The dimensions of clinical competence of nurses working in critical care units and their relation with the underlying factors

Clinical competency is the use of skillful, technical and communication skills, knowledge, clinical reasoning, emotions and values in clinical settings. Developing the professional competence of investment nurses to ensure the safety and quality of patient care. The factors influencing the clinical competence of experience, environment, and the use of opportunities, motivation, theoretical knowledge and individual characteristics can be mentioned. The competence of nurses in critical care units is very effective because of the sensitivity and complexity of these wards in improving their scientific and practical quality and ultimately improving the care of patients with critical conditions.

The purpose of this study was to determine the clinical competency of nurses working in critical care units and its relation with the underlying factors.

The type of study is descriptive - analytical. The statistical population included nurses working in 11 critical care units, 3 educational-medical hospitals in Kurdistan University of Medical Sciences in 2018. Sampling method was census. 122 (87.2%) nurses completed the questionnaires by self-report method. The research instrument consisted of a demographic questionnaire with clinical competency questionnaire of nurses in Ebadi and colleagues with five factors of care management, Technical Competency, individual management, Human-oriented Care and Scholarship-oriented Care. To measure the items, a 5-point Likert Scale (from a minimum score of one to a maximum score of 5) was used. The validity of the questionnaire was carried out in Ebadi et al., in 2014. Reliability of the questionnaire in this study was obtained using Cronbach's alpha coefficient (α = 94). Data analysis was performed using SPSS 24 software and descriptive and inferential statistics.

The mean and standard deviation of nurse’s clinical competency score were 4.24 ± 0.42 from 5. The highest score of its factors was in the factor of individual management with a score of 4.37 ± 0.49 and Technical competence and the lowest scores related to the Scholarship-oriented Care factor with a score of 3.72 ± 1.31. Among factors, care management has a direct correlation with female gender (p = 0.017 t=2.002). There was no relationship between other factors with clinical competency and its significance (α = 0.05).

The clinical competence of nurses in intensive care units is high in this study. Due to the attitude of women toward nursing, they are more competent in managing patient care. However, given the low scores of nurses in the field of scholarship-oriented Care, it is necessary to pay more attention to topics such as the use of modern technologies and information technology in nursing, evidence-based care, research-based, continuing education, and in-service training to enhance the competence of nurses, especially in critical care wards. This requires focusing more on these topics in policy makers and managers the limitations of the evaluation study are self-reporting, which requires further studies in other ways.