Construction of a post competency evaluation index system for fever clinic nurses: a single-center Delphi study in China

Fever clinic nurses act as a frontline “sentinel” in the surveillance and control of respiratory infectious diseases; however, more than three years after the COVID-19 pandemic began, no post-competency evaluation index system for this workforce exists in China. This study therefore aimed to develop and validate such a system to guide the selection, training, and performance management of fever clinic nurses during major public health crises. This mixed-methods study proceeded in two phases: (1) a systematic literature review framed by the onion model to derive an initial indicator pool, and (2) a three-round Delphi consultation with 14 experts from a single tertiary hospital in China, recruited by purposive and snowball sampling (from January to April 2023). Indicators were retained when the mean importance score exceeded 3.5 and the coefficient of variation was below 0.25. The expert’ positive coefficient, authority coefficient, and Kendall’s W were used to test the system. The final system comprised three first-level indicators (knowledge and skills, competency, personality), 17 s-level indicators, and 65 third-level indicators. The expert response rate was 100% across all three rounds, the authority coefficient was 0.868, and Kendall’s W ranged from 0.214 to 0.692 (all p < 0.001), indicating strong consensus. The resulting index system is a structured, evidence-informed tool supported by clear expert consensus, although its single-centre derivation limits generalisability. It provides nursing managers with a basis for competency-based selection, training, and evaluation of fever clinic nurses, and should be validated in multicentre studies.