1. ASSESSMENT OF ADVANCED NURSING CLINICAL COMPETENCE
Daugybę kartų buvo sakoma ir rašoma, kad kiekviena moteris yra gera slaugė. Priešingai aš manau, kad patys slaugos pagrindai yra beveik nežinomi. Florence Nightingale
ASSESSMENT OF ADVANCED NURSING CLINICAL COMPETENCE
DANGUOLĖ ŠEVCOVIENĖ Utena College

2. ORGANIZATIONAL LEADERSHIP (physical and mental characteristics)
INTRODUCTION (1)
ADVANCED NURSING
PRACTICE
COMPETENCE
ORGANIZATIONAL LEADERSHIP
PROFESSIONAL DEVELOPMENT
1. KNOWLEDGE
2. SKILLS
RESEARCH
EDUCATION
CLINICAL PRACTICE
3. SELF PERCEPTION
4. PERSONAL DATA:
(physical and mental characteristics)
5. REASONS

3. INTRODUCTION (2)
CLINICAL COMPETENCE
DOES
SHOWS HOW
KNOWS HOW
KNOWS

4. THE AIM & OBJECTIVES OF THIS STUDY
TO ASSESS ADVANCED NURSING CLINICAL COMPETENCE ACCORDING TO PROFESSIONAL SKILLS COMPARING GROUPS WITH DIFFERENT EDUCATIONAL BACKGROUNS AND WORK EXPERIENCE
TO SET THE LEVEL OF NURSING COMPETENCE
TO INVESTIGATE THE ACTIVITIES CARRIED OUT BY NURSES IS OFTEN MENTIONED IN ACTION, DEPENDING ON THE PRACTICAL EXPERIENCE, AND EDUCATION LEVEL OF COMPETENCE.
TO DIAGNOSE THE MAIN FEATURES OF ADVANCED CLINICAL COMPETENCE.
TO FIND OUT THE IMPACT OF NURSES RESPONSIBILITY TO THE DEVELOPMENT OF ADVANCED NURSING DEVELOPMENT OF CLINICAL COMPETENCE.
Keliamas tikslas įvertinti pažangią slaugos klinikinę kompetenciją pagal profesiją apibūdinančius įgūdžius, lyginant skirtingo išsilavinimo ir darbinės patirties grupes. Tikslui pasiekti formuluojami uždaviniai: nustatyti slaugytojų kompetencijos lygmenį, ištirti slaugytojų atliekamų veiklų taikymo dažnį praktikoje, priklausomai nuo praktinės patirties, išsilavinimo ir kompetencijos lygmens. Diagnozuoti pagrindinius pažangios klinikinės kompetencijos požymius. Atskleisti slaugytojų atsakomybės įtaką pažangios slaugos klinikinės kompetencijos vystymui.

5. THE NURSE CLINICAL COMPETENCE SCALE: PROCESS OF ITS DEVELOPMENT
IDENTIFYING A THEORETICAL MODEL FOR THE INTENDED CONCEPTS
GENERATING ITEMS FROM LITERATURE REVIEW AND ADVICE OF EXPERTS IN NURSING EDUCATION, PRACTICE REGULATION AND RESEARCH
OBTAINING EXPERT ACCEPTABILITY OF THE SCALE, AS DETERMINED BY ETHICAL COMMITTE.
ESTABLISHING RELIABITY, VALIDITY AND COMPONENT STRUCTURE.

6. NURSE COMPETENCE SCALE Meretoja 2004
NURSES SELF-ASSESSMENT OF COMPETENCE
73-ITEM INSTRUMENT (OF CLINICAL INDICATORS)
VAS-SCALE MM(VISUAL ANALOGUE SCALE)
4-POINT SCALE (0= NOT APPLICABLE IN MY WORK, 1= USED VERY SHELDOM, 2=USED OCCASIONALLY AND 3= USED VERY OFTEN
DERIVED FROM BENNER´S THEORY: FROM NOVICE TO EXPERT
CATEGORIES: HELPING ROLE(7 ITEMS), TEACHING-COACHING (16ITEMS), DIAGNOSTIC FUNCTIONS (7 ITEMS), MANAGING SITUATIONS (8 ITEMS), THERAPEUTIC INTERVENTIONS (10 ITEMS) AND WORK (PROFESSIONAL) ROLE (19 ITEMS)

