Competence of healthcare professionals in stroke care pathways: a cross-sectional study.

AIMS: To describe healthcare professionals' self-assessed competence in stroke care pathways based on their self-evaluation and identify the factors associated with competence. DESIGN: A cross-sectional, descriptive explorative study design was used. METHODS: The data were collected during May and September 2021 through a survey sent to healthcare professionals (N=1200, n=215) working in neurological care. Competence in stroke care pathways was measured using the RN-STROKE, PT-STROKE and OT-STROKE instruments defined by four-factor model. The instruments' validity and reliability were confirmed through exploratory factor analysis and Cronbach's alpha. K-means clustering, one-way ANOVA, Chi Square, Mann Whitney U and Kruskal-Wallis were used to analyze the data. The results were reported as frequencies, percentages, mean and standard deviation. The results were reported according to STROBE guidelines. RESULTS: Four main areas of healthcare professionals' competence in stroke care pathways were identified: (1) counseling and interaction competence (2) competence to use evidence-based information, (3) self-management and development competence, and (4) multiprofessional and collaboration competence. The study then identified three competence profiles of healthcare professionals working in the stroke care pathway. Professionals in Profile A evaluated their competence at the highest level, those in Profile B at the average level, and those in Profile C at the lowest level. Healthcare professionals' occupation and participation in their organisation's expert network were found to be associated with competence profiles. CONCLUSION: The overall competence of healthcare professionals in the stroke care pathway was rated as good, but competence to use evidence-based information in clinical practice, in particular, should be improved. Organisations should, therefore, increase education and training in this area and provide adequate resources to enable the use of evidence-based information in clinical work. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The study identifies three profiles relating to healthcare professionals' competence in the stroke care pathway, which can be used to create continuous education and ensure better patient care according to participants' profiles. REPORTING METHOD: The study was reported using the STROBE Statement checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Healthcare professionals' experience regarding competencies in specialized and primary stroke units: A qualitative study.

AIM: To describe healthcare professionals' experience of needed competence in patient stroke care within specialist and primary healthcare. BACKGROUND: Healthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. DESIGN: A descriptive qualitative study. METHODS: Six focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS: Five main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. CONCLUSION: Competence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Healthcare professionals' digital health competence profiles and associated factors: A cross-sectional study.

AIMS: To identify healthcare professionals' digital health competence profiles and explore associated factors to digital health competence in healthcare settings. DESIGN: A cross-sectional study. METHODS: Data were collected from 817 healthcare professionals from nine organizations with an electronic questionnaire by using Digital Health Competence instrument (42 items) and Aspects Associated with Digital Health instrument (15 items) between 1st March and 31st July 2022. K-means clustering was used to describe digital health competence profiles. Binary logistic regression analysis was used to explore associated factors. RESULTS: Analysis revealed three digital health competence profiles: A - high competence (n = 336), B - intermediate competence (n = 352) and C - low competence (n = 129). Between the profiles, digital health competence showed significant differences (p < .001). Recent graduation year, working in outpatient environments and leader or specialist position were associated with higher digital health competence. Organizational practices and the influence from colleagues improved competence in human-centred remote counselling, digital solutions as part of work, competence in utilizing and evaluating digital solutions and ethical competence. Support from management improved digital solutions as part of work and ethical competence. CONCLUSION: Nursing and allied health professionals working in other than outpatient environments should be specifically acknowledged when digital health competence development initiatives are designed and targeted. The positive influence from colleagues could be harnessed by enhancing their involvement in digital health competence development methods such as orientation, mentoring or coaching. Additionally, managers should take a stronger role in supporting different areas of digital health competence. IMPACT: This was the first study that explored healthcare professionals' digital health competence profiles and associated factors. The detection of healthcare professionals' digital health competence profiles guides the development of digital health education according to different needs in healthcare environments. REPORTING METHOD: The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Generic competence among health sciences students in higher education - A cross-sectional study.

