Abstract
BackgroundNurses’ clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses’ clinical competence is of major concern. A validated instrument for the self-assessment of nurses’ clinical competence at different educational levels across specialties and countries is lacking. The aim of this study was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale (ProffNurse SAS) questionnaire in long term and home care contexts in Norway. The questionnaire is based on the Nordic Advanced Practice Nursing model, in which the nurse-patient relationship is central.MethodsThe study has a cross-sectional survey design. A purposive sample of 357 registered nurses who worked in long term and home care contexts in two geographical regions encompassing eight municipalities and three counties was included. The respondents completed the 74-item ProffNurse SAS questionnaire and demographic background data was collected. Data collection was conducted in two phases: first region autumn 2011 and second region spring 2012.Exploratory factor analyses (EFA) were used to test the psychometric properties of the questionnaire and included the following steps: assessment of the factorality of the data, factor extraction by Principal Component Analysis (PCA), oblimin (oblique) factor rotation, and interpretation. Cronbach’s alpha was used to estimate the internal consistency.ResultsThe PCA revealed a six-component structure, reducing the number of items in the questionnaire from 74 to 51. Based on the content of the highest-loading items, the six components were named: Direct Clinical Practice, Professional Development, Ethical Decision-Making, Clinical Leadership, Cooperation and Consultation, and Critical Thinking. The Cronbach’s alpha values ranged from 0.940 (highest; Direct Clinical Practice) to 0.737 (lowest; Critical Thinking), leading to the estimation that the ProffNurse SAS is reliable.ConclusionsThe six components support the study’s theoretical framework. The ProffNurse SAS showed acceptable reliability and construct validity and may therefore be a promising instrument for the assessment of practicing nurses’ clinical competence. However, we recommend further psychometric testing in other countries and contexts and the inclusion of larger samples of nurses at various levels of education, particularly master’s level APNs.
Highlights
Nurses’ clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses’ clinical competence is of major concern
In that adverse health care events threaten the realization of high quality care in all care settings [1], it is imperative to improve patient safety [2]
Many countries are facing shortages in the health care workforce [7, 8]. This relates to the ability to maintain a sufficient number of care staff and to the ability to provide a suitable mix of nursing competence, with the aim to ensure patient safety in all care contexts
Summary
Nurses’ clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses’ clinical competence is of major concern. A validated instrument for the self-assessment of nurses’ clinical competence at different educational levels across specialties and countries is lacking. The importance of nurses’ roles and competence in ensuring patient safety has been confirmed in several studies [3, 4]. Many countries are facing shortages in the health care workforce [7, 8] This relates to the ability to maintain a sufficient number of care staff and to the ability to provide a suitable mix of nursing competence, with the aim to ensure patient safety in all care contexts. Systematic assessment enables the tracking of competence throughout an individual career and the assessment of whether nurses’ competence levels meet the requirements of the health care services. Measuring nurses’ competence may be useful for a variety of reasons
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