

The aim of this study was to report a systematic and psychometric review.

BACKGROUND

The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence.

DESIGN

A systematic literature review of research evidence and psychometric properties.

DATA SOURCES

Nine databases from 2004 - October 2015.

REVIEW METHODS

We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist.

RESULTS

A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in hospital settings. Length of work experience, age, higher education, permanent employment and participation in educational programmes correlated positively with competence. Variables including empowerment, commitment, practice environment, quality of care and critical thinking were also associated with higher competence. The Nurse Competence Scale has demonstrated good content validity and appropriate internal consistency.

CONCLUSION

The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.

Health visitor education for today's Britain: Messages from a narrative review of the health visitor literature

OBJECTIVES

This paper draws on a narrative review of the literature, commissioned to support the Health Visitor Implementation Plan, and aimed at identifying messages about the knowledge, skills, and abilities needed by health visitors to work within the current system of health care provision.

DESIGN

The scoping study and narrative review used three complementary approaches: a broad search, a structured search, and a seminal paper search to identify empirical papers from the health visitor literature for review. The key inclusion criteria were messages of relevance for practice.

DATA SOURCES

378 papers were reviewed. These included empirical papers from the United Kingdom (UK) from 2004 to February 2012, older research identified in the seminal paper search and international literature from 2000 to January 2016.

REVIEW METHODS

The review papers were read by members of the multidisciplinary research team which included health visitor academics, social scientists, and a clinical psychologist managed the international literature. Thematic content analysis was used to identify main messages. These were tabulated and shared between researchers in order to compare emergent findings and to confirm dominant themes.

RESULTS

The analysis identified an 'orientation to practice' based on salutogenesis (health creation), human valuing (person-centred care), and viewing the person in situation (human ecology) as the aspirational core of health visitors' work. This was realised through home visiting, needs assessment, and relationship formation at different levels of service provision. A wide range of knowledge, skills, and abilities were required, including knowledge of health as a process and skills in engagement, building trust, and making professional judgments. These are currently difficult to impart within a 45week health visitor programme and are facilitated through ad hoc post-registration education and training. The international literature reported both similarities and differences between the working practices of health visitors in the UK and public health nurses worldwide. Challenges related to the education of each were identified.

CONCLUSIONS

The breadth and scope of knowledge, skills, and abilities required by health visitors make a review of current educational provision desirable. Three potential models for health visitor education are described.

Research literature production on nursing competences from 1981 till 2012: A bibliometric snapshot

BACKGROUND

When nurse education has moved away from a hospital based apprenticeship to a higher education institutions and new EU legislature enabled nurse workforce mobility, the term "competence" became an important concept in nurse education and practice. However, there is still a lot of confusion about its definition, how it should be assessed and implemented and which competences does a contemporary nurse need.

OBJECTIVES

To find publishing patterns in the nursing competence research literature production, focusing on publishing dynamics, identifying prolific research entities, most cited papers, and visualising the content of the research.

DESIGN AND DATA SOURCES

A bibliometric analysis of 370 information sources (288 original papers and 82 review articles) found in the Scopus database using the search string "nursing competenc*" for the period 1981-2012 was conducted. The SciMago database was used to identify country and source title ranks.

METHODS

Common elements of bibliometric data were extracted from each information source. Descriptive, correspondence and text analyses were used on the retrieved bibliometric data.

RESULTS

The production of research literature has a positive trend. The research on nursing competences is being performed on all five continents, however is not yet published in top journals. Most prolific countries are the United States of America, the United Kingdom and Australasia, and most prolific source titles are the Journal of clinical nursing, the Journal of nursing education and Public health nursing. The results confirmed the still persisting confusion in the definition of the competence and the emergence of the need for defining new nursing competences.

CONCLUSIONS

Study confirmed that there are still open questions in the nursing competence research that will require actions on different levels including policy makers, educators and practising nurses.

A review of clinical competence assessment in nursing

AIMS

To investigate trends in the evaluation of clinical competence in nursing students and newly qualified nurses over the last 10 years.

DESIGN

A literature review following PRISMA guidelines.

METHODS

The following databases were searched: Cochrane, Medline and CINAHL using the terms competenc*, nurs*and assess*, evaluat*, measure*, from January 2001-March 2010. Strict inclusion and exclusion criteria were applied.

RESULTS

Twenty three papers were included and these mainly considered the following topics: instrument development and testing; approaches to testing competence; assessment and related factors. A holistic concept of competence is gaining popularity, and consensus around definitions is emerging. Some methods and instruments to measure competence are under systematic development and testing for reliability and validity with large samples and rigorous statistical method. Wider national and international cooperation is evident in competence-based assessment.

