Sociodemographic characteristics of nurses
The statistical population of the study was as follows: 78.6% (n=55) were female nurses, 67.1% (n=47) were nurses under 30 years old, 51.4% (n=36) were single, 88.6% (n=62) had Bachelor's degree, 71.4% (n=50) has an average of 16-18, 58.6% (n=41) had a work experience of less than 5 years, 74.3% (n=52) had a work experience of more than 5 years in an emergency department, 50% (n=35) worked partly, and the total nurses population of the emergency department of Ganjouyan hospital was 33 nurses (47.1%). These factors are the most frequent in the statistical population of the study.
Table 1. The assessment level of nurses’ clinical competency using self-assessment and assessment by head nurses
Clinical competencies areas
|
Nurses self-assessment
|
Assessment by head nurses
|
Frequency
|
%
|
Frequency
|
%
|
Patient support and assistance
|
Weak
|
17
|
24.3
|
31
|
44.3
|
Medium
|
50
|
71.4
|
36
|
51.4
|
Good
|
3
|
4.3
|
3
|
4.3
|
Education and guidance
|
Weak
|
8
|
11.4
|
5
|
7.1
|
Medium
|
49
|
70.0
|
57
|
81.4
|
Good
|
13
|
18.6
|
8
|
11.4
|
Diagnostic measures
|
Weak
|
1
|
1.4
|
3
|
4.3
|
Medium
|
29
|
41.4
|
41
|
58.6
|
Good
|
40
|
57.1
|
26
|
37.1
|
Managerial abilities
|
Weak
|
1
|
1.4
|
2
|
2.9
|
Medium
|
30
|
42.9
|
40
|
57.1
|
Good
|
39
|
55.7
|
28
|
40.0
|
Therapeutic measures
|
Weak
|
2
|
2.9
|
5
|
7.1
|
Medium
|
48
|
68.6
|
51
|
72.9
|
Good
|
20
|
28.6
|
14
|
20.0
|
Quality assurance
|
Weak
|
32
|
45.7
|
27
|
38.6
|
Medium
|
35
|
50.0
|
42
|
60.0
|
Good
|
3
|
4.38
|
1
|
1.48
|
Occupational tasks
|
Weak
|
9
|
12.9
|
12
|
17.1
|
Medium
|
51
|
72.9
|
51
|
72.9
|
Good
|
10
|
14.3
|
7
|
10.0
|
Total clinic competencies
|
Weak
|
2
|
2.9
|
3
|
4.3
|
Medium
|
58
|
82.9
|
62
|
88.6
|
Good
|
10
|
14.3
|
5
|
7.1
|
* The Excellent row was removed due to zero in order to reduce the size of the table
clinical competence of nurses
In the present study, nurses assessed their clinical competence at moderate, good, and poor level by 82.9% (n = 58), 14.3% (n=10), and 2.9% (n=2), respectively. In the assessment method performed by head nurses, 88.6% (n=62) of head nurses assessed nurses competence at a moderate level, 7.1% (n=5) at a good level, and 4.3% (n=3) at a poor level (Table 1). In addition, 72.9% (n=51) of nurses in the field of occupational tasks, 71.4% (n=50) in the field of patient support and assistance, and 70.0% (n=49) in the field of education and guidance were assessed at a moderate level. However, 57.1% (n=40) and 55.7% (n=39) were assessed at a good level in the field of diagnostic measures and managerial abilities, respectively. On the other hand, 45.7% (n=32) of nurses were evaluated in a poor level in the field of quality assurance. From the head nurses viewpoints, 81.4% (n = 57) of nurses were assessed in a moderate level in the field of education and guidance, 37% (n=26) were assessed in a good level in the field of diagnostic measures, and 44.3% (n=31) were assessed in a poor level in the field of patient support and assistance.
Comparison of nurses' clinical competency by using two methods of self-assessment and assessment by head nurses
The average scores of clinical competencies were 116.85±26.52 and 107.48±24.60 from the nurses and head nurses’ point of view, respectively. This difference was statistically significant (p<0.03) based on the independent t-test (Table 2). In order to compare nurses' clinical competency by using two methods of self-assessment and assessment by head nurses, there was a statistically insignificant difference between the scores average of education and guidance, therapeutic measures, and quality assurance fields, which is not statistically significant (P<0.05). However, this difference was statistically significant in the fields of patient support and assistance, diagnostic measures, managerial abilities, and occupational tasks. Consequently, nurses working in Emergency departments of Dezful, Shoosh, and Gatond hospitals assessed their clinical competencies in a significant higher level, compared to the assessment of head nurses, in the self-assessment method in all fields of patient support and assistance, diagnostic measures, managerial abilities, and occupational tasks (Table 2).
Table 2. The comparison of the mean score of nurses clinical competency with two methods of self-assessment and assessment performed by head nurses in emergency departments of hospitals affiliated to Dezfoul University of Medical Sciences
Competency area
|
Nurses
|
Head nurses
|
Sig.
|
Patient support and assistance
|
7.70 ± 1.89
|
6.39 ± 2.14
|
0.016
|
Education and guidance
|
25.14 ± 7.13
|
23.57 ± 5.83
|
0.43
|
Diagnostic measures
|
14.25 ± 3.40
|
11.66 ± 3.38
|
0.08
|
Managerial abilities
|
16.55 ± 3.90
|
12.60 ± 3.26
|
0.001
|
Therapeutic measures
|
18.30 ± 4.81
|
15.96 ± 4.39
|
0.12
|
Quality assurance
|
6.04 ± 2.59
|
6.30 ± 1.72
|
0.69
|
Occupational tasks
|
28.85 ± 8.11
|
22.66 ± 6.70
|
0.046
|
Total clinic competencies
|
116.85 ± 26.52
|
99.18 ± 21.98
|
0.001
|
relationship between clinical competence of nurses with demographic characteristics
Based on the Pearson correlation test results on age, education level, and work experience in the emergency department, as well as investigating the relationship between the clinical competence of nurses with demographic characteristics in the self-assessment method, a significant relationship was observed at 0.05 significance level, indicating direct relationship between the clinical competence of nurses with age, level of education, and work experience in the emergency department. However, no significant relationship was observed between clinical competence and other components such as gender, marital status, average, clinical experience, and employment status (Table 3).
Table 3. The relationship between clinical competence of nurses with demographic characteristics in self-assessment method
Demographic variables
|
Nurses’ clinical competence
|
r
|
Sig.
|
Gender
|
0.04
|
0.73
|
Age
|
0.245
|
0.034
|
Marital status
|
0.084
|
0.47
|
Education level
|
0.242
|
0.042
|
Average
|
0.203
|
0.08
|
Clinical work experience
|
0.201
|
0.083
|
Work experience in emergency
|
0.304
|
0.008
|
Employment status
|
0.156
|
0.18
|