INTRODUCTION:

Nursing, the nurturing profession is a boon to the mankind. Nursing is caring, enabling, knowledge based and competence assessed profession which is dynamic in meeting the changing health needs of society. The role of the nurse is evolving as the mode of health care delivery system has undergone major changes in the past decades.¹

To enable the nurse to assume different role in various situations, the competency areas required for staff nurses are subjected to constant review. The staff nurses are expected to possess competencies in commensurate with experience, and are accountable for practicing nursing according to the code of professional conduct, the scope of professional practice, as well as legal and ethical requirements.²

Each nurse is accountable for safe, competent and ethical nursing practice. Professional practice occurs within the context of provincial/territorial standards of practice and legislation. Nurses are expected to demonstrate professional conduct as reflected by knowledge, attitudes, beliefs and values of professional nursing practice.³Professional practice in nursing involves the demonstration of teamwork, leadership attributes, basic management skills, advocacy and socio-cultural awareness. Leadership attributes such as vision, knowledge, initiative, integrity, confidence, communication skills, and innovation are necessary for the advancement of nursing practice, the nursing profession and health care delivery system. Professional nursing practice includes awareness of the need for, and the ability to ensure continued professional development.⁴This involves the capacity to perform self-assessment, seek feedback from supervisors and plan self-directed learning activities that ensure professional growth. Nurses are expected to know how to locate and use results of research findings to inform and build an evidence-based practice.⁵

Nurses demonstrating integration of the attributes of competencies at an acceptable standard level, make their nursing practice easy and effortless, which other nurses can recognize the knowledge behind decisions, the attributes underlying the care, the abilities that permit the multitude of activities to be managed and skills that demonstrate the expertise of staff nurses in their nursing practice.⁶ The staff nurses practice independently and interdependently assuming accountability and responsibility for their own actions and delegation of care to other members of the health care team.⁷ The staff nurses provide evidence based nursing care to people of all ages and cultural groups including individuals, families, and communities. The role of the staff nurse includes promotion and maintenance of health and prevention of illness for individuals with physical and mental illness, disabilities and/or rehabilitation needs, as well as alleviation of pain and suffering at the end stage of life.⁸

NEED FOR THE STUDY:

Competent nursing personnel are assets of the healthcare delivery system. The availability of qualified and competent health care professionals is essential in providing and maintaining high standards of care. As nurses play a pivotal role in the promotion, maintenance and restoration of health, there is need to develop competent nurses who are able to take up the extended and expanded roles in the health care delivery of primary, secondary and tertiary care. Thus, apart from the roles of a care giver, the nurse needs to develop competencies to take up the roles of a health promoter, educator. counselor, case manager, researcher as well as that of a client advocate, which enables them to fulfill these roles competently and ethically.⁹

In response to worldwide changes in the health care delivery system, the demand for competent professional nurses is on the rise. The International Council of Nurses (ICN) has published the first such guidelines on essential generic competencies. The ICN Framework of Competencies for the Generalist Nurse is sufficiently broad to apply internationally, yet specific enough to provide guidance to countries developing their own competencies.⁷As a result, there is growing interest in common standards and competencies of nurses. ICN, by virtue of its global leadership role in nursing, and the fact that it represents the voice of nursing internationally, considers that the time is right to establish international competencies for the generalist nurse. In the current climate of globalization and mobility, there is need to work together to ensure safe professional nursing care. ICN intends that core competencies will help to clarify the role of nurses and guide future mutual recognition agreements and multi-country licensure programmes. The publication presents a framework of competencies for the generalist nurse at the point of entry to practice.¹¹The competencies were derived following a comprehensive review of literature from many countries and a series of consultations. To ensure that the competencies remain relevant over time in the rapidly changing healthcare environment, ICN will ensure that they are reviewed regularly, updated as required and reissued as continuing guidance to countries.¹²

In line with recent trends, there is need for developing a healthcare system that provides lifelong holistic care, promotes health, enhances the quality of life and enables human development. The provision of holistic, client centered care requires research based professional knowledge and skills through the implementation of the nursing process, the adoption of a caring and responsible attitude, effective communication and interpersonal skills as well as ethical principles. The quality of care is maintained through the enhancement of professional competencies via continuous nursing education.¹⁰

This study examines, from the patients' perspective, what is meant by competent nursing and how, with this perspective in mind, patients would view the prospect of assessing the competence of nurses. There is a little empirical research that clarifies professional competence from the patient's perspective. Patients described the foundation of competent nursing practice as technical care and nursing knowledge. Patients assume that technical care is competent as safe guards are considered to be in place to protect patients. When technical competence is assumed, interpersonal attributes become the most important indicator of the quality of nursing care.

