The development of competency standards for specialist critical care nurses

Sandra V. Dunn, Di Lawson, Sally Robertson, Marianne Underwood, Robyn Clark, Teresa Valentine, Nicky Walker, Christine Wilson-Row, Kerrie Crowder, Deb Herewane

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.

Original languageEnglish
Pages (from-to)339-346
Number of pages8
JournalJournal of Advanced Nursing
Issue number2
Publication statusPublished or Issued - Feb 2000
Externally publishedYes


  • Attitudes
  • Certification
  • Clinical nursing research
  • Competence/standards
  • Decision making
  • Education
  • Health care
  • Intensive care
  • Knowledge
  • Models-nursing
  • Nursing staff
  • Outcome assessment
  • Practice

ASJC Scopus subject areas

  • Nursing(all)

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