CONCLUSIONS

Competence-based education is evident, but this does not mean that issues related to competence definition have been resolved. Larger and more international cooperation is required to reach common agreement and validity in competence-based education and assessment.

Nurse migration: the effects on nursing education

This paper is an opinion piece based on experience and supported where possible with literature, which addresses an issue of both national and international interest. It focuses on one aspect of the multifaceted social phenomenon of nurse migration, i.e. nurse education.

BACKGROUND

Much has been written about the direct effects of nurse migration on the nurse migrant, the delivery of health care in the countries that supply the nurses, and the countries that receive them. However, there is little information regarding the direct effects of migration on nurse education within the literature.

AIM

The aim of this paper is to raise awareness of the positive and negative effects of nurse migration on nurse education both in the countries that supply nurses and those which receive them.

METHODS

Both scholarly and 'grey' literature is used to support the discussion on the 'real' challenges faced by nurse educators and clinical nurses in those countries that supply or receive nurses. In addition, practical recommendations for nurse educators are presented. Furthermore, the nursing profession is challenged to become politically active, to become involved and to take responsibility for the decisions made about nurse education in order to protect the integrity of nurse education and patient safety.

CONCLUSION

The quality of nurse education in many countries has been undermined as a result of rapid, mass migration. There is an urgent need to take practical steps to maintain the integrity of nurse education and the nurse's preparation for practice in order to protect patients' safety.

Measuring nursing competence: Development of a self-assessment tool for general nurses across Europe

In response to the global challenge of providing and delivering effective health care, the aim of the European Healthcare Training and Accreditation Network project is to work towards improving the transparency of European Union (EU) nurse workforce qualifications, competence, skills, experience and culture. Currently, there is no detailed or tangible method available for comparison, which is perceived as an obstacle to EU nurse workforce mobility.

OBJECTIVES

Clearly, this is an important issue that needs to be addressed. Accordingly, this paper reports on the development and psychometric testing of a nurse competence self-assessment questionnaire tool, with the aim of contributing to and enhancing the transparency of nurse competence and ultimately facilitating greater nurse workforce mobility across the EU.

SETTINGS

The project comprises a partnership led by a school of nursing in London, operating in collaboration with nursing and other academics from institutions in Belgium, Germany, Greece and Spain.

METHODS

Subsequent to a review of literature on nurse competence, a 108 item, post-registration nurse competence self-assessment questionnaire was developed. It elicits information indicating nurse's self-assessment of their competence in the EU country where they trained and qualified and are currently still employed. Responses invite a self-reported frequency of nursing function, this being recommended as the most accurate and least threatening way of assessing competency. During the development process, the questionnaire, constructed from EU countries' competence frameworks, was deemed to be relevant to the measurement of nurse competence by a group of professors of nursing, senior nurse educators, senior nurse managers and other academics thus attesting to the questionnaire's content validity.

PARTICIPANTS

A convenience sample of 588 post-registration, generalist nurses from medical or surgical inpatient wards/units were surveyed from acute hospitals in the partner countries (UK n=100, Belgium n=113, Greece n=95, Germany n=150, Spain n=130).

RESULTS

Psychometric testing, as expressed by Cronbach's alpha values and by principal component factor analysis, suggests that the questionnaire has an acceptable degree of reliability, construct validity and further supports the content validity.

CONCLUSION

In the future, it is envisaged that nurses will be able to utilise the questionnaire to make more informed judgement about the match between their competence and that required of a possible host country. Employers will be able to detect any differences in the required competence levels of potential employees, thus facilitating greater EU nurse workforce mobility.

A European survey of general nurses' self assessment of competence

Policy initiatives have prompted examination of the deployment and mobility of the nursing workforce within the European Union (EU). The European Health Care Training and Accreditation Network [EHTAN, 2005. Available from: <www.kcl.ac.uk/nursing/research/ehtan>] project aims to improve the transparency of nursing qualifications, working practices, skills and experience, thus facilitating nurse workforce mobility, through compilation of a competency matrix [Cowan, D.T., Norman I.J., Coopamah, V.P., 2005a. European healthcare training and accreditation network. British Journal of Nursing 14, 613-617; EHTAN, 2005. Available from: <www.kcl.ac.uk/nursing/research/ehtan>]. This paper reports on a survey across five EU countries in which the EHTAN nurse competence self-assessment tool was utilised. The purpose is to describe migrant nurses perception of their competence in: (a) the country where they trained and qualified and (b) the new country in which they are working and (c) to compare non-migrant nurses perception of their competence across different EU countries.