Advanced practice nursing competence profile in emergencies : insights from Spain

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Abstract

Introduction: The development of Advanced Practice Nursing roles in Emergency Care is crucial due to the growing demand for healthcare services, driven by the rising prevalence of chronic diseases, the impact of the COVID-19 pandemic on healthcare systems, and the need for cost-effective solutions amid workforce shortages in various healthcare professions. Aim: To establish a well-defined competency profile for Advanced Practice Nursing in emergency care using the Delphi method, ensuring that the identified competencies are relevant, clearly articulated, and systematically structured for effective practice in urgent and emergency settings. Methodology: A mixed-methods design, structured in three phases, was implemented to develop a competency profile for Advanced Practice Nursing in emergency care in Spain. The first phase utilized qualitative focus groups with experienced nurses to identify foundational competencies. The second phase applied a modified Delphi method with a panel of 42 experts to refine and validate these competencies through iterative feedback and consensus-building. Finally, a quantitative approach was employed, incorporating statistical techniques such as the Content Validity Index and Cronbach's alpha to ensure the clarity, coherence, and relevance of the competency items. Results: The study identified eight competency units, comprising 17 competency criteria and 99 descriptors, of which 25 correspond to various competency units. Conclusions: The validated competency units, criteria, and descriptors serve as a cornerstone for establishing a comprehensive Advanced Practice Nursing in Emergency Care framework. This framework plays a crucial role in standardizing practices, improving care quality, and ensuring that nurses are well-equipped to address the complex challenges of emergency settings.