Nursing competency assessment in the emergency department of Dolo Hospital: a self-assessment checklist for improving training and clinical practice

Introduction: competency-Based Education (CBE) is widely used in the training of healthcare professionals. Competency is defined as an expected level of performance integrating knowledge, clinical skills, and professional attitudes. In emergency nursing, performance levels evolve from novice to expert depending on the nurse’s learning and experience. A key principle of CBE is the evaluation and identification of competency development over time. The aim of this study is to define the knowledge and skills required for nurses working in the Emergency Department, using a Clinical Skills Checklist. This tool allows for the identification of individual competencies as well as educational gaps, which can be addressed through targeted training. Moreover, it enables monitoring of training effectiveness and the maintenance of competencies over time.

Materials and Methods: a literature review was conducted to identify and adapt a self-assessment instrument for nursing competencies. The resulting checklist consisted of 72 performance indicators, categorized into seven core domains, and was administered to 40 nurses working in the Emergency Department of Dolo Hospital (ULSS3 Serenissima). Participants completed the instrument in self-assessment mode, employing a four-point Likert scale (0 to 3).

Results and Discussion: data analysis highlighted both areas of consolidated competence and domains in which staff reported a need for support. Specifically, in six skills (management of patients with psychiatric disorders, management of patients with AIDS, care of abused children, care of pregnant women with hemorrhage, care of pregnant women with hemodynamic instability, and performance of FAST ultrasound in polytrauma patients) more than 50% of nurses reported limited experience and the need for supervision, indicating the necessity of targeted educational interventions. These findings suggest that the checklist may serve as a valuable tool not only for identifying individual training gaps but also for defining team-level educational priorities.

Conclusions: the use of a structured checklist enables nurses to reflect on their own level of competence and allows the organization to strategically guide training programs. The findings highlight the need to plan targeted educational interventions in specific critical areas, thereby promoting the standardization of competencies within the Unit. Periodic administration of the instrument can support the continuous monitoring of competencies and contribute to the improvement of care quality.