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Objective: this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. Method: advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. Results: consensus for Core Competencies was established. Conclusion: the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment. [ABSTRACT FROM AUTHOR]

Background: Murray score is the result of an equation that gives all its variables the same linear contribution and weight and makes use of consented cut-offs. Everyday physicians' vocabulary is full of terms (adjectives) like: little, small, low, high, etc. that they handle in an intuitive and not always linear way to make therapeutic decisions. The purpose of this paper is to develop a fuzzy logic (FL) vision of Murray's score variables to enable the measurement of physicians' knowledge, experience and intuition in diagnosing lung injury and test if they followed Murray's equation predictions., Methods: For a prospective survey carried out among a team of professionals (aged 29 to 53) in a University Hospital Intensive Care Unit, twelve physicians filled in two questionnaires. In the first one they had to define the ranks which should be categorized as normal, moderate and severe for three of four Murray variables. In another questionnaire, which represented all probable combinations of those categories, they had to tick the pulmonary condition as: no injury, mild, moderate, and ARDS. This procedure gave rise to a Fuzzy Inference System designed to provide the degree of severity as sensed by the group., Results: The survey showed fuzzy frontiers for the categories and fuzzy diagnosis. In all, 45% of the hypothetical patients (n 18,013) were equally diagnosed by the survey and Murray's equation, whereas another 51% was overestimated in one level by the survey. Physicians agreed with 96.5% of ARDS cases according to Murray's test but only 11.6% of its mild cases were equally diagnosed by the survey. Nonlinearity of the survey reasoning (high relevance to gas exchange and chest film) was apparent., Conclusions: The contiguous categories of the variables confirm the existence of fuzzy frontiers. An overestimation was found in the surveyed group's interpretation of severity. This overestimation was mainly due to the different weight assigned to PO2/FiO2 and chest film variables. The FL approach made it possible to measure knowledge, experience and intuition as they appear in physicians' thinking. FL methodology could overcome a series of restrictions that current tests have due to cut-offs.