Care home nursing professionals' competence in older people nursing

Reforms in aged care have influence on nursing practice. Therefore, it is important to be aware of the current competence requirements and of the preparedness of nursing staff to meet these competence demands in older people nursing. The purpose of this study was to identify and describe competence requirements in older people nursing in care homes and to describe and predict care home nursing professionals’ self-assessed competence. In addition, the purpose was to develop a self-assessment instrument that can be used to measure care home nursing professionals’ competence in older people nursing. The main focus of the study was on competence of nursing professionals who take care of older people in Finnish care homes that provide intensive service housing. In phase one, a Delphi study and an interview study were conducted to identify the required competence. An expert panel of professionals (n=38) was recruited for the Delphi study, which involved two rounds and was preceded by an integrative literature review (n=10). In total, 18 care home residents’ family members were involved in the interview study. In phase two, a web-based survey that explored care home nursing professionals’ (n=781) selfassessed competence was conducted. Survey participants worked either as licensed practical nurses (n=680), as registered nurse and/or in managerial positions (n=101). The psychometric properties of the instrument were tested after collecting the survey data. Inductive qualitative content analysis, descriptive statistics and multivariate methods were used in data analysis. According to this study there are several aspects of competence in older people nursing in care home. These include ethical, interactional, cooperation, clinical, guidance, leadership and development competence, as well as competence in promoting the wellbeing of older people. While most participants described their competence as good or adequate, the measurement of these aspects revealed several gaps in care home nursing professionals’ self-assessed competence. Older age and further training were predictors of higher self-assessed competence of the participants working in licensed practical nurse positions, while longer work experience in intensive service housing was a predictor of higher self-assessed competence for registered nurses/managers. A new competence selfassessment instrument, the Nurse Competence in Care Home Scale, was developed, which contains 84 statements under seven subscales. In conclusion, multifaceted competence is required for older people nursing in care homes. Not all care home nursing professionals’ competence is adequate, and it is recommended that nurses, managers, educators and those responsible for development of nursing curricula strive to promote competence in older people nursing. The Nurse Competence in Care Home Scale can be used to assess care home nursing professionals’ competence in older people nursing. The instrument should be further developed in the future. National Library of Medicine Classification: WY 152 Medical Subject Headings: Geriatric Nursing; Nurses; Nursing Staff; Professional competence; Nursing Homes; Homes for the Aged; Residential Facilities