Päivystyshoitotyön osaaminen valmistuvien sairaanhoitajaopiskelijoiden arvioimana

The care of acutely ill or injured patients in emergency nursing requires wide-ranging competencies. In patient treatment, the following aspects are emphasised: triage, patient follow-up, fast decision-making and ensuring the patient treatment path. The focus of this two-phase study is emergency nursing competence. Firstly, the term ‘emergency nursing competence’ was defined. Secondly, the emergency nursing competence of graduating nursing students and factors related to the competence were evaluated. The students assessed their emergency nursing competence themselves, and the competence of the graduating students was compared with the emergency nursing competence of registered nurses already working in the field. The purpose of the study was to define the present level of emergency nursing competence and to make necessary suggestions for the development of emergency nursing competence. In the first phase of the study (2006–2012), the data collection methods were a literature review and an expert evaluation utilising the delphi method. Based on the results of the literature review, main categories, generic categories and sub-categories were created. The sub-categories (n=61) were given to some experts (registered nurses, teachers, head nurses in the field of nursing and health care) for evaluation. On the basis of the expert assessment, 92 sub-categories describing emergency nursing competence were created. In the second phase of the study (2007–2012), the emergency nursing competence of graduating nursing students (N=382, n=208, response rate 55%) was evaluated with a tool developed for this study. The framework of the tool was the emergency nursing competence defined in the first phase of the study. Emergency nursing competence was measured on the VAS scale (scale 0–100), where the value 100 was the optimal target level. The target level of the graduating nursing students was set at 80, assuming that the emergency nursing competence of the graduating nursing students will develop along with working experience. The self-assessment of the emergency nursing competence of registered nurses already working in the field (N=586, n=280, response rate 48%) was compared with the equivalent of the nursing graduates. The results show that the emergency nursing competence of graduating nursing students, based on self-assessment, was lower than the target level. Graduating students evaluated their competence to be the highest within ethical competence and in interaction and co-operation competence. The scores were the lowest within decision-making competence and clinical competence. The registered nurses already working in the field also evaluated their own competence to be the highest in interaction and co-operation competence. They had the lowest scores in patient education competence and decision-making competence. Statistically, registered nurses had a significantly higher emergency nursing competence than students. The strongest factor explaining some of the graduating nursing students` high scores was a previous degree in nursing and health care. The suggestions for the development of emergency nursing competence focus on developing the content and, quantity of teaching within vocational upper secondary and updating education and training, teaching and study methods, the assessment of competence and career planning. Areas suggested for further study are the further development of the definition of emergency nursing competence and the tool used for assessing competence, development of various assessment methods as well as the further study of factors related to competence.