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Nursing Competencies: New Advances in Nursing Care
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Nursing Competencies: New Advances in Nursing Care

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 12153

Special Issue Editors

Dr. Ippolito Notarnicola

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Guest Editor
Department of Medicine and Surgery, University of Enna "Kore", 94100 Enna, Italy
Interests: nursing competence; professional competencies; clinical competencies; leadership; healthcare
Dr. Alessandro Stievano

E-Mail Website
Guest Editor
1. Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
2. Centre of Excellence for Nursing Scholarship, OPI, 00131 Rome, Italy
Interests: ethics; transcultural competencies; global health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, demands have been voiced calling for profound changes to the structure of healthcare systems to meet future challenges. Nurses are at the heart of such systems; without them, no such restructuring would be possible. To prepare nurses to take on this task, healthcare professionals from across the sector need to think about the changes that will occur in healthcare strategies and how they will affect the needs of patients. All of this change will involve a new system of nursing education, based on the new competencies nurses will need to acquire over the coming decade in order to face the interconnected challenges of our global society.

This will unquestionably involve a reform of nursing education. Nurses have many vital competencies that can help people improve adherence to the rules of healthcare systems, meet the population's future needs, and further advance epidemiological circumstances.

In this Special Issue, researchers, teachers, and academics are invited to present their work on nursing competencies based on new advances in nursing. Articles, reviews, and concept papers might focus on the evolution of nursing skills or other related concepts based on contemporary nursing.

Possible research topics include but are not limited to:

  • Meta-analyses and systematic reviews of nursing assessment instruments currently in use;
  • Research that validates the currently used evaluation instruments;
  • Studies that quantify the psychometric properties of assessment instruments;
  • Research comparing several assessment instruments used to measure the same domain;
  • Cross-sectional research for the purpose of culturally adapting assessment instruments in certain nations.

We look forward to receiving your contributions.

Dr. Ippolito Notarnicola
Dr. Alessandro Stievano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical competence
  • professional competence
  • nursing
  • healthcare
  • healthcare education

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Published Papers (9 papers)