7. NURSE CLINICAL COMPETENCE SCALE, ŠEVCOVIENĖ & KRIUKELYTĖ 2010
NURSES SELF-ASSESSMENT OF CLINICAL COMPETENCE. VAS-SCALE mm (VISUAL ANALOGUE SCALE)
74-ITEM INSTRUMENT (OF CLINICAL INDICATORS) CATEGORIES: HELPING ROLE (7 ITEMS), TEACHING-COACHING (12 ITEMS), DIAGNOSTIC FUNCTIONS (7 ITEMS), MANAGING CRITICAL SITUATIONS (5 ITEMS), THERAPEUTIC INTERVENTIONS (9 ITEMS), QUALITY ASSURANCE (6 ITEMS), WORK (PROFESSIONAL) ROLE (14 ITEMS) AND TECHNICAL PROFESSIONAL SKILLS (14 ITEMS)
4-POINT SCALE (0= NO EXPERIENCE, 1=NOT APPLICABLE IN MY WORK, 2= USED VERY SHELDOM, 3=USED OCCASIONALLY AND 4= USED VERY OFTEN
THEME-RELATED ADDITIONAL QUESTIONS

8. INVESTIGATION GROUP
STUDENTS OF NURSING STUDY PROGRAMME IN THE COLLEGES& UNIVERSITIES PROGRAMS (EXCEPT FOR THE 1st COURSE),
NURSES IN PRIMARY HEALTH CARE INSTITUTIONS
NURSES IN HOSPITAL SETTINGS
RESPONDENTS FOR THE STUDY WERE CHOSEN FROM TWO EDUCATIONAL INSTITUTIONS PROVIDING PROFESSIONAL NURSING AND TWO HEALTH CARE INSTITUTIONS.

9. DATA ANALYSIS STATISTICS CONTENT ANALYSIS DESCRIPTIVE ANALYSIS
CORRELATION ANALYSIS
ANOVA TEST
CONTENT ANALYSIS
USE STATISTICAL HYPOTHESIS SIGNIFICANCE LEVELS: AT p> STATISTICALLY INSIGNIFICANT (ins) WHEN p < SIGNIFICANT (p) - INTERPRETATION OF THE SIGNIFICANCE LEVEL: P <0.05 (SIGNIFICANT), P <0.01 (VERY IMPORTANT), P <0.001 (PARTICULARLY SIGNIFICANT).

10. ASSESSMENT OF NURSES COMPETENCY LEVEL

11. ACTIVITIES CARRIED OUT BY NURSES FREQUENCY ASSESSMENT

12. THE MAIN FEATURES OF ADVANCED NURSE CLINICAL COMPETENCE
ORIENTATION TO THE OPERATIONAL ROLES AND PERSONALITY
COGNITIVE SKILLS AND COMPETENCES
SPECIALIZED TECHNICAL SKILLS AND CAPACITIES
CLINICAL AND CRITICAL THINKING SKILLS
USE OF TECHNOLOGIES.
ORIENTACIJA Į DARBINES UŽDUOTIS IR ASMENYBĘ;
PAŽINTINIAI ĮGŪDŽIAI IR GEBĖJIMAI;
SPECIALIZUOTI TECHNINIAI ĮGŪDŽIAI IR GEBĖJIMAI;
KLINIKINIO IR KRITINIO MĄSTYMO GEBĖJIMAI, BESIREMIANTYS MOKSLINIAIS TYRIMAIS;
TECHNOLOGIJŲ PANAUDOJIMAS.
„...profesionalus savo pareigų atlikimas, bendradarbiavimas su kolegomis, kvalifikuotas pagalbos teikimas pacientui. Pakankami komunikacijos įgūdžiai, o slaugytoja nėra akla gydytojų paskyrimų vykdytoja <..> daug funkcijų ji gali atlikti savarankiškai...“
“…professional performance of our duties, working with colleagues, and qualified assistance to the patient. Sufficient communication skills, nurse is not a perpetrator of blind doctors appointments<..> many functions she can perform self ... "

13. LONELY  INDEPENDENCE; SCARING  TEMPTING AND CHALLENGING;
INFLUENCE OF NURSES RESPONSIBILITY ON THE DEVELOPMENT OF ADVANCED NURSING CLINICAL COMPETENCE
LIMITATE  FREEDOM;
LONELY  INDEPENDENCE;
SCARING  TEMPTING AND CHALLENGING;
BURDENSOME  PLEASANT
„... mūsų darbe atsakomybė labai didelė, tik gaila, kad kartais nešame ją ne tik už save, bet ir už gydytojus. Nes jie labai dažnai nurodo žodžiu, o ne raštu atlikti veiksmą. Ir jai kas nors atsitinka tai jie labai lengvai gali išsisukti nuo atsakomybės ...“
„... Our responsibility is a very high, just a pity that sometimes we can not exclude it, not only for ourselves but also for doctors. Because they are very often the oral rather than written to take action. It happens to someone that they can easily get away from responsibility...“

