Comparison of head nurses and practicing nurses in nurse competence assessment

<p><strong><em>Background</em></strong><strong><em>:</em></strong><em> Nursing care provided to patients, especially in hospitals, is expected to be of high quality, and its implementation is in accordance with the nurse's clinical competence. </em></p><p><em><strong>Objectives:</strong> This scoping review aimed to assess the implementation of the clinical competence of nurses in hospitals so that a clear picture of the implementation of these competencies is obtained. In addition, this study can be evidence-based and related to implementing these clinical competencies. </em></p><p><strong><em>Methods:</em></strong><em> </em><em>This literature review used PICO framework to develop articles questions (P: nurses, I: not applicable, C: not applicable, and O: application of clinical nursing competency). Articles search for literature review was conducted during April and May 2023. </em><em></em></p><p><em>This study used Pubmed and ScienceDirect Databases and other sources. The keywords that used in this scoping review was </em><em>“nursing competency” OR “clinical nursing competency” AND “evaluation” OR “implementation” AND “hospital”.</em><em></em></p><p><strong><em>Results: </em></strong><em>There were 1,150 articles from the search results, but only seven were included for review. One article is a descriptive comparative study using a qualitative approach, and six articles are cross-sectional studies. The articles are publications within five years (2019-2023). In its implementation, the average clinical competency of nurses is at a low to moderate level, and only one study found was at high nurse competency. The results of the supervisor's clinical competency assessment were significantly lower than those assessed by oneself and the group. In addition, </em><em>the nurse competency level was moderate, and there was no significant difference in the clinical competency of nurses before and during the COVID-19 pandemic.</em><em></em></p><strong><em>Conclusions: </em></strong><em>The implementation of nurses' clinical competence has yet to be optimal, so hospital management needs to improve nurses' clinical competence so that nurses can provide higher quality and professional nursing care in the hospital.</em>

Improving the interpersonal competences of head nurses through Peplau's theoretical active learning approach

Validation of time to task performance assessment method in simulation: A comparative design study

Objectives: This study aimed to assess perceived clinical competence levels of emergency department nurses in Iran and to identify association with the demographic variables. Methods: In this cross-sectional study, all 131 employed nurses from emergency departments of four educational hospitals were included in the study using a census method. Data collection tools included a demographic information form and the “Nurse Competence Scale”. Data were analyzed using descriptive and analytical statistics. Results: The mean age of the nurses was 32.41± 6.35 years. 14 nurses were male and 117 nurses were female, the average work experience of the nurses was 8.48±5.98 years. The mean score of nurses' clinical competence score of the nurses was 68.68 ± 3.24 out of 100, which was a “good level”. Among the subscales of clinical competence, the highest mean score was related to “managing situation” and lowest to “ensuring quality”. There was no statistically significant difference of clinical competence by gender, age, and academic degree. However, the level of clinical competence differed significantly depending on work experience. Conclusions: The emergency department nurses at Mazandaran University of Medical Sciences, Iran, reported a good level of clinical competence across all categories. Hospital managers’ awareness of the level clinical competence of emergency department nurses helps them design educational programs and effective training session to improve the quality of nursing services. Moreover, it is necessary to upgrade nursing education programs at all levels of nursing education in to improve graduating nurses’ clinical competences.

Head nurses' performance plays an important role in the successful operation of hospitals. Identification and prioritisation of managerial competencies required for these supervisors and evaluation of their performance on this basis are necessary. This study aimed to provide a valid tool for assessing managerial competencies of hospital department head nurses. First, through literature review, Delphi technique and expert panel, a competency model was developed. Then using the analytic hierarchy process, competencies were weighted and prioritised. Finally, based on the model, an instrument was designed to measure the competencies of head nurses. Validity and reliability of the instrument was also checked. The proposed framework included 27 competencies categorised by four main managerial tasks: planning, organising, leadership and control. Findings revealed that the highest priority was given to strategic thinking (0.1221) and the lowest priority was given to evidence-based decision making (0.007). Based on impact score and content validity ratio results, the content validity of all questions has been proved. Furthermore through the use of a content validity index, 11 questions were omitted or modified. The study presents a valid and comprehensive model for assessing managerial competencies of hospital department head nurses in order to take an important step towards improving their performance.

