en Nursing Orginal research <div style="text-align: justify;"><span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#2980b9;"><b>Background:</b></span> 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.<br> <span style="color:#2980b9;"><b>Objectives:</b></span> This study aimed to determine the clinical competencies of nurses in the intensive care unit.<br> <span style="color:#2980b9;"><b>Methods:</b></span> 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 &ge;75% agreement, a mean score of &ge;2.25 for necessity, and &ge;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 &ge;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 &ge;0.75 (with 75% consensus) were considered final.<br> <span style="color:#2980b9;"><b>Results:</b> </span>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 &ge;3.9 and agreement levels &ge;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.<br> <span style="color:#2980b9;"><b>Conclusion:</b> </span>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<b>.</b></span></span></span><br> &nbsp;</div> Clinical Competence, Nurse Specialists, Delphi Technique. 50 60 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-1039-1&slc_lang=en&sid=1 Seyedeh Esmat Hosseini esmat.hosseini_110@yahoo.com 100319475328460013451 100319475328460013451 Yes Assistant professor, Department of Medical- Surgical Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran Mohamadreza setavand r.setavand@gmail.com 100319475328460013452 100319475328460013452 No MSc student, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran mostafa javadi javadinurse@gmail.com 100319475328460013453 100319475328460013453 No Associate professor, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran