IMEMR
EMRO
Volume 6, Issue 4 (2025)
J Clinic Care Skill 2025, 6(4): 185-202 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2025/08/12 | Accepted: 2025/09/28 | Published: 2025/10/3
Received: 2025/08/12 | Accepted: 2025/09/28 | Published: 2025/10/3
How to cite this article
Zarshenas L, Mehri Z, Rakhshan M, Khademian Z, Mehrabi M, Jamshidi Z. A Systematic Review and Nursing Organizations Guidelines on Professional Competence Standards for Nurses. J Clinic Care Skill 2025; 6 (4) :185-202
URL: http://jccs.yums.ac.ir/article-1-442-en.html
URL: http://jccs.yums.ac.ir/article-1-442-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
1- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
2- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
3- “Community Based Psychiatric Care Research Center” and “School of Nursing and Midwifery”, Shiraz University of Medical Sciences, Shiraz, Iran
4- Department of e-Learning in Medical Sciences, Virtual School, Center of Excellence for e-Learning in Medical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
2- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
3- “Community Based Psychiatric Care Research Center” and “School of Nursing and Midwifery”, Shiraz University of Medical Sciences, Shiraz, Iran
4- Department of e-Learning in Medical Sciences, Virtual School, Center of Excellence for e-Learning in Medical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract (675 Views)
Aims: This study aimed to conduct a systematic review of professional competence standards for nurses based on literature and nursing organization guidelines.
Information & Methods: This systematic review assessed nursing professional competence standards in 2023, based on articles from national and international nursing organizations, and utilized the preferred reporting items for systematic reviews and meta-analyses guidelines. The databases reviewed included PubMed, MEDLINE, Embase, Scopus, Cochrane, ProQuest, Web of Science, Google Scholar, SID, IranMedex, IranDoc, and Magiran. Search strategies were performed using keywords, such as “Nurse,” “Professional Competence,” and “Competence Standard,” based on Medical Subject Headings, employing the syntax and operators “AND” and “OR.” Inclusion and exclusion criteria were applied in the selection of studies. The handling of the results was carried out using Mendeley software, and screening and quality control were conducted based on appropriate checklists. Finally, data extraction and synthesis of results were performed, and the standards were presented.
Findings: A total of 2,078 documents from scientific articles and national Iranian and international nursing organizations were reviewed, resulting in a final total of 50 included documents. There were 428 standards as standards of professional competence for nurses. The synthesis of these standards led to the identification of five domains of professional competence standards for nurses.
Conclusion: Clinical competence, educational and research competence, ethical competence, communication and interpersonal competence, and management and leadership competence are five domains of competence based on articles and guidelines from nursing organizations.
Information & Methods: This systematic review assessed nursing professional competence standards in 2023, based on articles from national and international nursing organizations, and utilized the preferred reporting items for systematic reviews and meta-analyses guidelines. The databases reviewed included PubMed, MEDLINE, Embase, Scopus, Cochrane, ProQuest, Web of Science, Google Scholar, SID, IranMedex, IranDoc, and Magiran. Search strategies were performed using keywords, such as “Nurse,” “Professional Competence,” and “Competence Standard,” based on Medical Subject Headings, employing the syntax and operators “AND” and “OR.” Inclusion and exclusion criteria were applied in the selection of studies. The handling of the results was carried out using Mendeley software, and screening and quality control were conducted based on appropriate checklists. Finally, data extraction and synthesis of results were performed, and the standards were presented.
Findings: A total of 2,078 documents from scientific articles and national Iranian and international nursing organizations were reviewed, resulting in a final total of 50 included documents. There were 428 standards as standards of professional competence for nurses. The synthesis of these standards led to the identification of five domains of professional competence standards for nurses.
Conclusion: Clinical competence, educational and research competence, ethical competence, communication and interpersonal competence, and management and leadership competence are five domains of competence based on articles and guidelines from nursing organizations.
