Construction Of Nurse Competency Model In Tertiary Hospitals In Hebei Province

Objective:To construct a scientific,effective and practical nurse competency model for tertiary hospitals in Hebei Province,and provide scientific theoretical basis for nursing human resource management in tertiary hospitals in Hebei Province.Methods:The first stage: The initial model was constructed through literature review and semi-structured interviews.The Chinese and English databases were searched to collect relevant papers on the nurses competency model,and the nurse competency indicators were analyzed.Referring to the 360-degree feedback method,excellent nurses,head nurses,directors of nursing department,department heads,doctors and patients of a tertiary hospital in Hebei Province were selected to accept semi-structure interviews to collect nurse competency indicators from multiple perspectives,aiming to form an initial model based on the characteristics of nurses in the tertiary hospitals of Hebei Province.The second stage: The final model is determined by Delphi technique and Analytic Hierarchy Process.The questionnaire was formulated based on the initial model,and it included the name,the definition of each competency indicators and behavior descriptions at four levels;25 experts from 11 cities in Hebei Province were selected;experts were invited to judge the importance of each competency by the Likert 5 scoring method and propose suggestions to the behavioral descriptions;To modify the indicators by analyzing the mean,the standard deviation and the variable coefficient of the indicators and the suggestions proposed by the experts;to analyze the reliability of the suggestions by employing the expert positive coefficient and the authority coefficient;to employ the Kendall’s coefficient of concordance(W)to test the consistency of the suggestions of the experts;The Analytic Hierarchy Process was used to derive the weights of the competency indicators to form the final model.Results:The first stage: A total of 41 articles were included in the literature review,and 33 nurses competency indicators were obtained.A total of 24 competency indicators that appeared equal or more than twice in all interviews were screened by content analysis.Finally,the initial model was formed through the group analysis which included 3 first-class indicators,and 24 second-class indicators.The second stage:After the first round of consultation,the content of the self-evaluation form of one expert was“unfamiliar”,24 experts completed the two rounds of investigations.The average age of the experts was 44.46±7.66 years,the years of working in this field were 24.33±9.17 years;19 experts(79.17%)had undergraduate degree,4 experts(16.67%)had master’s degree,1 expert(4.17%)had doctoral degree;16 experts(66.67%)had associate senior professional title or above;In the first round,20 suggestions were proposed by 13 experts,2 second-class indicators were added and 6 were revised;In the second round,9 suggestions were proposed by 6 experts and 2 second-class indicators were revised.In the two rounds of consultation,the expert positive coefficient is 96%-100%,the expert authority coefficient is 0.84,the coefficient of variation is 0.00-0.19,and the Kendall ’ s coefficient of concordance is 0.245-0.317(P<0.001),which show good concordance between the experts and the high reliability of the result of the investigation.According to the Analytic Hierarchy Process,the weights of the three first-level indicators are: occupational qualities(0.539),personal traits(0.164),and professional abilities(0.297);the top 10 in the 26 second-class indicators are: responsibility(0.110),love and dedication(0.093),professional knowledge and manipulative skills(0.072),disease observation ability(0.072),helping and human service(0.071),self-supervision spirit(0.071),teamwork(0.058),emergency response ability(0.051),attention to detail(0.048),diligent in thinking(0.041).Conclusion:The research combines literature review,semi-structured interview,Delphi technique and Analytic Hierarchy Process to construct the nurse competency model in tertiary hospitals in Hebei Province.The final model includes 3 first-level competences(occupational qualities,personal traits,professional abilities),and 26 secondary-level competences(love and dedication,teamwork,responsibility,helping and human service,self-supervision spirit,empathy,attention to detail,Work coordinating,diligent in thinking,emotional regulation,initiative,self-confidence,self-motivation,adaptability,self-examination,innovation,interpersonal skill,honesty and integrity,professional knowledge and manipulative skills,disease observation ability,health education ability,emergency response ability,communication and coordination ability,learning capacity,scientific research capacity,clinical teaching ability),each of the secondary-level competency indicators has behavior descriptions at four level,level of unqualified,level of qualified,level of excellent,and level of superb,with detailed behavioral descriptions.Combining the opinions of nursing management experts,hospital management experts,nurses,department heads,doctors and patients,the nurse competency model is scientific and effective,which can provide guidance for the practice of nursing human resource management in tertiary hospitals in Hebei Province.This study only constructs a scientific theoretical model,and it needs to be verified and improved in the practice of nursing human resource management in the future.