Comparison of nurse competence in different hospital work environments.

AIM: 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.