STATEMENT OF THE PROBLEM:

“A Study to Assess the Knowledge Regarding Core Competencies in Nursing among Nursing staff Working At Selected Hospitals In Bengaluru with a view to provide information booklet”.

OBJECTIVES:

1. To assess the knowledge of staff nurses on core competencies in nursing.

2. To find the association between knowledge with selected demographic variables.

3. To provide an information booklet to improve core competencies in nursing practice.

OPERATIONAL DEFINITIONS:

Core competencies in nursing

The essential competencies that a staff nurse is expected to possess, to provide safe, effective and ethical care.

Knowledge

It is the ability of the staff nurses to respond to the structured knowledge questionnaire on core competencies in nursing as evident from their knowledge score.

Staff Nurse

A nurse who has successfully completed G.N.M./ B.Sc. Nursing / P.B.B.Sc Nursing and registered with State Nursing Councils.

ASSUMPTIONS

1. Staff nurses have basic knowledge regarding core competencies in nursing.

2. Staff nurses are willing to participate to improve their knowledge of core competencies in nursing.

LIMITATIONS OF THE STUDY:

This study is limited to

1. Staff Nurses who are working at Victoria Hospital, Bengaluru.

2. Staff Nurses who are willing to participate in the study.

3. Staff Nurses who are present at the time of data collection.

RESEARCH METHODOLOGY:

Research Approach

The present study is a descriptive survey approach to assess knowledge regarding core competencies in nursing among staff nurses working at Victoria Hospital, Bengaluru.

Research Design

Descriptive survey design was selected to find the knowledge regarding core competencies in nursing among staff nurses working at Victoria Hospital, Bengaluru.

Variables under study

Dependent Variable

Knowledge level of core competencies in nursing among staff nurses.

Independent Variables

Age, Gender, Religion, Professional Qualification, Additional Nursing qualification, marital status, professional experience and in-service education programme.

Setting of the study

This study was conducted on staff nurses working at selected hospitals, i.e., Victoria Hospital, Bengaluru.

Population

The population for the study was staff nurses working at Victoria Hospital, Bengaluru.

Sampling and sampling technique

Sample

Staff nurses working at Victoria Hospital, Bengaluru.

Sample size

Total 80 staff nurses working at Victoria Hospital, Bengaluru.

Sampling technique

Simple Random sampling technique was used to select the sample.

Criteria for the selection of sample

Inclusion Criteria

Staff Nurses with more than two years of experience.

Staff Nurses, willing to participate.

Staff Nurses available at the time of study in the hospitals.

Exclusion Criteria

Staff Nurses with less than two years of experience.

Staff Nurses, who are not willing to participate.

Selection of the tool

A self-administered structured questionnaire was felt to be appropriate to assess knowledge regarding core competencies among nurses working at Victoria Hospital in Bengaluru.

Development of the tool

The structured questionnaire developed, was based on the domains of the core competencies in nursing. Steps adopted in the development of the tool are,

Review of literature, which provides adequate content for the tool preparation.

Consultation with experts like, Nursing educators, Hospital administrators and Nursing administrators.

The past clinical experience of the investigator provided relevant data necessary to construct the tool on core competencies in nursing.

Description of the tool

The structured questionnaire was designed and developed with three sections consisting of 78 items as follows,

Section –I Consists of 8 items pertaining to demographic variables of the respondents such as age, sex, marital status, educational qualification, years of experience, religion, additional nursing qualification and exposure to In-Service education.

Section-II Consists of 35 items, based on the four domains was prepared in the form of multiple choice questions with one appropriate answer pertaining to knowledge on core competencies in nursing. Each correct response was allotted a score of one and a wrong response a score of zero.

Description of the Informational Booklet:

The Guide sheet was titled as “Core Competencies in Nursing” which included introduction, definition, domains of competencies and indicators of competencies. The contents of guide sheet were as follows:

· Introduction

· Definition of core competencies

· Domains of core competencies

· Performance Criteria /Standards of core competencies.

MAJOR FINDINGS:

1. Results of demographic characteristics

Majority of the respondents belong to the age group of 30-37 and 38-47 years of age group with majority of female respondents married (77.5%) compared to unmarried respondents in the study.

