Basic competence in intensive and critical care nursing: development and psychometric testing of a competence scale

Aims and objectives: To develop a scale to assess basic competence in intensive and critical care nursing. In this study, basic competence denotes preliminary competence to practice in an intensive care unit. Background: There is a need for competence assessment scales in intensive care nursing practice and education. The nursing care performed in the intensive care unit is special by its nature and needs to be assessed as such. At this moment, however, there is no tested, reliable and valid scale in this field. Design: A multi-phase, multi-method development and psychometric testing of the scale was conducted. Methods: The scale was developed in three phases. First, following a literature review and Delphi study, the items were created. Second, the scale was pilot tested twice by nursing students (n1 = 18, n2 = 56) and intensive care nurses (n1 = 12, n2 = 54), and revisions were made. Third, reliability and construct validity were tested by graduating nursing students (n = 139) and intensive care nurses (n = 431). Results: The Intensive and Critical Care Nursing Competence Scale (ICCN-CS-1) is a self-assessment test consisting of 144 items. Basic competence is divided into patient-related clinical competence and general professional competence. In addition, basic competence is comprised of knowledge base, skill base, attitude and value base and experience base. ICCN-CS-1 is a reliable and tolerably valid scale. Conclusions: The ICCN-CS-1 is a promising scale for use among nursing students and nurses. Future research is needed to evaluate its construct validity further and to assess its suitability for completion during intensive care unit's orientation programmes and nursing students' clinical practice in an intensive care unit. Relevance to clinical practice: The ICCN-CS-1 can be used for basic competence assessment in professional development discussions in intensive care units, in mentor evaluation situations during nursing students' clinical practice and in intensive care nursing education. © 2013 Blackwell Publishing Ltd.