Gill Fenella J, Kendrick Tina, Davies Hugh, Greenwood Melanie
Princess Margaret Hospital for Children, Child & Adolescent Health Services, Australia; School of Nursing, Midwifery & Paramedicine, Curtin University, Australia.
NSW Newborn and Paediatric Emergency Transport Service (NETS), Australia; University of Tasmania, Australia.
Aust Crit Care. 2017 May;30(3):173-181. doi: 10.1016/j.aucc.2016.06.001. Epub 2016 Jul 27.
Observational work to develop the ACCCN Competency Standards was undertaken more than 20 years ago. Since then the landscape of critical care nursing as a specialty has changed and it is not known if the Competency Standards reflected contemporary practice.
To revise the ACCCN Competency Standards for Specialist Critical Care Nurses to ensure they continue to meet the needs of critical care nurses and reflect current practice.
A two-phased project was undertaken. In Phase I focus groups were held in all states. Thematic analysis was conducted using two techniques. The standards were revised based on the main themes. Phase II consisted of an eDelphi technique. A national panel of critical care nurses responded to three survey rounds using a 7 point likert-type scale to indicate their level of agreement with the revised standards. A 70% agreement level for each statement was determined a priori.
Phase I: 12 focus groups (79 participants) were conducted. Phase II: A panel of specialist critical care nurses (research, management, clinical practice and education) responded to round 1 (n=64), round 2 (n=56), and round 3 (n=40). Fifteen practice standards with elements and performance criteria were grouped into four domains (professional practice, provision and coordination of care, critical thinking and analysis, collaboration and leadership). The revised Practice Standards for Specialist Critical Care Nurses build upon and are additional to the Nursing & Midwifery Board of Australia National Competency Standards for Registered Nurses. The standards reflect contemporary critical care nurse practices using an expanded range of technologies to care for complex critically ill patients across the lifespan in diverse settings.
The national study has resulted in the 3rd edition of the Practice Standards for Specialist Critical Care Nurses. There was input from stakeholders and agreement that the revised standards capture contemporary Australian critical care nursing practice.
制定澳大利亚重症监护与危重病护理协会（ACCCN）能力标准的观察性工作是在20多年前开展的。从那时起，重症监护护理作为一个专业领域的情况已经发生了变化，尚不清楚这些能力标准是否反映了当代实践。
修订澳大利亚重症监护与危重病护理协会专科重症监护护士能力标准，以确保它们继续满足重症监护护士的需求并反映当前实践。
开展了一个分两阶段的项目。在第一阶段，在所有州举行了焦点小组讨论。使用两种技术进行主题分析。根据主要主题对标准进行了修订。第二阶段采用电子德尔菲技术。一个由重症监护护士组成的全国性小组使用7点李克特量表对三轮调查做出回应，以表明他们对修订后标准的同意程度。事先确定每条陈述的同意水平为70%。
第一阶段：进行了12个焦点小组讨论（79名参与者）。第二阶段：一个由专科重症监护护士（研究、管理、临床实践和教育）组成的小组对第一轮（n = 64）、第二轮（n = 56）和第三轮（n = 40）做出了回应。15项包含要素和绩效标准的实践标准被归为四个领域（专业实践、护理提供与协调、批判性思维与分析、协作与领导）。修订后的《专科重症监护护士实践标准》以澳大利亚护理与助产士委员会注册护士国家能力标准为基础并加以补充。这些标准反映了当代重症监护护士的实践，使用了范围更广的技术，以便在不同环境中为各个年龄段的复杂危重病患者提供护理。
这项全国性研究产生了《专科重症监护护士实践标准》第三版。有利益相关者的参与，并且大家一致认为修订后的标准体现了当代澳大利亚重症监护护理实践。
