Emergency room nurse competencies: narrative review of the literature
Keywords:emergency department, emergency room, competencies, framework, nurse
BACKGROUND: Emergency departments are dynamic and unpredictable environments that must ensure timely responses and interventions by addressing urgent emergency situations. The diversity of nurses' roles in different clinical areas leads to developing tools for their context. Competency frameworks make it possible to decline distinctive area competencies and ensure competent and safe care.
AIM: To identify the competencies of the Emergency Room nurse in order to define the distinctive ones in this setting through existing frameworks in the literature.
METHODS: A narrative review of literature by searching databases and journals. The search was supplemented with secondary resources.
RESULTS: Five frameworks were identified from the international literature (FEN; RCN; NENA; CENA; ENA & AAENP). They were analyzed according to nine domains: clinical competence, communication, teamwork, environment and resource, professional development, leadership, legal practice, and professional ethics, research, and quality. No framework of emergency nurse competencies was identified in our country.
CONCLUSION: The development of mappings aims to ensure safe and standard practices for professional education. The competencies analyzed within this study vary according to the educational background and the Health Care Systems of different States. The nine domains highlighted the similarities of the mappings that allow for the definition of standards for the emergency urgency nurse.
Jones T, Shaban R, Creedy D. Practice standards for emergency nursing: An international review. Australas Emerg Nurs J. 2015; 18: 190 -203. doi: 10.1016/j.aenj.2015.08.002. Epub 2015 Oct 3.
Crouch R, Brown R. Advanced clinical practitioners in emergency care: past, present and future. Br J Hosp Med (Lond) 2018; 79(9): 511-515. doi: 10.12968/hmed.2018.79.9.511.
Hitchcock M, Gillespie B, Crilly J, Chaboyer W. Triage: an investigation of the process and potential vulnerabilities. J Adv Nurs. 2014; 70(7): 1532-1541. doi: 10.1111/jan.12304. Epub 2013 Dec 23.
Ministero. Linee di indirizzo nazionale per lo sviluppo del piano di gestione del sovraffollamento in pronto soccorso. Ministero della salute, 2019. Available from: https://www.salute.gov.it/portale/documentazione/p6_2_2_1.jsp?id=3143 30.08.22
McCarthy G, Cornally N, Mahoney CO, White G, Weathers E. Emergency nurses: procedures performed and competence in practice. Int Emerg Nurs 2013; 21(1):50-7. doi: 10.1016/j.ienj.2012.01.003. Epub 2012 Feb 25.
Flinkman M, Leino-Kilpi H, Numminen O, Jeon Y, Kuokkanen, Meretoja R. Nurse Competence Scale: a systematic and psychometric review. Journal of Advanced Nursing 2016; 73(5): 1035-1050. doi: 10.1111/jan.13183. Epub 2016 Nov 7.
ENA NP Validation Work Team, Hoyt KS, Coyne EA, Ramirez EG, Peard AS, Gisness C, et al. Nurse Practitioner Delphi Study: competencies for practice in emergency care. J Emerg Nurs. 2010; 36(5):439-49. doi: 10.1016/j.jen.2010.05.001. Epub 2010 Jun 11.
Haske D, Beckers SK, Hofmann M, Lefering R, Preiser C, Gliwitzky B, Munzberg M. et al. Performance Assessment of Emergency Teams and Communication in Trauma Care (PERFECT checklist) - Explorative analysis, development and validation of the PERFECT checklist: Part of the prospective longitudinal mixed-methods EPPTC trial. PLoS ONE 2018; 13(8): e0202795. doi: 10.1371/journal.pone.0202795.
Meretoja R, Eriksson E, Leino-Kilpi H. Indicators for competent nursing practice. J Nurs Manag. 2002; 10(2): 95-102. doi: 10.1046/j.0966-0429.2001.00299.x.
Camera, M. Le competenze infermieristiche ed ostetriche. 1th ed. Roma: Libreria Universitaria; 2012, pag.126.
Wilson R, Godfrey C.M, Seras K, Medves J, Ross-White A, Lambert N. Exploring conceptual and theoretical frameworks for nurse pratitioner education: a scoping review protocol. JBI Database System Rev Implement Rep. 2015; 13(10): 146-155. doi: 10.11124/jbisrir-2015-2150.
Sponton A, Zoppini L, Iadeluca A, Angeli C, Caldarulo T. Mappare le competenze infermieristiche per lo sviluppo organizzativo: utilizzo della Nursing Competence Scale. Evidence 2013; 5(4): e10000041.
Saiani L, Dimonte V, Palese A, Chiari P, Laquintana D, Tognoni G, Di Giulio P. Il dibattito sullo sviluppo di competenze specialistiche/avanzate degli infermieri. Assist Inferm Ric. 2016; 35: 116-121. doi: 10.1702/2438.25568.
