SEARCH · PubMed Health

Results for “Competency framework”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources

PubMed2004

The model of cultural competence through an evolutionary concept analysis.

Becoming a culturally competent health professional is a demanding prerequisite in this multicultural society. Cultural competence is explored and abstracted as a conceptual framework through a concept analysis using the evolutionary method. Its model is constructed from a systemic, comprehensive literature review and analysis. Taking into account how cultural competence is viewed by other disciplines (medicine, psychology, education, and social work), a comprehensive definition, antecedents, and consequences of cultural competence in nursing are described and diagrammed. Additionally, two model cases and future implications are discussed. The broader American society is composed of a mosaic of discrete cultural groups existing within the context of their values and identities. Those distinct cultures affect each patient's ways of thinking and his or her perceptions on health care and health behaviors. The proposed model of cultural competence provides a theoretical guide for developing strategies to achieve culturally competent care in nursing practice and research.

Humans↗

PubMed1996

Estimating treatment benefits for the elderly: the effect of competing risks.

To fully involve patients in treatment decisions, physicians need to communicate future health prospects that patients will have both with and without newly diagnosed disease. These prospects depend not only on the risks patients face from the new disease but also on the risks they face from other causes. Nowhere is an understanding of these competing risks more relevant than in the care of the elderly. In this study, we use the declining exponential approximation for life expectancy (DEALE) to provide a framework to help clinicians gauge the effect of competing risks as a function of age. Because older patients have many competing risks for death, the absolute effect of a new diagnosis on life expectancy is often relatively small. Consequently, the potential gain in survival even from perfect therapy may also be small. Moreover, no therapy is perfect, and the risks of therapy often increase with age. In the elderly, the combination of a high burden of competing risks and high rates of treatment-related complications conspires to reduce the net benefit of numerous interventions. We conclude that, compared with younger patients, the elderly should request only the more clearly effective treatments and should be willing to tolerate fewer associated complications before they agree to initiate therapy.

Aged↗

PubMed1994

Intraoperative nursing activities performed by surgical technologists.

In this study of delegated intraoperative nursing activities performed by surgical technologists (STs) in low-risk and high-risk surgical procedures, 343 OR directors, perioperative nurses, and STs from rural, community, and medical center hospitals reported that STs frequently perform activities related to surgical counts, the sterile field, and equipment and supplies. Surgical technologists do not frequently perform tasks related to patient transportation, teaching, medication administration, OR environment, patient monitoring, and patients' rights. The investigator used nine competency statements of intraoperative nursing as a framework for the research instrument. Data analysis determined that the levels of risk in patient situations affects how frequently STs perform transportation, teaching, sterile field, OR environment, and patients' rights activities.

Clinical Competence↗

PubMed2005

End-of-life care for children and adolescents.

OBJECTIVES: To describe the complexities in end-of-life care of children and adolescents dying cancer-related deaths. DATA SOURCES: Research studies, review articles, and government reports. CONCLUSION: The complexities in providing competent and compassionate care to the dying child and the family is intense, undeniable, and may in some clinical situations be unavoidable. IMPLICATIONS FOR NURSING PRACTICE: It is important for all those involved with the care at the end of life for a child or adolescent dying a cancer-related death create the framework that will support the provikion of competent and compassionate end-of-life care.

Adolescent↗

PubMed1995

[Informed consent and mental competence of the elderly in medical-scientific studies].

The decision whether a potential subject is competent or incompetent is a necessary and crucial part of conducting medical research in the elderly. The assessment of competency is required by the legal and ethical frameworks in which this research has to take place. The state of play in the national and international discussions of bills for legislation of this topic will be summarized. Especially the practical consequences of this forthcoming legislation for researchers will be explained. The ethical framework for medical research with elderly subjects will be described from a historical point of view. By means of a review of relevant literature the legal definition of competency will be operationalized and tests for its assessment will be discussed. Competency of consent is assessed by asking several questions about the essential elements of the study. The introduction of a try out of the study for a subject before asking consent ('experienced consent') is propagated as a method to optimize this consent of elderly subjects. Special conditions for giving the required information to elderly subjects, for the informed consent by proxy and for the inclusion of nursing-home residents, are discussed.

Aged↗

PubMed2006

Continuing education: a national imperative for school nursing practice.

Competency-based continuing education is critical to the professional development of school nurses to ensure the application of timely, age-appropriate clinical knowledge and leadership skills in the school setting. School nurses are responsible for a large number of students with a variety of complex and diverse health care needs. Benner's theory of novice to expert provides a framework for the development of roles and competencies in the practice of school nursing. This manuscript synthesizes research reviewed in 15 articles. Common themes found in the articles include the importance of continuing education and identified barriers to attainment. In response, methods to access continuing education and financial resources are presented.