14. CONCLUSION (1)
49,35 percent RESPONDENTS BELIEVE THAT THEIR LEVEL OF COMPETENCE VERY GOOD percent ARGUES THAT IT THE GOOD, 12,66 percent CONSIDER THAT IT QUITE GOOD AND 5.2 percent OWN COMPETENCE TO ASSESS AS LOW.
IN AREAS OF GENERAL OPERATING SCALE RESPONDENTS EVALUATED THE ACTIVITIES BY ACCORDING TO THE FREQUENCY OF THE SEQUENCE WAS: TECHNICAL PROFESSIONAL SKILLS (overall average 2,42), MANAGING CRITICAL SITUATIONS (overall average 2,31), THERAPEUTIC INTERVENTIONS (overall average 2,23), HELPING ROLE (overall average2,14), WORK (PROFESSIONAL) ROLE (overall average2,09), DIAGNOSTIC FUNCTION (overall average1,97), TEACHING/COACHING (overall average1,90), QUALITY ASSURANCE(overall average1,89).
49,35 proc. apklausoje dalyvavusiųjų slaugytojų praktikų, absolventų ir studentų mano, kad jų kompetencijos lygis labai aukštas, 32,79 proc. teigia, kad aukštas, 12,60 proc. tiriamųjų, mano, kad pakankamai aukštas ir 5,2 proc. savo kompetenciją vertina kaip žemą.
Bendroje veiklų sričių taikymo skalėje tiriamųjų vertintos veiklos sritys pagal taikymo dažnį sudarė tokią seką: techninė (2,42), kritinių situacijų valdymo (2,31), priežiūros (2,23), pagalbos suteikimo (2,14), profesinė (2,09), vertinimo (1,97), mokymo/mokymosi (1,90), kokybės užtikrinimo (1,89).

15. CONCLUSION (2)
THE MAIN FEATURES OF ADVANCED NURSING CLINICAL COMPETENCE ARE: EXPERIENCE AND CLEVERNESS, MONITORING AND EVALUATION OF CARE TRAINING AND LEADERSHIP AND NEEDS OF NEW COMPETENCY OF MODERN TECHNOLOGY.
FOR THE MOST OF RESPONDENTS LIMITED RESPONSIBILITY OR IMPOSING A GREAT RESPONSIBILITY – INCLUDES WORK THAT HAS NOTHING IN COMMON WITH NURSING. IN REAL NURSING PRACTICE SPACE THERE IS NO POSSIBILITY TO REALIZE AND DEVELOP ALL ADVANCED NURSING CLINICAL COMPETENCIES: PERSONALISED NURSING, RESEARCH USE IN THE PRACTICE, INCORPORATING RELEVANT KNOWLEDGE TO PROVIDE OPTIMAL CARE, CONTRIBUTING TO FURTHER DEVELOPMENT OF MULTIDISCIPLINARY CLINICAL PATHS, ACTING AUTONOMOUSLY AND GIVING FEEDBACK TO COLLEAGUES IN A CONSTRUCTIVE WAY.
Pagrindiniai pažangios slaugos klinikinės kompetencijos požymiai: patirtis ir sumanumas, priežiūros tyrimas ir vertinimas, mokymas ir vadovavimas bei naujos šiuolaikinių technologijų kompetencijos poreikis.
Daugumai tyrime dalyvavusiųjų ribojamos atsakomybės ribos arba užkraunama per didelė atsakomybė – priskiriami darbai, kurie neturi nieko bendro su slauga. Realioje slaugos praktikos erdvėje nėra galimybės realizuoti ir plėtoti visų pažangios slaugos klinikinių kompetencijų: individualizuotos slaugos, mokslinių tyrimų taikymo praktikoje, priežiūros optimizavimo, taikant aktualią informaciją, multidisciplininio klinikinio kelio plėtros palaikymo, autonominio pareigų atlikimo ir konstruktyvaus grįžtamojo ryšio su kolegomis užtikrinimo.

16. CONCLUSION (3) THE SCALE OF CLINICAL COMPETENCE IS:
A PROMISING NEW METHOD IN EVALUATING THE CLINICAL COMPETENCE OF NURSES AND NURSING STUDENTS.
EASY TO ADMINISTER
HAVING THE POTENTIAL TO BE ADAPTED TO MEASURE CONTINUE COMPETENCE

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