Facco S, Finiguerra I, Fuggetta L, Garrino L, Dimonte V. Profiles and evaluation process: what integration? Experience of the Local Health Agency TO2 of Turin. Prof Inferm. 2014; 67(2):85-94. doi: 10.7429/pi.2014.672085.
Borgioli M, Chiappi S, Bini B, Rasero L. A system for evaluating nursing competencies: definition of operative instruments. Prof Inferm. 2010; 63(4): 200- 204.
Borgioli M, Chiappi S, Bini B, Rasero L. Assessment of competence: literature review and project reaserch. Prof Inferm. 2010; 63(4): 194-199.
Notarnicola I, Stievano A, De Jesus Barbarosa M.R, Gambalunga F, Iacorossi L, Petrucci C, Pulimeno A, et al. Nurse Competence Scale: psychometric assessment in the Italian context. Ann Ig. 2018; 30:458-469. doi: 10.7416/ai.2018.2246.
Leung K, Trevena L, Waters D. Development of a competency framework for evidence-based practice in nursing. Nurse Educ Today 2016; 39:189-196. doi: 10.1016/j.nedt.2016.01.026. Epub 2016 Feb 6
Sastre-Fullana P, De Pedro-Gòmez J, Bennasar-Veny M, Serrano-Gallardo P, Morales-Asencio J.M. Competency frameworks for advanced practice nursing: a literature review. Int Nurs Rev. 2014; 61(4): 534-538. doi: 10.1111/inr.12132.
DeGrande H, Liu F, Greene P, Stankus J. Developing professional competence among critical care nurses: An integrative review of literature. Intensive Crit Care Nurs. 2018; 49: 65-71. doi: 10.1016/j.iccn.2018.07.008.
O’Leary J. Comparison of self-assessed competence and experience among crical care nurses. Journal of Nursing Management 2012; 20: 607-614.
Lakanmaa R.L, Suominen T, Perttila J, Casten R, Vahlberg T, Leino-Kilpi H. Basic competence in intensive and critical care nursing: development and psychometric testing of a competence scale. J Clinic Nurs. 2013; 23: 799-810. doi: 10.1111/jocn.12057.
Imbriaco G, Mostardini M, Erbacci M, Gamberini G, La Notte M, Dal Bosco L, Fazì A. Analisi delle competenze infermieristiche nei servizi di emergenza preospedaliera: i risultati di un’indagine multicentrica italiana. Scenario 2010; 27(4): 35-42. Available from: scenario.aniarti.it/index.php/scenario/article/viewFile/221/205 19.07.2022
Bornaccioni, C, Coltella A, Pompi E, Sansoni, J. Accessi non urgenti nel Dipartimento di Emergenza (D.E.) e ruoli dell’infermiere. Una revisione narrativa della letteratura. Prof Inferm. 2014; 67(3): 139-154. doi: 10.7429/pi.2013.673139.
Dankbaar M, Stegers-Jager K.M, Baarveld F, Merrienboer J, Norman G.R. Assessing the Assessment in Emergency Care Training. PLoS ONE 2014; 9(12): e114663. doi: 10.1371/journal.pone.0114663.
Evans L, Kohl D, Darby P. Mission Impossible? Educating an emergency nurse. J Emerg Nurs. 2014; 40(3): 253 -256.
Fan L, Gui L, Xi S, Qiao A. Core competence evaluation standards for emergency nurse specialist: Developing and testing psychometric properties. Int J Nurs Sci 2016; 3: 274-280. doi.org/10.1016/j.ijnss.2016.08.005
Campo T.M, Comer A, Dowling Evans D, Kincaid K, Norton L, Ramirez E.G, Roberts E, Smith A, Stackhouse K, Wilbeck J. Practice Standards for the Emergency Nurse Practitioner Specialty. Adv Emerg Nurs J 2018; 40(4): 240-245. doi: 10.1097/TME.0000000000000166.
O’Connell J, Gardner G. Development of clinical competencies for emergency nurse practitioners: A pilot study. Australas Emerg Nurs J 2012; 15: 195-201. doi: 10.1016/j.aenj.2012.10.004.
Burnet L. Local implementation of a national curriculum and competency framework for emergency nursing: a review of the evidence. Emerg Nurse. 2019; 4;27(2):32-36. doi: 10.7748/en.2019.e1898.
Harding A. D, Walker-Cillo G.E, Duke A, Campos G.J, Stapleton S.J. A framework for creating and evaluating competencies for emergency nurses. J Emerg Nurs 2013; 39(3): 252-264. doi: 10.1016/j.jen.2012.05.006.
