THE IMPACT OF UNIT SPECIFIC COMPETENCIES ON QUALITY OF NURSING PRACTICE FOR NURSES IN CRITICAL CARE UNIT

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ACKNOWLEDGEMENT

I would first like to express my gratitude for my research supervisor, colleagues, peers and family whose immense and constant support has been a source of continuous guidance and inspiration.

DECLARATION

I [type your full first names & surname here], declare that the following dissertation/thesis and its entire content has been an individual, unaided effort and has not been submitted or published before. Furthermore, it reflects my opinion and take on the topic and is does not represent the opinion of the University.

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ABSTRACT

Measurement of nurse competency presents a formidable challenge. Indicators used to measure an individual nurse's competence vary depending on the construct being examined. Nursing care in the hospital setting is delivered by a workgroup comprised of individual RNs who potentially possess different professional competencies. Measuring effects of individual RN competencies as against the performance within the critical care unit is methodologically difficult due to a group practice model and relatively small patient population per RN; consequently, RN competencies must be aggregated to the patient unit level for purposes of study. RN certification is one method for assessing nursing competence in a practice specialty. Keeping in view the importance and significance of competencies that influence a nurse's performance in a critical care unit, the researcher, in this thesis has provided a detailed account of what it needs to be a competent nurse in a hospital setting. The first chapter provides a comprehensive introduction to the topic, covering the problem statement, aims, objectives, and significance of the topic of research. The second chapter presents the literature review; covering competency theories, their applications in critical care scenarios; and other relevant concepts. The third chapter deals with the methodology. The researcher has used qualitative case study research method, with sample participants selected from three London hospitals. In the fourth chapter, the researcher has recorded in-depth interview analysis and related findings. The research concludes the fifth chapter, in which implications, recommendations for further research, and limitations are presented.

TABLE OF CONTENTS

ACKNOWLEDGEMENTI

DECLARATIONII

ABSTRACTIII

CHAPTER 1: INTRODUCTION1

1.1. Overview of he Chapter1

1.2. Background of the Study1

1.3. Statement of the Problem13

1.4. Purpose of the Study20

1.5. Aim of the Study22

1.6. Objective of the Study23

1.6.1 Specific Objectives24

1.6.2. Secondary Objectives24

1.7. Research Questions24

1.8. Significance of the Study25

1.9. Identification of Stakeholders and Project Mentor31

1.10. Assumptions32

1.11. Definition of Terms33

1.12. Summary34

1.13. Organisation of the Remainder of the Study36

CHAPTER 2: LITERATURE REVIEW37

2.1. Overview of the Chapter37

2.2. Theoretical Framewrork38

2.3. Nurse Competency42

2.3.1. Why be competent?43

2.4. Competency Theories44

2.5. NHS Standards and Competency46

2.6. Critical Care UnitManagement49

2.6.1. Patient Care in the CCU61

2.6.2. Timeliness of Care in the CCU64

2.7. Measuring Performance66

2.7.1. Key Performance Indicators67

2.7.2. Patient-Related Indicators68

2.7.3. Health Care Providers Related Indicators71

2.7.4. Standards of Performance72

2.7.5. Teamwork73

2.7.6. Prior RN and Critical Care Unit Work Experience75

2.7.7. Critical Care Nursing Expertise in the Delivery of Patient Care at CCU78

2.8. Measurement of the Nursing Work Environment80

2.9. Summary81

CHAPTER 3: METHODOLOGY83

3.1. Overview of the Chapter83

3.2. Research Method84

3.3. Research Design84

3.3.1. Case Study Research86

3.4. Research Questions88

3.5. Pilot Study89

3.6. Population89

3.7. Sampling Procedure90

3.7.1. Selection of Nurse ...