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EPM.106
"How has the national critical care competency framework impacted patient experience", the perceptions of service managers, clinical educators and registered nurses.

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How widely has the competency framework been adopted?

71.7% of critical care service providers have adopted the national competency framework either in part or full. Suggesting that the framework is increasingly being adopted to support and structure critical care nurse education and training. Although 71.7% of critical care providers are using the framework, only a limited number (N=3) of regions have achieved full implementation, suggesting that challenges to implementation exist (e.g. time & infra-structure required).

Measuring critical care patient experience

In total 332 papers were identified (excluding duplications), 210 relating to nurse competence, 105 relating to patient experience and 17 national policy publications relating to either healthcare education or patient experience. Meta-analysis of literature revealed; 15 important aspects to critical care patient experience. Each aspect was broken down further into the commonly identified characteristics relating to it. Ensuring all the key concepts under investigation were captured. Reducing the likelihood of measurement error, as multiple items were measured in relation to each identified aspect.

Design & Methodology

Sample: One region that had implemented the framework across all critical care providers.

Method: Questionnaire distributed  11 critical care service providers. 8 organisations participated providing a 72.7% response rate.

Analysis: Data was analysed using SAS v9 software. The  71 data fields (within the 15 identified aspects of patient experience) were ranked and coded using a Likert-type scale. The chi squared statistical technique was used to investigate the relationship between the dependent (competency framework) and independent (reported effect on patient experience) variables, using the agree vs disagree responses. The t-test and ANOVA analysis was then applied to explore if there was any statistical significance between responses from different organisations, staff groups or years of clinical experience.

Findings 

All 15 areas of critical care patient experience had significantly more ‘agrees’ than ‘disagrees’ in the responses seen, with statistically significant agreement demonstrated in the majority of statements and across all staff groups, p<0.001. Most agreement can be seen in the ‘competence’ aspect of patient experience. Suggesting that the national competency framework has significantly impacted on the registered nurses ability to deliver safe evidenced based care, develop effective and collaborative relationships with multi-professional team members and work autonomously as a competent practitioner. The majority of items on the questionnaire demonstrated staff (across all groups) significantly agreed with the statement, p<0.001. For the majority of items there were no significant differences between staff groups or length of time in post (seen in 70 out of 71 data fields) and there were no significant differences between organisations (seen in 69 of the data fields).

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