Construction Of The Post Competency Evaluation Index System For Nurses In Extracorporeal Membrane Oxygenation

1 Objective1.1 To construct a post competency evaluation index system applicable to extracorporeal membrane oxygenation nurses in China and to clarify the post competences that extracorporeal membrane oxygenation nurses should obtain when delivering care for patients supported by extracorporeal membrane oxygenation.1.2 To explore the applicability and reliability of the index system and to provide theoretical references for the training,assessment and qualification of extracorporeal membrane oxygenation nurses.2 Methods2.1 Semi-structured interviews based on the critical incident technique: Using purposive sampling,ICU nurses and nursing managers engaged in extracorporeal membrane oxygenation care were selected to participate in key event interviews to obtain post competency characteristics of extracorporeal membrane oxygenation nurses.Continuous comparison method and content analysis method were applied to initially formulate post competency index for extracorporeal membrane oxygenation nurses.2.2 Delphi technique: 19 experts who met the selection criteria were selected to implement two rounds of expert consultations.Statistical analysis was conducted using Excel 2019 and SPSS 25.0 software to test the authority and reliability of the result.Finally,the analytic hierarchy process was carried out to determine the weight of each indicator following 2 rounds of expert consultations to establish a post competency evaluation index system for extracorporeal membrane oxygenation nurses.2.3 Reliability test: According to the post competency evaluation index system,a self-assessment questionnaire about post competency of extracorporeal membrane oxygenation nurses was prepared.A convenience sampling method was used to select extracorporeal membrane oxygenation nurses who met the inclusion criteria for the questionnaire survey to test the reliability of the index system.Excel 2019 and SPSS25.0 software were used for statistical analysis.The general information and questionnaire scores of the respondents were described by frequency,composition ratio,mean and standard deviation;reliability was examined by Cronbach’s alpha coefficient;validity was examined by content validity index and exploratory factor analysis.A P value less than 0.05 was considered as statistical significance.3 Results3.1 Semi-structured interviews based on the critical incident technique: a total of19 interviewees completed face-to-face personal interviews,including 13 ICU nurses engaged in ECMO nursing and 6 critical care nursing managers,and a post competency evaluation index system containing 4 primary indicators,33 secondary indicators and66 tertiary indicators for extracorporeal membrane oxygenation nurses was formed preliminary.3.2 Delphi technique: A total of 19 experts in the field of critical care were included in the expert consultations of this study.The response rates of the effective questionnaires of both rounds were 100%.The authority coefficients of experts were0.834 and 0.879 respectively.The Kendall coordination coefficients of total indicators of two rounds were 0.294 and 0.281,both of which were statistically significant(P<0.001).The opinions and suggestions put forward in the two rounds of expert consultation were integrated to finally establish a post competency evaluation index system containing 4 primary indicators,28 secondary indicators and 59 tertiary indicators for extracorporeal membrane oxygenation nurses,and the weight and the consistency test result of each indicator was satisfactory.3.3 Reliability test: A total of 376 extracorporeal membrane oxygenation nurses were given the questionnaire and 376 questionnaires were returned,with 321 valid ones.The overall Cronbach’s alpha coefficient was 0.989.The scale-level content validity index was 0.971 while the item-level was 0.842～1.000.Principal component analysis was conducted to extracted 4 common factors,and total variance explained 73.913%.The average total score of the questionnaire was(248.81 ± 35.41).The three highest scoring items were items 57,19,and 18,and the three lowest scoring items were items36,12,and 31.4 Conclusion4.1 The study finally constructed a post competency index system containing 4primary indicators(professional knowledge,professional skills,professional behavior and professional attitude),28 secondary indicators and 59 tertiary indicators for extracorporeal membrane oxygenation nurses.The index system was proven to be reliable and valid.4.2 The overall competency level of extracorporeal membrane oxygenation nurses is good.The lower scoring items reflect,to some extent,the deficiencies in the current training of extracorporeal membrane oxygenation nurses.Nursing managers and educators could develop targeted training programs accordingly,to optimize the training system and improve the evaluation and qualification criteria for extracorporeal membrane oxygenation nurses.