The development of competency standards for specialist critical care nurses

Abstract

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.

Competence requirements in intensive and critical care nursing – Still in need of definition? A Delphi study

“…Dunn et al, 2000;Lindberg, 2006;Schribante et al, 1996) on this topic. These studies share some findings on competence requirements in intensive and critical care nursing; these include collaboration, professional practice and clinical decision-making (Dunn et al, 2000;Lindberg, 2006;Schribante et al, 1996). The main categories of competence requirements for registered critical care nurses are professional competence, cognitive competence, interpersonal skills and critical care patterns of interaction (Schribante et al, 1996).…”

“…Empirical research is also lacking in this field: We found only a few empirical studies (e.g. Dunn et al, 2000;Lindberg, 2006;Schribante et al, 1996) on this topic. These studies share some findings on competence requirements in intensive and critical care nursing; these include collaboration, professional practice and clinical decision-making (Dunn et al, 2000;Lindberg, 2006;Schribante et al, 1996).…”

“…The main categories of competence requirements for registered critical care nurses are professional competence, cognitive competence, interpersonal skills and critical care patterns of interaction (Schribante et al, 1996). Competency standards are grouped into six domains: professional practice, reflective practice, enabling, clinical problemsolving, teamwork and leadership (Dunn et al, 2000). In the study by Lindberg (2006), nurses understood competence in intensive and critical care in five different ways.…”

“…Descriptions of competence requirements in the intensive and critical care nursing literature vary widely, and they can be found under various headings, such as competence standards (e.g. AACN, 2008;Canadian Association of Critical Care Nurses, 2009;Dunn et al, 2000), guidelines (e.g. Schribante et al, 1996), framework (e.g.…”

Communication Competencies of Oncology Nurses in Malaysia

“…For instance, "patients who enjoy effective communication with their nurses tend to be more satisfied with the overall care received, exercise greater adherence to recommended treatment regimens, and seem to make more rapid recoveries with fewer complications" (Irving and Dickson, 2004). A competency in nursing setting is not only a skill and tasks but also includes a nurses' characteristic in order to perform effectively (Dunn et al, 2000).…”