Education and competencies of nurses are one of the human resources concerns in all health care systems around the world [1].
Competencies are a set of demonstrable knowledge and skills that enable and improve efficiency or successfulness of a certain activity. The term “competence” first appeared in an article by R. W. White in 1959, as a concept for motivation [2]. The development of competence is the objective of each educational program and is determined in different levels of education. Some competencies are specific to a particular discipline, while others are common to all educational programs. It is common for competence development to take place cyclically and in an integrated manner throughout education [3].
For the nursing profession, competencies are essential because they can guarantee high quality and efficiency of the health care provided [4], and they maintain the social value and status of the nursing profession.
The basic competencies of the nursing profession include basic behavioural guidelines as well as mastering advanced practice skills. Nurse competencies include, above all, characteristics such as tenderness, willingness to help, careful observation and judgment, efficiency, dexterity and responsibility. Other competencies include nursing, communication and cooperation skills, management, self-development, innovation, research and adaptation to stress [5]. In the professional development of nurses, it is desirable to encourage and develop moral thinking, critical thinking skills, as well as social adaptability, but the nurses should also be enabled and prepared to identify and properly respond to ethical dilemmas from the health care area [6]. The World Health Organization requires all Member States to report and implement their plans to improve the knowledge of nurses and programs to improve their professional competence [7, 8].
Several reforms have been implemented in Europe in the education of nurses with the aim of harmonizing curricula and education programs among all members of the European Union, with the aim to facilitate the mobility of workers in order to meet the requirements of demand and supply in the dynamic labour market of the European Union. However, differences remain across Europe in nurse education [9]. As a member of the EU, the Republic of Croatia has adopted a national curriculum that complies with the standards of higher education of nurses (Croatian Classifications Framework) and with the Directive 2005/36/EC, through various projects aimed at harmonization. The Directive 2005/36/EC defines in detail the minimal conditions for education of nurses, and determines that the education consists in 4600 hours of theoretical and clinical training. However, the field of professional nursing competencies in terms of education is not defined by the Directive, but it requires compliance through different country-specific documents [7, 10].
In Croatia, the competencies of nurses, according to the level of education, are regulated by the Nursing Act, and, together with responsibility and ethics, they are defined by the Ethical Code of Nurses following international guidelines (International Council of Nurses). The Nursing Act in the Republic of Croatia lists competencies for nurses with basic education, with a bachelor’s degree and those with a master’s degree, divided into eight components 1. Responsibility, 2. Ethical practice, 3. Principles of providing nursing care, 4. Health promotion, 5. Evaluation, 6. Health care planning, 7. Implementation of procedures, 8. Education [5].
The high level of acquired competencies through education affects the quality and safe health care provided by nurses [1], which contributes noticeably to reducing mortality and adverse events in patients within hospital facilities [11].
The process of competence development lasts throughout the professional development of nurses [12] and therefore it is necessary to evaluate acquired competencies throughout education and to continue throughout the nursing career [13]. In the last decade, several tools have been developed to assess the competencies of nurses and nursing students [14–20], however, no tools have been developed or tested so far to be used in the Republic of Croatia.
Therefore, we decided to test the Nurses Professional Competence Scale (NPC) [20] in order to be used for assessing competencies of nurses in the Republic of Croatia.
The NPC scale assesses the capability level of nurses when performing various tasks in the field of nursing care. The scale contains 35 statements grouped into 6 clusters: 1. Nursing care; 2. Value-Based Nursing; 3. Medical and Technical Care, 4. Care Pedagogics; 5. Documentation and Administration of Nursing Care; 6. Development, Leadership and Organization of Nursing Care.
The use of the scale identifies the level of acquired nursing competencies as well as skill gaps in clinical practice and the quality of nurse education programmes [20].
All instruments used for assessment must be appropriate, reliable, valid and accurate [21]. Therefore, this paper aims to assess the validity of the structure and consistency of the NPC scale in the Republic of Croatia.