The Construction Of Stratified Index System Of Geriatric Nursing Competence Of Clinical Nurses Based On Nursing Clinical Ladder Program

Objective:1.To initially construct the stratified index system of geriatric nursing competence of clinical nurses based on the understanding and suggestions of senior elderly nursing workers.2.To revise the stratified index system of geriatric nursing competence of clinical nurses,and determined the weight of each index at each level.Methods:Based on literature review and theoretical analysis,this study extensively collects relevant items to form an item pool.Then,based on the theoretical framework of our previous research,face-to-face semi-structured interviews with geriatric nursing experts were conducted from June to September 2019.Combined with the interview results,the contents of the initial item pool were verified and supplemented and the stratified index system of geriatric nursing competence of clinical nurses was preliminarily constructed.Items were screened and modified through Delphi method to determine the content of the formal system.The weighting coefficients of each indicator were generated by the sequence diagram method and Delphi method.Results:1.Through in-depth interviews with 12 geriatric nursing experts engaged in clinical nursing,nursing management and nursing education,and combined with the results of previous literature review,the stratified index system of geriatric nursing competence of clinical nurses was preliminarily formed,including three first-level indicators,ten second-level indicators,and third-level indicators:30indicators at basic practice level,47 indicators at competent practice level and 54 indicators at advanced practice level.2.A total of 18 geriatric nursing experts participated in two rounds of expert consultation,and the effective recovery rate of the two rounds of questionnaires was 100%.The degree of familiarity of experts,the coefficient of judgment and the degree of authority were 0.867,0.961,0.914,respectively;The coefficients of variation of each index in the two rounds of consultation were 0.00～0.31 and 0.00～0.27,respectively.The Kendall’s W in the two rounds were 0.091～0.824 and 0.084～0.778respectively(P<0.05).Finally,it was determined that the stratified index system of geriatric nursing competence of clinical nurses included three levels,including three first-level indicators,ten second-level indicators and third-level indicators:31 indicators in basic practice level,39 indicators in competent practice level and 49 indicators in advanced practice level.3.The weight value of first-level indicators at basic practice level,competent practice level and advanced practice level are as follow:Professional literacy(0.3611,0.3519,0.3148),Professional practice(0.3889,0.3519,0.3519),Professional development(0.2500,0.2963,0.3333);The weight value of second-level indicators are as follows:Law and ethics(0.1204,0·1155,0.1038),Critical thinking(0.1162,0.1169,0.1061),Professional knowledge(0.1246,0.1195,0.1049),Clinical practice(0.1321,0.1173,0.1191),Safety management(0.1306,0.1186,0.1177),Communication and consultation(0.1262,0.1160,0.1151),Quality management(0.0652,0.0769,0.0840),Leadership and education(0.0585,0.0716,0.0850),Professional learning(0.0702,0.0769,0.0831),Research and innovation(0.0560,0.0708,0.0812),Conclusion:1.Through literature research,qualitative interview and Delphi method,the stratified index system of geriatric nursing competence of clinical nurses was established,including basic practice level(three first-level indicators,ten second-level indicators,thirty-one third-level indicators),competent practice level(three first-level indicators,ten second-level indicators,thirty-nine third-level indicators)and advanced practice level(three first-level indicators,ten second-level indicators,forty-nine third-level indicators).The weight value of three levels of indicators were determined based on the sequence diagram methodand Delphi method.2.The construction of this system provides a theoretical basis for the construction of a stratified training program for geriatric nursing competence of clinical nurses,and provides a basis for nursing managers to carry out stratified and standardized training,assessment and evaluation of geriatric nursing competence of clinical nurses.