Developing a competence framework for nurses in pharmaceutical care: A Delphi study.

BACKGROUND: Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. OBJECTIVES: To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. METHODS: A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses' roles in interprofessional pharmaceutical care. Descriptive statistics supported the data analysis. RESULTS: The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. Forty-one competences were related to 15 generic nursing tasks and 33 competences were related to seven specific nursing tasks. CONCLUSIONS: This study resulted in a competence framework for competency-based nurse education. Future research should focus on imbedding these competences in nurse education. A structured instrument should be developed to assess students' readiness to achieve competence in interprofessional pharmaceutical care in clinical practice.

A functional measurement approach to the Children’s Anxiety and Pain Scale - CAPS: contributions to its construct validity

The Children's Anxiety and Pain Scales-CAPS (Kuttner & LePage, 1989) is the only faces measure to date aimed at separately assessing anxiety and pain intensity through self-report. Despite early indications that the two sets of schematic faces included in the CAPS possess face validity regarding the constructs of anxiety/fear and pain, the extent to which they allow differentiating between them has remained controversial, especially in younger children. In this study, the inner features of CAPS’s faces were taken as factors in integration tasks performed by children differing in age (6-8 and 9-11 years old) and pain experience (pain-free and acute postoperative pain). Different integration patterns were found for the CAPS-pain and the CAPS-anxiety subscales, along with distinct profiles of relative importance among upper-and lower-face features. These differences did not depend on the assigned judgment dimension (conveyed pain or conveyed fear), and partly concurred with collateral evidence on the relative importance of facial features in prototypical pain and fear expressions. Overall, outcomes were supportive of several facets of the construct validity of the CAPS (AU)

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