Assessing Nurses’ Competencies in Managing Critically Ill Patients in the Intensive Care Unit. A Study at the Korle-Bu Teaching Hospital

Abstract

Critically ill patients have life-threatening health problems that leave them in a vulnerable state and thus need urgent medical attention. The critical care nurse (CCN) forms an integral part of the expert team of medical professionals who provide the needed care for such patients and spend the most time with the patient. The CCN possesses the requisite set of competencies to decide care strategies for patient management for optimum recuperation, and comfort for the patient. Lack of these competencies as a result of the shortage of CCNs could have dire consequences for the patient in the ICU. Critical care nurses form approximately one-third of the nursing workforce in the ICUs of Korle-Bu Teaching Hospital (KBTH). Thus, evaluation of nurse competencies in the ICUs of KBTH was found to be necessary. A quantitative and cross-sectional study employing a 66-item questionnaire was used to assess demographic characteristics, critical thinking, professional development and practice, and communication and coordination competencies of 133 nurses from all the ICUs at the Korle-Bu Teaching Hospital (KBTH). Benner’s scale was used to guide the grading of the level of competence of all consenting participants. The study revealed that more than 80% of nurses in the ICUs were competent although critical care nurses formed less than one-third of participants. The areas of competencies assessed were also found to correlate strongly with each other (p<0.001). Competence was found to be significantly associated with age, status in the ICU, level of education, specialty, and years of experience (p<0.001). Additionally, logistic regression analysis showed that the years of experience, as well as Senior and Principal officer ranks significantly (R 2 = 0.407, F(4, 128) = 21.98, p < .001) predicted the overall competence of the ICU nurse. Steps would have to be taken to train and mentor younger and less experienced staff of the ICU even if they are trained as critical care nurses to achieve an acceptable level of competence in their duties towards the critically ill.