Background: Empowerment is necessary for the era of competition and service because every organization needs employees who are fast, responsive and independent so they can be competitive through human resources and strengthen the capability and commitment of employees. The lack of empowerment of nurses in hospitals is one of the main causes of nurses’ burnout. Aim of the study: The aim of this study was to examine the effect of head nurses’ empowerment educational program on staff nurses’ burnout. Research Design: A quasi-experimental design utilized to achieve the aim of the current study. Study Setting: The study conducted in medical, surgical and critical care units at Benha University Hospital, Egypt .Study sample: were all available head nurses who met the inclusion criteria (65) distributed as the following; 24 of head nurses working at medical units, 19 of head nurses working at surgical units and 22 head nurses working at critical care units. Convenience sample of staff nurses (342) who meet the inclusion criteria from the total number (716) nurses. Tools of data collection: Four tools utilized; namely, empowerment knowledge questionnaire, Conditions of Work Effectiveness Questionnaire, Psychological Empowerment Scale and Maslach-Burnout-Inventory-General Survey. Results: There was statistically significant improvement in head nurses' knowledge and level of empowerment after implementation of the program. In addition, there was a statistically significant improvement of staff nurses' level of burnout after implementation of the program. Also, there was a highly statistically significant negative correlation between head nurses’ empowerment level and studied staff nurses' level of burnout post-program (P<0.001). Conclusion: The study concluded that there was a positive effect of the educational program regarding empowerment for head nurses on the burnout of staff nurses. Recommendations: Future studies recommended to investigate the effect of psychological empowerment and employee engagement on other variables such as staff turnover, absenteeism, performance, and safety.

Factors Influencing the Competency of Head Nurses When Assisting With Inhospital Cardiopulmonary Resuscitation

The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home-based care (HBC) nurses' competencies. A hybrid systematic narrative review was performed. The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full-text items in the English language. A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home-based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem-solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses. This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home-based nursing care practice in the future. This review consolidated instruments used to measure home-based care nurses' competency. The instruments were often designed for ward-based care nurses hence a comprehensive and validated home-based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home-based nursing care competency scale is being developed. No patient or public contribution was required in this review.

Background: ‘Competency’ is an important word in health care settings. From a novice nurse to a proficient registered nurse whoever is assessing a newly admitted patient or feeding a patient in a unit or a student nurse in a nursing education program continuous clinical competence is essential for everyone. The definition of clinical competence clearly refers to individual competence. It is thought to involve many aspects of the nurses’ professional attributes, including the individual’s personality trait, level of education, experience in practice and health care management skill. ICU nurses are expected to have superior professional knowledge and skills, be familiar with modern technical equipment and dedicated to the patient. Requirements for working in ICUs differ from one country to another. Nurses previously registered just once, after graduation, but are now required to demonstrate continuing competence if they are to maintain their registration. At the same time, communities expect safe and competent health care as a right. To fulfil their expectation, nurses need to be professionally and clinically competent.Materials and Methods: The present research study was conducted on 218 registered nurses selected by simple random sampling. The purpose of the study was explained to the nurses and written consent was taken from them and also assurance was given to maintain the confidentiality. The baseline data was collected from the samples using the structured interview schedule. Level of nurses clinical competencies was assessed by using the observational checklist and the factors influencing the clinical competencies of the ICU nurses was assessed by the Nurses competence scale (Rating Scale).Results: As per the score of observation checklist and three longitudinal observations to assess the level of clinical competencies of ICU nurses, the maximum score of clinical competencies of ICU nurses are within the range of very good (38-48) with majority of nurses (84.86% in 1st observation, 74.31% in second observation and 68.34% in third observation respectively %) with an average mean± SD of 44.87± 3.04, 44.36± 2.86 & 45.16± 2.876 respectively. There is no significant difference among the average of three observations made while assessing the level of clinical competencies of ICU nurses.The factors especially teaching –coaching (37.66±10.06; Range: 10-68), diagnostic functions (16.6 ± 4.56; Range 3-37) and work role (45.4±12.48; Range: 0-58) has maximum score suggesting that these three factors had influence on the clinical competencies of ICU nurses. The factors especially teaching-coaching, diagnostic functions and work role are significantly influencing the level of the clinical competencies of ICU nurses.There is significant association between the levels of clinical competencies of ICU nurses such as knowledge, experiences, environment, independence and work satisfaction with only four selected demographic variable i.e. age, usual length of shift duty the nurses work, average patient assignment and years of experience in the hospital. The factor such as teaching-coaching is significantly associated with average patient assignment. Diagnostic functions’ is associated with salary per month (in Rs.) of ICU nurses and work role is significantly associated with years of experience of ICU nurses.Conclusion: The study concludes that the factors such as teaching-coaching, diagnostic functions & work role have maximum influences on the level of clinical competencies of ICU nurses.

