Nurse Manager Core Competencies: A Proposal in the Spanish Health System

The Journey to First-Line Nursing Management: A Qualitative Study in a Spanish University Hospital

AIM

To explore nurse managers' perceptions at first-line, middle and executive levels regarding their transition to first-line management in two divisions of a highly specialised university hospital in Spain.

DESIGN

A qualitative descriptive study.

METHOD

A purposive sampling technique was employed to conduct four focus groups and two semi-structured interviews with 31 nurse managers across three hierarchical levels in two divisions of a highly specialised university hospital in Spain. Participants included two Chief Nursing Officers, four Nursing Directors and 25 first-line nurse managers. Data were analysed thematically.

RESULTS

Three themes emerged: 'Bridging the Readiness Gap: Training, Role Clarity, and Institutional Alignment', revealing the lack of structured transition plans, role ambiguity and gaps in managerial skills, such as human resources, financial management and leadership; 'Fighting Loneliness: A Common Challenge in Care Management', highlighting the isolation of first-line nurse managers due to the absence of structured mentorship and peer support; 'Clinical Expertise as a Cornerstone: The Role of Prior Experience in Nurse Management', examining how clinical expertise facilitates leadership transitions but also presents challenges, particularly for managers promoted within their teams, where authority negotiation and role redefinition become critical.

CONCLUSIONS

Findings underscore the need for structured training and mentorship to address role ambiguity, enhance managerial competencies and support nurse managers' transitions through targeted education.

IMPLICATIONS FOR PROFESSION AND PATIENT CARE

Structured transition programmes focusing on role clarity, training and institutional alignment can ease transitions, boost leadership confidence and enhance peer collaboration. Providing mentoring and training tailored to first-line nurse managers can improve team dynamics, support professional integration and strengthen organisational cohesion.

IMPACT

Tailored educational interventions are essential in supporting nurse managers' transitions. Structured mentorship and targeted training enhance leadership readiness, adaptability and institutional alignment, strengthening healthcare leadership, efficiency and patient care quality.

PATIENT AND PUBLIC CONTRIBUTION

No patient or public contribution.

Characteristics of Nurse Managers' Conflict Management Competency. A Systematic Review

AIM(S)

To identify and describe the characteristics that constitute a nurse manager's conflict management competency.

DESIGN

This study is a systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in PROSPERO (CRD42024542605).

DATA SOURCES

A systematic search was conducted in Web of Science, Scopus and PubMed databases, covering literature published from 1 January 2014 to 1 April 2024.

RESULTS

This review included 14 studies selected from an initial pool of 86 records. From the included articles, 71 characteristics associated with nurse manager conflict management competency were identified and categorised into seven distinct characteristics: Collaborative resolution (19.72%), collaborative support (18.31%), balanced compromise (14.08%), conflict avoidance (14.08%), supportive accommodation (14.08%), assertive dominance (12.68%) and leadership and resilience in conflict management (7.04%). The most frequent conflicts were interpersonal conflicts (22.22%), resource allocation issues (20.00%) and conflicts between personal values and organisational goals (17.78%).

CONCLUSIONS

This review highlights the importance of developing characteristics, such as collaborative resolution, collaborative support and balanced compromise, for effective conflict management by nurse managers. Addressing interpersonal conflicts and aligning personal values with organisational goals is essential for maintaining team cohesion and reducing stress. Ethical leadership and emotional intelligence are crucial for managing conflicts and improving the work environment. Forward-looking healthcare organisations should prioritise the development of conflict management competencies to create healthy and efficient work environments capable of facing disruptive changes, such as those brought about by artificial intelligence.

IMPACT

The characterisation of conflict management competency allows the creation of simulated scenarios that are free of associated risks. Additionally, the findings facilitate a comprehensive analysis of how conflict management competency influences leadership competency and ethical principles in nursing teams. This is particularly relevant in the context of profound and disruptive change.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Management of resources during COVID-19 pandemic at an academic hospital in Gauteng, South Africa: nurse managers' experiences

BACKGROUND

The onset of the COVID-19 pandemic required the mobilization of resources specifically for managing patients during the pandemic. The need for the mobilization of resources at the time of COVID-19 increased the nurse managers' responsibilities regarding the management of resources. Failure to prioritize the requirement for resource mobilization during COVID-19 can result in several adverse effects, notably in terms of nurse managers' obligations. Such a negative incident could result from decreased quality and patient safety. The study, therefore, sought to examine the nurse managers' resource management experiences under the new context caused by the pandemic.

OBJECTIVE

The study aimed to explore and describe nurse managers' experiences regarding managing resources during the COVID-19 pandemic in an academic hospital in the Tshwane District of the Gauteng Province.

METHODS

A qualitative, exploratory, descriptive, and contextual research design was followed. Twenty-six purposefully sampled nurse managers attended semi-structured interviews. A thematic analysis was conducted to identify patterns and themes within the data collected.

RESULTS

The following three themes emerged: The nurse managers experienced budget constraints to address the patient's health needs. More human and material resources are needed, which makes monitoring patient care challenging. Lastly, the hospital infrastructure needed to be Inadequate and unsupportive for easy management of the pandemic.

