Advanced nursing competencies in critical care: education and evaluation tools. A narrative review

Introduction: advanced nursing competencies refer to expanded and improved health care services and interventions delivered by nurses who, with advanced skills, influence clinical health outcomes and deliver direct health services to individuals, families, and communities. What distinguishes the critical care from other settings, where nurses can develop advanced skills, is its complexity and dynamism. The aim of this review is to outline the advanced skills in critical areas through training path description for their achievement and the tools used to evaluate them in the international context.

Materials and Methods: a narrative literature review has been performed. The main scientific databases were consulted (Medline/PubMed, CINAHL, Cochrane Library, EMBASE), selecting articles in English and Italian published in the last ten years, since the establishment of the working group for advanced skills of the European federation of Critical Care Nurses Association (EfCCNa). All the articles dealing with advanced skills in the critical area and the related evaluation tools were included.

Results: a total of thirtheen articles were selected, including two literature reviews.

Formal training programs for critical care nurses are present in 17 out of 24 European countries and critical care nursing has been recognized as a specialty in 13 of them. There are ten assessment tools for assessing advanced critical care skills.

Discussion: the educational status of critical care nurses in the EU is extremely varied and disomogeneus. Currently, the literature offers valid and reliable assessment tools for skills, but they are heterogeneous and not usable in every context.

Conclusions: it is necessary an institutional intervention at national and community level, aimed at regulating the training and recognition of nursing competencies in critical care also through a uniformity of evaluation tools.