Todays' human resource and management professionals have become interested in the concept of organizational citizenship behavior because they considered improving nursesOrganizational Citizenship Behavior(OCB) is a crucial factor for developing organizations.It improves efficiency and generally provides a healthy work environment. The field of occupational health has started to pay increased attention to the concept of job crafting specifically in nursing profession.Job crafting was defined as employees’ self-initiated, proactive behavior aimed at aligning their jobs with their own preferences, motives, and passions. Through job crafting, employees can optimize their work environment and work experience. This may affect both individual and organizational outcomes as wellbeing, performance, and job involvement. The aim of the present study is to determine relationships between job crafting and work involvement with head nurses' organizational citizenship behavior at Mansoura University Hospitals. A descriptive correlation design was used in carrying outthis study. All head nurses (n=122) who working in all general units at three Mansoura University Hospitals namely; Main University Hospital, Emergency Hospital, and Specialized Medical Hospital. were included in the study. Three tools were used for data collection, namely; Job Crafting Scale, Job Involvement Questionnaire, and Head Nurse' Organizational Citizenship Behavior Questionnaire. A major finding of the present study there was statistically significant correlation between head nurses job crafting and job involvement and their organizational citizenship. It was concluded that increasing social job resources job crafting play a significant role in the organizational citizenship behavior of head nurses Furthermore, the hypothesis that head nurses' work involvement has a mediating effect on organizational citizenship behavior. It is recommended that to promote head nurses'organizational citizenship, it is necessary to acknowledge and consider organizational-level job demands and job resources such as increasing social job resources job crafting and decreasing hindering job demands. As well as additional research should be conducted to test to what extent the study results can be generalized.

To examine in hospitals whether head nurses' humility impacts nurses' affective commitment and explore the role of safety, trust and participative communication. A cross-sectional survey design. In 2023, we assessed the perceptions of 536 nurses, nested in 103 wards of 12 hospitals. The data were analysed using multilevel structural equation modelling. In line with our conceptual model, head nurses' humble leadership is positively associated with a psychological safety climate at the ward. Both humble leadership and a psychological safety climate are positively associated with nurses' trust in the head nurse, which, in turn, is positively associated with nurses' voice behaviour and their feeling of being heard (i.e., participative communication). Finally, nurses' feelings of being heard is positively associated with nurses' affective commitment, while-in contrast to our hypotheses-nurses' voice behaviour is not. This study highlights the importance of a leadership approach that contrasts with traditional power-oriented leadership styles. Head nurses in hospitals demonstrating humble leadership behaviours (e.g., appreciating others, acknowledging weaknesses), and fostering a psychologically safe environment, can build trust, encourage open communication and make nurses feel heard. This, in turn, can enhance nurses' affective commitment to their hospital. Feeling genuinely heard when speaking up is significantly more impactful than merely voicing concerns. Nurses are confronted with increasing work pressure weighing in on their affective commitment. The findings indicate that when head nurses acknowledge their limitations, ask for feedback and empower nurses in their ward, it can help build nurses' affective commitment through safety, trust and participative communication. This study adhered to the cross-sectional Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. No Patient or Public Contribution.

Revisiting 'Assessment of clinical competence using an objective structured clinical examination (OSCE)'.