CONCLUSION

The management of resources is critical for managing crises. Therefore, the managers must actively participate in the strategic plans and budget allocation meetings. The nurse manager's active involvement in budgetary plans will enable the managers to pre-empt administrative challenges in case of disaster. Consequently, the nurse managers may have control over finance, human, and material resources in their roles as accounting officers.

CONTRIBUTION

The findings provided some insights into the experiences of nurse managers in managing resources during the COVID-19 pandemic. It will assist nurse managers in reviewing existing contingency plans to address intensified and prolonged crises like COVID-19 pandemic.

Characteristics of the Competency Ethical Principles for the Nurse Manager: A Systematic Review

Background: The escalating complexity of healthcare environments underscores the importance of nurse managers' ethical competency, which impacts organizational culture, work climate, and healthcare outcomes. Objective: The purposes of this study were to identify and describe the characteristics of nurse managers' competency in ethical principles in healthcare settings. Methods: A systematic search was conducted across the Web of Science, Scopus, and PubMed databases, covering the literature from January 1, 2014, to April 1, 2024. Articles were selected based on specific inclusion criteria, and data were extracted and analyzed using a frequency analysis of the identified characteristics. This systematic review adhered to the PRISMA guidelines and the Joanna Briggs Institute assessment tools. The review protocol was registered in PROSPERO (ID: CRD42024542594). Results: The review analyzed 22 studies, each focusing on nurse managers and their ethical competencies. Fourteen distinct characteristics of ethical competency were identified, with ethical leadership, ethical decision-making, and conflict resolution being the most prominent. Key ethical problems included conflicts between personal values and organizational policies, pressures to compromise ethical standards, and management of limited resources. These problems often led to significant consequences such as decreased staff morale, increased stress and burnout, and compromised patient care quality. Conclusions: The development of ethical leadership and the ability to make ethical decisions are fundamental for nurse managers to create supportive work environments and reduce burnout. Promoting continuous professional development and fostering an ethical culture is essential for maintaining high ethical standards. Future research should explore how cultural, organizational, and environmental differences influence ethical decision making and leadership. Implications for the Nursing Management: The development of ethical leadership and the ability to make ethical decisions are fundamental characteristics of ethical principles competency, as they facilitate the achievement of an adequate work environment and reduce burnout and emotional overload.

Relationship between dominant decision-making style and creativity of nursing managers: A cross-sectional study

OBJECTIVE

This study aims to investigate the connection between dominant decision-making style and creativity among nursing managers.

BACKGROUND

The dominant style of decision-making nursing managers use definitely affects the quality of decisions. Also, in another way, it can develop a skill of creative thinking that may influence the entire health care system.

METHODS

Data from 229 nursing managers in four university hospitals were gathered using a cross-sectional study methodology and questionnaires about general decision-making styles and managerial creativity.

RESULTS

nursing managers are highly creative. In general, the dominant decision-making style is rational and is correlated positively with creativity. Dependent style is the second one, while it is correlated negatively and significantly with creativity. Intuitive style is the third one and correlated negatively but is insignificant with creativity. Regression analysis revealed that only three styles have an effect on creativity: rational (positive), dependent (negative), and avoidant (negative), respectively.

CONCLUSION

The most dominant style is rational, which has the highest effect, which is positive on creativity. The dependent is the second dominant style and has a negative effect. Whereas intuitive is the third dominant style and did not have any effect on creativity.

Nurse leaders' interpersonal communication competence: A mixed-method systematic review

AIM(S)

To identify and synthesize evidence available on nurse leaders' interpersonal communication competence.

DESIGN

Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist.

METHODS

The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used.

DATA SOURCES

CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022.

RESULTS

A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert.

CONCLUSIONS

This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication.

IMPACT

This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence.

PROSPERO ID

CRD42023385058.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Licensed Practical Nurses' (LPNs') Evaluations of the Attractiveness of Work and Wellbeing at Work: A Cross-Sectional Nationwide Study

Background

Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly.

Objective

The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work.

Design

A cross-sectional survey study. Participants. A large-scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland.

Methods

An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739-0.915). An ANOVA or t-test result which indicated a statistically significant between-group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice.

Results

The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well-functioning practices (m = 4.55) were most important. Well-functioning practices associated with several background variables, e.g., with working for full-time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well-functioning practices important (p=3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important.

Conclusions

The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life.

The relationship of perceived nurse manager competence with job satisfaction and turnover intention among clinical nurses: an analytical cross-sectional study

BACKGROUND

Nursing managers have the potential to significantly impact the outcomes of nurses, patients, and organizations. Their competencies for effective performance are crucial. The global nursing workforce is facing a severe shortage of nurses. Dissatisfaction with management is one of the most important reasons for nurses' inclination to leave their jobs. Therefore, this study examines the relationship between nursing managers' competencies, job satisfaction and intention to leave among clinical nurses.

METHODS

An analytical cross-sectional study was conducted on 354 nurses in five hospitals affiliated with Ardabil University of Medical Sciences from May to August 2023. This research used web-based software to design demographic information forms, nurse manager competency scale, turnover intention, and single-item job satisfaction questionnaires. The significance level for the study was set at p < 0.05.

