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Developing Nurse Practitioner Treatment Competencies in Emergency Care Settings

Ramirez, Elda G. RN, PhD, FNP, BC, CEN, FAANP; Tart, Kathryn EdD, RN; Malecha, Ann PhD, RN


Nurse practitioners (NPs) providing care in the emergency department do not have recognized treatment competencies. The purpose of the study was to establish a definition of the NPs in emergency care settings, by examining the treatment competencies. The overall goals of this research project were to perform psychometric testing on the Nurse Practitioner Treatment Competency Instrument (NPTCI) and identify competencies relevant to the NP in the emergency department. The research questions for this study were as follows: What were the internal consistency reliability estimates for the NPTCI as measured by Cronbach's alpha reliability coefficients? What was the construct structure of the NPTCI as evidenced by the factor loading extracted from an orthogonal, rotated, exploratory factor analysis? What items in the NPTCI were relevant to the emergency nurse practitioner? The task analysis branch of the Kane model, “Model-Based Practice Analysis and Test Specifications,” is the segment this study used to establish the framework for conceptualization and identification of treatment competencies for NPs in emergency care. A descriptive postal survey was conducted using a national sample. The data for this study was collected using the NPTCI that examines demographic information related to NP practice and the relevance of specific activities/tasks that are identified by established family and acute care competencies. The instrument was sent to family, acute care, and emergency NPs. The total estimated sample size was 1,778; of the 582 who responded to the questionnaire, 42 were emergency NPs. The NPTCI was found to be reliable and valid using factor analysis and Cronbach's alpha. Fifteen competencies out of 89 were not relevant to the emergency NP.

Division of Emergency Care, University of Texas Health Science Center, Houston; and Texas Woman's University, Denton, Tex (Drs Tart and Malecha).

Corresponding author: Elda G. Ramirez, RN, PhD, FNP, BC, CEN, FAANP, Emergency Care, University of Texas Health Science Center, 501 W 25th, Houston, TX 77008 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.