BACKGROUND: Highly competent health care experts are needed for the development of the social and health care sectors. More knowledge is needed on the levels of generic competencies that health sciences experts possess, particularly in the context of complex decision-making. OBJECTIVES: To describe self-evaluated generic competence of health sciences students and its associated factors. DESIGN: A cross-sectional observational study design. PARTICIPANTS: A total of 291 health science students in five universities in Finland participated in this study during the spring of 2022. METHODS: The data was collected by using the HealthGenericCom instrument with 88 items and 8 sum dimensions using a five-point Likert scale (1-poor to 5-excellent): 1) competence in leadership, administration, and finance; 2) people-centred guiding competence; 3) competence of health promotion; 4) competence of evidence-based practice; 5) digital competence; 6) competence in work well-being and self-management; 7) competence in collaboration and problem-solving, and 8) competence in societal interaction. The K-means cluster algorithm was used to classify generic competence profiles to identify the profiles of health sciences students. RESULTS: Four generic health sciences competence profiles (A = 18 %, B = 23 %, C = 33 %, D = 26 %) were identified. Profile A demonstrated the lowest level of most generic competencies in health sciences. Digital competence was shown to be at the lowest level among the participants, whereas competence in collaboration, problem-solving, and health promotion was evaluated as the highest competence level. The students evaluated their competence as being higher when they were older, were currently engaged in master's degree programmes, had completed work-based practical training in social and health care, and had varied work experiences or held leading positions. CONCLUSIONS: Students need to improve their generic competencies in health sciences, with a particular focus on developing their digital competence. More focus should be given to work-based practical training.

Randomised controlled trials addressing how the clinical application of information and communication technology impacts the quality of patient care-A systematic review and meta-analysis.

BACKGROUND: The number of people with chronic and long-term conditions has increased during recent decades; this has been addressed by leveraging information and communication technology (ICT) to develop new self-care solutions. However, many of the developed technological solutions have not been tested in terms of impact(s) on patients' quality of care. OBJECTIVES: This systematic review aimed to identify the current best evidence on the types of interventions that have been developed to improve the quality of patient care through the clinical application of ICT in primary, tertiary or home care. DESIGN: A systematic review, including a meta-analysis, was conducted according to the JBI Manual for Evidence Synthesis guidelines. DATA SOURCES: Relevant data were identified from four electronic databases: CINAHL, PUBMED, SCOPUS and MEDIC. REVIEW METHODS: The eligibility criteria were formatted according to PICOS inclusion and exclusion criteria. At least two researchers performed the screening process separately, after which they agreed upon the results. The Cochrane Risk of Bias Assessment and JBI Critical Appraisal tool for randomised controlled studies (RCTs) were used to assess research quality. Data were extracted, and a meta-analysis was performed if the research met quantitative requirements. RESULTS: Of the 528 initially identified studies, 11 studies were chosen for final data synthesis. All of the interventions integrated ICT solutions into patient care to improve the quality of care. Patients across all of the RCTs were educated through direct training, the provision of information relevant to their disease or one-to-one educational coaching. The interventions included various interactions, e.g. nurse expert visits and support, and support provided by peers, groups or family members. These interactions occurred through face-to-face coaching, virtual human coaching or virtual coaching that relied on an algorithm. The performed meta-analysis included 6 of the 11 identified studies. The overall effect was nonsignificant, with three studies demonstrating a significant postintervention effect on patients' quality of care and quality of life and three studies a nonsignificant effect. CONCLUSIONS: The presented results suggest that ICT-based care should be developed in collaboration with nurses and other health care professionals, involve patients in decision-making and combine ICT solutions with human interaction and coaching. ICT education was found to be essential to the success of an intervention.

eHealth competence building for future doctors and nurses - Attitudes and capabilities.

BACKGROUND: Digitalisation is rapidly changing health care processes and the health care sector, thus increasing the need to improve the digital competence of future health care professionals. PURPOSE: The aim of this study was to describe the attitudes of medical and nursing students towards digital health based on self-evaluation as well as to compare the differences in perceptions between the two student groups. METHODS: A cross-sectional study was conducted as an online survey using the Webropol in April 2021 at the University of Oulu and Oulu University of Applied Sciences in Finland. The survey questionnaire consisted of seven background questions and 16 statements on a five-point Likert scale (fully disagree to fully agree) to survey student attitudes towards eHealth, and their digital capabilities. RESULTS: A total of 250 medical and nursing students were invited to participate in the study and 170 of them took the survey (response rate 68 %). Of those answered, 38 % (n = 64) were nursing and 32 % (n = 106) medical students. Students generally had a positive attitude towards eHealth and health care digitalisation. The differences in perceptions and preparedness between medical and nursing students were surprisingly small in the two student groups. There was a statistically significant difference between the two groups in three out of 16 statements: these were related to changes in the roles of health care professionals and patients as well as the students' knowledge of information contained in the national patient portal. CONCLUSIONS: The results of this study provide a good starting point for further harmonisation of the curriculum for both health professional groups regarding the teaching of eHealth and telemedicine.

Health care managers' competence in knowledge management: A scoping review.

