Clinical competencies of ICU nurses and the association of factors influencing the level of competencies in selected hospitals of Kamrup (Metro) Assam

Abstract

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.