Development The Competency Model For Head Nurses In Tertiary Hospital

Objectives: The purpose of the study was to provide scientific and theoretical evidence for the selection,education and assessment of head nurses in tertiary hospital by constructing a scientific,practical and effective competence model.Methods:Part 1:Literature retrieval,expert consultation,behavioral event interview and check form method were used to develop an initial model.Competences dictionary of head nurses was compiled by literature reading and expert consultation;head nurses were divided into excellent group and ordinary group on the basis of performance evaluation results.Behavioral event interview was made with 17 and 13 head nurses randomly selected from each group respectively by employing EXCEL.“Differentiating competences”were obtained from comparison between the differences of the scores of the two groups by t test and Kruskal Wallis rank test after encoding and analyzing the interview data based on the competence dictionary.Then Check Form was designed on the basis of the competence dictionary.22 leaders of functional departments and 18 excellent nurses were invited to check and assess the competence data by choosing 10-15 most important competences of head nurse,complementing the interview data.We analyzed statistically the competence frequency ranking and obtained “general competences” which have no differences between the two groups by removing the “differentiating competences” in the top 15 competences in the Check Form.An initial competence model of head nurse in tertiary hospitals was constructed with the combination of “differentiating competence” and “general competences”.Part 2: We optimized and verified the model by using questionnaire survey and designed questionnaires on basis of initial model.Questionnaire survey was conducted among 412 head nurses in five tertiary hospitals who identified the importance degree of each competence according to working experiences by using 7 point Likert Scales.exploratory factor analysis was used for constructing framework of the model,confirmatory factor analysis,content validity and internal consistency inspection were used to test the structure of the model.Results:Part 1:1 competences dictionary of head nurses in tertiary hospitals were developed.The dictionary comprised of 6 categories and 31 competences,each of which contains four levels.2 There were significant statistical differences of the scores of 15competences(empathy,self-discipline,initiative,attention to the quality and order,motivation,executive ability,purpose of role,authorization,supervision ability,problem-solving ability,professional dedication,learning ability,communication and coordination skills,developing talents,nursing knowledge and skills)between excellent group and general group(P<0.05),and they are differentiating competences.3 we found out the top 15 competences by referring to the check form in which the remaining five competences(formulation and implementation of the plan,making people has the sense of responsibility,honest and fair,tolerance,service consciousness)selected by removing differentiating competency,were general competences.The initial model was made up of 5 general competences and 15 differentiating competences.Part 2:1 A total of 427 copies of the questionnaires were issued,412 copies of questionnaires were recycled effectively.The effective recovery rate was96.49%.2 Pre-survey finding: S-CVI was 0.95,I-CVI ranged from 0.89 ~ 1,Cronbach's ? was 0.907.this indicates good internal consistency reliability3 Formal survey finding: the average score of the level of significance of each competence item: 6.41-6.82(total points: 7).It indicates a high level of significance of each competence.4 Three factors were extracted by exploratory factor analysis,which contributed 70.214% of the total variance.Twenty competence items were uniformly distributed in the three factors,and every item's load factor was greater than 0.4 ranging from 0.665 to 0.919 without double load.The three factors were named as management ability(1 ? 2 ? 3 ? 4 ? 5 ? 6 ? 8 ? 9 ? 10),influence ability(11?12?13?15?16)and personality(7?14?17?18?19?20).The confirmatory factor analysis revealed a good fit of the model based on various fit indice(?2/df=1.395,GFI=0.922,RMSEA=0.044,NFI=0.946,CFI=0.984,TLI=0.976).The Cronbach's ? was 0.951,the Cronbach' s ? of each factor was 0.865,0.886,0.906.Conclusions:The final model comprised of three first-level indicators and twenty second-level indicators,each second-level indicators contains four levels which include specific behavior descriptions.The competency model established by a variety of methods is scientific and practical.It provides effective and scientific basis for nursing management practice.