Comparison of nurse competence in different hospital work environments.
OBJECTIVE
This study examines nurses' perceptions of competence in different university hospital work environments.


BACKGROUND
Nurses' self-recognition of own level of competence is essential in maintaining high standards of care. The demands for nurse competence may vary between work environments. However, there are very few studies that compare nurse competence in different hospital work environments.


METHODS
We analysed self-assessments of competence of 593 Registered Nurses working in wards, emergency/outpatient or intensive care units or in operation rooms. The instrument used was a pretested 73-item questionnaire consisting of seven competence categories. The level of competence was assessed on a Visual Analogue Scale (VAS) scale of 0-100 and the frequency of using items of competencies in clinical practice was assessed on a four-point scale.


RESULTS
Nurses reported their overall level of competence as good. They felt most competent in the categories of Managing situations, Diagnostic functions and Helping role (VAS-means 68-69), and least competent in Ensuring quality category (VAS-mean 56). Operation room nurses compared with other nurses reported lower level of competence and lower frequency of using items of competencies in several competence categories. In general, the self-assessed level of competence was greater the higher the frequency of using of competencies. Correlations between both age and length of work experience and the self-assessed overall level of competence were positive.


CONCLUSIONS
Nurse competence profiles differed in both the level of and in frequency of using competencies between work environments. Context-specific knowledge of nurse competence from real work life situations provides direction on how to structure work environments and staff development interventions to provide qualified care.
Corporate Headquarters, Hospital District of Helsinki and Uusimaa, Vironkatu 12 B 24, Fin-00170 Helsinki, Finland. ritta.meretoja@hus.fi
Riitta
R
Meretoja
Helena
H
Leino-Kilpi
Anna-Maija
AM
Kaira
D000328:Adult; D000553:Ambulatory Care / Q000592:standards; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003422:Critical Care / Q000592:standards; D016529:Emergency Nursing / Q000193:education / Q000592:standards; D005387:Finland; D006272:Health Facility Environment / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009871:Operating Room Nursing / Q000193:education / Q000592:standards; D012647:Self-Assessment; D011795:Surveys and Questionnaires