Keywords:
References
1. WHO. Nursing and midwifery in the history of the World Health Organization (1948-2017). Geneva: World Health Organization; 2017. [Link]
2. Health Resources and Services Administration. The future of the nursing workforce: National- and state-level projections, 2012-2025. Rockville. Department of Health and Human Services; 2014. [Link]
3. AACN. Nursing fact sheet [Internet]. Washington, DC: American Association of Colleges of Nursing; 2019 [cited 2024 May 20]. Available from: https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage. [Link]
4. Fukada M. Nursing competency: Definition, structure and development. Yonago Acta Med. 2018;61(1):1-7. [Link] [DOI:10.33160/yam.2018.03.001]
5. Karami A, Farokhzadian J, Foroughameri G. Nurses' professional competency and organizational commitment: Is it important for human resource management?. PLoS One. 2017;12(11):e187863. [Link] [DOI:10.1371/journal.pone.0187863]
6. Nehrir B, Vanaki Z, Mokhtari Nouri J, Khademolhosseini SM, Ebadi A. Competency in nursing students: A systematic review. Int J Travel Med Glob Health. 2016;4(1):3-11. [Link] [DOI:10.20286/ijtmgh-04013]
7. Valizadeh L, Zamanzadeh V, Eskandari M, Alizadeh S. Professional competence in nursing: A hybrid concept analysis. Med Surg Nurs J. 2019;8(2):e90580. [Link] [DOI:10.5812/msnj.90580]
8. Tabari Khomeiran R, Yekta ZP, Kiger AM, Ahmadi F. Professional competence: Factors described by nurses as influencing their development. Int Nurs Rev. 2006;53(1):66-72. [Link] [DOI:10.1111/j.1466-7657.2006.00432.x]
9. Pai HC, Huang YL, Cheng HH, Yen WJ, Lu YC. Modeling the relationship between nursing competence and professional socialization of novice nursing students using a latent growth curve analysis. Nurse Educ Pract. 2020;49:102916. [Link] [DOI:10.1016/j.nepr.2020.102916]
10. Mehri Z, Zarshenas L, Rakhshan M, Khademian Z, Mehrabi M, Jamshidi Z. Novice nurses' professional competence: A qualitative content analysis. J Educ Health Promot. 2025;14(1):17. [Link] [DOI:10.4103/jehp.jehp_1819_23]
11. Gunawan J, Aungsuroch Y, Fisher ML, Marzill C, Liu Y. Factors related to the clinical competence of registered nurses: Systematic review and meta-analysis. J Nurs Scholarsh. 2020;52(6):623-33. [Link] [DOI:10.1111/jnu.12594]
12. Garside JR, Nhemachen JZZ. A concept analysis of competence and its transition in nursing. Nurse Educ Today. 2013;33(5):541-5. [Link] [DOI:10.1016/j.nedt.2011.12.007]
13. Merriam-Webster. Competence. Springfield: Merriam-Webster Dictionary Online; 2020 [cited 2021 Jan 1]. Available from: https://www.merriam-webster.com/dictionary/competence?src=search-dict-box. [Link]
14. Gunawan J, Aungsuroch Y. Managerial competence of first‐line nurse managers: A concept analysis. Int J Nurs Pract. 2017;23(1):e12502. [Link] [DOI:10.1111/ijn.12502]
15. DeGrande H, Liu F, Greene P, Stankus JA. Developing professional competence among critical care nurses: An integrative review of literature. Intensive Crit Care Nurs. 2018;49:65-71. [Link] [DOI:10.1016/j.iccn.2018.07.008]
16. Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. Nursing competency standards in primary health care: An integrative review. J Clin Nurs. 2016;25(9-10):1193-205. [Link] [DOI:10.1111/jocn.13224]
17. Smith SA. Nurse competence: A concept analysis. Int J Nurs Knowl. 2012;23(3):172-82. [Link] [DOI:10.1111/j.2047-3095.2012.01225.x]
18. Rizany I, Hariyati R, Handayani H. Factors that affect the development of nurses' competencies: A systematic review. ENFERMERÍA CLÍNICA. 2018;28(Suppl 1):154-7. [Link] [DOI:10.1016/S1130-8621(18)30057-3]
19. Almada P, Carafoli K, Flattery JB, French DA, McNamara M. Improving the retention rate of newly graduated nurses. J Nurses Staff Dev. 2004;20(6):268-273. [Link] [DOI:10.1097/00124645-200411000-00006]
