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The clinical nursing competences and their complexity in Belgian geriatric care
T.Defloor *, M.Gobert , E.Darras, M. Grypdonck
BACKGROUND: Competence is an essential factor for assuring quality and cost-effective healthcare. There are patient-related, professional and economic reasons for developing and assessing competence.
AIM: The purpose of this study was to chart the complexity of clinical nursing competences in elderly care, basic care and specialised care.
METHOD: Three care areas have been studied: elderly care, basic care, and specialised care. Head nurses of 176 participating departments processed 564 patient situations. In a Delphi-procedure 100 experts selected 150 cases and described the nursing competences required in each situation necessary to provide qualitative acceptable care. Of each of these competences the global complexity has been determined as well as the complexity of the cognitive, psychomotor and affective aspects.
RESULTS: The global complexity of the three care areas is similar. Cognitive and affective aspects of competences score higher than psychomotor aspects. The continuous presence of care providers with experience and additional education will be necessary for each care area in order to adequately respond to emergency situations and difficult situations. Nurses with an additional academic education need to be available for consultation. There are only few possibilities of employing lower qualified staff in direct care, with the exception of support with regard to administrative tasks.
CONCLUSION:
The competences needed in elderly care are complex and have a comparable complexity as those in basic and specialised hospital care. Quality elderly care hinges on having highly educated nurses.
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