Construction of the matrix of individual nursing competences in surgical units

Exploratory, qualitative study. 43 nurses from five surgical units participated, and data collection was carried out between April and September 2017. The focus group technique was used and for data interpretation an inductive thematic analysis was performed. The competence matrix was built from the testimonies of the participants plus a search in the literature for concepts directed to each competence and description of the expected behaviors and / or attitudes.

Results:

For the Matrix, the following individual skills were identified: Planning; Communication, Relational Competence, Leadership, Decision Making and Ethics.

Final Considerations:

The construction of a Matrix should assist managers in recognizing the professional profile and assessing their performance, strengthening the achievement of professional and organizational objectives, as well as contributing to the quality and effectiveness of the care provided by nurses in these places.

Descriptors:
Nurses; Perioperative Nursing; Professional Competence; Surgical Centers; Hospitals

INDIVIDUAL COMPETENCES
Planning of the unit and nursing care It is the ability to organize, schedule activities and actions related to nursing care according to current situations.
Behaviors/attitudes
• Characterize the available assets and those that need to be recruited; • Identify the profile of nursing professionals that are recruited in this context. • Plan and elaborate the manual of regulations and routines of the sector, protocols, as well as the standard operational procedures (sops). • Identify the sector's problems in relation to the people and work routines of the nursing team, making the diagnosis of reality and, thus, planning priorities, seeking solutions, in the short and long term. • Organize the service, the activities to be carried out in the surgical unit and indicate them to the nursing team. • Schedule the activities performed inside the operating room and specificities of the sector, such as the physical structure, the work routine. • Organize the process for the assembly and disassembly of the operating room, as well as the material needed to perform the surgical procedure. • Know the computerized data recording system for scheduling surgeries and user records, as well as surgical indicators. • Identify surgical scale procedures and elaborate/organize an agenda aimed at the fulfilment of scheduled surgeries. • Carry out the comprehensive care plan for the user during their stay in the surgical unit, ensuring their reception. • Apply the steps of the nursing process in order to systematize care in the surgical unit in order to plan its actions and prevent complications.
Nursing communication It is the ability to share information, ideas, suggestions that contribute to the smooth running of the service.
Behaviors/attitudes
• Express yourself with clarity, precision and make yourself understood, verbally, in the form of records, for your team members and other professionals of the Surgical Unit and support sectors. • Try to adapt your speech and language with different professional categories. • Be assertive in exposing your ideals and being able to arouse the attention of the nursing team.
Relational competence It is knowing how to deal with situations that generate disagreement between the teams; this implies dialogue, deep knowledge of the work dynamics to find possibilities/alternatives in order to solve the existing problems, whether related to human, material or financial resources.
Behaviors/attitudes
•Develop collaborative and cooperative relationships within the unit. • Assist the team in conflict management, approaching workers in a respectful, cordial manner, showing understanding in adverse situations. • Demonstrate respect for the opinions of the multidisciplinary team, listening to and valuing them. • Listen carefully and be accessible to the unit's health and nursing staff, facilitating the creation of bonds. • Demonstrate self-confidence in the relationship with the team, act in different contexts preserving harmonious interaction with superiors and subordinates. • Meet with the multi-professional team, establishing a constant dialogue about the activities and incidents of the surgical unit, promoting the sharing of ideas, negotiation and conflict management. • Support the team when there are situations that generate interpersonal and work conflicts.
Nursing leadership It is the ability to command, direct, influence and motivate people and groups in a positive way in order to achieve a common goal, stimulating initiative and accountability.
Behaviors/attitudes
•Promote a group sense of participation and mutual collaboration. • Encourage initiative, proactivity, as well as autonomy, delegating tasks to be performed and sharing responsibilities with the team. • Encourage compliance with surgery schedules according to what was planned without allowing unnecessary changes in the surgery map to meet the particular purpose of the anaesthetic or medical team. • Guide and supervise and evaluate the use of equipment. • Guide and supervise the nursing team. • Encourage team improvement through permanent education. • Present monthly report on surgical quality indicators, proposing improvement strategies with the team. • Propose daily and monthly schedules distributing their professionals according to their knowledge, skills and attitudes. • Apply a tool to assess the professional performance of the nursing team.
Nurses' managerial decision-making It is the nurse's ability to characterize situations in the context of work, listing possible solutions, and take the necessary measures in a timely manner, effectively, that is, to act in situations that require decision making for their resolution.
Behaviors/attitudes
• Take measures or make choices to direct actions to solve problems, or situations in the work environment, in a timely manner, bearing in mind the priorities of the service and the urgency of the situations. , • Analyze the alternatives for solving problems in the sector and their potential implications for the service, fundamentally choosing the appropriate options. • Be self-confident and determined to make decisions, even when it comes to difficult choices. • Assume co-responsibility for decisions made in front of the nursing team in the Surgical Unit.
Ethics It is the ability that each professional has to think before acting, and make the right decisions, taking into account the ethical values of the profession; to act with fairness, always taking into account impartiality in decision making, as well as having knowledge and respecting the professional code of ethics.
Behavior/attitudes
• Know the legislation and demonstrate commitment to your professional responsibilities. • Act on confidential information that you have access to, in a strict, confidential manner, respecting legal, ethical and deontological principles
•Know and always apply the professional code of ethics in matters related to the team, acting with impartiality, fairness and professional ethics in judging issues. • Notify the ethics committees and nursing councils of situations that do not comply with the legislation and that disrespect the code of ethics, be they institutional or the team's. • Know and apply the code of ethics in customer service whenever necessary, respecting their autonomy and singularities of each user. • Recognize and guide your team on issues of posture and morals and ethics at work.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Laura Andrian Leal. E-mail: laura.andrian.leal@usp.br