Academic journal article Journal of Nursing Measurement

Nursing Older People-Competence Evaluation Tool: Development and Psychometric Evaluation

Academic journal article Journal of Nursing Measurement

Nursing Older People-Competence Evaluation Tool: Development and Psychometric Evaluation

Article excerpt

Background and Purpose: To evaluate the quality of care provided to older people, the competence of the nursing staff must be measured. This study evaluates a new instrument called Nursing Older People-Competence Evaluation Tool (NOP-CET). Methods: A 65-item questionnaire was completed by 1,016 community-based nursing staff and evaluated for validity, reliability, precision, interpretability, acceptability, and feasibility. Results: The survey demonstrated good content validity; conceptually coherent factor structure explaining 54.98% (knowledge items), 65.03% (skills items), and 52.83% (personal attribute items) of the total variance; and internal consistency (.77-.93). Conclusions: The NOP-CET showed good validity and reliability as a measure of community-based nursing staff competence and may be used in further investigations of competence in older people nursing.

Keywords: competence; home care; nursing home; nursing staff; psychometric evaluation

This article concerns the development and psychometric evaluation of the questionnaire Nursing Older People-Competence Evaluation Tool (NOP-CET). To measure and evaluate the competence of community-based staff providing care and treatment to older people in nursing homes and home care services, we conducted a large-scale survey with the NOP-CET (N 5 1,016) in the autumn of 2013. The NOP-CET was developed as a measure to improve quality processes because nursing staff competence is closely linked to quality of care (Harrington, Zimmerman, Karon, Robinson, & Beutel, 2000).


Our aging population implies that the health care needs of older people are increasing and changing. Large proportions of older patients suffer from more than one disease, receive a mix of health care services, and are treated by several workers from different disciplines (Boerma, 2006; Gautun & Hermansen, 2011). Health care systems often inadequately deal with older people with complex health care needs, which may result in unmet needs, adverse events, and other threats to their quality of care (Boerma, 2006; Sørbye, Grue, & Vetvik, 2009; Swedberg, Chiriac, Tornkvist, & Hylander, 2013). In all developed countries, nursing staff are central to older people nursing (Boerma, 2006; Colombo, Llena-Nozal, Mercier, & Tjadens, 2011); therefore, high-quality improvement processes that assess preconditions for quality nursing care are of great importance. Quality improvement methods consist of specifying desired performance, changing clinical practice, and measuring quality (Donabedian & Bashshur, 2003). Because competence is an inherent component of the quality of care delivered to patients (Harrington et al., 2000; Randolph et al., 2012; Schnelle et al., 2004), measuring the competence of nursing staff is an important step in quality improvement.

This study was performed in Norway, a country with a health care system similar to those of the United Kingdom and southern Europe; because of the tax-based systems, most services are free of charge, and the main actors are public (Hagen, 2011). In Norway, the municipalities (approximately 420) are responsible for providing community elderly care (Hagen, 2011), which is staff-intensive compared to most European countries and relies more on formal than informal care compared to southern and eastern European countries (Angermann & Eichhorst, 2012). In Norway, community care for older people includes services provided in nursing homes and home care, which are the services investigated in this study. Although nursing homes and home care services differ in the sense that the first consists of care provided in an institution and the latter, of care provided in patients' own homes, these two health care arenas are similar in that they both provide care and treatment to frail older adults characterized by multimorbidity, polypharmacy, and cognitive failure (Boerma, 2006; Gautun & Hermansen, 2011; Pedersen & Kolstad, 2009; Selbæk, 2008). …

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