Nursing Competence in Norwegian Municipal in-patient Acute Care. Professional Accountability, Environment, and Leadership

Abstract

Background: Changes from the introduction of the Coordination Reform in Norway have induced an increase in the need for highly qualified nursing staff in the primary health care service. Among the most important initiatives of the Coordination Reform in Norway is the municipal in-patient acute care (MipAC) service. All municipalities must provide in-patient acute care for patients requiring 24-hour care or observation. The MipAC is expected to deliver safe quality care and may entail many patient and societal benefits. However, the service establishment and organisation differ per municipality, putting the service quality into question. Older and vulnerable patients constitute the largest group of patients under the MipAC service. Even though the benefits of well-educated and competent nursing staff to care for vulnerable older people are broadly recognised, the requirements for nursing competence are sparsely defined in governmental documents, and knowledge of nursing competence in the services is lacking.

Aim: This study explores and describes aspects of nursing competence in the MipAC service. It answers the following question: What is the necessary nursing competence in MipAC, and how is it facilitated, maintained, and enhanced?