20. Denison HJ, Dodds RM, Ntani G, Cooper R, Cooper C, Sayer AA, et al. How to get started with a systematic review in epidemiology: An introductory guide for early career researchers. Arch Public Health. 2013;71(1):21. [Link] [DOI:10.1186/0778-7367-71-21]
21. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6(7):e1000097. [Link] [DOI:10.1371/journal.pmed.1000097]
22. Woods D, Trewheellar K. Medline and embase complement each other in literature searches. BMJ. 1998;316(7138):1166. [Link] [DOI:10.1136/bmj.316.7138.1166]
23. Lawrence DW. What is lost when searching only one literature database for articles relevant to injury prevention and safety promotion?. Inj Prev. 2008;14(6):401-4. [Link] [DOI:10.1136/ip.2008.019430]
24. Nehrir B, Vanaki Z, Mokhtari Nouri J, Khademolhosseini SM, Ebadi A. Competency in nursing students: a systematic review. Int J Travel Med Glob Health. 2016;4(1):3-11.. [Link] [DOI:10.20286/ijtmgh-04013]
25. Haghdoust A, Sadeghirad B. Systematic review and meta-analysis. 4th ed. Tehran: Gap; 2017. [Persian] [Link]
26. Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14(1):579. [Link] [DOI:10.1186/s12913-014-0579-0]
27. Davey GD. Developing competency standards for occupational health nurses in Australia. AAOHN J. 1995;43(3):138-43. [Link] [DOI:10.1177/216507999504300304]
28. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ. 2009;339:b2700. [Link] [DOI:10.1136/bmj.b2700]
29. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. [Link] [DOI:10.1093/intqhc/mzm042]
30. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34(4):285-91. [Link] [DOI:10.3233/EFI-180221]
31. PRISMA flow diagram [Internet]. Greenville: PRISMA Executive; 2020 [cited 2025 Sep 26]. Available from: https://www.prisma-statement.org/prisma-2020-flow-diagram. [Link]
32. Sakuramoto H, Kuribara T, Ouchi A, Haruna J, Unoki T, et al. Clinical practice competencies for standard critical care nursing: Consensus statement based on a systematic review and Delphi survey. BMJ Open. 2023;13(1):e068734. [Link] [DOI:10.1136/bmjopen-2022-068734]
33. Dung PT, Hung DK, Cuong BM, Trang LTT. Nurses' knowledge, practice and confidence about wound care based on the competency standards in 8 hospitals in Vietnam. J Clin Images Med Case Rep. 2021;2(5):1364. [Link] [DOI:10.52768/2766-7820/1364]
34. Bickford CJ. Updated nursing scope and standards. Foundational document reflects changes in healthcare. Maryland: American Nurses Association; 2021. [Link]
35. Baker C, Cary AH, Da Conceicao Bento M. Global standards for professional nursing education: The time is now. J Prof Nurs. 2021;37(1):86-92. [Link] [DOI:10.1016/j.profnurs.2020.10.001]
36. Ha DT, Nuntaboot K. New competencies required for nurses as compared to the national nursing competency standards in Vietnam. KONTAKT. 2020;22(2):92-5. [Link] [DOI:10.32725/kont.2020.016]
37. Tønnessen S, Scott A, Nortvedt P. Safe and competent nursing care: An argument for a minimum standard?. Nurs Ethics. 2020;27(6):1396-407. [Link] [DOI:10.1177/0969733020919137]
38. Maphumulo WT, Bhengu BR. Perceptions of professional nurses regarding the national core standards tool in tertiary hospitals in KwaZulu-Natal. Curationis. 2020;43(1):1971. [Link] [DOI:10.4102/curationis.v43i1.1971]
39. Lee H, Kim DJ, Han JW. Developing nursing standard guidelines for nurses in a neonatal intensive care unit: A delphi study. Healthcare. 2020;8(3):320. [Link] [DOI:10.3390/healthcare8030320]
40. Usui M, Yamauchi T. Guiding patients to appropriate care: Developing Japanese outpatient triage nurse competencies. Nagoya J Med Sci. 2019;81(4):597-612. [Link]
41. Salem OA, Aboshaiqah AE, Mubaraki MA, Pandaan IN. Competency based nursing curriculum: Establishing the standards for nursing competencies in higher education. Open Access Libr J. 2018;5(11):1-8. [Link] [DOI:10.4236/oalib.1104952]
