ABSTRACT
BACKGROUND: Too few of nursing competencies framework exceed applicability to a given environment, are validated by a research process or used to guide continuing development of nursing competencies. OBJECTIVES: The study objectives were: 1) to adapt and validate a nursing competencies framework from the continuum of care from childhood to adulthood and 2) to explore implementation strategies. DESIGN: A collaborative approach including nurses from different practice perspectives. A modified Delphi method supported the adaptation and the validation of a nursing competencies framework. SETTING: This study was conducted in a pediatric and an adult care university hospitals in Montreal. PARTICIPANTS: Forty-two nurses were recruited from both university hospitals. METHODS: A modified Delphi study was conducted. An online questionnaire, containing dichotomous and open-ended questions, was used to collect data on the nursing competencies framework and the suggested implementation strategies for its use. Consensus percentage was calculated, and thematic analysis was used to analyze nurses' comments and implementation strategies suggested. RESULTS: The nursing competencies framework (NCF), adapted and validated in this study, includes seven competencies and four development stages, from advanced beginner to clinical expert nurses. After three rounds, the nursing competencies framework describes the professional role from the continuum of care from childhood to adulthood, and proposes a self-assessment tool that promotes professional development and continuing education of nurses. Moreover, four strategies for implementing the framework in the clinical setting obtained a consensus of 70% or more. CONCLUSIONS: A nursing competencies framework was validated by a rigorous research process and adapted to diverse contexts of care. The results revealed a common vision of the nursing practice for patients and their families on the life course from childhood to adulthood. This innovative framework carries the potential to be a relevant and unique reference tool. The nursing competencies framework can provide guidance for the development of nurses' competencies in clinical setting. Additionally, it is a relevant reference that should be use for knowing the scope and the standards of the professional practice in nursing education.
Subject(s)
Clinical Competence/standards , Continuity of Patient Care , Cooperative Behavior , Delphi Technique , Pediatrics , Surveys and Questionnaires , Adult , Child , Education, Nursing, Baccalaureate , Female , Humans , Male , Quebec , Self-Assessment , Staff DevelopmentABSTRACT
As in many other countries, Québec is not immune to healthcare reforms, which can unfortunately hinder quality of care as well as induce some dehumanization, both for the patients and the healthcare professionals. Thus, the « Humanistic Model of Nursing Care - UdeM ¼ (HMNC-UdeM) aspires to offer an innovative perspective that aims at improving the quality and the safety of care, in addition to satisfaction and well-being for both patients and nurses. While respecting their theoretical influences, the authors present their vision of the central concepts of the discipline and the Model's key concepts, seeking to make them more understandable, accessible, and applicable in nurses' daily practice. Therefore, the aim of this article is to raise awareness of the Model into the nursing community, to promote its implantation in nursing's spheres of activities, in addition to demonstrate its applicability and impact in nursing research. It appears that this model is promising for the renewal and the development of humanistic interventions for patients' care.
Subject(s)
Humanism , Nursing Care , Clinical Competence/standards , Humans , Models, Nursing , Nursing Care/methods , Nursing Care/psychology , Nursing Care/standards , Quality of Health Care/organization & administration , Quality of Health Care/standards , QuebecABSTRACT
CONTEXT: Few data are available on the use and consequences of decentralized automated dispensing cabinets (ADCs) in institutional settings. METHOD: This descriptive study examined compliance with published guidelines on the implementation of decentralized ADCs. The primary objective was to evaluate overall compliance, as well as compliance with specific steps in the medication cycle. The study was carried out at the Centre hospitalier universitaire (CHU) Sainte-Justine, a 500-bed mother-and-child hospital. The 2008 guidelines of the Institute for Safe Medication Practices (US) concerning the safe use of decentralized ADCs and the associated self-assessment tool (2009) were used to evaluate compliance at 30 days and at 120 days after implementation. RESULTS: From November 2009 to April 2010, 7 decentralized ADCs were brought into service at the CHU Sainte-Justine. Overall compliance with published guidelines increased from 66% to 74% between January and April 2010. For each process related to the safe use of the ADCs, the criteria were briefly described, along with the non-compliance components related to technological or organizational aspects of implementation. For each component for which practice was noncompliant with guidelines, the actions required to modify the equipment (i.e., technological aspects) were determined and conveyed to the manufacturer; similarly, modes of use requiring modification (i.e., organizational aspects) were determined and conveyed to the institution. CONCLUSION: This study has described the compliance of practices at the CHU Sainte-Justine with published guidelines of the Institute for Safe Medication Practices. The use of published guidelines can help to guide both the technological and organizational aspects of implementing decentralized ADCs. [Publisher's translation].
