Construction And Research On Essential Nursing Skills For Baccalaureate Nursing Graduates

Objective To explore the essential nursing skills for baccalaureate nursing graduates.Methods ①Through literature research, identified the gap between nursing skill education and clinical nursing development, the current situation of clinical nursing practice and the research status of essential nursing skills for baccalaureate nursing graduates. Based on the result of literature research, drew up a closed questionnaire named "the performing frequency and importance of clinical nursing skills" and an open questionnaire for nursing graduates. ② A convenience sampling method was used to recruit 400 clinical nurses from five first-class comprehensive hospitals in Zhejiang province, in order to obtain the most frequent and important clinical nursing skills. A cluster sampling method was used to recruit 280 undergraduate nursing students who had just ended their clinic practice at fourth grade from a nursing school for the survey, in order to get their recommendations on which nursing skills should be taught during school period. The results of investigations were used as a source of expert advice for third class entries. ③With the panel discussion, the expert consultation questionnaire of essential nursing skills system for baccalaureate graduates was studied, and the consultant selection criteria strictly followed to select 42 nursing specialists from different areas. After two rounds of consultation, the essential nursing skills system for baccalaureate graduates was constructed.Results ①The survey on the frequency and importance of clinical nursing skills showed that among the investigated 233 nursing skills,92 (39.48%) nursing skills were categorized as high frequency,48 (20.60%) nursing skills were categorized as moderate frequency, and 93 (39.91%)nursing skills were categorized as low frequency.157 (67.38%) nursing skills were considered as the most important,47 (20.17%) nursing skills were considered as the moderately important, and the rest 29 (12.45%) nursing skills were considered as the least important. Moreover,75 nursing skills were both belong to the high frequency nursing skills and most important skills by clinical nurses.49 nursing skills were considered as low frequency, but still considered important clinical nursing skills. In contrast,2 nursing skills were considered as high frequency, but least important.23 nursing skills were considered as low frequency and least important.②The survey on the importance of clinical nursing skills for nursing graduates showed that among the investigated 233 nursing skills, only 4 fundamental nursing skills had importance of choosing rate (4 points or less) lower than 50%. They were bed bathing, helping patient manicure their nails, combing patient’s hair and helping patients to shampooing their hair in bed. There were 26 fundamental nursing skills, and 15 Traditional Chinese Medicine (TCM) nursing skills having importance of choosing rate lower than 80%.The remaining 188 nursing skills had importance of choosing rate greater than 80%. Based on the open questionnaire result, the same nursing skills were organized and classified, and if one skill had been mentioned more than twice by nursing undergraduate, they should be included into the core nursing skills entry pool. Finally, a total of 33 skills were collected which nursing students believed had not been taught in school and 29 skills were not emphasized in nursing skills teaching.③After two-round of consultation, four dimensions of essential nursing skills, including fundamental nursing skills, specialized nursing skills, basic critical and emergency nursing skills and TCM nursing skills were constructed. The fundamental nursing skills included 18 aspects involving 97 items, the specialized nursing skills included 7 aspects involving 32 items, the basic critical and emergency nursing skills included 2 aspects involving 11 items, and the TCM nursing skills included 15 items directly. Delphi method reliability analysis showed that the expert positive coefficient of two rounds were 88.10% and 86.11%, the authority coefficients were 0.836 and 0.841, the entries coefficient of variation were 0.033-0.402 and 0.036-0.234, the entry levels of Kendall’s coefficient of concordance (W) were 0.186-0.520 and 0.357-0.493, and all P values were less than 0.01 by chi-square test, with statistical significance.Conclusion The essential nursing skills system for baccalaureate graduates was constructed by different methods, covering 4 first class entries,27 second class entries and 155 third class entries. This system defined which nursing skills should belong to essential nursing skills for nursing graduates. On the basis of previous studies, the current specialist nursing skills with widespread clinical application were added and the undergraduate from TCM colleges should possess essential traditional Chinese medicine nursing skills. It can provide reference for nursing school teachers and clinical nursing teachers to design teaching content and distribute hours for undergraduate nursing skills teaching.