Anaesthesia nursing competence: Self-assessment of nursing students.

BACKGROUND: The importance of competence assessment in anaesthesia nursing education has increased since nurse educators and anaesthesia care employers have identified the gap between nursing education and nursing practice. In order to ensure nursing students' preparedness for entry into anaesthesia nursing practice, it is necessary to measure whether nursing students have achieved the required competence to practice as anaesthesia care providers. OBJECTIVES: To assess the anaesthesia nursing competence of nursing students and to describe factors related to their anaesthesia nursing competence. This study will provide new knowledge to support the curricula of nursing education and new nurses' practice in anaesthesia care. DESIGN: Cross-sectional survey design. METHODS: Data from a sample of Finnish nursing students (n = 205) were collected by using an on-line/paper and pencil survey (the Anaesthesia Nursing Competence Scale, 7 categories) in 2017. The assessment was based on self-assessment and used a Visual Analogue Scale (0-100). Descriptive statistics, a Pearson correlation coefficient, independent sample t-tests and a multivariable regression were used to analyse the data. RESULTS: The self-assessed overall competence of graduating nursing students was 59 (range 43-73). Approximately half of the students reached an acceptable level (60≤) and half did not. The highest self-assessed category was collaboration within patient care, and the lowest was knowledge of anaesthesia patient care. The number of credits, anaesthesia courses, and experience of clinical practice in anaesthesia nursing were significantly related to anaesthesia nursing competence. CONCLUSIONS: Competence development in the knowledge of anaesthesia patient care should be considered in general nursing education. Student nurses' competence could be developed by providing more opportunities for theoretical studies and clinical practice in anaesthesia nursing. A specialised post-registration education in anaesthesia nursing might be one solution to overcome the limitations in the competence that general nursing education is not fully able to cover for anaesthesia nursing.

Developing and psychometric testing of the anaesthesia nursing competence scale.

RATIONALE, AIMS, AND OBJECTIVES: The competence of nurses in anaesthesia care is important for the quality of anaesthesia nursing care and patient safety. However, there is a lack of psychometrically tested instruments to measure the competence. Therefore, this study aimed to develop and test the psychometric properties of an anaesthesia nursing competence scale (AnestComp) assessing nurses' competence in anaesthesia care. METHOD: The scale development and psychometric testing had three phases: (1) based on literature reviews and the description of experts, competence areas were identified and items were created; (2) the content validity of the scale was tested by a content expert group, and the scale was pilot tested; and (3) psychometric testing of scale was tested by anaesthesia nurses' (n = 222) and nursing students' (n = 205) self-assessments. The psychometric testing assessed the reliability when using Cronbach's α and the construct validity using factor analyses (confirmatory and exploratory) and known-group technique. Nursing students were included for the purpose of construct validity testing. RESULTS: The AnestComp has 39 items and consists of seven competence areas: (a) ethics of anaesthesia care, (b) patient's risk care, (c) patient engagement with technology, (d) collaboration within patient care, (e) anaesthesia patient care with medication, (f) peri-anaesthesia nursing intervention, and (g) knowledge of anaesthesia patient care. Cronbach's α values were high in all categories (0.83-0.95), and factor analyses and known-group technique supported a seven-factor model. CONCLUSION: The initial results supported the reliability and construct validity of the AnestComp. The scale is considered a promising instrument for measuring anaesthesia nursing competence among anaesthesia nurses. Further research with larger and more diverse samples is suggested to refine the current psychometric evaluation.

Critical care nurses' self-assessed patient observation skills: a cross-sectional survey study.