RESULTS

This study revealed that participants had an average score of 3.06 out of 5 in perceived nurse manager competence. Only one-fourth of the participants (25.7%) were satisfied with their current job, and less than half (46.9%) intended to leave. Employee support and development, change and resource management, supervision and quality monitoring, and personal mastery positively influenced nurses' job satisfaction. These competencies hurt employees' intention to leave their jobs.

CONCLUSIONS

The research findings indicate that nursing managers in Iran have lower competency than in previous studies. Developing and strengthening these competencies is very important, as it significantly improves job satisfaction and reduces nurses' tendency to leave their jobs. Additionally, the results show that nursing managers who excel in supporting and developing staff, resource management, quality supervision, and personal mastery positively impact nurses' job satisfaction. However, these competencies can also help reduce employees' intention to leave their jobs. Retaining and maintaining nurses in the healthcare field is of utmost importance.

Characteristics of Leadership Competency in Nurse Managers: A Scoping Review

Aim

Identify the characteristics of leadership competency for the nurse manager and describe the most cited leadership styles in the literature.

Background

Leadership is a fundamental competency for nurse managers, as it plays an important role in the healthcare environment to achieve Sustainable Development Goals and promote people-centered organizations. Therefore, understanding the characteristics of leadership and the leadership style to be employed is important.

Methods

A scoping review was conducted from January 2009 to January 2024 using the design of González Garcia et al., the Arksey and O'Malley framework, and databases including Web of Science, Scopus, and PubMed. Articles reporting on the characteristics of leadership for nurse managers were reviewed. The authors performed the review based on a search syntax, inclusion and exclusion criteria, and the data extraction process.

Results

Sixty-two studies were included in the final review. The review identified 38 characteristics related to leadership competency, among which we highlighted caring for nurses as individuals, being a visionary, knowledgeable, a change agent, and a communicator. This review highlights the prevalence of transformational leadership, which constitutes 69.57% of the leadership styles cited, and underscores its pivotal role in improving the work environment, effectiveness in nursing care, conflict management, team commitment, and adaptability to change within healthcare settings.

Conclusions

The most commonly cited characteristics of leadership include caring for the team, effective communication, and a vision for change. Transformational, people-centered, and motivational leadership is the most appropriate style. Implications for Nursing Management. The characterization of leadership competency will allow the development of training adapted to the current requirements for nursing leaders. This training could be developed in simulation and virtual reality environments. It also allows for a deeper understanding of how leadership competency affects teams and their functioning.

Reliability and validity of the Italian Version of the Chase Nurse Manager Competencies Scale

Objectives

This study aimed to translate and test the psychometric properties of the Chase Nurse Manager Competency Instrument (CNMCI) among Italian nurse managers and to provide further support for the scale's validity testing.

Methods

An instrument translation and cross-sectional validation study was conducted. The English version was translated into Italian using the translation method, which included pre-translation (establishing equivalence), initial translation, pretesting, review, and administration. From August 2022 to June 2023, 349 nurse managers were recruited through a web survey from 31 public and private healthcare organizations in North, Central, and Southern Italy. Validity assessments included content and structural validity. Reliability was evaluated using Cronbach's α coefficient and test-retest reliability.

Results

The content validity confirmed all the items of the CNMCI in the Italian version, including the two measurement sections, "knowledge and understand" and "ability to implement and/or use." The instrument's item-content validity index (I-CVI) ranged from 0.83 to 1.00, while the scale-level content validity index (S-CVI) for both instrument sections was 0.97. The confirmatory factor analysis showed an acceptable fit. In the "knowledge and understand" section, Cronbach's α coefficient was 0.978, and in the "ability to implement and/or use" section, Cronbach's α coefficient was 0.976. The correlation coefficient between each dimension was 0.494-0.908. The test-retest reliability score was 0.82, suggesting good instrument consistency.

Conclusions

Overall, the Italian CNMCI demonstrates good reliability and validity for measuring nurse managers' core competencies and supports the construct's multi-dimensionality. Also, our findings support the hierarchical nature of the factors, further supporting the validity of the instrument.

Evaluation of the Relationship between the Levels of Patience and Tranquillity and Conflict Resolution Styles of Executive Nurses

Aims

This study examined nurse managers' conflict resolution styles, tranquillity and patience levels, and their relationships.

Background

Managers are supposed to know how to manage conflict to reduce the destructive effects of conflict and create constructive effects.

Methods

The study was a descriptive cross-sectional study and in a city centre in Karadeniz region, in May 2022. It was aimed to reach all executive nurses but was completed with 41 executive nurses. The data were collected face to face using a Sociodemographic Questionnaire, the Rahim Organizational Conflict Inventory, the Patience Scale, and the Tranquillity Scale.

Results

51.2% experienced conflict with colleagues and 46.3% with other employees. In conflict management, the most commonly used style was integrating and the least was dominating, respectively. The Patience Scale score (39.15 ± 6.09) and Tranquillity Scale score (3.70 ± 0.70) were moderate. At the same time, long-term (10.19 ± 2.18), short-term (8.90 ± 2.54), and total patience scores were significantly lower in case of conflict with nurses. Interpersonal patience levels were significantly lower in case of conflict with other employees. There was a negative correlation between working as a manager and compromising style.

