CLINICAL COMPETENCE AND ITS RELATIONSHIP WITH JOB STRESS AMONG NEONATAL INTENSIVE CARE UNIT NURSES: A DESCRIPTIVE STUDY

Clinical competence has a great impact on providing quality nursing care in Neonatal Intensive Care Units (NICU). Clinical competence is a complex concept that has different dimensions and its level and related factors have been reported numerously and sometimes contradictory in different clinical wards. The aim of this study was to evaluate the clinical competence and its relationship with job stress of nurses in NICUs affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2018.

In this descriptive cross-sectional study, 143 nurses working in NICU of hospitals affiliated to Shahid Beheshti University of Medical Sciences were enrolled by census sampling.  Clinical competence (level of competence and rate of application of clinical skills) and job stress of nurses were measured using "Nurse Clinical Competence Scale" (with 73 items and 7 domains) and "ASIPO Job Stress Questionnaire" (with 60 items and six domains). Data were analyzed using SPSS 22 statistical software using descriptive statistics and Pearson correlation test, independent t-test and one-way analysis of variance at a significance level of p <0.05 .

The mean score of clinical competency level was 68.3 ± 21.19 and was at a good level. The mean job stress of nurses was 207.43 ± 34.59 and was evaluated at a moderate level. The mean clinical skill utilization was 241.3 ± 31.9 which was at the moderate level.  Work shift-type showed a significant relationship with total clinical skill utilization score (p = 0.041). A negative correlation was found between the clinical skill utilization and job stress (p = 0.006) and also the rate of using clinical skills in the domains of education and guidance (p = 0.017), managerial skills (p=0.045), therapeutic intervention (p=0.041), quality assurance (p=0.001), and organizational tasks (p = 0.007) had a negative correlation with total job stress of nurses.

The level of clinical competence of nurses and the level of utilization of skills from their point of view were good and average, respectively. Increased total clinical competency was associated with reduced total job stress. Reduced job stress was associated with increased use of clinical skills in the domains of education and guidance, managerial skills, therapeutic intervention, quality assurance, and organizational tasks. Therefore, it is necessary for nursing managers to pay attention to reduce the job stress in order to promote the use of clinical skills in different dimensions and to provide conditions for improving the clinical competence.