title: Sufficient competence in community elderly care? Results from a competence measurement of nursing staff.
abstract: BACKGROUND
  Multi-morbidity, poly-pharmacy and cognitive impairment leave many old patients in a frail condition with a high risk of adverse outcomes if proper health care is not provided. Knowledge about available competence is necessary to evaluate whether we are able to offer equitable and balanced health care to older persons with acute and/or complex health care needs. This study investigates the sufficiency of nursing staff competence in Norwegian community elderly care.
  
  
  METHODS
  We conducted a cross-sectional survey of 1016 nursing staff in nursing homes and home care services with the instrument "Nursing Older People - Competence Evaluation Tool". Statistical analyses were ANOVA and multiple regression.
  
  
  RESULTS
  We found that nursing staff have competence in all areas measured, but that the level of competence was insufficient in the areas nursing measures, advanced procedures, and nursing documentation. Nursing staff in nursing homes scored higher than staff in home care services, and older nursing staff scored lower than younger nursing staff.
  
  
  CONCLUSIONS
  A reason for the relatively low influence of education and training on competence could be the diffuse roles that nursing staff have in community elderly care, implying that they have poor standards against which to judge their own competence. Clearer role descriptions for all groups of nursing staff are recommended as well as general competence development in geriatric nursing care.
authors.affiliation: Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
authors.forename: Pia Cecilie
authors.initials: PC
authors.lastname: Bing-Jonsson
authors.affiliation: Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
authors.forename: Dag
authors.initials: D
authors.lastname: Hofoss
authors.affiliation: Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Kirkevold
authors.affiliation: Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
authors.forename: Ida Torunn
authors.initials: IT
authors.lastname: Bjørk
authors.affiliation: Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
authors.forename: Christina
authors.initials: C
authors.lastname: Foss