Explaining the competencies required for intensive care unit nurses: A delphi study

Background: Rapid changes in the healthcare system necessitate the provision of high-quality and safe nursing care, a long-standing goal in nursing that depends on maintaining competence throughout the process.Objectives: This study aimed to determine the clinical competencies of nurses in the intensive care unit.Methods: This study, conducted in three rounds using the Delphi method, selected 32 participants for participation through purposive sampling.In the first round, items were rated for necessity and relevance using 3-and 4-point Likert scales, respectively.Items that achieved 75% agreement, a mean score of 2.25 for necessity, and 3.0 for relevance were retained.In the second round, participants rated the importance of each item on a 4-point scale, and items with a mean score of 3.0 were included in the third round.In the final round, agreement was assessed on a two-way scale (agree = 1, disagree = 0), and items with a mean agreement score 0.75 (with 75% consensus) were considered final.Results: A three-round Delphi study was conducted with 30 expert panelists (retention rate: 93.75%).Through systematic consensus-building, 185 competency items across 17 distinct domains were validated.The final framework encompasses critical areas such as personality traits, evidence-based care, patient safety, professionalism, communication, critical thinking, professional development, cultural/spiritual competence, and documentation.These domains demonstrated robust consensus, with mean relevance and importance scores 3.9 and agreement levels 97%.The competency framework achieved a high level of expert endorsement, with no items eliminated in the final round, confirming its comprehensiveness and contextual relevance for ICU nursing practice.Conclusion: Assessing the clinical competence of nurses can help improve the quality of care.It is suggested that health policymakers consider these competencies as minimum standards for nurses. Implications for Nursing and Midwifery Preventive Care The competency framework emerging from this study can serve as a foundation for developing evidence-based educational programs to strengthen nurses' preventive and clinical decisionmaking skills. This helps improve the quality and safety of care across healthcare systems.