Assessing the Confidence and Competency of Nurses in the Management of Pharmacotherapy in Older Patients: a Cross-sectional Study

Background Nurses are on the frontline in drug treatment of older persons, which impacts on patients’ safety and well-being. Aim of the study was to assess nurses’ confidence and competency in geriatric pharmacotherapy. Methods After literature search, a questionnaire was developed and then refined with a Delphi procedure and cognitive interviews. In a cross-sectional study design, nurses attending an educational event in six Italian cities answered the questionnaire, exploring participants’ general characteristics and scoring confidence (range 0-40) and competency (range 0-100). Satisfactory competency was defined by a score in the top tertile. Results Out of 174 participants, 24, 67, and 83 were from Northern (NI), Central (CI), and Southern Italy (SI), respectively. The mean±SD confidence score was 23.9±4.8. Working in a Geriatrics setting and being employed in a hospital were independent predictors of higher confidence. The competency score (mean: 61.9±11.0) was independent of confidence (r= -0.026; p=0.729). Multivariable predictors of satisfactory competency scoring were: participants’ geographic location in NI (OR 3.3, 95% CI 1.0-10.9) or CI (OR 4.3, 95% CI 1.9-9.9) vs. SI, previous Geriatrics education (OR 2.2, 95% CI 1.0-4.7), and familiarity with bibliographic search engines (OR 1.55, 95% CI 0.99-2.43). Years since graduation were inversely associated with satisfactory scoring (OR 0.95, 95% CI 0.91-0.98). Conclusions This sample of Italian nurses showed moderate confidence and competency in managing drug therapy in older persons. Education, and not experience, was associated with satisfactory scoring. Efforts should be made to enhance training in Geriatrics and the utilization of tools for continuing education.