| New nurse is the new force in the nursing team and the development of hospital nursing in the future.According to the《State of the World’s Nursing Report-2020》compiled by the World Health Organization(WHO),the number of worldwide nurses had increased by 4.7 million from 2013 to 2018,but there is still a gap of 5.9 million,this means that there will be a large number of new nurses join to the clinic.At the same time,with the proposal of the concept of healthy China,the aging of China’s population is worsening,the people’s demand for nursing services is constantly improving,and the number of new nurses in China is also growing rapidly.From 2015 to 2020,the number of nurses in China has increased by nearly 1.5 million.The new nurses injects vitality into clinical nursing team,but because of the relative lack of professional knowledge,skills and clinical experience,there is still a certain gap between new nurses and professional nurses.They haven’t formed completely clinical thinking system,attitudes and values,some skills will need to be further improved,such as clinical communication,clinical collaboration,the prudence and self-discipline.Because the post competency of new clinical nurses is directly related to the clinical nursing quality and safety.As a result,it is necessary to establish a scientific post management and evaluation system for new clinical nurses to quantitatively evaluate their post competency.Our intention is to encourage the excellent staff and train the incompetent person for them.This is also the need to adapt to the development of nursing profession and constantly improve the quality and connotation of nursing.However,the research on the competency evaluation of new nurses starts late in China in recently,lack of operational evaluation tools.Therefore,we intend to study to develop a set of post competency assessment tools for new clinical nurses,to provide a reference for new nurses’ evaluation,targeted training,assessment and post management.Objective:1.The competency factors of the new clinical nurse post were extracted,and the competency evaluation index system of the new clinical nurse post was preliminarily formulated and constructed.2.We verified the scientificity and feasibility of the index system through investigation,and established the competency evaluation index system for new clinical nurses.3.We have applied the evaluation index system of the post competency of clinical new nurses into practice,exploring the status and influencing factors of the post competency of new nurses through multi-agent evaluation,to provide reference for the proposal of countermeasures and suggestions based on post competency management.Methods:1.We based on the post competency theory,through job analysis,literature analysis,semi-structured interview and expert group discussion,extracted the post competency factors of new clinical nurses.The indexes are screened,supplemented and improved by Delphi method.We used the Analytic hierarchy process(AHP)to determine the weight of the index system.We initially constructed a preliminary evaluation index system for the post competency of new clinical nurses.2.We conducted a questionnaire survey on 701 new clinical nurses from three GradeⅢ hospitals in Xi’an by using the post competency evaluation index questionnaire.Firstly,we tested the reliability of the index system by internal consistency test,split-half reliability and test-retest reliability.Secondly,We used the Exploratory factor analysis and confirmatory factor analysis were used to test the validity of the questionnaire.Finally,we established the evaluation index system of new clinical nurses.3.We select 312 new nurses by adopted convenience sampling method from a GradeⅢ hospital in Xi ’an.With the questionnaire for Post Competence Evaluation of new clinical nurses as the survey tool,the post competence of new clinical nurses was evaluated by multiple subjects,and analyzed the current status and influencing factors of new clinical nurse post competency.Results:1.We extracted 29 competency factors of new clinical nurses by job analysis,36 competency factors of new clinical nurses by literature analysis,and 48 competency factors by semi-structured interview.With the three methods,52 competency factors were extracted.After the discussion of the expert group,We developed a new clinical nurse post competency evaluation index system finally preliminarily,including 4 first-level indicators,13 second-level indicators and 63 third-level indicators.2.Through literature review and semi-structured interview,the post competency factors of new clinical nurses were extracted.After two rounds of Delphi expert letter consultation,the indicators were screened and standardized,a post competency evaluation indicator system for new clinical nurses was finally formed,which included 3 first-level indicators,8 second-level indicators and 62 third-level indicators.The weights of different indexes were divided by the analytic hierarchy process(AHP),and the weights of the three first-level indexes were 0.503,0.321 and 0.176.Among the secondary indicators,the indicators with higher weight are professional knowledge,values,professional attitude and professional skills.3.According to the post competency index system of new clinical nurses,we To compiled the "Post Competency Evaluation Questionnaire for New Clinical Nurses",we tested the reliability and validity of the questionnaire.