explaining the competencies required for intensive care unit nurses: a delphi study

Background: rapid changes in the healthcare system necessitate the provision of high-quality and safe nursing care, a long-standing goal in nursing that depends on maintaining competence throughout the process.objectives: this study aimed to determine the clinical competencies of nurses in the intensive care unit.methods: this study, conducted in three rounds using the delphi method, selected 32 participants for participation through purposive sampling. in the first round, items were rated for necessity and relevance using 3- and 4-point likert scales, respectively. items that achieved ≥75% agreement, a mean score of ≥2.25 for necessity, and ≥3.0 for relevance were retained. in the second round, participants rated the importance of each item on a 4-point scale, and items with a mean score of ≥3.0 were included in the third round. in the final round, agreement was assessed on a two-way scale (agree = 1, disagree = 0), and items with a mean agreement score ≥0.75 (with 75% consensus) were considered final.results: a three-round delphi study was conducted with 30 expert panelists (retention rate: 93.75%). through systematic consensus-building, 185 competency items across 17 distinct domains were validated. the final framework encompasses critical areas such as personality traits, evidence-based care, patient safety, professionalism, communication, critical thinking, professional development, cultural/spiritual competence, and documentation. these domains demonstrated robust consensus, with mean relevance and importance scores ≥3.9 and agreement levels ≥97%. the competency framework achieved a high level of expert endorsement, with no items eliminated in the final round, confirming its comprehensiveness and contextual relevance for icu nursing practice.conclusion: assessing the clinical competence of nurses can help improve the quality of care. it is suggested that health policymakers consider these competencies as minimum standards for nurses.