42. Cashin A, Heartfield M, Bryce J, Devey L, Buckley T, Cox D, et al. Standards for practice for registered nurses in Australia. Collegian. 2017;24(3):255-66. [Link] [DOI:10.1016/j.colegn.2016.03.002]
43. Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. The development of professional practice standards for Australian general practice nurses. J Adv Nurs. 2017;73(8):1958-69. [Link] [DOI:10.1111/jan.13274]
44. Douglas MK, Rosenkoetter M, Pacquiao DF, Callister LC, Hattar-Pollara M, Lauderdale J, et al. Guidelines for implementing culturally competent nursing care. J Transcult Nurs. 2014;25(2):109-21. [Link] [DOI:10.1177/1043659614520998]
45. Douglas MK, Pierce JU, Rosenkoetter M, Pacquiao D, Callister LC, Hattar-Pollara M, et al. Standards of practice for culturally competent nursing care: 2011 update. J Transcult Nurs. 2011;22(4):317-33. [Link] [DOI:10.1177/1043659611412965]
46. Deputy for nursing, Ministry of Health and Medical Education, Ministry of Health. Professional Nursing Care Standards. 2020. [Link]
47. Iranian Nursing Organization. Nursing service standards. Tehran: Iranian Nursing Organization; 2010. [Link]
48. Palliative Care Nurses Australia. The competency standards for specialist palliative care nursing practice comprise five domains. Brisbane: Palliative Care Nurses Australia; 2022. [Link]
49. Nurses Association of New Brunswick. Standards of practice for registered nurses. Fredericton: Nurses Association of New Brunswick; 2022. [Link]
50. Indiana University Southeast. Standards of professional performance. New Albany: Indiana University Southeast; 2022. [Link] [DOI:10.2979/13126.0]
51. BCCNM. Professional standards for registered nurses and nurse practitioners. Vancouver: British Columbia College of Nurses and Midwives; 2020. [Link]
52. Helene Fuld College of Nursing (HFCN). Helene Fuld College of Nursing technical standards for core professional nursing competency performance. New York: Helene Fuld College of Nursing; 2020. [Link]
53. Saskatchewan Registered Nurses Association (SRNA). Registered nurse practice standards. Canada: Saskatchewan Registered Nurses Association; 2019. [Link]
54. College of Registered Nurses of Newfoundland and Labrador (CRNNL). Standards of practice for registered nurses and nurse practitioners. Mount Pearl: College of Registered Nurses of Newfoundland and Labrador; 2019. [Link]
55. College of Registered Nurses of Prince Edward Island. Standards for nursing practice. Charlottetown: College of Registered Nurses of Prince Edward Island; 2018. [Link]
56. CNO. Professional standards, revised 2002. Toronto: College of Nurses of Ontario; 2018. [Link]
57. Nursing and Midwifery Council (NMC). Future nurse: Standards of proficiency for registered nurses. London: Nursing and Midwifery Council; 2018. [Link]
58. Nova Scotia College of Nursing (NSCN). Standards of practice for registered nurses. Canada: Nova Scotia College of Nursing; 2017. [Link]
59. NMBA. Registered nurse standards for practice. Melbourne: Nursing and Midwifery Board of Australia; 2016. [Link]
60. Australian College of Children and Young People's Nurses (ACCYPN). The development of standards of practice for children and young people's nurses. Brisbane City: Australian College of Children and Young People's Nurses; 2016. [Link]
61. Nursing and Midwifery Board of Ireland. Nurse registration programmes standards and requirements. Dublin: Nursing and Midwifery Board of Ireland; 2016. [Link]
62. Hospital Services Department and Cambodian Council of Nurses. Guideline for the standard of nursing care, Cambodia. Cambodia: Cambodian Council of Nurses; 2015. [Link]
63. The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS). The QNI/QNIS voluntary standards for district nurse education and practice. London: The Queen's Nursing Institute; 2015. [Link]
64. American Nurses Association. Nursing: Scope and standards of practice. 3rd ed. Maryland: American Nurses Association; 2015. [Link]