Conclusion

It was concluded that executive nurses used the integrating style more, and their patience and tranquillity levels were moderate. In addition to using the integration style more, the fact that nurse managers have moderate levels of patience and calmness will reflect positively on the quality of patient care. It will also increase employee satisfaction. Increasing the level of peace in health institutions will support patience, happiness, and a sense of belonging among employees.

Status and Influencing Factors of Nurses' Perception of Toxic Leadership Behavior: A Cross-Sectional Study

Aim

The aim of this study is to analyse the toxic leadership behavior of nurse managers perceived by nurses and its related factors.

Background

Toxic leadership is becoming more common as a risk factor in nursing. However, there is a scarcity of research on the elements that influence toxic leadership practices from the perspective of nurses' perceptions.

Methods

A cross-sectional study was conducted with 455 nurses from August to October 2022. A demographic information questionnaire and a negative behavior scale for nurse managers were used. Descriptive statistics, Kruskal-Wallis H test or Mann-Whitney U test, and multiple linear regression were used to explore the relevant factors of nurses' perceived toxic leadership behaviors of nurse managers.

Results

The population was dominated by 423 (92.97%) females, 318 (69.89%) married, and 420 (92.31%) with a bachelor's degree. The toxic leadership behavior scale score for nurse managers was 109 (87, 123) and the score for each entry was (2.94 ± 0.92). Gender, educational level, department, number of night shifts, and nature of employment were the influencing factors of the negative leadership behavior of nurse leaders as perceived by nurses (P < 0.05), explaining a total of 43.1% of the total variance.

Conclusion

In general, nurses' perceived toxic leadership behaviors of nurse managers were at a moderate level. More toxic leadership behaviors were observed by nurses who were female, less educated, on busy units, with unstable nature of appointments, and with frequent night shift rotation. Implications for Nursing Management. Focus on the psychological condition of nurses who are female, less educated, work in busy units, have an unstable nature of employment, and rotate night shifts frequently. The negative impacts of toxic leadership behaviors might be lessened as a result.

Refining core competencies of first-line nurse managers in the hospital context: A qualitative study

Objectives

As the world moves towards a new normal, challenges continue to emerge while simultaneously inspiring us with new solutions. Strengthening the skills of first-line nurse managers (FLNMs) to fulfill a wide range of complex roles and responsibilities effectively necessitates refining core competency guidelines or standards. This study aimed to explore the perceived core competencies of Indonesian FLNMs within the context of the post-pandemic era.

Methods

The study employed a qualitative descriptive design. Face-to-face interviews were conducted in a public hospital in Indonesia from January 2022 through August 2022. Seven head nurses with direct experience managing a unit during the COVID-19 pandemic were selected. The interviews were audio-recorded, transcribed verbatim, and validated by re-listening. Data were analyzed using thematic analysis.

Results

Four main themes of the core competencies developed, including 1) managerial core competencies, 2) clinical core competencies, 3) technological core competencies, and 4) socio-emotional skills/personal traits consisting of the following: be brave, fast, patient, optimistic, consistent, and responsible.

Conclusions

The findings demonstrate that the managerial and clinical core competencies of the FLNMs must be aligned, while technological core competencies are the mediating component of both. Personal traits are essential for FLNMs as they undergird the other three core competencies and the success of the FLNMs.

Nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings: An interview study

AIM

To describe nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings.

DESIGN

A qualitative descriptive study design.

PARTICIPANTS

A total of 13 nurse leaders were recruited from four primary and specialized healthcare organizations in Finland.

METHODS

Data were collected through individual semi-structured interviews and analyzed using inductive content analysis.

RESULTS

Nurse leaders' experiences were categorized into seven main categories as follows: leadership, which concerns a leader's roles, style, and experience; organizational strategy and culture, which includes structure, policies, and intra-organizational culture; support strategies, including workplace and outside-of-work integration strategies; relationships and interactions, which considers interpersonal relationships and interactions; nurse competence requirements and development, which concerns both organizational and ward level competence demands, and support for competence development; language competence, which concerns challenges relating to language proficiency and development of language competence; and cultural diversity, which considers the importance of competence development brought about through experiences of being in a multicultural workplace.

CONCLUSIONS

Culturally and linguistically diverse nurses are important within healthcare systems. These nurses constitute additional human resources, bring diverse experiences and expertise, and add to organizational cultural capital. Nurse leaders require competencies that are suitable for leading a diverse workforce, utilizing its competencies, establishing staff members' needs, and ensuring their continuous development. Resourcing, planning, and structuring the integration process affects nurses' experiences of the organizational socialization process.

IMPACT

The findings of our study can offer guidance to healthcare organizations with regard to structural integration strategies at an institutional level. Leadership and management educators can benefit from the findings towards developing a curriculum that supports leaders' diversity, equity and inclusion, knowledge management and formal leadership competencies. Finally, nurse leaders may benefit from this study through being more aware towards supporting a multicultural, cohesive, and competent workforce through strong social capital.