50.5 per cent of the respondents are Hindus compared to Christians (45.2%). Regarding professional qualification majority (54.4%) were GNMs and additional nursing qualification found among only 10.8 per cent of respondents.

Higher respondents (52.5%) found with experience between 5-10 years compared to below 5 years of experience respondents (21.3%). Nursing in-service education programme acquired by 32.2 per cent of respondents among the study group.

2(a). Overall and Domain wise mean knowledge of respondents

The overall mean knowledge score was found to be 59.5 per cent with SD as 11.4 per cent among the respondents on core competencies. .

Higher respondents (66.2%) found with moderate knowledge compared to 33.8 per cent with moderate knowledge. However, the association was found to be statistically significant (P<0.05)

2(b). Domain wise mean knowledge about core competencies respondents

The mean knowledge about core competencies on different domains ranged between 52.0 per cent in management of nursing care and 53.6 per cent in collaborative health care and professional development. The overall mean knowledge was 55.6 per cent.

3(a). Association between knowledge of Respondents with Demographic variables

It was found that higher the age of respondents lesser is the knowledge level on core competencies. It was statistically non-significant association between age and knowledge level of respondents (P>0.05).

Female respondents indicate better adequate knowledge level compared to male respondents. However, statistical non-significant association found between gender and knowledge level of respondents (P>0.05).

The knowledge level of respondents with P.B.B.Sc.(N) had slightly better knowledge compared to respondents of GNM and B.Sc. (N) background on core competencies. However, the association was found to be non-significant (P>0.05).

Higher the total professional experience of respondents lesser is the knowledge level on core competencies. However, statistically significant association was found between experience and knowledge level of respondents (P<0.05). Respondents with in-service education had higher knowledge as compared to respondents without in-service education programme. There exists a significant association between educational programme and knowledge level (P<0.05) of core competencies.

It can be summarized that out of 8 demographic variables under study two variables i.e., experience and in-service education programme found significant association with the knowledge level of respondents on core competencies (P<0.05) i.e. Hypothesis (2) is rejected.

Further, for four variables viz., age, gender, religion, marital status, educational qualification, additional nursing qualification was found to be non-significant with knowledge level of respondents on core competencies (P>0.05) i.e. Hypothesis (2) is accepted.

DISCUSSION:

The above topic is discussed under the following headings.

1. Demographic characteristics of respondents.

2. a) Overall mean knowledge of respondents

b) Domain wise mean knowledge about domains on core competencies of respondents.

3. Association between knowledge and demographic characteristics.

1. Demographic characteristics of respondents

Classification of respondents on age indicate that majority of the respondents belong to the group of 30 – 37 years (56.6 %) and 38-47 years (30.0%). Majority of the respondents (77.5%) were females and remaining 22.5 per cent were male respondents. Regarding marital status majority (67.5%) of the respondents were married compared to 23.8 per cent who were unmarried.

Majority of the respondents were found to be Hindus background (50.5%) compared to Christians with 45.2 per cent. The classification on professional education indicates that 54.4 per cent GNM and 23.5 per cent respectively B.Sc. (N) and P.B. B.Sc.(N) only 22.1 per cent of respondents selected possess with additional nursing qualification.

52.5 per cent of the respondents had professional experience of 5 – 10 years compared to 21.3 per cent found below 5 years of experience. Lesser per cent of respondents (28.8%) possess with in-service education programme in the finding group.

2 a) Overall mean knowledge of respondents

35 statements considered for knowledge measurement. The overall mean knowledge score of respondents was found to be 59.5 per cent and SD at 11.4 per cent.

2 b) Domain wise mean knowledge about domains on core competencies of respondents

The result showed that the mean knowledge of respondents as 5.5 per cent. The domain wise mean knowledge noticed to be 52.0 per cent to 55.6 per cent among respondents.

3 a) Association between knowledge and demographic variables

Higher per cent of respondents in the age group of 26 – 29 (63.2%) and 30 – 37 years (75.7%) had moderate knowledge compared to later age group. The association between knowledge level and age showed non-significant findings (X²= 3.12 ^NS, P>0.05).

Female respondents (77.8%) had slightly higher adequate knowledge as compared to male respondents (51.9%). However, the association between knowledge level and gender found to be non-significant (X²=0.24 ^NS, P>0.05).

