Zhang Xiaoning, Meng Kun, Chen Shuang
School of Nursing, Xuzhou Medical University, Xuzhou, China.
Nurs Crit Care. 2020 Jan;25(1):45-52. doi: 10.1111/nicc.12467. Epub 2019 Aug 2.
The specialist critical care nurse plays a vital role in the delivery of evidence-based practice, and specific competency guidance has been established to facilitate critical care nursing practice and education development in many developed countries. However, no research has been conducted to develop a competency framework for specialist critical care nurses in China.
To construct a competency framework specific to specialist critical care nurses in China.
A two-phased procedure was implemented. In phase 1, a literature review and four focus groups were used to develop the initial competency framework, which consisted of 101 statements. During phase 2, three rounds of a modified Delphi process were conducted and involved a national panel of 30 experts, including physicians, specialist critical care nurses, managers, and educators, who responded to the survey using a 5-point Likert-type scale to indicate their level of agreement with the competency framework. A 75% threshold for each competency was used to achieve panel consensus.
Experts in the field of critical care responded to rounds 1 (n = 29), 2 (n = 28), and 3 (n = 28). Seventy-eight competencies were agreed upon after round 1, increasing to 88 after round 2 and 92 after round 3. The final competency framework was classified into six domains: evidence-based practice, complex decisions, professionalism, communication and co-operation, education and development, and leadership.
The output of this study is an expert consensus competency framework that provides a sound foundation for the assessment and training of specialist critical care nurses.
The proposed competency framework should be used to assess nursing performance, promote continuing professional development, and further improve the delivery of quality health care and optimal patient outcomes.
专科重症护理护士在循证实践中发挥着至关重要的作用，许多发达国家已制定了特定的能力指南，以促进重症护理实践和教育发展。然而，尚未开展研究来构建中国专科重症护理护士的能力框架。
构建中国专科重症护理护士特有的能力框架。
实施了两阶段程序。在第一阶段，通过文献综述和四个焦点小组来制定初始能力框架，该框架由101条陈述组成。在第二阶段，进行了三轮改进的德尔菲法，参与的全国专家小组有30人，包括医生、专科重症护理护士、管理人员和教育工作者，他们使用5点李克特量表对调查做出回应，以表明他们对能力框架的认同程度。每项能力以75%的阈值达成专家小组共识。
重症护理领域的专家对第1轮（n = 29）、第2轮（n = 28）和第3轮（n = 28）调查做出了回应。第1轮后有78项能力达成共识，第2轮后增至88项，第3轮后为92项。最终的能力框架分为六个领域：循证实践、复杂决策、专业素养、沟通与合作、教育与发展以及领导力。
本研究的成果是一个专家共识能力框架，为专科重症护理护士的评估和培训提供了坚实基础。
所提出的能力框架应用于评估护理绩效、促进持续专业发展，并进一步改善优质医疗服务的提供和实现最佳患者结局。