Clinical Competence↗

PubMed1997

A framework for assessing the performance of integrated health delivery systems.

Competing demands for resources within the health care system require health care providers to ensure the most effective and efficient use of resources. The evidence from the United States, the United Kingdom and other jurisdictions suggests that integrated health delivery systems (IDS) may be a cost-effective way to meet the health care needs of a population. This article introduces a framework for use in monitoring and evaluating the performance of an integrated delivery system. The establishment of a consistently used evaluation framework for integrated delivery systems will provide the government, governing bodies and other evaluators with an effective assessment tool that will enable greater understanding of the impact of the IDS on the health care system. It will also provide information to enable ongoing performance improvements within the system.

Canada↗

PubMed2006

Meeting the informatics needs of today's nursing students.

Today's nurses must be well prepared with informatics skills in order to work more efficiently and safely in this world of evidence-based practice and consumer health. Competency based education provides the mechanism to measure selected skills at various levels and provides a standardized framework from which educators can plan appropriate learning activities. Informatics competencies have been developed for various levels of nursing, but none have been developed that level the educational preparation of the students or are designed to meet a cluster of identified courses. This paper will describe informatics competencies for nursing students across academic levels. The proposed integration plan can be used to identify informatics competencies for faculty and contemporary strategies to meet the informatics needs of today's nurses.

Education, Nursing↗

PubMed1994

Patient perceptions of nursing care: an emerging theory of interpersonal competence.

Nurse-patient interactions were examined to identify elements of interpersonal competence among nurses from the perspective of patients. Forty patients and 12 nurses participated in this qualitative study at a private acute care hospital. Two-hundred and forty-five observations were completed. Open-ended questions were utilized in 85 audio-taped semi-structured interviews. Data collection and analysis occurred simultaneously using the constant comparative method. Four major processes emerged from the data to provide the framework for the themes: 'translating', 'getting to know you', 'establishing trust', and 'going the extra mile'. In the 'translating' theme, patients expressed satisfaction with the nurse-patient interaction when nurses informed, explained and instructed on specific aspects of treatment, and taught general principles of care. The nurses' personal sharing, kidding and clicking appeared as important processes in 'getting to know you'. Patients reported confidence and trust when nurses took charge and appeared to enjoy their work. The theme of 'going the extra mile' included friendship and providing care beyond that expected. The processes provide a framework for an emerging theory of interpersonal competence.

Adolescent↗

PubMed2004

Capacity and competence in child and adolescent psychiatry.

Capacity and competence in the field of child and adolescent psychiatry are complex issues, because of the many different influences that are involved in how children and adolescents make treatment decisions within the setting of mental health. This article will examine some of the influences which must be considered, namely: developmental aspects, the paradoxical relationship between the need for autonomy and participation and the capacity of children, family psychiatry, and the duty of care towards children and adolescents. The legal frameworks relevant to consideration of consent and competence will be briefly considered, as well as some studies of children's consent, participation and competence. A case vignette will be used as a focus to consider the complexity of the issue of competence in child and adolescent psychiatry, in the particular mental disorder of anorexia nervosa.

Adolescent↗

PubMedDate not supplied

Advanced nursing practice: old hat, new design.

Advanced practice nurses positively impact the delivery of healthcare and client outcomes. However, in the past these positions have been seen to have variable value and were often vulnerable during budget cuts. Lack of a clear advanced nursing practice (ANP) framework probably contributed to the compromised effectiveness of these roles and evolution of roles with different titles, scopes of practice and reporting structures. To build the foundation for developing an ANP framework, a task force at The Ottawa Hospital (TOH) conducted a literature review related to ANP roles and completed a review of all clinical nursing roles at TOH. In addition, focus groups with nurses and other health professionals elicited ANP perceptions. The ANP framework includes a standardized job description that details competencies under five role components: clinical practice; consultation; research; education; and, leadership. Recommendations for assessment, implementation and evaluation of ANP roles are identified. The process undertaken by our ANP task force proved to be thorough and sound in developing a framework within which to move forward with ANP role implementation throughout TOH. This article, describing the process, may assist other organizations in defining ANP roles to better meet patient needs in changing health care environments.

Clinical Competence↗

PubMed1987

Assessing staff competency.

In the absence of a national credentialing center for nursing and in the interest of ensuring competencies, Forbes Regional Health Center has developed a framework for internal credentialing. This framework, while initiated in a specialty area, has application to all areas of acute care including the medical-surgical areas. Program development within this framework provides a consistent, structured method of documenting selected clinical proficiencies and facilitates the achievement of individual learning needs.