ENA NP Validation Work Team, Hoyt K.S, Coyne E.A, Ramirez E.G, Peard A.S, Gisness C, Gacki-Smith J. Nurse Practitioner Delphi Study: competencies for practice in emergency care. J Emerg Nurs 2010; 36(5):439-49. doi: 10.1016/j.jen.2010.05.001.
Emergency Nurses Association. Emergency Nursing Scope and Standards of Practice 1th ed.. Des Plaines: Emergency Nurses Association. 2011.
College of Emergency Nursing Australasia. Practice standards for the specialist emergency nurse (4ed.). Victoria: CENA. 2020. Available from: https://www.cena.org.au/public/118/files/Policies/2020%20PracStnd%20SpecEmergNurse.pdf
Faculty of Emergency Nursing (FEN). Competency Framework. 2021. Available from: https://fen.uk.com/wp-content/uploads/2021/12/2021-10-1-FFEN-Original-Compentencies-Framework.pdf
National Emergency Nurses Association (NENA). Emergency nursing core competencies (4ed.). Canada: NENA. 2019. Available from: https://nena.ca/w/wp-content/uploads/2014/11/NENA-Core-Competencies-10%EF%80%A211%EF%80%A219.pdf
College of Emergency Nurses New Zealand (CENNZ). Standards of Practice (1ed.). 2007. Available from: https://www.nzno.org.nz/groups/colleges_sections/colleges/college_of_emergency_nurses/resources/publications 22.04.2021
Royal College of Nursing (RCN). National Curriculum and Competency Framework: Emergency Nursing (Level 1) (Level 2) (1ed.). London: RCN 2017. Available from: https://www.rcn.org.uk/-/media/royal-college-of nursing/documents/publications/2017/june/pub-005923.pdf 12.12.22
AAENP Emergency Nurse Practitioner Scope and Standards of Practice. Adv Emerg Nurs J.l2016; 38(4):251. doi: 10.1097/TME.0000000000000124.
Calder S, Tomczyk B, Cussen ME, Hansen GJ, Hansen TJ, Jensen J et al. A Framework for Standardizing Emergency Nursing Education and Training Across a Regional Health Care System: Programming, Planning, and Development via International Collaboration. J Emerg Nurs. 2022; 48(1):104-116. doi: 10.1016/j.jen.2021.08.006.
Emergency Nurses Association. Emergency Nurse Practitioner Competencies. 2019. Available from: https://www.ena.org/docs/default-source/resource-library/practice-resources/other/practitionercompetencies.pdf?sfvrsn=db39b977_10 12.12.22
Katz J, Powers M, Amusina O. A review of procedural skills performed by advanced practice providers in emergency department and critical care settings. Dis Mon. 2021; 67(1):101013.
Vand Tamadoni B, Shahbazi S, Seyedrasooli A, Gilani N, Gholizadeh L. A survey of clinical competence of new nurses working in emergency department in Iran: A descriptive, cross-sectional study. Nurs Open. 2020; 28;7(6):1896-1901. doi: 10.1002/nop2.579.
American Academy of Emergency Nurse Practitioners & Emergency Nurses Association. Emergency Nurse Practitioner Competencies. 2021. Available from: https://www.ena.org/docs/default-source/education-document-library/enpcompetencies_final.pdf?sfvrsn=f75b4634_0 12.12.22
American Academy of Emergency Nurse Practitioners. Scopes & Standards for Emergency Nurse Practitioner Practice. Houston, TX: Author.2016. doi: 10.1097/TME.0000000000000126.
Holleran, R. S., Campo, T. Emergency Nurse Practitioner Core Curriculum. 1th ed. New York: Springer Publishing; 2022.
American Association of Colleges of Nursing. The Essentials: Core Competencies for Professional Nursing Education. 2021. Available from: https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf 27.07.22
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372:n71. doi: 10.1136/bmj.n71.
International Council of Nurses (ICN). The Icn Code of Ethics for Nurses. Geneva. 2021. Available from: https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_EN_Web_0.pdf 30.08.2022
Great Britain Masson J. Children Act 1989. London: Sweet & Maxwell. 1990. Available from: https://www.legislation.gov.uk/ukpga/1989/41 30.08.22
The Equality Act , 2010. Available from: https://www.gov.uk/guidance/equality-act-2010-guidance 30.08.22
Department of Health. Mental Capacity Act. London: HMSO.2005. Available from: https://www.legislation.gov.uk/ukpga/2005/9/contents 30.08.22
Department of Health and Human Services. The Emergency Medical Treatment and Labor Act. 2001. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA 30.08.22
McClelland H. The future of nursing for emergency care. Int Emerg Nurs. 2012; 20(2):49-50. doi: 10.1016/j.ienj.2012.02.003.
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