Validating international CanMEDS-based standards defining education and safe practice of nurse anesthetists

Aim

To investigate whether the CanMEDS‐based International Federation of Nurse Anesthetists’ Standards could adequately define the scope of practice and reliably be used to train and evaluate Swiss nurse anesthetists (NAs).

Background

Although nurse anesthetists represent a majority of the global workforce in anesthesia, policies that define the scope of practice are frequently non‐existent. In low‐ and middle‐income countries, the lack of anesthesia providers with adequate training is a major challenge.

Introduction

Despite stringent training requirements, the scope of practice of Swiss nurse anesthetists is actually not defined. Therefore, we surveyed and assessed whether nurse anesthetists felt that the professional competencies outlined in this framework were aligned with their clinical practice.

Methods

A cross‐sectional survey investigated Swiss nurse anesthetists’ relevance ratings of 76 competencies of the International Federation of Nurse Anesthetists according to their professional practice. Cronbach's alpha coefficients were used to determine the internal consistency of the competencies, as well as factor analyses to assess construct validity of these competencies integrated into the CanMEDS roles model.

Results

Participants rated the Standards overall as very relevant with high reliability. Factor analyses provided evidence of construct validity of these.

Discussion

The International Federation of Nurse Anesthetists' Standards of Practice provide a highly relevant framework and a valuable set of competencies for the scope of practice of Swiss nurse anesthetists, which enabled translation from global guides to local national standards.

Conclusion and implication for nursing and health policy

Adopted by low‐ and middle‐income countries or countries where national standards are non‐existent, this survey could introduce national and local policies at minimally acceptable standards of care for nurse anesthetists worldwide. The above standards have the potential to align education, outcomes and assessment of nurse anesthetists with the needs of national healthcare systems.

The creation and integration of a nurse educator position in two hospitals in Haiti

BACKGROUND

Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited.

PURPOSE

To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role.

METHODS

Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed. Supplementary data were gathered through participant observation and document review. Data were compiled and summarized.

DISCUSSION

NEs were hired to assess learning needs, evaluate skills, train and mentor nurses, and provide ongoing support to assure application of new knowledge. Barriers included lack of specialized training and limited informational resources to develop education activities, role confusion and heavy workload, poor attendance and disparate education needs of nurses, and insufficient hospital resources and support to implement practice changes. Facilitators included previous management experience, peer support, and a perception of being valued by patients and colleagues and making a difference regarding nursing care and patient outcomes.

CONCLUSION

The NE is a leadership role and a promising, sustainable initiative for developing the nursing profession in Haiti.