Status and associated factors of gerontological nurse specialists' core competency: a national cross-sectional study

BACKGROUND

Nurses' core competency directly affects patients' safety and health outcomes. Gerontological nurse specialists play an essential role in improving older adults' health status. However, little is known about their core competency level and the factors influencing core competency. Therefore, this study aimed to investigate the status of core competency and factors influencing the core competency of gerontological nurse specialists in China.

METHODS

A multicenter cross-sectional study was conducted on gerontological nurse specialists certified by province-level or above organizations across China between March 2019 and January 2020. The Revised Core Competency Evaluation Instrument for Gerontological Nurse Specialists was used to measure participants' core competency. The median, frequencies, and percentages were used to describe participants' characteristics and level of core competency. Multivariate stepwise regression analysis was applied to analyze the factors influencing core competency.

RESULTS

The median score of gerontological nurse specialists' core competency was 3.84, and professional development skills and research and analysis decision-making skills had the lowest scores among the dimensions. The multivariate stepwise regression analysis showed that individual-level factors (i.e., working experience length of geriatric nursing and attitudes toward caring for older adults), employer-level factors (i.e., departments, job responsibilities, the degree of satisfaction toward the attention and support and the promotion rules provided by the hospital or department), and training-associated factors (i.e., economic zone where training organizations are located and the degree to which the training content met clinical needs) are independently associated with gerontological nurse specialists' core competency level (P < 0.05).

CONCLUSIONS

This study showed that gerontological nurse specialists' core competency needs further improvements, especially regarding professional development skills and research and analysis decision-making skills. Additionally, individual-, training-, and employer-level factors could influence their core competency level, indicating that interventions targeting these factors could be applied to improve the core competency of gerontological nurse specialists.

Learning and assessment strategies to develop specific and transversal competencies for a humanized medical education

Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency "to know"); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency "to know how to do"). They are also evaluated on the transversal competencies that we call "communication with the patient" (transversal competency "to know how to be there") and "dealing with the patient" (transversal competency "to know how to be"). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students' awareness in the development of a more humanized medicine, allowing a better response to the patients' needs. Our rubric, which clearly indicate the performance criteria, have become an excellent method to carry out the assessment of competencies, both for students and teachers, since they allow to obtain clear evidence of the level of acquisition and application of knowledge.

A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations

Introduction

One vital strategy for the success of healthcare organisations currently resides in the capacity of the nurse managers (NMs) to develop informatics competencies in management.

Aim

The aim of this review was to synthesise the evidence related to the informatics competencies of NMs in healthcare settings.

Methods

The databases of PubMed, Web of Science, Scopus and Education Resources Information Center were searched. All publications were accepted if they had been published in English and full texts were accessible. The study was carried out using a systematic literature search of work published between January 2000 and December 2021. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications was carried out independently by two reviewers using the Critical Appraisal Skills Programme guidance. A descriptive summary with data tables was produced to summarise the literature.

Results

After screening the search results, 12 studies published between the period 2001 and 2019 met the inclusion criteria. Analysis of the included studies led to the classification of informatics competencies in three main themes: skills related to work with computers (four sub-themes), informatics skills of NMs (three sub-themes) and knowledge of NMs about informatics (five sub-themes).

Conclusion

These systematic review results can lead to the identification of informatics competency gaps and recommend and provide solutions to address these gaps and increase competencies for nursing managers.

Training Priority for Managerial Competence of Nurse Managers in Small and Medium-Sized Hospitals: Focusing on the Management Level

Introduction

The managerial competence of nurse managers varies according to their management level.

Objectives

This study aims to explore the training priority of managerial competence for nurse managers in small- and medium-sized hospitals based on their management level.

Methods

Nurse managers (122 front-line and 65 middle-level nurse managers and chief nurse executives (CNEs)) from 21 small- and medium-sized hospitals with less than 300 beds participated in a survey. T-test and Borich Priority were analyzed.

Results

Nurse managers identified control competence as the most significant management function in both groups. The training priority for front-line nurse managers was motivation in directing, while it was human resource development in human resource management for middle-level nurse managers and, CNEs.

Conclusion

Five management strategies were reported, which will be the basis for future systematic nursing management in nursing organizations.

Exploration of knowledge, attitudes, and perceived benefits towards nurse managers' participation in the health policy-making process: a qualitative thematic analysis study

Background

Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes.

Objective

This study aimed at exploring the attitudes and perceived benefits of nurse managers' participation in the health policy-making process.

Methods

In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012).

Results

After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers' participation, advantages of nurse managers' participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process.

Conclusion

The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers' participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.

A competency model for nurse executives

BACKGROUND

Nurses capable of adequately developing their competencies in the management field are essential for the sustainability of health-care organizations. Such competencies should be included in a model of specific competencies.

AIM

The aim of this research is to propose a competency model for nurse executives.

METHODS

The Delphi method was applied to reach a consensus on the required competencies, and Principal Component Analysis (PCA) was applied to determine the construct validity and reduce the data set's dimensionality. Consensus was defined based on at least 80% of the experts agreeing with the proposed competencies. For each competency, the development levels were beginner, advanced beginner, competent, highly competent and expert.

RESULTS

From among the 51 competencies that were identified to define a model for nurse executives, decision-making, leadership and communication stood out. The PCA indicated the structural validity of the proposed model by saturation of the principal components (Cronbach's α > 0.631).

CONCLUSION

Nurses wishing to develop their professional careers as nurse executives must first develop the competencies shown in the proposed model. Nurse executives should follow the educational programmes specified in this study, to adapt their knowledge to this role's requirements.

Nurse leaders' experiences of professional responsibility towards developing nursing competence in general wards: A qualitative study

AIM

To explore nurse leaders' experiences of professional responsibility to facilitate nursing competence in general wards.

BACKGROUND

Nurse leaders are responsible for maintaining high levels of competence among nurses to improve patient safety.

METHODS

Qualitative analysis was conducted between February and April 2019 using semi-structured interview data from 12 nurse leaders in surgical and medical wards at three Norwegian hospitals.

RESULTS

Four main themes were identified: struggle to achieve nursing staff competence; focus on operational and budgetary requirements rather than professional development; demands to organize sick leaves and holiday periods; and challenges in facilitating professional development.

CONCLUSION

Nurse leaders felt that their responsibilities were overwhelming and challenging. They witnessed more support for current administrative tasks than for the implementation of professional development. Additionally, unclear work instructions from the employer provided few opportunities to facilitate professional development. Hospital management failed to ensure quality of care and patient safety in general wards by not supporting the strengthening of nurses' professional competence and preventing turnover.

IMPLICATIONS FOR NURSING MANAGEMENT

Management may integrate formal work instructions that clarify nurse leaders' responsibilities as professional developers, allowing nurse leaders to meet their obligation of maintaining adequate professional competence among nursing staff in general wards.

Bibliometric analysis of core competencies associated nursing management publications

AIMS

This study aimed to identify high-impact papers on global nursing to determine and analyze the publication of articles on core competencies in nursing-related journals and the research trends in the era of globalization.

BACKGROUND

Bibliometrics has been shown to be an effective method for analyzing publications. Through bibliometrics, nursing managers and researchers can understand the trends of high-impact international nursing core competencies research, identify mainstream research directions, and obtain relevant knowledge and information, thereby facilitating the translation of research outcomes into nursing management practice.

EVALUATION

The study adopted bibliometric analysis and the VOSviewer software to explore dynamic publication trends and analyze the current situation of nursing research from a comprehensive development perspective, which was realized by searching for nursing core competencies papers in the Web of Science (WoS) database, calculating citations, and determining the trends of the most influential papers.

RESULTS

Nursing core competencies research grew rapidly between 1997 and 2022. Countries with the most core competencies publications were the United States, England, Australia, and Canada. The Journal of Nursing Management has attracted substantial attention from researchers worldwide. Education, Management, and Nurses were the most frequently used keywords in the study. A total of 534 papers were retrieved from the WoS database with the main research fields, including nursing, business economics, public environmental occupational health, and health care science services.

CONCLUSION

Equipping nursing graduates with core competencies has always been an important goal of global medical and nursing education. This study analyzed papers across 35 years, most of which were published in the Journal of Nursing Management. In addition, the study identified some of the main research topics of nursing management, such as the integration of education with nursing management and the cultivation of nurses' core competencies. The study also provides a fresh review of highly cited articles. The results of the study show that high-quality articles play the role of improving both the quality and the quantity of related research. By analyzing the trends of the research on core competencies, this study lays a bibliometric foundation for researchers regarding international journals, hot topics, and relevant fields. In addition, the highly cited articles reveal new perspectives for the nursing field, providing inspiration for nursing management and education researchers.

IMPLICATIONS FOR NURSING MANAGEMENT

This study provides scholars and managers with an overview of the current situation of nursing management research and the development of benchmark journals. The study provides researchers not only with a better understanding of various international journals, allowing them to transition out of traditional thinking in the era of science and technology, but also with innovative thinking by combining research with nursing management. The results of this study invite nursing managers to study relevant topics of core competencies and integrate information technology to education, management, and nurses, thereby contributing to nursing management and educational research.

Multi-Generational Perspectives on the Competencies Required of First-Line Nurse Managers: A Phenomenological Study

First-line nurse managers play an integral role in ensuring team and organizational effectiveness and quality of care. They are facing increasing challenges arising from the need to lead a generation-diverse workforce. Further research that examines multi-generational perspectives on the competencies of first-line nurse managers is warranted. This paper aimed to elucidate multi-generational perspectives on the competencies required of first-line nurse managers based on their lived experiences and perceptions, as well as those of frontline nurses. A descriptive phenomenological approach was adopted. A total of 48 informants were invited to individual semi-structured interviews to share their perspectives on the competencies required of first-line nurse managers. Findings were analyzed using Van Kaam's controlled explication method. Four themes that described four areas of competency were generated: (1) advocating for the interests of the staff, (2) allocating resources effectively, (3) building cohesive teams, and (4) embracing change and quality. The findings indicated that there were significant discrepancies among the different generations of informants in terms of their degree of commitment to work, preferred modes of team communication and collaboration, and perspectives on the role and function and preferred leadership styles of first-line nurse managers. This study fell short in examining the experiences of Generation Z nurses, and the findings are subject to further validation by larger samples. However, this study has implications for hospital administrators, nurse educators, and managers, encouraging them to rethink the notion of management competencies to develop effective strategies for leading a multi-generational workforce.