BACKGROUND: Observing a patient's clinical condition is an important responsibility of critical care nurses and an essential component of their competence. Critical care nurses' patient observation skills contribute to patient safety and quality of care. These observation skills have not been assessed or measured previously. AIM: The aim of this study was to measure the self-assessed level of critical care nurses' patient observation skills and to explore the factors associated with these skills. STUDY DESIGN: This was a multicentre cross-sectional survey conducted in Finland. METHODS: The sample consisted of critical care nurses working at Finnish university hospitals. The data were collected between September 2017 and January 2018 using an instrument developed for the study - Patient Observation Skills in Critical Care Nursing (visual analogue scale 0-100). Descriptive and inferential statistics were used to analyse the data. RESULTS: A total of 372 critical care nurses (49%) responded. Finnish critical care nurses assessed their patient observation skills overall as excellent. The bio-physiological foundation was assessed as good, whereas skills in using observation methods and skills in recognizing changing clinical condition were assessed as excellent. Education for special tasks in intensive care units, information searching in scientific journals, working experience in critical care nursing and critical care nurses' perception of critical care as a preferred field of nursing were factors promoting patient observation skills. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: The study provided a novel instrument for measuring critical care nurses' patient observation skills. The instrument may be used as an assessment tool in clinical practice and education. Developing orientation and on-the-job training in intensive care units are essential in assuring critical care nurses' adequate patient observation skills. Patient observation skills could be developed during nursing education by providing students with opportunities for clinical training and applying patient cases in virtual learning environments.

Competence Assessment Instruments in Perianesthesia Nursing Care: A Scoping Review of the Literature.

PURPOSE: To identify competence assessment instruments in perianesthesia nursing care and to describe the validity and reliability of the instruments. DESIGN: A scoping review in a systematic manner. METHODS: A search in CINAHL, MEDLINE, and ERIC was carried out to identify empirical studies from 1994 to 2015. A narrative synthesis approach was undertaken to analyze the data. FINDINGS: Nine competence assessment instruments in perianesthesia nursing care were identified. The instruments used three types of data collection methods: Self-report, observation, and written examinations. The most commonly reported validity method was content validity involving expert panels and reliability tests for internal consistency and inter-rater's consistency. CONCLUSIONS: Integrating more than one data collection method may give support to overcoming some of the limitations, such as lack of objectivity and misinterpretation of the assessment results. In an ever-changing environment, perianesthesia nursing competence requires constant reassessment from the perspective of content validity, scoring methods, and reliability.

Nurse Competence Scale: a systematic and psychometric review.

AIM: The aim of this study was to report a systematic and psychometric review. BACKGROUND: The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence. DESIGN: A systematic literature review of research evidence and psychometric properties. DATA SOURCES: Nine databases from 2004 - October 2015. REVIEW METHODS: We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist. RESULTS: A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in hospital settings. Length of work experience, age, higher education, permanent employment and participation in educational programmes correlated positively with competence. Variables including empowerment, commitment, practice environment, quality of care and critical thinking were also associated with higher competence. The Nurse Competence Scale has demonstrated good content validity and appropriate internal consistency. CONCLUSION: The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.

Anaesthesia nursing education in the Nordic countries: Literature review.

OBJECTIVES: The purpose of this review was to analyse post-registration anaesthesia nursing education in the Nordic countries. The analysis was based on key determinants fundamental to analysing nursing education: 1) the sys]tem of anaesthesia nursing education, 2) entry requirements, 3) credits, the duration and the title or degree awarded, and 4) the amount of practical training. METHODS: A scoping review was approached in a systematic manner. The literature was analysed using deductive content analysis. Data was gathered based on key determinants. The data were quantified into frequencies and percentages to compare the similarities and differences of anaesthesia nursing. RESULTS: The Nordic countries have different types of post-registration anaesthesia nursing education from non-degree supplementary programmes to Master's degree programmes. Even though the entry requirements correspond between countries, many more differences than similarities in anaesthesia nursing education were noted. A title granting the right to work as a nurse anaesthetist can be obtained through a variety of educational systems, credit requirements, the duration, and the amount of practical training in post-registration anaesthesia nursing programmes. CONCLUSION: This aim of the study was to analyse post-registration anaesthesia nursing education from the Nordic perspective. Harmonising the educational system and minimum education requirements in anaesthesia nursing education is recommended in order to facilitate free movement and assure the quality of care from the Nordic perspective. Since each Nordic country has its own native language, it was difficult to gather information from all the Nordic countries. Therefore, creating common educational database published in English can help to bench mark each country's educational system.