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Research

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15 pages, 435 KiB  
Article
Pretransplant Physical Activity and Cardiovascular Risk Factors in Kidney Transplant Candidates: A Cross-Sectional Study
by Emilia Ferrer-López, Víctor Cantín-Lahoz, Francisco Javier Rubio-Castañeda, Juan José Aguilón-Leiva, María García-Magán, Carlos Navas-Ferrer, Eva Benito-Ruiz, María Isabel Serrano-Vicente, Isabel Blázquez-Ornat, Isabel Antón-Solanas and Fernando Urcola-Pardo
Healthcare 2025, 13(10), 1200; https://doi.org/10.3390/healthcare13101200 - 20 May 2025
Viewed by 71
Abstract
Background/Objectives: Individuals with chronic kidney disease often face significant physical and clinical challenges, such as muscle weakness, fatigue, and reduced cardiorespiratory capacity, that impact their quality of life. Physical activity has emerged as an effective intervention to counteract these effects, with clinical guidelines [...] Read more.
Background/Objectives: Individuals with chronic kidney disease often face significant physical and clinical challenges, such as muscle weakness, fatigue, and reduced cardiorespiratory capacity, that impact their quality of life. Physical activity has emerged as an effective intervention to counteract these effects, with clinical guidelines recommending exercise as a standard treatment for kidney transplant recipients. The aim of this study was to assess pretransplant physical activity levels in a cohort of transplant patients and analyze their relationships with cardiovascular risk factors. Methods: A cross-sectional, analytical, and correlational study was conducted from September 2020 to June 2022 with a sample of 122 kidney transplant recipients assessed before kidney transplantation. Sociodemographic data, anthropometric data, comorbidities, renal replacement therapy types, and clinical and analytical data were collected from the patients’ clinical records. Physical activity was assessed via the International Physical Activity Questionnaire. Results: The average time spent waiting for transplantation was 423 ± 405 days, which was longer (387 ± 524) in the group of those under 65 years than in those over 65 years (194 ± 256) (p = 0.010). The median energy expenditure was 1742 (IQR = 1719) METs. In addition, 15.6% of the participants reported inactivity. Men reported higher physical activity levels (median: 2076 METs/week; IQR: 2037) than women did (median: 1386 METs/week; IQR: 1238). A higher level of physical activity was found in non-dialysis patients, overweight patients, and those with a history of stroke. A significant positive correlation was found between physical activity levels and serum urea. Conclusions: Increased physical activity levels were observed in men and in participants under 65 years of age. Patients with cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, overweight and obesity, reported lower activity levels, whereas those with a prior history of cerebrovascular accidents engaged in more physical activity. This study highlights the importance of assessing physical activity and promoting exercise for chronic kidney disease patients awaiting kidney transplantation. Further research is needed to explore the evolution of physical activity in this population and its impact post-transplantation. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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16 pages, 230 KiB  
Article
Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study
by Laura Iacorossi, Simona Molinaro, Francesca Gambalunga, Fabrizio Petrone, Flora Desiderio, Francesca Piacentini, Antonino Guerrisi, Fulvia Elia and Mauro Caterino
Healthcare 2025, 13(8), 845; https://doi.org/10.3390/healthcare13080845 - 8 Apr 2025
Viewed by 331
Abstract
Background/Objectives: Diagnostic examinations that cutaneous melanoma (CM) patients undergo during follow-up can generate various emotional states related to the possibility of recurrence or disease progression. Understanding the emotions and perceptions of patients during the wait for diagnostic exams is crucial for improving care. [...] Read more.
Background/Objectives: Diagnostic examinations that cutaneous melanoma (CM) patients undergo during follow-up can generate various emotional states related to the possibility of recurrence or disease progression. Understanding the emotions and perceptions of patients during the wait for diagnostic exams is crucial for improving care. This study aims to explore the experiences of CM patients awaiting follow-up diagnostic investigations. Methods: This is a qualitative descriptive inductive, single-center study, structured according to COREQ criteria. The sample of CM patients was recruited at the Radiology and Diagnostic Imaging Unit of the San Gallicano Dermatological Institute in Rome. Data were collected through semi-structured interviews and analyzed using Framework Analysis, as described by Ritchie and Spencer. Results: A total of 30 patients with an average age of 57.4 were recruited. The interviews revealed the following four themes: waiting influences the emotional experience; the double face of family support; strategies of support during the waiting period; and waiting requires attention to the person and the environment. Conclusions: This study revealed that waiting for a diagnostic exam for cutaneous melanoma (CM) is often characterized by anxiety and worry. Healthcare professionals need to implement positive coping strategies, balanced family support, and improved communication to enhance patient care and satisfaction in oncology settings. Recognizing and addressing patients’ emotional dynamics is crucial for improving care. Training healthcare staff, providing psychological interventions, and leveraging technological innovation can improve the waiting experience, foster a more welcoming and reassuring environment, and enhance patients’ psychological well-being and satisfaction with care pathways. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
11 pages, 430 KiB  
Article
Implementation Science Competencies for Policy Transformation Framework (ISCPT)
