Postlicensure nurse competence in the United States: A concept clarification

Background

Postlicensure nurse competence is a critical factor in healthcare quality and safety, yet a research gap exists in the U.S.-specific context.

Purpose

This study aimed to clarify the concept of postlicensure nurse competence in clinical settings in the United States, establish an operational definition, and develop a conceptual model.

Methods

The Norris method of concept clarification was used. Data were compiled from literature and health/nursing professional organization websites. Inclusion criteria were full-text articles written in English that were conducted exclusively in the United States, were focused on postlicensure registered nurses, and contained either a theoretical or operational definition of nurse competence.

Results

Data were collected from 44 published articles and information from eight professional organization websites. The analysis revealed that postlicensure nurse competence consisted of five domains: knowledge, technical skills, judgment and decision-making, communication, and professionalism. The conceptual model illustrated that the operational definition of nurse competence is shaped by and relative to three tiers of constantly evolving practice standards at the employer, state board of nursing, and professional organization levels; is acquired and sustained through initial and ongoing education and experience; and impacts various health and healthcare outcomes.

Conclusion

The operational definition provides an improved understanding of what constitutes nurse competence for postlicensure nurses in the United States. The conceptual model further highlights the context, antecedents, and consequences of nurse competence and their relationships. This study provides a framework for the operationalization and assessment of postlicensure nurse competence and helps advance consistency in regulation of postlicensure nurse competence in the United States.