(1)The reliability test results show that the total Cronbach’s α coefficient of the questionnaire is 0.961,the Cronbach’s α coefficient range of the first-level index is 0.819～0.946,and the Cronbach’s α coefficient range of the second-level index is 0.780～0.841.The internal consistency of the questionnaire is well.According to the items by random order,Cronbach’s α the split-half reliability was calculated,and the total split-half reliability of the questionnaire was 0.904,the split-half reliability of each dimension of the first-level indicators ranged from 0.801 to 0.874,and the range of split-half reliability of each dimension of the second-level indicators ranged from 0.804 to 0.945,all results higher than 0.8.The test-retest reliability of the questionnaire is 0.935,P=0.005,the test-retest range of each dimension of the first-level index is 0.866～0.978,and that of each dimension of the second-level index is 0.707～0.973.It suggested that the test-retest of the questionnaire is good.(2)The results of the validity test showed that the total Content validity ratio of the questionnaire was 0.909,the content validity range of each dimension of the first-level index was 0.908～0.922,the content validity range of each dimension of the second-level index was 0.905～0.933,indicating a good content validity.The correlation coefficients between all items and the total score were above 0.4;KMO was 0.966,Bartlett’s sphericity test was χ2=30492.788,P<0.01,it is suitable for factor analysis.Through exploratory factor analysis,eight factors with characteristic roots greater than 0.9 were extracted for structural validity,and the total cumulative variance contribution rate of the eight factors was 74.086%.The classification and naming of the indicators included in each common factor,the generalized meaning is basically consistent with the previous preset,and the preset 8 dimensions are still maintained,namely,humanities and social science knowledge,professional knowledge,professional skills,scientific research ability,management ability,professional attitude,values,and personal traits.The confirmatory factor analysis(CFA)and structural model fitting test results of first-level indicators wereχ2/df=2.930,AGFI=0.941,NFI=0.913,NNFI=0.954,CFI=0.920,RMSEA=0.056.Confirmatory factor analysis fitting indexes of secondary indexes were χ2/df=2.090,AGFI=0.808,NFI=0.922,NNFI=0.903,CFI=0.907,RMSEA=0.064,which all met the requirements of surveying.(3)According to the results of convergent validity and differentiate validity analysis,the secondary indicators of factor loading were greater than 0.5,the average variance of the latent variables extracted values were greater than 0.5,the combination of the primary index of reliability CR is greater than 0.7,the secondary index of each dimension of CR is greater than 0.8,questionnaire convergent validity ideal,and each has a certain correlation among latent variables,but also has a certain degree of differentiation each other.4.The results of the survey on the competency of new clinical nurses showed that:(1)The results showed that the first-level indicators scores from low to high were knowledge,ability,values and personal characteristics,the scores were respectively 84.15±10.99,85.13±10.03,91.27±9.08,the second-level indicators scores from low to high were scientific research ability 77.49±14.98 and management ability 78.32±14.53,humanities and social science knowledge 83.02±11.76,professional knowledge 85.64±9.97,professional skills 86.02±10.74,personal characteristics 88.05±9.69,values 91.22±10.48,professional attitude 91.30±10.08;Among the third-level indicators,the scores of the first five indicators were writing ability of scientific research paper 79.18 ± 13.54 and innovation ability 80.19±13.38,statistical analysis ability 80.22±14.11,study design and implementation ability 80.69±13.43,data collection ability 81.69±13.18.(2)One-way ANOVA results showed that there were statistically significant differences in humanistic and social science knowledge,professional knowledge,professional skills,scientific research ability,management ability,professional attitude and values among new clinical nurses of different years,titles,educational backgrounds and departments(P<0.05).The results of multiple linear regression analysis showed that the influencing factor of professional skill dimension was department(P<0.05).The influencing factor of scientific research ability was educational background(P<0.05).The influencing factor of management ability was educational background(P<0.05).The influencing factor of values was gender(P<0.05).Different evaluation subjects’evaluation results have different correlations in different dimensions.(3)The results of multi-subject competency evaluation of new clinical nurses showed that there was a significant positive correlation(P<0.05)between the chief nurse and the supervisors nurse in the dimensions of humanities and social science knowledge,professional knowledge,professional skills and scientific research ability,and there was a certain correlation between the head nurse and the self-evaluation of nurses,but it didn’ t reach a significant level.In terms of management ability,there was a significant positive correlation between the chief nurse and the supervisor nurses((P<0.05),and a negative correlation between the self-evaluation of nurses and the chief nurse.In terms of professional attitude,values and personal traits,there was a significant positive correlation between the evaluation results of the supervisor nurse((P<0.05),and there was a certain correlation between the chief nurse and the self-evaluation of nurses,but it did not reach the significant level.Conclusions:1.In this study,an evaluation index system for the post competency of new clinical nurses was constructed,which contains 3 first-level indicators,8 second-level indicators and 62 third-level indicators.It is scientific and practical and can be used to evaluate the competency of new clinical nurses.It also provided a scientific and effective tool for the new clinical nurse competency assessment.2.Multiple subjects were selected to evaluate the post competency of new clinical nurses to understand their current competency status and influencing factors,providing reference for the proposal of competency management for new clinical nurses. |
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