National Competencies for Registered Nurses in Primary Care: A Delphi Study.

A Delphi (consensus) process was used to obtain national agreement on competencies for registered nurses (RNs) in primary care. A draft of competencies was developed by key informants. Following this, nurses with primary care experience/expertise completed a Delphi survey to rate the importance of competency statements on a six-point Likert scale. Statements not reaching consensus (agreement ≥80%) were modified and included in a second (final) round. The first survey was completed by 63% (n = 86/137) of participants and 84% (n = 72/86) of these participants completed the second survey. Most statements (n = 45) achieved agreement after the first survey; one statement was dropped and two were combined following the second round. The final list of competencies consists of 47 statements across six domains (professionalism; clinical practice; communication; collaboration and partnership; quality assurance, evaluation, and research; leadership). National competencies will help strengthen the RN workforce within primary care, improve team functioning, and support role integration/optimization.

Exploring the role of RNs in family practice residency training programs.

The authors developed a survey as part of a study to explore the role of nurses employed in Canadian family practice residency training programs, which provide physicians with two years of additional training after they have completed undergraduate medical education. Licensed practical nurses, registered nurses and nurse practitioners employed at residency traininig program sites have a unique opportunity to educate new physician about nursing scopes of practice and about how to work effectively with nurses. A total of 127 nurses, including 94 RNs, from 41 program sites across Canada completed the survey. In this article, the authors present the finding specific to this RN group. RN respondents reported performing a wide range of nursing and non nursing activities, and only 61 per cent indicated that they felt they worked to full scope. That so many RN respondents were performing below their scope of practice may be the result of employer and organizational policies or a lack of understanding and awareness of scope of practice. The authors propose that family practice residency training programs adopt a standardized approach to the role of RNs.