Prioritizing Competencies of Nurses by a New Fuzzy Method: A Case Study on Hospital Emergency Wards

Jahanara  Mamikhani; Shahram  Tofighi; Yasaman  Alikhani

doi:10.18502/htaa.v10i1.21563

Jahanara Mamikhani Department of Economics, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Iran, Iran Health Management Association
Shahram Tofighi National Center for Health Insurance Research, Iranian Academy of Medical Sciences
Yasaman Alikhani National Center for Health Insurance Research

DOI: https://doi.org/10.18502/htaa.v10i1.21563

Keywords: Clinical competence, Nurses, Hospital emergency services, Hospital, Workplace environment, Fuzzy logic, Iran

Abstract

Introduction: Core nursing competencies refer to the effective application of a person’s combination of knowledge, skills, and judgment in job. This study aimed to determine the essential competencies of nurses working in hospital emergency wards, considering the characteristics of the emergency workplace, using a new approach.

Methods: A mixed-method study was conducted in 2023. Twenty-two experts were organized into two groups of five and two groups of six. Then, qualitative approaches were employed to collect data. Group brainstorming sessions identified the list of essential competencies and characteristics of the emergency workplace, while focus group discussions were used to finalize them. Ultimately, a fuzzy pairwise comparison matrix was applied using MATLAB 23.1 to weight and prioritize the competencies.

Results: Eleven key items emerged as the main characteristics of the workplace, while thirteen were identified as the essential competencies of nurses in the emergency ward. The “unpredictability of clients” and “high levels of team discipline and autonomy” were rated as the most important workplace features. In terms of nursing competencies, “high scientific abilities and skill capacities in managing diverse care situations from infancy to elderly” also received the highest score. When incorporating the workplace characteristics into the evaluation, “speed of action, professionalism, and coordination” notably ascended to the top rank, while “responsibility” dropped to fourth.

Conclusion: The characteristics of the workplace represented a more realistic rank of nurses’ competencies. Accordingly, emergency department nurse staff should be selected and evaluated based on competencies adapted to the characteristics of the workplace