Development and Psychometric Evaluation of the “Nurses’ competency in post-resuscitation care” scale

Abstract

Abstract Introduction: nurses’ competency is an essential element for effective and high-quality care in the post-resuscitation period. Resuscitated patients require comprehensive care to meet their complex and diverse needs. However, there are inconsistencies in post-resuscitation care and discrepancies in the performance of healthcare providers have been reported. For this reason, we need strategies to promote competency, ensure adequacy of competency, monitor and evaluate. Planning to improve nurses' competency requires identifying the dimensions and assessing this concept with a standard instrument. No specific instrument was found to assess the competency of nurses in post-resuscitation care. Therefore, this study was conducted with the aim of using real experiences of nurses to develop and evaluate psychometric properties of the nurses’ competency in post-resuscitation care scale. Methods: This study is a mixed-methods research with an exploratory sequential design. In the first phase, a qualitative study was conducted to explain the concept of nurses’ competency in post-resuscitation care using the conventional content analysis approach. Semi-structured interviews were conducted with 19 nurses involved in post-resuscitation care through purposive sampling. The items of the scale were then developed based on the results of the qualitative phase and the results of the literature review. In the second phase face validity, content validity (content validity ratio and content validity index), construct validity using two methods of exploratory factor analysis and convergent validity, internal consistency reliability and stability (25 nurses) were assessed. Findings: six categories were identified during the data analysis in the qualitative phase: professionalism, continuous monitoring, improving the quality of care, preventive measures, crisis situation management and family care. After explaining the concept of nurses’ competency in post-resuscitation care, a draft instrument with 131 items in a five-point Likert spectrum from never to always was developed. Exploratory factor analysis of the 40-item scale reveled the existence of three factors: "continuous monitoring and rapid response", "effective collaboration and communication" and "professionalism" with an overall variance of 37.96%.

The Cronbach’s alpha coefficient of the final scale was 0.843 for 34 items. The Pearson correlation coefficient between the nurses' competency in post-resuscitation care scale and the nurse competence scale developed by Meretoja was 0.71. The intraclass correlation coefficient was 0.885. Conclusion: The results suggest that nurses’ competency in providing post-resuscitation care requires professionalism and nurses should have sufficient knowledge and skills in this area and should endeavor to investigate the cause of cardiac arrest and the complications of resuscitation through continuous monitoring. In the post-resuscitation period, nurses ensure the adequacy of care with quality improvement measures and implement preventive measures by anticipating equipment and following up on care needs. The nurses try to manage and control the critical situation by managing time and adjusting the unnecessary workload in the environment. They also take care of the family members of the resuscitated patient by facilitating their presence, involvement and empowerment. The developed scale can be used in education, research, management and nursing services. A confirmatory factor analysis of the scale is suggested.