A Conceptual Model of Nurses' Turnover Intention

The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses' turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.

Construction of a competency evaluation index system for front-line nurses during the outbreak of major infectious diseases: A Delphi study

Introduction

As the frequency of infectious diseases rises, it’s more important than ever to pay attention to the competency level of front-line nurses as the primary force in front-line rescue, which has an impact on the quality of anti-epidemic response. This paper aims to construct the competency evaluation index system for front-line nurses during the outbreak of major infectious diseases.

Materials and methods

This study combined literature review, critical incident technique interviews, and semi-structured in-depth interviews, as well as two rounds of Delphi expert correspondence, to construct a competence evaluation index system for front-line nurses during the outbreak of major infectious diseases. The study used purposive sampling to select 26 experts from 11 provinces and cities across China to conduct two rounds of Delphi expert consultation, and the indicators were selected based on the mean importance score > 3.5 and the coefficient of variation < 0.25, and the weights of the indicators were calculated by the Analytic Hierarchy Process. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%.

Results

The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%, the authority coefficients of experts were 0.96 and 0.98, the Kendall’s coordination coefficients of the first, second, and third level indexes were 0.281, 0.132, and 0.285 (P < 0.001), 0.259, 0.158, and 0.415 (P < 0.001). The final index system includes 4 primary indicators (Knowledge System of Infectious Diseases, Nursing Skills for Infectious Diseases, Related Professional Abilities for Infectious Diseases, and Comprehensive Quality), 10 secondary indicators, and 64 tertiary indicators.

Conclusion

The competency evaluation index system of front-line nurses during the outbreak of major infectious diseases is scientific, reasonable, and practical, which can provide a scientific basis for nursing managers to accurately understand, describe, analyze, and evaluate the competence level of nursing staff and scientifically implement the allocation of human resources in the future, as well as serve as a content framework for subsequent training programs.

Core competencies for a biomedical laboratory scientist - a Delphi study

BACKGROUND

After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist.

METHODS

A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary.

RESULTS

The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality.

CONCLUSIONS

We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.

Development and Evaluation of the "High-Up" Program for Enhancing the Nursing-Management Competency of Mid-Career Hospital Nurses: A Quasi-Experimental Study

The aim of this study was to develop an educational program to strengthen the nursing management competency of experienced nurses who are prospective nurse managers and then determine the effectiveness of the program. This quasi-experimental study was conducted from January to April 2021. A total of 22 nurses were assigned to the experiment group (mean age: 26.55 ± 1.30 years; 2 males, 20 females), and 20 were assigned to the control group (mean age: 27.55 ± 2.04 years; 20 females). The program, known as the "High-Up" program, comprised problem-based learning (PBL) and video lectures. In the experiment group, nurses discussed PBL cases through video conferences and applied problem-solving methods. The collected data were analyzed using the Friedman test and Wilcoxon rank-sum test (administered through SPSS). At four weeks after the intervention, the experiment group showed higher critical thinking tendency scores than the control group (pre-intervention score: 3.48 ± 0.36; post-intervention score: 3.71 ± 0.49; Z = -1.99, p = 0.046). The findings indicate that the "High-Up" program can enhance the nurse management competency of experienced nurses who need to prepare for nurse manager roles, and that it can also positively influence the performance of nursing organizations. However, it can be difficult to comprehensively enhance nursing management competency in a short period of time, meaning continuous education is required.

Perceived importance of competencies by nurse managers at all levels: A cross-sectional study

AIM

To explore nurse managers' perceived importance of competencies for their current job at different levels and the associated factors.

BACKGROUND

Little work to date has explored the perceived importance of competencies in nursing leadership and management or considered the related factors in the Taiwan healthcare context.

METHODS

Data collected from a previous large study comprising a cross-sectional web-based survey were analysed. Kruskal-Wallis test, two-sided Fisher exact test and multiple linear regression models were used for statistics analysis.

RESULTS

The mix of three skills in Katz's model indicated that human skills were equally important in all three managerial levels. Of the 23 competencies, effective communication and political astuteness were rated by nurse managers at all levels as the highest-scored (M = 4.88, SD = 0.34) and lowest-scored competency (M = 3.92, SD = 0.78), respectively. Managerial level was a significant predictor of the perceived importance of competency.

CONCLUSIONS

Relationship-based competencies were prominent in the perceived importance of competencies among nurse managers at different levels. Managerial hierarchy influences the relative importance of the different managerial competencies.

IMPLICATIONS FOR NURSING MANAGEMENT

This study's results provide the talent strategy framework required for improving the competencies of nurse managers at all levels.

Leadership competencies of first-line nurse managers: a quantitative study

PURPOSE

This paper aims to examine the leadership competencies of first-line nurse managers (FLNMs) at the unit level in the eastern region of Ghana.

DESIGN/METHODOLOGY/APPROACH

The paper is a quantitative cross-section design.

