Research On The Evaluation Indicator System For The Competency Of ICU Nurses

ObjectivesThe purpose of the study was to develop a scientific and systematic evaluation index system for ICU nurses, to form the competency self assessment questionnaire (CSAQ) at general ICU in 3A hospitals of Shanghai, to provide the data and information for the authorities by using the CSAQ to assess the competency of ICU nurses.Methods①The literature review was used to get the research and development trends of competency of ICU nurses at home and abroad, get the competency standards, and then analyze the content and structure.②The study analyzed the conceptual model from the data collected from 8 nursing experts by semi-structured interview, formed the evaluation indicator draft of the ICU nurses.③The evaluation index system was revised through the two round Delphi technique.④The CSAQ was formed by the Expert Meeting.⑤The tool was tested with a sample of 220 ICU nurses from thirteen 3A general hospitals in shanghai from September 2010 to November 2010. The reliability and validity of the CSAQ were tested by the statistic methods, including the correlation analysis, discrimination analysis, Cronbach'αcoefficient, and so on. Meanwhile, the study got the competency level and the influential factors .Results①Defined the concept of competency and the relevant indicators.②Constructed the structural model of competency for ICU nurses.③The framework of this system was composed of three grades with different items, i.e. 4 items in the first grade, including professional knowledge, skills, abilities and personal traits,16 items in the second and 53 items in the third. The weights were determined by analytic hierarchy process for the first grade indicators and expert advice for other grade indicators.④The CSAQ included 58 items with likert five level from 0 to 4 points.The final scores equal to the scores of 58 items multiply the weights, and then converted into percentile scores. The percentile score was divided into four levels of competency,as follow: less than 60 scores was unquailified, 60～70 scores was good,70～85 scores was better,85～100 scores was best.⑤The reliability of the CSAQ: the total test-retest reliability was 0.884,the total Cronbach'αcoefficient was 0.933. The validity of the CSAQ: the content validity was 0.870, the correlation coefficients were significantly different for the scores of the first grade indicators and total scores, the scores of the second grade indicators and the scores of the first grade indicators, the scores of the third grade indicators and total scores. The discriminant validity was tested by the indepentdent samples t test between 110 ICU nurses certificated and 85 ICU nurses uncertificated. The total scores and the scores of the first grade indicators were significantly different between two groups(P<0.01). The total scores of the CSAQ were different in same level of age, working time in ICU, professional title, formal or informal position, initial education and the last education for two groups(P<0.01 or P<0.05).The multiple linear regression showed whether ICU nurses had been certificated or not was the influencing factors of the total scores.⑥The total average score of ICU nurses certificated was 83.84±10.30, the competency was better. The total average score of ICU nurses uncertificated was 69.67±13.67, the competency was good. The scores of ICU nurses certificated were higher than ICU nurses uncertificated.There were no difference in career development and scientific research abilities(P>0.05).⑦The influencing factors of ICU nurses certificated were the time of certification, working time in ICU, professional title, initial education. The influencing factors of ICU nurses uncertificated were professional title, age and initial education.Conclusions①This study analyzed the requires and standards of competencies for ICU nurses, which would be benefit for the development of critical care.②This evaluation index system paid attention to the working characteristics of ICU, which based on the competency model.③By using the CSAQ: nurses might choose the right position and the departmemt; the manager might allocate the job, train nurses so as to develop the advanced nursing practice; the human resources derpatment might also elvaluate the performance of ICU nurses.In addition, the training organization would know the advantage and disadvantage of training, further the trainging effect.