AIM: To identify current evidence on health care managers' competence in knowledge management. BACKGROUND: Although successful knowledge management improves the quality of care and performance of health care organisations, there is limited evidence on health care managers' competence in knowledge management EVALUATION: A scoping review was conducted by including original published and unpublished studies (qualitative, quantitative, and experimental) and review designs in English, Finnish, or Swedish. The studies were retrieved from six databases (CINAHL, ProQuest, PubMed, Scopus, Mednar, and Finnish database Medic) in November 2020 and then complemented in January 2022. Narrative synthesis was used to synthesize data. KEY ISSUES: A total of 21 articles was included in the review. The main themes of managers' competence in knowledge management presented in these were system management, professional development, and leadership behaviour and attitude. No valid and reliable instruments were described in the included studies. CONCLUSION: At present, there is a limited understanding of health care managers' competence in knowledge management. A comprehensive understanding of this topic can provide a direction for future research. IMPLICATIONS FOR NURSING MANAGEMENT: The results can be utilized in the assessment and development of managers' competence in knowledge management, as well as the formulation of education and in-service training for health care managers.

Healthcare professionals' perceptions of digital health competence: A qualitative descriptive study.

AIMS AND OBJECTIVES: This study aims to provide insight into healthcare professionals' lived experiences of digital health competence with the objective of improving the knowledge of how digital health competence is perceived by healthcare professionals. BACKGROUND: Healthcare professionals need to adjust to the digital era to provide quality and ethical care. Previous research has rarely adopted a healthcare professional's standpoint to describe their perceptions of digital health competence, even though their perspective in how new care practices are designed and implemented is vital. DESIGN: A qualitative descriptive study. METHODS: Healthcare professionals (nurses and allied health professionals) from versatile healthcare settings were recruited for individual semi-structured interviews in Sweden (n = 5) and Finland (n = 15) (spring 2019-summer 2020). Purposive and convenience sampling was used. Participants' backgrounds were in the public and private sectors. The interviews were transcribed for inductive content analysis. The SRQR guideline guided the study process. RESULTS: Healthcare professionals' perceptions of digital health competence are connected to competence to provide patient-centric care through digital channels, using technology and digital health systems, interacting with the patient through digital means, evaluating what digital health is and combining digital and traditional methods. Professionals' perceptions of their own digital health competence were divided, with the participants either reporting sufficient competence or perceiving a lack of skills in some specific areas. CONCLUSIONS: Healthcare professionals' perceptions of digital health competence focus on the ability to provide patient-centric care by evaluating the need and possibilities for using digital health services jointly with more traditional methods. This study provides a sound basis for digital health research, but future studies should focus on elucidating factors which affect digital health competence and competence development. RELEVANCE TO CLINICAL PRACTICE: The results of this study can guide healthcare practices and digital health implementation, as well as function as a basis for instrument or theory development. Health care and nursing leaders should enable the resources to hybrid practices in patient-centric care provision.

Healthcare professionals' competence in stroke care pathways: A mixed-methods systematic review.

BACKGROUND: The challenges of caring for stroke patients are growing due to population ageing and improved survival rates. Healthcare professionals' competence development in stroke care is a necessity to ensure high-quality patient care. OBJECTIVES: To identify and describe the competence areas of healthcare professionals working in the stroke patient care pathway and factors influencing these competences. DESIGN: A mixed-methods systematic review. METHODS: The review was conducted according to the JBI guidelines and registered in the PROSPERO database (CRD42020204062). PRISMA checklist guided the review process. Relevant original studies were identified by searching four databases-CINAHL (EBSCO), PubMed, Scopus and Medic. After researcher consensus was reached, 32 studies were selected for inclusion and subjected to content analysis and data tabulation. RESULTS: Competence in care processes, clinical competence, competence in using self-management strategies, interaction skills, skills in acknowledging family and competence in integrating the available evidence base into patient care were identified as key competence areas. Organisation of services, specialisation in stroke care, continuous development and education, family and carer and training in oral care and cognitive rehabilitation were identified as factors that influence healthcare professionals' competence. CONCLUSIONS: Diverse clinical and interaction competencies are needed throughout the stroke care pathway, and various factors affect healthcare professionals' competence. Further research on healthcare professionals' stroke care competence will be needed to respond to changing healthcare demand. RELEVANCE TO CLINICAL PRACTICE: We recommend organisational support and formulation of stroke care patient guidelines in line with healthcare competence requirements. Focus should be added for nursing professions in developing interactive communication competence since nurses spend the majority of the time providing individual patient care. Also, organisations should integrate continuing training in specialised stroke care for healthcare professionals' competence development.