Construction Of Core Competence Training Course For New Nurses In Primary Hospitals

Objectives:1.Assess the basic level of core competence of new nurses in primary hospitals;2.Construct an appropriate training course for new nurses in primary hospitals;3.Verify the effectiveness and feasibility of the training course.Methods:Through literature analysis,semi-structured interview and Nurses’ Core Competence Assessment Scale designed by Liu Ming,this study constructed a content item pool of the core competence training course for new nurses in primary hospitals,on the basis of fully assessing the current status of core competence of new nurses in primary hospitals,combined with the training program of National Health Commission of People’s Republic of China and Jiangsu Commission of Health for new nurses.Then,two rounds of Delphi expert consultation were conducted to develop the "Core Competence Training Course for New Nurses in Primary Hospitals",which were validated in primary hospitals.1.Cross-sectional survey based on core competence:A total of 45 new nurses from three primary hospitals in Jingjiang recruited in 2018 were selected for baseline survey according to Liu Ming’s scale "Framework of Core Competence of Registered Nurses in China".After that,the results of the cross-sectional survey and training needs of the new nurses were analyzed.2.Construction of core competence training course for new nurses in primary hospitals:According to the results of cross-sectional survey and combined with interviews with heterogenous groups,the item pool of "Core Competence Training Course for New Nurses in Primary Hospitals" was formed.Based on the item-pool of the preliminary training course,opinions of experts on training from hospitals of the same level and new nurses were solicited.Through literature review and according to the training guidelines of National Health Commission,preliminary modules of the training course based on core competence were established.Two rounds of Delphi expert consultation were conducted among 18 experts selected from primary and tertiary hospitals in Jiangsu Province to repeatedly consult,induce and modify the feasibility of all items in the core competence curriculum until a consensus was reached,and finally the core competence training course for new nurses in primary hospitals was constructed.3.Validation of the core competence training course for new nurses in primary hospitals:Using the core training course formed in the previous study,developing core knowledge points for training,selecting various forms of training methods for pre-training,31 new nurses recruited by Jingjiang People’s Hospital in August 2018 were selected to receive training for three months and their core competence was assessed at the orientation and at after three months respectively.A comparison of their core competence before and after the three-month training was made.At the same time,the core competency assessment indicators and the job satisfaction of the nurses were retrospectively compared with those of new nurses from previous years.Results:1.The results of the cross-sectional survey based on core competence showed:the core competence scores of new nurses were relatively low,with critical thinking ability,education and counseling ability,and clinical nursing skills having the lowest scores,all lower than average.Among them,the newly recruited nurses scored the lowest(P<0.01)in items such as analyzing patients’ crisis,adapting to new work environment,making good clinical decisions,comprehensive implementation of nursing practice,and acceptance of pre-employment training programs.2.The results of construction of core competence training course indicated:The opinions of provincial and primary-level training experts as well as new nurses combined with literature review were used to construct training courses according to the training guidelines of the National Health Commission.Two rounds of Delphi expert consultation were conducted and finally 36 lessons in 8 dimensions were developed,which include:7 lessons of Critical Thinking Ability,8 lessons of Clinical Nursing Skills,3 lessons of Communication Skills,3 lessons of Caring Ability,3 lessons of Education and Consulting Ability,3 lessons of Interpersonal Relationship Skills,2 lessons of Professional Development Ability,and 7 lessons of Legal Ethics Practice.The average positive coefficient of the experts was 97%;the average authoritative coefficient was 0.731;the variation range of the two rounds was 0.100～0.234,and the coordination coefficient was 0.302～0.403,P<0.01.3.Main results of the training course application showed:①Self-control before and after the core competence training of the new nurses:the ability in seven dimensions,such as critical thinking,clinical nursing skills,professional development,and consulting and education and so on has been significantly improved(P<0.01);②Job satisfaction of new nurses:the post-training survey showed that nurses’ satisfaction with nursing work was as high as 94.76%.The 31 new nurses had 100%satisfaction with flexibility of working time,degree of mutual recognition between superiors and colleagues,degree of participation in decision-making,number of encouragement and positive feedbacks,degree of responsibility,and self-control of the environment,etc.They were found to be competent as a nurse.③Comparing the effect of the core competence training course for new nurses with that of the previous routine training:in the process of clinical practice,the nurses had significant improvement in critical thinking,observation and assessment of the disease,standardized skills,and the mastery of specialty knowledge,etc.Their actual work capacity was significantly improved(P<0.05).There was a statistically significant difference between 2018 and 2017,2016(P<0.01).Conclusion:The pre-service training course based on core competence for new nurses in primary hospitals has its theoretical foundations,and is not only in line with the standardized training of new nurses of the National Health Commission,but also can be combined with the characteristics of primary hospitals.It is both scientific and applicable.Through individualized training and adaptation to local conditions,it helps new nurses to become accustomed to their role as a nurse and adapt to the working environment as soon as possible,and improves their clinical problem-finding and problem-solving skills.This training course can provide some reference for the training of new nurses in all primary hospitals.