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Mapping the Domains of General Nurse Practice in Performance Evaluation Instruments: A Scoping Review

Background: Public demand has intensified for greater accountability in clinical quality provided by caring and competent nurses. Measuring
and reporting a nurse’s ability to meet role and performance expectations is core to that accountability. Although the literature is replete with
performance appraisal (PA) and competency assessment (CA) instruments, the absence of a universally adopted conceptual framework impedes
the industry’s ability to convey whether a nurse is meeting role and performance expectations across the industry. This scoping review will
identify systematic reviews and single-instrument studies that examine PA and CA instruments explicitly listing the domains of assessed practice.
Domains will then be collated and examined to identify common terminology that could inform the creation of a universal conceptual model that
depicts the performance expectations of nurse generalists.
Methods: The scoping review uses the Johanna Briggs Institute Scoping Review Methodology. A search was conducted between March 2018 and
March 2019 for systematic and literature reviews published between January 2000 and December 2018 indexed in PubMed, CINAHL, Medline,
ScienceDirect, Cochrane, and Google Scholar along with studies found in grey literature. Additionally, studies examining single instruments with
clearly identified domains that evaluate generalist nurse performance were included.
Results: Eight systematic reviews and 11 single-instrument studies were selected for examination, yielding 37 instruments. Of the 230 total
unique domains, the most common domain titles were centered on basic nursing skills (n=50, 22%), foundational skills and capabilities (n=34,
15%) and values (n=26, 11%). 14 instruments were associated with a conceptual model/framework.
Conclusions: A conceptual model with standardized terminology is the antecedent of an effective, generalizable performance evaluation
instrument. The creation of an industry-wide conceptual model can strengthen role clarity for new and experienced nurses and offer higher
accountability to health care colleagues and the public at large.

Author(s): Sean E. McNeal

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