Saari Margaret, Coumoundouros Chelsea, Tadeo John, Chyzzy Barbara, Northwood Melissa, Giosa Justine
SE Research Centre, SE Health, 90 Allstate Parkway, Suite 800, Markham, ON, L3R 6H3, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
BMC Nurs. 2025 Apr 7;24(1):378. doi: 10.1186/s12912-025-03045-5.
Home health nursing competencies outline the knowledge, skills and attributes home health nurses need for safe and ethical practice. Since the Canadian Home Health Nursing Competencies were first developed in 2010, several important contextual changes have occurred. To ensure competencies reflect current practice contexts, this study aimed to update Canada's home health nursing competencies.
A four-phase modified eDelphi study was conducted using online surveys, consensus meetings and feedback forms. An environmental scan was conducted to identify home health competencies emerging since 2010, to create a comprehensive set of preexisting competencies to serve as the starting point for a 3-round modified eDelphi process. The eDelphi was conducted with a panel of home health nurses (n = 43) to identify core competencies relevant to current home health nursing practice environments. Broader consultations with home health nurses (n = 41) and interdisciplinary home care team members (n = 12) were held to validate eDelphi findings. An advisory working group (n = 24) of home health nursing leaders provided guidance on study decision-making and final recommendations.
Three hundred fifty-nine preexisting competencies were consolidated into 96 unique home health nursing competencies. In Round 1 of the eDelphi, home health nurses reached consensus (agreement ≥ 75%) that 94 competencies were relevant to current practice environments and suggested five new competencies. Subsequent eDelphi rounds resulted in 93 competencies being brought forward as both relevant and essential for current home health nursing practice. Further consultations refined recommendations, resulting in a final set of 79 competencies. Qualitative feedback provided insights into the relevance and importance of competencies, opportunities for comprehension improvements, and implementation considerations.
The home health nursing competency set generated through this study incorporates core concepts in home health nursing practice, such as evidence-informed practice and interdisciplinary collaboration, along with several new concepts, such as trauma-informed care, data-driven decision-making, and provision of culturally safe care. This updated competency set can be used to inform prelicensure education and professional development opportunities to enhance home health workforce capacity. Future work exploring strategies to support competency uptake in education and home and community care organizations is needed.
家庭健康护理能力概述了家庭健康护士进行安全且符合伦理的实践所需的知识、技能和特质。自2010年首次制定《加拿大家庭健康护理能力》以来，发生了一些重要的背景变化。为确保能力反映当前的实践背景，本研究旨在更新加拿大的家庭健康护理能力。
采用在线调查、共识会议和反馈表进行了一个四阶段的改良德尔菲研究。进行了一次环境扫描，以确定自2010年以来出现的家庭健康护理能力，创建一套全面的既有能力作为三轮改良德尔菲过程的起点。与一组家庭健康护士（n = 43）进行德尔菲研究，以确定与当前家庭健康护理实践环境相关的核心能力。与家庭健康护士（n = 41）和跨学科家庭护理团队成员（n = 12）进行了更广泛的磋商，以验证德尔菲研究结果。一个由家庭健康护理领导者组成的咨询工作组（n = 24）为研究决策和最终建议提供指导。
359项既有能力被整合为96项独特的家庭健康护理能力。在德尔菲研究的第一轮中，家庭健康护士达成共识（同意率≥75%），认为94项能力与当前实践环境相关，并提出了五项新能力。随后的德尔菲轮次产生了93项被认为与当前家庭健康护理实践相关且必不可少的能力。进一步的磋商完善了建议，最终形成了一套79项能力。定性反馈提供了有关能力的相关性和重要性、理解改进机会以及实施考虑因素的见解。
通过本研究生成的家庭健康护理能力集纳入了家庭健康护理实践中的核心概念，如循证实践和跨学科协作，以及一些新概念，如创伤知情护理、数据驱动决策和提供文化安全护理。这套更新后的能力集可用于指导执照前教育和专业发展机会，以提高家庭健康劳动力能力。未来需要开展工作，探索支持在教育以及家庭和社区护理组织中应用能力的策略。
