Slide Title Professional competencies of nurses working in Palliative Care specialized services in Romania Nicoleta Mitrea APRN, PhD s Hospice Casa Sperantei, Romania EAPC, Prague 2013 www.hospice.ro
Slide Research Title objectives To determine the level of professional competencies of nurses working in Palliative Care specialized services in Romania, throughout the selfevaluation method, in comparison with the professional competencies described by the European Association for Palliative Care (EAPC); To determine the educational needs of those nurses in order to develop post-graduation programs, namely Continual Medical Education (CME) and specialization programs.
Research methodology Slide Title Prospective study, run between January and May 2012, which combines quantitative and qualitative research; questionnaire, as method for data collection, based on the EAPC recommendations : 1. o 3 levels of education: o A basic (undergraduate), o B intermediate (post-graduate), o C specialization. o 7 domains of activity: the patient, the patient and the family, the interdisciplinary team, ethical dilemmas, Palliative Care in the Health System, Train the Trainers and Forming the researchers in Palliative Care o Likert scale: Not at all 2. In small measure 3. Moderate 4. 6. I do not consider this competencies to be important In good measure 5. In great measure
The Slide research Title sample 170 nurses work currently for the PC specialized services that function since 2010 148 of them answered to the questionaire = 87% the respondance rate Sex: 134 F, 14 M Age: o under 40 years old 105, o over 41 years old 43 Area covered: o urban 125, o rural 3, o urban/rural 20
The Slide research Title sample City/county: o Alba - 17 o Bacău -9 o Braşov - 23 o Bucureşti - 31 o Cluj - 9 o Constanţa -6 o Iaşi -21 o Bihor-10 o Sibiu - 10 o Timiş -12
The Slide research Title sample Form of undergraduate nursing school finished: o technical nursing college 113 o university 35 Work contract: o full time 141 o ½time 5 o collaboration contract 2
The research sample Slide Title Clinical experience as a nurse: o Under 10 years 84 o Over 11 years 64 Clinical experience in PC: o under 10 years 138 o over 11 years - 10
The research sample Slide Title Type of PC service where they perform their clinical practice: o Ambulatory 1 o Home care 38 o Inpatient unit, Hospice like 47 o Day center 2 o Hospital woard - 60
Centralized data on domains of competencies and levels of education
General level of knowledge and implementation of PC competencies Level A
Results: Slide Title Research hypothesis There is no correlation between the level of competencies on different domains and the general level of education of nurses Correlation coefficient (r) Significance threshold (p) 2-tailed Patient.427**.000 Patient and family.331**.000 Interdisciplinary team.105.204 Ethical dilemas.253**.002 PC in the health system.215**.009 Train the trainers in PC.197*.016 Research in PC.225**.006 * = r is significant, for p <.05 (the probability of obtaining this correlation is less than 0,05); ** =r is very significant, for p <.01 (the probability of obtaining this correlation is less than 0,01) 6 out of 7 competencies domains significantly positively correlates with the general level of education The first nule general research hypothesy is roles out
Level of competencies and education differs significantly depending Slide Title on the city/county where the nurses work The nurses working in Braşov self-evaluates their level of competencies as being higher than the level of competencies of nurses working in Bucharest
Level of competencies and education differs significantly depending Slide Title on the years of experience in PC Nurses working for less than 10 years in PC specialized services self-evaluates their level of competencies as being higher than the level of competencies of nurses working for more than 11 years in PC specialized services.
Slide Qualitative Titleresearch Which are the barriers in implementing the professional nursing competencies in our daily clinical practice?
Qualitative Slide Titleresearch What positive changes you believe will determine the official/legal recognition of PC nursing competencies?
Conclusions Slide Title the majority of respondents have a basic level of education in PC, acquired after graduating a basic level of education (level A); this level of education is not sufficient in the case of nurses performing their clinical practice in PC specialized services; the results substantiate the necessity of forming those subjects in the framework of a specialty educational program (getting the level C education), where to form and attest the specific nursing competencies required by this medical specialty.
Limitations Slide Title Self perception of the professional competencies and not necessary their actual implementation in the clinical practice; Likert scale Social desirability
Value Slide and Titlecontribution First paper to address this theme which offers, besides gathering the theoretical and international recommendations, the scientific base for considering the official/legal recognition of PC as a specialty for nurses in Romania; Plea for the development and running of the Specialty Educational Program for nurses in the field of Palliative Care; The results can be generalized.
Thank Slide Title you! www.hospice.ro