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.
Background. Self‐assessment assists nurses to maintain and improve their practice by identifying their strengths and areas that may need to be further developed. Professional competence profiles ...encourage them to take an active part in the learning process of continuing education. Although competence recognition offers a way to motivate practising nurses to produce quality care, few measuring tools are available for this purpose.
Aim. This paper describes the development and testing of the Nurse Competence Scale, an instrument with which the level of nurse competence can be assessed in different hospital work environments.
Methods. The categories of the Nurse Competence Scale were derived from Benner's From Novice to Expert competency framework. A seven‐step approach, including literature review and six expert groups, was used to identify and validate the indicators of nurse competence. After a pilot test, psychometric testing of the Nurse Competence Scale (content, construct and concurrent validity, and internal consistency) was undertaken with 498 nurses. The 73‐item scale consists of seven categories, with responses on a visual analogy scale format. The frequency of using competencies was additionally tested with a four‐point scale.
Results. Self‐assessed overall scores indicated a high level of competence across categories. The Nurse Competence Scale data were normally distributed. The higher the frequency of using competencies, the higher was the self‐assessed level of competence. Age and length of work experience had a positive but not very strong correlation with level of competence. According to the item analysis, the categories of the Nurse Competence Scale showed good internal consistency.
Conclusion. The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.
Professional competence of practising nurses Numminen, Olivia; Meretoja, Riitta; Isoaho, Hannu ...
Journal of clinical nursing,
20/May , Volume:
22, Issue:
9-10
Journal Article
Peer reviewed
Aims and objectives
To compare nurse competence in terms of its quality and frequency of action in medical, surgical, paediatric/obstetric/gynaecological and psychiatric clinical fields.
Background
...One challenge of current health care is to target practising nurses' competencies to optimal use. Therefore, a systematic assessment of nurse competence is justified. Studies using the Nurse Competence Scale have found that nurses' competence is on a good or very good level and it increases with age and work experience.
Design
A cross‐sectional comparative survey using the Nurse Competence Scale.
Methods
A purposive sample of 2083 nurses in a major University Hospital in Finland participated in this study in 2007–2008. Descriptive statistics and inferential statistics' anova with Bonferroni correction, and Pearson/Spearman correlation coefficients were used to analyse the data.
Results
The overall level of competence of nurses was good, and the quality of action correlated positively with the frequency of action. Nurses in the psychiatric field reached somewhat higher overall mean scores than nurses in other clinical fields. On item level, nurses seemed to be the most competent in actions related to immediate individualised patient care, the maintenance of their own professional competence and commitment to nursing ethics. Age and particularly work experience were positively correlated with the competence.
Conclusion
Findings from this large data corroborate previous study results on the category level assessment of nurse competence using the Nurse Competence Scale indicating a good level of competence. On item level, findings revealed more detailed themes of nurse competence, which complements earlier knowledge retrieved from the category level analysis and could be used to target nurses' competencies to even more optimal use.
Relevance to clinical practice
Competence assessment and targeted interventions are recommended as tools for the management for planning nurses' career development and continuing education to ensure competent and motivated work force and high‐quality care.
Research indicates significant differences between nurse cohorts in many work‐related factors. This study compared nurse competence between three generational cohorts comprising the current nursing ...workforce. The Nurse Competence Scale was used to collect data for this cross‐sectional study from 2052 nurses in a university hospital in Finland. Data were analysed statistically. Significant differences were found between nurse cohorts in their competence. The length of work experience had a significant impact on the development of competence. The oldest cohort, with the longest work experience, had the highest competence scores (70.1 on a visual analogue scale), and the youngest had the lowest (59.0). All cohorts were most competent in patient‐related nursing tasks, in maintenance of professional competence and in ethical care. Nurses were weakest in the development of nursing practice and the use of evidence‐based knowledge. Targeted interventions in teaching–coaching for different nurse generations are needed to ensure the maintenance of nurse competence and high‐quality patient care.
Background Preceptorship is an essential method of supporting nurse competence, guaranteeing high quality care and increasing job satisfaction.
Aim To describe recently registered nurses’ ...perceptions of their competence level, and to identify factors influencing these perceptions.
Method The survey was conducted by using Meretoja's Nurse Competence Scale. The sample comprised 235 registered nurses working in intensive and emergency settings. The data were analysed by using statistical methods.
Results Nurses’ self‐assessed competence level ranged from moderate to good. A statistically significant association was seen between competence level and age, length of current work experience and the frequency of using competencies.
Conclusions The results shed useful light on the educational needs of nurses and provide important clues for the development of preceptorship programmes. The Nurse Competence Scale proved to be a reliable and valid instrument in assessing the competence of recently registered nurses.
Implications for nursing management We recommend that management strategies be developed to enhance and support positive learning environments for competence development. We recommend preceptorship programmes based on systematic competence assessments made by nurses themselves, their preceptors and managers.
meretoja r. & koponen l. (2012) A systematic model to compare nurses’ optimal and actual competencies in the clinical setting. Journal of Advanced Nursing 68(2), 414–422.
Aim. This paper is a report ...of a study to develop a model to compare nurses’ optimal and actual competencies in the clinical setting.
Background. Although future challenge is to focus the developmental and educational targets in health care, limited information is available on methods for how to predict optimal competencies.
Method. A multidisciplinary group of 24 experts on perioperative care were recruited to this study. They anticipated the effects of future challenges on perioperative care and specified the level of optimal competencies by using the Nurse Competence Scale before and after group discussions. The expert group consensus discussions were held to achieve the highest possible agreement on the overall level of optimal competencies. Registered Nurses (n = 87) and their nurse managers from five different units conducted assessments of the actual level of nurse competence with the Nurse Competence Scale instrument. Data were collected in 2006–2007.
Results. Group consensus discussions solidified experts’ anticipations about the optimal competence level. This optimal competence level was significantly higher than the nurses’ self‐reported actual or nurse managers’ assessed level of actual competence. The study revealed some competence items that were seen as key challenges for future education of professional nursing practice.
Conclusion. It is important that the multidisciplinary experts in a particular care context develop a share understanding of the future competency requirements of patient care. Combining optimal competence profiles to systematic competence assessments contribute to targeted continual learning and educational interventions.
Aim This study examines nurses’ perceptions of competence in different university hospital work environments.
Background Nurses’ self‐recognition of own level of competence is essential in ...maintaining high standards of care. The demands for nurse competence may vary between work environments. However, there are very few studies that compare nurse competence in different hospital work environments.
Methods We analysed self‐assessments of competence of 593 Registered Nurses working in wards, emergency/outpatient or intensive care units or in operation rooms. The instrument used was a pretested 73‐item questionnaire consisting of seven competence categories. The level of competence was assessed on a Visual Analogue Scale (VAS) scale of 0–100 and the frequency of using items of competencies in clinical practice was assessed on a four‐point scale.
Results Nurses reported their overall level of competence as good. They felt most competent in the categories of Managing situations, Diagnostic functions and Helping role (VAS‐means 68–69), and least competent in Ensuring quality category (VAS‐mean 56). Operation room nurses compared with other nurses reported lower level of competence and lower frequency of using items of competencies in several competence categories. In general, the self‐assessed level of competence was greater the higher the frequency of using of competencies. Correlations between both age and length of work experience and the self‐assessed overall level of competence were positive.
Conclusions Nurse competence profiles differed in both the level of and in frequency of using competencies between work environments. Context‐specific knowledge of nurse competence from real work life situations provides direction on how to structure work environments and staff development interventions to provide qualified care.
The purpose of this study was to explore comprehensively expectations of patients with colorectal cancer towards nursing care in the chemotherapy context.
A purposive sample of patients with ...colorectal cancer (n = 15) was interviewed individually at the outpatient clinic in one university hospital chemotherapy unit. The data were analysed with thematic analysis.
Three main themes were identified in the data. Firstly, patients expected to be empowered with knowledge of disease process, side effects and their self-management and peer support. Secondly, patients expected to be humanely encountered, which included being encountered with support, compassion and hope. Thirdly, patients expected to be skillfully cared for with systematic assessment, expertise, continuity and advocacy.
Besides reliable knowledge of cancer treatment and care, patients expected the sympathetic presence of a nurse whose professional skills they can trust. The results may be utilised in intervention development by focusing on themes significant to these patients. The results may help nurses to enhance person-centred care as well as to encounter patients according to their expectations.
•This study provides a holistic insight into the expectations of patients with CRC towards their care in the CT context.•Expectations of patients with colorectal cancer for their nursing care are multifaceted yet practicable.•Patients expected to be empowered with knowledge, humanely encountered and skillfully cared for.•Results may be used in clinical practice as well as in education to enhance patient-centred nursing.
This study compares nurse and manager assessments of nurse competence in a university hospital setting. Although managers carry out annual reviews, few studies have examined the agreement between the ...competence assessments made by practising nurses and their managers. Using a pretested 73‐item questionnaire, consisting of seven competence categories, we compared self‐assessments and manager assessments of the level of nurse competence on a Visual Analogue Scale of 0–100 and the frequency of using competencies by using statistical analyses. Managers assessed the overall level of competence (70.8 ± 19.3 vs. 63.9 ± 13.7) (mean ± SD) and the level of competence in five competence categories significantly higher than the nurses themselves. A high degree of agreement was found between the assessments for the frequency of using competencies. These results can be used to encourage nurses and to improve the quality of care in different hospital work environments.
Background:
Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element ...affecting nurses’ professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically.
Aim:
This study examined newly graduated nurses’ perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction.
Method:
Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically.
Ethical considerations:
Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate.
Findings:
Nurses’ overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively.
Conclusion:
Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses’ work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers’ ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses’ views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams.
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