Purpose
This study aimed to clarify the concept of nursing competence in coping with clinical deterioration by employing Rodgers’ evolutionary concept analysis, which reflects both sociocultural and temporal dimensions. Methods: A six-step concept analysis was conducted following Rodgers’ methodology. A systematic literature review was performed using PubMed, Embase, CINAHL, and Google Scholar, yielding 35 relevant studies published between 2000 and 2025. Data extraction followed the Joanna Briggs Institute template, and quality was appraised using the STROBE checklist. Results: Four key attributes of nursing competence were identified: technical skills in patient monitoring, situational awareness and clinical intuition, decision-making regarding escalation of care, and communication and teamwork to ensure timely intervention. Antecedents included formal education, clinical experience, and institutional support. Consequences encompassed enhanced patient safety, increased nurse confidence, and greater professional autonomy. The concept was demonstrated to be dynamic and influenced by healthcare policies, such as the implementation of rapid response systems. Conclusion: Nursing competence in managing clinical deterioration is a multidimensional and evolving concept that is essential for patient safety. Clarification of this concept can inform the development of assessment tools and simulation-based education. Further research should explore its application across diverse healthcare contexts and address challenges related to escalation of care.

PURPOSE
This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care.
METHODS
A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group (n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to 30°~45° high, maintaining continuous endotracheal cuff pressure at 25 cm H₂O, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, x² test, Mantel-Haenszel x² and Cox proportional harzard regression model.
RESULTS
The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant (x²=0.79, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group (x²=14.59, p<.001).
CONCLUSION
Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.

Citations

• Effects of Oral Care Using Chlorhexidine Gluconate on Ventilator-associated Pneumonia and Mortality: A Systematic Review and Meta-analysis
  Nam Young Kim, Seang Ryu, Yun-Hee Kim
  Korean Journal of Adult Nursing.2019; 31(2): 109.     CrossRef