308 The development of a competency toolkit for nurses working in stroke in the Irish healthcare setting

Abstract Background Stroke Unit Nurses require multifaceted competencies to manage the complex needs of the stroke patient. The National Clinical Programme for Stroke (NSP) set out to develop a competency toolkit for stroke nurses. A modified-Delphi format was used, the questionnaire was developed by an Irish expert advisory group. The development was informed by the group experience and review of existing stroke unit nurse competency toolkits In Ireland and abroad. Methods Round one of the Survey was conducted using a semantic differential question, with a 3 point score scale. The survey was sent to a subject matter expert group (32 Clinical Nurse Specialists & Advanced Nurse Practitioners). In round two, the participants were given controlled structured feedback based on the overall feedback from round one, which allowed for adjusted responses. The advisory group looked at themes that emerged in the answers in round one. This formed the basis for the questions in round two, a multiple-choice format, with one answer. Results Response rates for round one was 66%, Individual opinions were combined into a group consensus, which lead to the completion of the questionnaire for round two. A consensus definition of at least 80% agreement for each item was decided a priori, in round one, 75% of items reached consensus. Round two response rate was 71%, with 49% of items reaching consensus. Conclusion Development of a standardised competency toolkit for stroke unit nursing is a strategic goal of the NSP. While round one lead to considerable consensus, it is clear that what is not agreed initially can be difficult to reach a consensus on, with only 49% consensus in round two. A third round will be required, but if consensus remains elusive, additional methodology techniques such as a focus group may be used. Challenges are response exhaustion and availability of busy ‘experts’ in their fields.