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Development of Australian clinical practice outcome standards for graduates of critical care nurse education

Authors

  • Fenella J Gill BN, MNurs Graduate Certificate Tertiary Teaching,

    Lecturer, Nurse Researcher, Corresponding author
    1. Faculty of Health Science, School of Nursing and Midwifery, Curtin University, Perth, WA, Australia
    2. Child & Adolescent Health Services, Princess Margaret Hospital for Children, WA, Australia
    • Correspondence: Fenella J Gill, Lecturer, School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Telephone: +61 (0)402881604.

      E-mail: f.gill@curtin.edu.au

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  • Gavin D Leslie PhD, IC Cert, BAppSc,

    Professor
    1. Critical Care Nursing, Joint Appointment Royal Perth Hospital, Perth, WA, Australia
    2. Faculty of Health Science, School of Nursing & Midwifery, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
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  • Carol Grech PhD, BN, MN,

    Professor, Head
    1. School of Nursing & Midwifery, University of South Australia, Adelaide, SA, Australia
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  • Duncan Boldy PhD, BSc, CertEd,

    Professor and Research Advisor
    1. Faculty of Health Science, School of Nursing and Midwifery, Curtin University, Perth, WA, Australia
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  • Jos M Latour RN, PhD, FEfCCNa

    Professor, Nurse Scientist, Adjunct Research Fellow
    1. Faculty of Health Science, School of Nursing and Midwifery, Curtin University, Perth, WA, Australia
    2. Faculty of Health, Education and Society, School of Nursing and Midwifery, Plymouth University, Plymouth, UK
    3. Department of Pediatrics, Intensive Care Neonatology, Erasmus MC – Sophia Children's Hospital, Rotterdam, The Netherlands
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Abstract

Aims and objectives

To develop critical care nurse education practice standards.

Background

Critical care specialist education for registered nurses in Australia is provided at graduate level. Considerable variation exists across courses with no framework to guide practice outcomes or evidence supporting the level of qualification.

Design

An eDelphi technique involved the iterative process of a national expert panel responding to three survey rounds.

Methods

For the first round, 84 statements, organised within six domains, were developed from earlier phases of the study that included a literature review, analysis of critical care courses and input from health consumers. The panel, which represented the perspectives of four stakeholder groups, responded to two rating scales: level of importance and level of practice.

Results

Of 105 experts who agreed to participate, 92 (88%) completed survey round I; 85 (92%) round II; and 73 (86%) round III. Of the 98 statements, 75 were rated as having a high level of importance – median 7 (IQR 6–7); 14 were rated as having a moderate level of importance – median 6 (IQR 5–7); and nine were rated as having a low level of importance – median 4 (IQR 4–6)–6 (IQR 4–6). The majority of the panel rated graduate level of practice as ‘demonstrates independently’ or ‘teaches or supervises others’ for 80 statements. For 18 statements, there was no category selected by 50% or more of the panel. The process resulted in the development of 98 practice standards, categorised into three levels, indicating a practice outcome level by the practitioner who can independently provide nursing care for a variety of critically ill patients in most contexts, using a patient- and family-focused approach.

Conclusion/relevance to clinical practice

The graduate practice outcomes provide a critical care qualification definition for nursing workforce standards and can be used by course providers to achieve consistent practice outcomes.

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