Community care is characterised by a move from institutionalised to home-based care, a large patient population with comorbidities including cognitive failure, and nurses who struggle to keep up with their many competence demands. No study has examined the competence of nurses based on present demands, and an instrument for this purpose is lacking.
We conducted a Delphi study based in Norway to develop the substantial content of a new competence measurement instrument. We sought to reach consensus regarding which nursing staff competence is most relevant to meet the current needs of older patients.
A total of 42 experts participated in three consecutive panel investigations. Snowball sampling was used. The experts were clinicians, leaders, teachers, researchers and relatives of older people who required nursing. In Round 1, all experts were interviewed individually. These data were analysed using meaning coding and categorisation. In Rounds 2 and 3, the data were collected using electronic questionnaires and analysed quantitatively with SPSS.
The experts agreed that health promotion as well as disease prevention, treatment, palliative care, ethics and regulation, assessment and taking action, covering basic needs, communication and documentation, responsibility and activeness, cooperation, and attitudes towards older people were the most relevant categories of competence.
The experts showed clear consensus regarding the most relevant and current competence for nurses of older people. Assuming that older people in need of health care have the same requirements across cultures, this study's findings could be used as a basis for international studies.
Those who nurse older people require competence that is complex and comprehensive. One way to evaluate nursing competence is through evaluation tools such as the Nursing Older People--Competence Evaluation tool.
Many aged Norwegians live in sparsely populated areas where access to geriatric assessment is limited. In 1990 a non-acute, ambulatory service was started in the Nordmøre region. This article gives a description of the project. From 1990 to 1992 19 visits were made to six municipalities by a physician and a nurse from the out-patient clinic for the elderly at the local hospital. 59 patients were referred by general practitioners--mental impairment, general loss of function and assessment of possible rehabilitation being the most common causes for referral. Ten out of 11 GPs, all of whom had referred patients, and the leading district nurses in the municipalities expressed their satisfaction with the project through a postal questionnaire.