Competence in intensive and critical care nursing: A literature review

Ääri, Riitta-Liisa; Suominen, Tarja; Leino‐Kilpi, Helena

doi:10.1016/j.iccn.2007.11.006

Cited by 72 publications

(58 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The competence requirements established here are largely consistent with those presented in the previous competence literature on intensive and critical care nursing (AACN, 2008(AACN, , 2011Bench et al, 2003;CACCN, 2009;Dunn et al, 2000;Schribante et al, 1996;Ääri et al, 2008). The knowledge, skill and experience bases domains have been emphasised in many competence descriptions (e.g.…”

Section: Discussionsupporting

confidence: 81%

“…To summarise, based on the earlier literature, the following dimensions of competence requirements can be identified in intensive and critical care nursing: clinical decision-making (AACN, 2008(AACN, , 2011Bench et al, 2003;CACCN, 2009;Dunn et al, 2000;Schribante et al, 1996;Ääri et al, 2008), collaboration (AACN, 2008(AACN, , 2011CACCN, 2009;Dunn et al, 2000;Schribante et al, 1996;Ääri et al, 2008), ethical activity (AACN, 2008(AACN, , 2011CACCN, 2009;Dunn et al, 2000;Schribante et al, 1996;Ääri et al, 2008), caring practices (AACN, 2008(AACN, , 2011Bench et al, 2003;CACCN, 2009;Dunn et al, 2000;Schribante et al, 1996;Ääri et al, 2008), evidence-based nursing (AACN, 2008(AACN, , 2011CACCN, 2009;Dunn et al, 2000;Ääri et al, 2008) and leadership (AACN, 2008;CACCN, 2009;Dunn et al, 2000). These competence requirements are fundamental and now need to be evaluated, complemented and improved with new ideas from ICU professionals.…”

Section: Background and Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Competence requirements in intensive and critical care nursing – Still in need of definition? A Delphi study

Lakanmaa

Suominen

Perttilä

et al. 2012

Intensive and Critical Care Nursing

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 81%

Section: Background and Literature Reviewmentioning

confidence: 99%

Competence requirements in intensive and critical care nursing – Still in need of definition? A Delphi study

Lakanmaa

Suominen

Perttilä

et al. 2012

Intensive and Critical Care Nursing

View full text Add to dashboard Cite

“…An increase in nursing staff is costly and may be challenging for some centers, especially those with limited resources (e.g., safety net and critical access hospitals). Moreover,, intensive care nursing requires a high level of qualifications and competencies (29) and is associated with a high rate of burnout, each of which contribute to nursing shortages to adequately cover the growing demand for critical care. Thus, while nurse staffing may be important to achieve optimal clinical outcomes, it is constrained by both financial and workforce limitations.…”

Section: Discussionmentioning

confidence: 99%

Structure, Process, and Annual ICU Mortality Across 69 Centers

Checkley

Martin

Brown

et al. 2014

Critical Care Medicine

139

View full text Add to dashboard Cite

Objective Hospital-level variations in structure and process may affect clinical outcomes in intensive care units (ICUs). We sought to characterize the organizational structure, processes of care, use of protocols and standardized outcomes in a large sample of U.S. ICUs. Design We surveyed 69 ICUs about organization, size, volume, staffing, processes of care, use of protocols, and annual ICU mortality. Setting ICUs participating in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study (USCIITG-CIOS). Measurements and Main Results We characterized structure and process variables across ICUs, investigated relationships between these variables and annual ICU mortality, and adjusted for illness severity using APACHE II. Ninety-four ICU directors were invited to participate in the study and 69 ICUs (73%) were enrolled, of which 25 (36%) were medical, 24 were surgical (35%) and 20 (29%) were of mixed type, and 64 (93%) were located in teaching hospitals with a median number of 5 trainees per ICU. Average annual ICU mortality was 10.8%, average APACHE II score was 19.3, 58% were closed units and 41% had a 24-hour in-house intensivist. In multivariable linear regression adjusted for APACHE II and multiple ICU structure and process factors, annual ICU mortality was lower in surgical ICUs than in medical ICUs (5.6% lower, 95% CI 2.4%–8.8%) or mixed ICUs (4.5% lower, 95% CI 0.4%–8.7%). We also found a lower annual ICU mortality among ICUs that had a daily plan of care review (5.8% lower, 95% CI 1.6%–10.0%) and a lower bed-to-nurse ratio (1.8% lower when the ratio decreased from 2:1 to 1.5:1; 95% CI 0.25%–3.4%). In contrast, 24-hour intensivist coverage (p=0.89) and closed ICU status (p=0.16) were not associated with a lower annual ICU mortality. Conclusions In a sample of 69 ICUs, a daily plan of care review and a lower bed-to-nurse ratio were both associated with a lower annual ICU mortality. In contrast to 24-hour intensivist staffing, improvement in team communication is a low-cost, process-targeted intervention strategy that may improve clinical outcomes in ICU patients.

show abstract

“…() and Ääri et al . () also highlighted that mastery of technology is essential to the practice of critical care nursing. In addition, Kongsuwan and Locsin () suggested that technological mastery incorporates compassionate caring.…”

Section: Introductionmentioning

confidence: 99%