The purpose of this concept analysis was to further explore uses of the concept and theoretically define how important the multidimensional aspects of competency are to the professional practice of nursing.
Competency is essential to the profession of nursing, and providing a clear theoretical definition of competency is only the first step. The competency of all nurses and healthcare providers must be assessed to provide safe care, protect the public, and maintain the credibility of nurses. Standards must be established and adhered to both in practice and evaluation of competency. The Oxford English Dictionary describes competency as the ability to deal with a subject, and as the “sufficiency of qualification” (OED, 1989). Merriam-Webster Online defines competence as “a sufficiency of means for the necessities and conveniences of life” and “having sufficient knowledge” to enable an action. In legal terms, competency refers to an individual who exhibits the ability to act prudently in give circumstances, including the ability to perform a job or an occupation, or to reason or make decisions (Dusky v. U.S., 1960). The meanings of competency are varied and include the ability of a person to perform a job (Woodruffe, 1993); skills that are developed in a pattern (Bradley & Huseman, 2003); a behavior or series of actions that can be demonstrated, observed, and assessed (Manley & Garbett, 2000)
According to Walker and Avant (1995), defining attributes represent characteristics of a concept most frequently associated with the concept. These attributes appear repeatedly in references to the concept and are evident in both the theoretical and operational definitions making the concept unique and identifiable.
Defining attributes of competency in nursing that appear consistently in the literature are:
(c) professional standards
(d) internal regulation
Review and analysis of literature exploring competency reveal an array of synonyms for the identified attributes. Variation in terms used to define and describe competency further illustrates the need for analysis to clarify the theoretical definition of competency.
Synonyms of attributes
A model case as described by Walker and Avant (1995) is a “real life” example of how the concept is used and must include all attributes. The following case is an actual scenario and includes all of the critical attributes for the concept of competency. Nurse A is a registered nurse (RN) who graduated 5 years ago from a baccalaureate nursing program. Immediately after graduation, Nurse A began working on a medical–surgical unit with a patient ratio of 1:6. The floor is well staffed and patient assignments are determined based on patient acuity. Upon admission, all patients are seen within 3 –5 min of arrival by an RN. Responsibilities of the RN at this time include obtaining a complete medical history and physical assessment for the patient. The physical assessment components are determined by the hospital practice standards committee to include specific body system function. Nurse A has demonstrated the necessary skills to obtain data, and in addition, can discern the presence of any abnormal findings. Upon noting abnormal functions, Nurse A proceeds to investigate further with questions for the patient or by using advanced assessment skills to determine the significance of the assessment findings. Once the assessment is complete, Nurse A begins the process of clustering and analyzing data in order to develop a plan of care or as the patient’s condition may warrant take immediate action to prevent deterioration in the patient’s status.
The following case does not...
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