by Modi Al-Moteri, Jamil Aljuaid, Hayat Mohammed Alqurashi, Mashael Mohammed Otayni, Muneera Hasheem Al-Jaid, Amira Mohamed Hamed Ahmed, Bandar Obaid Al Sufyani, Saeed Atiah Almalki, Anare Dinnesse Cagoco, Rana Mohammed Bamansur, Digna Fatalla, Shara Hamad Muqree, Atheer Mutair Ammar Alkhaldi, Fatemah Nooralhak Turdi, Maaidah M. Algamdi, Rizal Angelo N. Grande, Daniel Joseph E. Berdida, Alalyani Mesheil and Emad Althobaiti
Healthcare 2025, 13(7), 723; https://doi.org/10.3390/healthcare13070723 - 25 Mar 2025
Viewed by 497
Abstract
Implementation science (IS) models play a crucial role in translating evidence-based practice (EBP) into sustainable policy reforms. However, the competencies required for nurses to lead these transformations remain poorly defined. Objective: This study develops a framework for implementation lead (IL) nurses, identifying [...] Read more.
Implementation science (IS) models play a crucial role in translating evidence-based practice (EBP) into sustainable policy reforms. However, the competencies required for nurses to lead these transformations remain poorly defined. Objective: This study develops a framework for implementation lead (IL) nurses, identifying the core competencies needed to drive evidence-based policy transformation within healthcare systems. Method: A secondary data analysis (SDA) was conducted using qualitative data from focus group interviews originally collected, recorded, and transcribed as part of the EQUIP (Evidence-based Quality Improvement Project). The dataset includes insights from 12 IL nurses who participated in PEACE-based training, addressing real-world clinical challenges. Their perspectives were thematically analyzed to generate a competency framework for policy leadership. Findings: The study developed the Implementation Science Competencies for Policy Transformation (ISCPT) framework, which highlights three pillars: (1) evidence appraisal and guideline development, (2) collaborative leadership for policy advocacy, and (3) continuous improvement through data-driven decision-making. Conclusions: Grounded in IL nurses’ perspectives, the ISCPT framework provides a nurse-centric roadmap for policy transformation, integrating interdisciplinary collaboration, adaptive leadership, and evidence-based decision-making into nursing education and practice. While the findings reflect a single healthcare context, the framework offers actionable guidance for preparing nurses to lead policy-driven healthcare improvements. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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16 pages, 231 KiB  
Article
Patient–Nurse Communication in an Oncology Hospital Setting: A Qualitative Study
by Laura Iacorossi, Giovanna D’Antonio, Maria Condoleo, Lara Guariglia, Fabrizio Petrone, Simona Molinaro and Anita Caruso
Healthcare 2025, 13(1), 50; https://doi.org/10.3390/healthcare13010050 - 30 Dec 2024
Viewed by 1648
Abstract
Background: Communication is an important aspect in making patients competent to define, process, and manage their disease condition as well as to intercept and satisfy psychosocial needs. Communication between patient and nurse is central to the learning and orientating process since the nurse [...] Read more.
Background: Communication is an important aspect in making patients competent to define, process, and manage their disease condition as well as to intercept and satisfy psychosocial needs. Communication between patient and nurse is central to the learning and orientating process since the nurse has the greatest frequency and continuity of relationship with patients and their families. This study aims to investigate the quality of communication between patient and nurse and the factors that promote or hinder effective communication from the oncology patient’s perspective within an inpatient hospital setting. Methods: A descriptive qualitative study was conducted with one-to-one semi-structured interviews analyzed using the Framework Analysis methodology. The population consisted of oncologic patients admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Data were analyzed using Ritchie and Spencer’s Framework Analysis. Results: The sample comprised 20 patients, with an average age of 61.35, admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Three themes emerged: positive communication as an element of care, factors fostering communication, and factors hindering communication. Conclusions: The sample interviewed deems the quality of communication satisfactory. Familiar communication style, direct language, and caring are factors fostering communication. In contrast, lack of communication between medical and nursing staff, shortage of staff, and lack of time are considered communication barriers. Advanced communication competencies in nurses are crucial for effectively addressing the emotional and psychosocial needs of cancer patients, fostering a more empathetic and supportive care environment. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
14 pages, 785 KiB  
Article
Recognizing Distress in Cancer Patients in Day Hospital, by Trained Nurses vs. Non-Trained Nurses: A Pilot Study
by Laura Iacorossi, Chiara Falcicchio, Francesca Gambalunga, Emanuela Taraborelli, Gabriella Maggi, Irene Terrenato, Fabrizio Petrone, Anita Caruso and Maria Perrone
Healthcare 2024, 12(24), 2498; https://doi.org/10.3390/healthcare12242498 - 11 Dec 2024
Viewed by 841
Abstract
Background: Psychological distress impacts 35–40% of cancer patients, significantly affecting their quality of life, treatment adherence, and relationships with healthcare professionals. Given this, there is a critical need to enhance nursing competencies to effectively monitor and address psychological distress. Previous studies have [...] Read more.
Background: Psychological distress impacts 35–40% of cancer patients, significantly affecting their quality of life, treatment adherence, and relationships with healthcare professionals. Given this, there is a critical need to enhance nursing competencies to effectively monitor and address psychological distress. Previous studies have highlighted discrepancies in capabilities based on nurses’ training status, emphasizing trained nurses’ critical role in providing appropriate psycho–social referrals. Objective: To evaluate the impact that trained nurses have on the detection of distress and the timely referral of patients for a psycho–oncology consultation. