The Clinical Competencies of Nurse Anesthetists in Response to Community Needs: A Delphi Study

Abstract

Introduction: Ensuring the clinical competencies of nurse anesthetists is an essential professional standard. The key and primary step in the assessment of nurse anesthesia educational programs is to understand the essential competencies from the perspective of anesthesia service providers in response to the community needs. This study aimed to determine the clinical competencies of nurse anesthetists for meeting the needs of the community. Materials and Methods: This descriptive survey was based on the classical Delphi method. The study was conducted in three stages. In the first stage, 25 questions were prepared by a non-systematic literature review. In the second and third stages, a list of clinical competencies for nurse anesthetists was determined. For assessing the content validity, two indices of content validity ratio and content validity index were calculated. Data were analyzed by SPSS software (version 16) using descriptive statistics and consensus validity. Results: After analyzing the data in the first stage, one item was removed from the 25 selected items, and 11 items were added to the initial checklist. The maximum and minimum coefficient of agreement was 100 and 0.54, respectively. The findings of the second stage showed that the percentage of agreement in 35 items was at least 70.7 and maximum 95.1. A competence from the education dimension was removed with a percentage of agreement of 0.59 and a total of 34 items were approved. Conclusions: This study determined the clinical competencies of nurse anesthetists. The development of clinical competencies for these nurses could be the starting point for understating, analyzing and planning in order to improve the quality of services provided.

Defining competencies for nurse anaesthetists: A Delphi study

“…Also under the expert domain, the nurse anaesthetists in our study recognized non‐invasive airway management as an autonomous activity (cannula, face mask) and invasive airway management as one they performed in collaboration with physicians (laryngeal mask, orotracheal intubation). The competencies related to monitoring, safety and recording information coincide with competencies signalled by the International Federation of Nurse Anaesthetists and other authors (Halakou et al, 2017; Herion et al, 2019; Syndicat National des Infirmier(e)s‐Anesthestits‐es, 2019). In terms of the pre‐anaesthesia visit, the nurse anaesthetists conducted preanaesthetic assessment autonomously or collaboratively, including patient history assessment, pharmacological treatments, preoperative tests and airway assessment (the latter of which varied depending on the patient's anaesthetic risk and the complexity of the surgery).…”

“…In terms of the scholar domain, the consensus percentage was high, especially in the competencies related to continuing education and participation in the training of other health professionals. Participation in and support for research has room for improvement, as is also the case in other countries (Halakou et al, 2017;Herion et al, 2019).…”

“…In this programme, clinical practice, health education and research were the core competencies that allowed nurse anaesthetists to administer anaesthesia, perform airway management and practice in recovery units, always under the supervision of an anaesthesiologist, according to Chinese legislation (Hu et al, 2017). In Iran, Halakou et al (2017) found that nurse anaesthetists participated in pre‐anaesthetic assessments, care management and the treatment of acute and chronic pain, not only in the hospital setting but also at home and at the end of life. The fact that Iranian nurse anaesthetists worked outside of hospital settings differentiates them from nurse anaesthetists in other countries.…”