Construction Of Evaluation Indexes Of Core Competencies For PICC Specialized Nurse And Clinical Investigation Analysis

Infusion nurses society defined infusion therapy nursing was “engage in infusiontherapy and clinical practice of fluid and electrolytes, pharmacology, infection preventionand control, infusion therapy in children, blood and blood components, nutritionalproducts,antineoplastic therapy and quality management.” All of the infusion therapies,Peripherally Inserted Central Catheter has an advantage in blood vessel protection,markedly reduced risk of catheter-related complication, the fee of insert and maintain ischeaper than the others, and widely used for central venous access in medium to long-termintravenous drug therapy. It is very important that core competencies of PICC specializednurses to the whole process of from assessment to extubation, patient’s education, as wellas quality promotion. At present, it is difficult that objective evaluate to the practice andmanagement level, because of lack of core competencies systematic training andevaluation criteria. Formulate the core competencies evaluation indexes for PICCspecialized nurses can provide quantitative standards for training, certification andevaluation of PICC specialized nurses. The study is composed by two parts as follows.The first part objective to formulate the core competencies evaluation indexes for PICCspecialized nurses. Altogether19experts were consulted through two-round Delphi method.The weight of each index was determined by hierarchy analysis. The core competencyevaluation indexes of PICC specialized nurses included3first class indexes,16secondclass indexes and42third class indexes. The Cr, Ca and Cs were0.871,0.900,0.842,respectively. Kendall w was0.526,0.418,0.369, respectively. P value is less than0.000,under of significant level of0.05indicated statistically significant different.The corecompetency evaluation indexes are reliable and valid, which can provide quantitativestandards for training, certification and evaluation of PICC specialized nurses.The second part was selected the professional knowledge of the evaluation of corecompetencies to design evaluation tools. Draw up outline through Delphi method andorganized questionnaire in accordance with the proposition principle. Pre-survey of39nurses, item difficulty coefficient P of the various parts of theoretical knowledgequestionnaire was0.74,0.48,0.79,0.54,0.69,0.66,0.63, respectively. The difficulty ofquestionnaire was0.65. The discrimination of the various parts was0.32,0.37,0.34,0.53,0.40,0.41,0.38, respectively. The distinction of questionnaire was0.24. The cronbachcoefficient was0.762. The quality of theoretical knowledge questionnaire was better.127 nurses were investigated by the theoretical knowledge questionnaire through conveniencesampling.68(53.5%) of the PICC specialized nurses has certification,59(46.5%) isnon-certification nurse.127cases overall score was73.25±7.80. PICC specialized nurseswho had certification was first group and the questionnaire’s overall score was77.40±5.50.Non-certification nurse was second group and the questionnaire’s overall score was68.47±7.33. The first group scored higher than the second group, the total score differencewas statistically significant (P<0.01). First part of the anatomy physiology knowledge, andthe third part of the basic knowledge of the PICC puncture tool, catheter and maintenanceof knowledge, the forth part of the PICC catheter indications, contraindications,complications, knowledge, the fifth part of the imaging knowledge, and infection controlknowledge of the first group of nurses scored significantly higher than the second group ofnurses, the various parts of the score difference was statistically significant (P<0.05). Afterinvestigation, the training time of the PICC specialized nurses was2to3days of trainingonce a year,88.2%of PICC specialized nurses who had received job training, traininginstitutions were concentrated in the hospital (88.2%).23.5%of PICC specialized nurseshad received the Nursing Association training and8.8%of the PICC specialized nurses hadreceived the training of the PICC manufacturers. In clinical practice, there are still manynon-certification nurses engage in PICC catheter puncture and maintenance.Comparison ofthe two groups, non-certification nurses’ master ability of theoretical knowledges far cryfrom the PICC specialized nurse who had certification. Without professional training andlack of theoretical knowledges, catheters puncture and routine maintenance operationswould not standardized, and will certainly affect the quality of PICC care nursing andresult in a threat to the health and safety of the patient. PICC specialized nurse’s workinghours, puncture time and the level of hospital were little impact on the professionaltheoretical knowledge capacity and difference was not statistically significant(P>0.05).The low level of training and certification, the shorter training time, unreasonablecourse and the same contents of training, those status quo could easily lead to waste oftraining resources. To recommend that seriously consider the appropriate training time andplan level-training to enhance assessment efforts, take intermittent post-trainingexamination and implement the re-certification system.