FINDINGS

Nurse managers exhibited a moderate level of knowledge and ability to apply leadership competencies. Gender, rank, qualification, professional experience, management experience and management training jointly predicted the leadership competencies of FLNMs [(R² = 0.158, p = 0.016]. However, only management training was a significant predictor in the model.

PRACTICAL IMPLICATIONS

Inappropriate leadership competencies have severe consequences for patients and staff outcomes. This situation necessitates a call for a well-structured program for the appointment of FLNMs based on competencies.

ORIGINALITY/VALUE

This study is the first in Ghana which we are aware of that examined the leadership competencies at the unit level that identifies predictors of leadership competencies.

Content validation in concepts of management and managerial practices in Nursing

ABSTRACT Objectives: to define and validate 37 concepts emanating from the epistemology of knowledge about Nursing Administration. Methods: theoretical-methodological study using the Delphi technique in 37 concepts and definitions built on the knowledge of more than half a century of research on Nursing Administration. The concepts were submitted to the judgment of a panel of 21 judges and the validation was measured by the content validity index (> 0.78) and Kappa coefficient (> 0.61). Results: enunciation of 37 concepts and definitions capable of reflecting the knowledge about Nursing Administration. The 37 concepts were validated by the judges, resulting in content validity indices that ranged from 0.81 to 1.00, with reliability higher than 0.79. Conclusions: the epistemological solution presented was validated by the judges with indices above 0.80 and high reliability of universal agreement, constituting a new object of ontological understanding for the scientific nursing community.

Experiences of first-line nurse managers during COVID-19: A Jordanian qualitative study

AIM

The aim of this study is to explore the experiences of Jordanian first-line nurse managers during COVID-19.

BACKGROUND

Nurses are exposed to life-threatening occupational risks during COVID-19. Exploring the first-line nurse managers' experiences will help in designing health policies to better deal with such emerging crises.

METHODS

A descriptive phenomenological study was conducted. A purposive sample was used to recruit 16 first-line nurse managers from Jordanian hospitals. Semistructured interviews were conducted. Phenomenological data analysis method was used to analyse the data.

RESULTS

Four major themes emerged: (a) unprecedented pressure (first-line nurse managers revealed their suffering with the unprecedented demanding situations during COVID-19 pandemic); (b) strengthening system and resilience (nurse managers employed several strategies to strengthen the health system and enhance resilience); (c) building a supportive team (the presence of a robust supportive system is vital to deal with the pandemic); and (d) maturity during the crisis (exposure to a new experience developed nurse managers management skills and self-awareness).

CONCLUSIONS

The unprecedented pressure associated with COVID-19 drained first-line nurse managers physically and psychosocially. Providing adequately trained staff and medical equipment is important to better deal with crises.

IMPLICATIONS FOR NURSING MANAGEMENT

Strengthening emergency training and improving emergency response plans of hospitals are essential.

Surge Planning and Implementation: A Required Competency for Today's Nurse Leaders

The ability to respond effectively and efficiently during times of crisis, including a pandemic, has emerged as a competency for nurse leaders. This article describes one institution's experience using the American Organization of Nurse Leaders Competencies for Nurse Executives in operationalizing the concept of surge capacity.

A multisite survey of managerial competence and organizational commitment among nurses working at public hospitals in Saudi Arabia

AIMS

The purpose of this study was to determine the relationship between managerial competence level and organizational commitment among nurses in Saudi Arabia.

BACKGROUND

Nurse managers who have a high degree of managerial competency and/or organizational commitment are seen as role models by their employees and can affect employees' sense of belonging to the organization.

METHODS

A cross-sectional, multisite study was conducted with 226 eligible nurses working at six public hospitals in Saudi Arabia. Data were collected from March through June 2021 through an online self-administered survey. Multivariate regression was used to determine the relationship between managerial competence and organizational commitment while controlling for demographic variables.

RESULTS

Both managerial competence (M = 152.9, SD = 48.41, range: 54-216) and organizational commitment (M = 49.4, SD = 22.15, range: 18-121) were reported to be slightly moderate among the sample. A significant positive association also existed between managerial competence and organizational commitment variables (r = .510, p < .05).

CONCLUSIONS

Future studies addressing potential issues for improving managerial competence and organizational commitment in clinical environments are recommended.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse administrations should use highly standard guidelines to improve nurses' managerial competence and organizational commitment.

Competency Model for the Middle Nurse Manager (MCGE-Logistic Level)

Healthcare systems are immersed in transformative processes, influenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The objective of this study was to propose the model of competencies to be developed by the middle nurse manager in the Spanish healthcare system. Our methodology consisted in the application of the Delphi method in order to reach an agreement on the necessary competencies, and principal component analysis (PCA) was used to determine the construct validity, reducing the dimensionality of the set of data. Fifty-one competencies were identified for the definition of the model, highlighting decision-making, leadership and communication. The PCA pointed out the structural validity of the proposed model through the saturation of the main components (α Cronbach > 0.631). The results show the model of competencies which the middle nurse manager in the Spanish healthcare system must develop. Middle nurse managers may use these as criteria to plan their professional strategies in the context of management. This model of competencies can be applied to establishing selection processes or training programs for the role of middle nurse manager.