Clinical Competence↗

PubMed2005

Preparing for the field: developing competence as an ethnographic field worker.

If ethnography can be considered as a form of work, then the rules and competencies of this work need to be learnt along with clear markers of progress to enable the ethnographer to gauge their developing competence. In this paper Fiona Murphy draws on the work of Benner (1984), which provides a framework for the proposition that there is a progression in developing competence as an ethnographic fieldworker from 'novice to expert'. This has implications for the preparation and support of novice fieldworkers in that these 'rules' and competencies should be made more explicit and transparent

Anthropology, Cultural↗

PubMed2005

The identification of best practices in teaching quality competencies for preparing future health care leaders.

The mandate for quality in all aspects of clinical practice, service delivery, and management practice has never been greater. The Institute of Medicine's (IOM) landmark work To Err is Human heightened the urgency of this serious issue. In a follow-up report, the IOM's Crossing the Quality Chasm called for radical change to achieve numerous quality objectives throughout the continuum of the healthcare system including the preparation of future healthcare leaders. This study was conducted to assess how effectively healthcare management education faculty are meeting the challenge of integrating quality improvement into their curricula and how faculty perceived their quality expertise. Another goal was to identify the student learning assessment strategies, teaching methods, content, and resources utilized by faculty to achieve this integration and to suggest a framework for "best practices" in teaching quality competencies citing the literature. The study's findings raise a number of important issues with respect to the ways in which QI is conceptualized and integrated into curricula and concludes that there is substantial need for 'quality improvement' in healthcare management education faculty's approaches to the teaching of QI.

Benchmarking↗

PubMed1994

An ethical framework for operating room infection control.

The operating room nurse has an ethical obligation to provide patients with safe, effective care during surgical intervention. Most basic to this care is surgical asepsis. Bioethics principles of autonomy, beneficence, nonmaleficence, justice, as well as the professional's character in meeting the responsibilities of competence and accountability, are presented as an ethical framework for surgical infection control.

Ethics, Nursing↗

PubMed2005

Cardiac nursing: achieving competent practitioners.

This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are "fit for purpose," and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.

Attitude of Health Personnel↗

PubMed2007

Role development and career stages in addiction nursing: an exploratory study.

AIM: This paper reports a study to explore factors influencing recruitment and retention in addiction nursing, and the stages and features of role acquisition and personal qualities important to that role. BACKGROUND: Specialist addiction nurses engage in a number of roles in the care of individuals with problematic use of psychoactive substances. These include assessment, outreach, prescribing, counselling, and harm reduction. In a climate of increasing demand for specialist substance misuse workers, and a trend to identify key occupational competencies, there is a need for a framework in which career progression can be supported. Studies exploring the roles of addiction nurses are minimal, and there is less comment on how these roles are developed in the context of career stages. METHOD: A qualitative study using focus groups was undertaken with specialist addiction nurses between March and June 2004. The data were transcribed verbatim and analysed using Burnard's six content analysis stages. FINDINGS: Positive factors identified as influencing recruitment and retention included: prior knowledge of the working environment (as a nursing student), opportunities for autonomous practice, the client profile, and associated treatment philosophy and care approach. There was consensus that nurses choosing to work in the field of addiction needed, in addition to being non-judgmental, personal qualities including hardiness, patience and tolerance. Five role development stages, with a set of descriptors, were identified: encounter, engagement, stabilization, competency and mastery. CONCLUSION: Identification of these five role development stages for addiction nurses offers employers, nurse managers, educators and addiction nurses a starting point from which specific occupational competencies can be further explored. In addition, continuing professional development needs can be mapped to specific role development stages. Employers and nurse managers may wish to offer increased learning opportunities to student nurses to gain work experience within specialist addiction units.

Adult↗

PubMed1991

Teaching clinical ethics in the residency years: preparing competent professionals.

Formal training in clinical ethics must become a central part of residency curricula to prepare practitioners to manage the ethical dimensions of patient care. Residency educators must ground their teaching in an understanding of the conceptual, biomedical, and psychosocial aspects of the important ethical issues that arise in that field of practice. Four aspects of professional competence in clinical ethics provide a useful framework for curricular planning. The physician should learn to: (1) recognize ethical issues as they arise in clinical care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about these issues in ways that lead to ethically justifiable courses of action; (3) apply those practical skills needed to implement an ethically justifiably course of action; and (4) judge when the management of a clinical situation requires consultation with individuals or institutional bodies with additional expertise or authority. We argue that these practical goals can be accomplished with a relatively modest emphasis on the theoretical aspects of medical ethics.

Bioethical Issues↗