Nurse competence became a relevant topic for discussion among nurse practitioners and nurse researchers. However, the factors connected with nurse competence need deeper exploring. The aim of this study was to explore nurse competence and factors associated with it from the perspective of nurses for predicting the possible ways for upgrading the nursing practice. A multicenter, descriptive study was performed in 11 surgical wards of 7 Lithuanian hospitals. Data were collected from November 2007 to January 2008. Lithuanian nurses (n=218) who were working with patients after abdominal surgery participated in this study. The response rate was 91%. Two instruments, both originally developed in Finland, were used: the Nurse Competence Scale and the Good Nursing Care Scale for Nurses. The overall level of nurse competence and the frequency of using the competencies in practice as perceived by nurses were high. Nurses assessed the competencies in managing situations and work role the highest and in teaching-coaching and ensuring quality the lowest. Sociodemographic factors such as nurse education, experience, professional development, independence, and work satisfaction as well as the evaluation of quality of nursing care were identified as factors associated with nurse competence. The findings of study allow us to make the assumption that nurse education, nurse experience, and nurse professional development play a significant role in the evaluation of nurse competence as well as the evaluation of quality of nursing care. It is necessary to upgrade nursing education programs at all levels of nursing education in Lithuania: university, non-university, and professional development courses. The qualities of preconditions for nursing care, cooperation with relatives, caring and supporting initiative are related to nurse competence.

Objective To construct a scientific, objective, and comprehensive clinical nurse culture competence scale. Methods By adopting Delphi method, the fitted clinical nurse culture competence scale was carried out two rounds experts′ consultation to acquire expert′s consensus consent, so as to primarily construct clinical nurse culture competence scale. Results Primarily constructed clinical nurse culture competence scale maintain 7 dimensions, 14 sub-dimensions and 84 clauses; expert′s judging coefficient was 0.917, value of mastery level 0.9, authority coefficient 0.909; the effective questionnaire collective rate was beyond 90%. The small sampling of 30 clinical nurses displayed that the content validity was 0.88, and Cronbach′s Alpha coefficient was 0.913. Conclusions Clinical nurse culture competence scale presented a excellent scientificalness and feasibility, so as to provide a tool for measuring clinical nursing staffs′ culture competence ability. Key words: Nursing staffs; Culture competence scale; Construction; Reliability; Validity

Head nurse evaluation of the nurses' performance of chest care procedures is vital to quality patient care at ICU. While nurses' self-evaluation help nurses to pay attention to their own performance, raise their self-awareness and efficacy to make efforts for improvement in performing of six chest care procedures. So head nurses and nurses actually need an educational training program for enforcing them for continuous performance improvement and updating knowledge .Objective: study head nurses' evaluation and nurses' self -evaluation of performing chest nursing care procedures. Setting: Tanta University Hospitals at Mobark ,Chest , and Tanta University International Educational Hospital. Tools two tools used Tool I: Evaluation and self -evaluation for nurses' actual performance of chest nursing care procedures observation checklists. And tool II: Knowledge assessment of chest nursing care procedures steps, evaluation and self -evaluation process. Result Preprogram researcher head nurses evaluation and nurses self -evaluation showed that nurses performance were at unsatisfactory level for all items of the six chest care procedures. Head nurses 55%,95%,100% and 85% showed poor level for plan ,needed information ,principles of evaluation and methods ,respectively . All head nurses evaluation and nurses self- evaluation level of knowledge pre- program was poor . Actually no one of nurses showed excellent level preprogram for performing items of vibration, coughing and suctioning procedures which changed post program to 65%, 78.8% and 100% , and at 3 month post program changed to 65%, 83.3% and 100% respectively . All head nurses and 80% of nurses had poor overall knowledge about six chest care procedure standard evaluation and self- evaluation principles preprogram .Implementation of educational program improved head nurses and nurses overall knowledge about chest care, evaluation and nurses self -evaluation statistically significant at P <0.01.Conclusion: Head nurses at Tanta university hospital were not evaluating nurses performance of chest care procedures leading to unsatisfactory nurses performance .Actually head nurses have insufficient knowledge to evaluate nurses performance and nurses have insufficient knowledge to perform chest care procedures according standard and cannot make self-evaluation for their performance. Implementation of educational program about evaluation principles,chest care procedure standard and self- evaluation principles successfully improved nurses staff performance and knowledge. Recommendation: Conduct regular training programs workshops and seminars for head nurses to update their knowledge and skills related to evaluation of nurses performance. Conduct periodical in service training program for nurses to refresh their knowledge and skills related to chest care procedure performance according to standard of its performance. Head nurses should encourage nurse self-evaluate their performance and provide supportive health work environment to help nurses improved their performance of chest care procedures