P.B. B.Sc.(N) was found to be slightly higher (70.6%) compared to GNM and B.Sc. (N) respondents. Statistical association was found to be non-significant between professional qualification and knowledge level of respondents (X²=0.18 ^NS, P>0.05).

Respondents with less professional experience possess higher knowledge as compared higher experience respondents found with inadequate knowledge. Further significant association noticed between experience and knowledge level of respondents on core competencies (X²=13.88*, P<0.05).

Higher per cent of respondents with in-service education programme found with moderate knowledge compared to respondents without in-service education programme. The association between in-service education programme and knowledge level of respondents on core competencies was found to be significant (X²=3.85*, P<0.05).

Among 8 demographic variables under study to understand the association with knowledge of respondents and core competencies, it was noticed that two variables i.e., profession experience and in-service education programme were found to be statistically significant at 5 per cent level (P<0.05).

IMPLICATIONS:

The finding of the study can be used in the following areas.

Nursing practice

· Nursing professional will be able to find opportunities to teach and improve knowledge and practice of core competencies in nursing.

· The guide sheet developed by the investigator can be used by staff nurses to improve knowledge and practice of core competencies in nursing.

Nursing Education

· As a nurse educator, with the knowledge of core competencies in nursing, there are abundant opportunities to educate and prepare students to provide quality nursing care in the clinical settings.

· The study emphasizes the significance of assessment of knowledge and practice of core competencies in nursing education and among nurses to improve knowledge and practice to provide safe and effective care to the clients.

Nursing Administration

· The nursing administrator should take part in health policy making, developing domains related to core competencies in nursing

· The nursing administrator should concentrate on the development of indicators/performance criteria to assess and observe the competent behavior among nurses.

Nursing Research

This study helps nurse researchers to develop interest in the development of core competencies in nursing practice.

RECOMMENDATIONS:

On the basis of the findings of the study, the following recommendations have been made.

· A similar study can be replicated on a large sample to generate the findings.

· A similar study can be done to assess the practice of Nursing staff.

· An experimental study can be undertaken with a control group for effective comparison.

· A study can be conducted on specific competencies in specialty areas.

· A comparative study can be conducted between private and Government Hospitals.

CONCLUSION:

The study was conducted to assess knowledge about core competencies among nurses working in selected hospital. In the present study 80 nurses as respondents were selected using purposive sampling method procedures. The research approach adapted to the present study is a descriptive survey design with a view to measure knowledge and practice regarding core competencies in nursing among nurses. The data was collected by a structured questionnaire. The data was interpreted with suitable application of statistical methods.

REFERENCES:

1. College of Nurses of Ontario. Entry to Practice Competencies for Ontario Registered Nurses. Toronto. 2005.

2. Victoria Hird, Nursing competencies- The Artistry of Nursing. Australian Nursing Council, conference paper II. 2003.

3. Parsons R. Nursing Competencies, The Australian Nursing Journal. July 21, 1992 (6) 78-79.

4. Nursing Council of New Zealand. Competencies for the registered nurse scope of Practice. New Zealand. 2005.

5. National Board for Nursing, Midwifery and Health Visiting for Scotland. Core skills and competencies for nursing. 2001.

6. Benner. P. From Novice to Expert. Menlo Parkcalif: Addision Wesley.1984.

7. Judith Oulton. International Council of Nurses (ICN) Position statement of scope of nursing practice. Geneva. 2003

8.     McGregor RJ. A Framework for developing staff competencies. Journel Nursing Staff Development. 1990 Mar-Apr, 6 (2) 79-83.

9. Schon, D A. Educating the reflective Practitioner San Francisco, Josey Bass 1998.

10. Heywood, L., Hager, P. A Guide to Development of Competency Standards for Professions. NOOSR Research paper no 7 Canberra.1992

11. The Hospital Authority of Hong Kong. Core –Competency Sets for Nursing Staff. Hong Kong SAR: Author 2002

12. Calman L. Patients' views of nurses' competence. Nurse Educ Today. 2006 Dec;26(8):719-25. Epub 2006 Oct 2. School of Nursing, Midwifery and Social Work, The University of Manchester, Coupland 3, Oxford Road, Manchester M13 9PL, UK.

Received on 27.01.2016 Modified on 17.02.2016

Asian J. Nur. Edu. and Research. 2016; 6(3): 307-312

DOI: 10.5958/2349-2996.2016.00057.4