65. Nursing and Midwifery Council (NMC). The code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: Nursing and Midwifery Council; 2015. [Link]
66. International Labour Organization (ILO). National nursing core competency standards-training modules for the Philippines. Geneva: International Labour Office; 2014. [Link]
67. Ministry of Health Brunei Darussalam. Core competency standards for registered nurses and midwives in Brunei Darussalam. Bandar Seri Begawan: Ministry of Health Brunei Darussalam; 2013. [Link]
68. College of Registered Nurses of Nova Scotia (CRNNS). Standards of practice for registered nurses. Canada: College of Registered Nurses of Nova Scotia; 2012. [Link]
69. New Zealand Nurses Organization. Standards of professional nursing practice. Wellington: New Zealand Nurses Organization; 2012. [Link]
70. Professional Regulatory Board of Nursing. The 2012 national nursing core competency standards. Manila: Professional Regulation Commission; 2012. [Link]
71. Nursing and Midwifery Board of Australia (NMBA). National competency standards for the registered nurse. Melbourne: Nursing and Midwifery Board of Australia; 2010. [Link]
72. American Nurses Association. Nursing: Scope and standards of practice. 2nd ed. Maryland: American Nurses Association; 2010. [Link]
73. NMC. Standards for competence for registered nurses. London: Nursing and Midwifery Council; 2018. [Link]
74. Expert Panel on Global Nursing & Health. Standards of practice for culturally competent nursing care. Livonia: Transcultural Nursing Society; 2010. [Link]
75. Affara F. ICN framework of competencies for the nurse specialist. Geneva: International Council of Nurses; 2009. [Link]
76. Professional Regulation Commission (PRC). Revisiting the core competency standards of nursing practice in the Philippines. Manila: Republic of the Philippines Professional Regulation Commission; 2009. [Link]
77. Queensland University of Technology. 2005 nursing core competency standards. Manila: Professional Regulation Commission; 2005. [Link]
78. Australian Nursing and Midwifery Council (ANMC). National competency standards for the nurse practitioner. Canberra: Australian Nursing and Midwifery Council; 2004. [Link]
79. Papua New Guinea Nursing Council. Papua New Guinea nursing competency standards. Port Moresby: Papua New Guinea Nursing Council; 2002. [Link]
80. Currie J, Thompson C, Grootemaat P, Andersen P, Finnegan A, Carter M, et al. A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries. J Clin Nurs. 2023;32(1-2):283-97. [Link] [DOI:10.1111/jocn.16239]
81. Li L, Benton WC. Hospital technology and nurse staffing management decisions. J Oper Manag. 2006;24(5):676-91. [Link] [DOI:10.1016/j.jom.2005.06.001]
82. Cook MP, Álvarez E. Nursing clinical teacher's characteristics. HORIZONTE DE ENFERMERIA. 2010;20(2):53-61. [Spanish] [Link] [DOI:10.7764/Horiz_Enferm.20.2.53]
83. Parnikh H, Torabizadeh C, Najafi Kalyani M, Soltanian M. A study of the relationship between professional communication and professional commitment in operating room nurses. Nurs Res Pract. 2022;2022:5871846. [Link] [DOI:10.1155/2022/5871846]
84. Sato T, Ishimaru M. Hypothetical model for on-the-job training through case conferences of public health nurses. Public Health Nurs. 2022;39(6):1334-45. [Link] [DOI:10.1111/phn.13115]
85. Sudarmika P, Santyasa IW, Tegeh IM, Sudarma IK. How to assess nurse learning needs through training needs analysis: Mixed methods study. Int J Health Sci. 2023;7(1):13-25. [Link] [DOI:10.53730/ijhs.v7n1.13843]
86. Panneerselvam S. Feedback among nursing professionals: A narrative review. Int J Health Sci Res. 2018;8(2):266-71. [Link]
87. Scott H. Working environments have a direct impact on care. Br J Nurs. 2004;13(15):893. [Link] [DOI:10.12968/bjon.2004.13.15.15520]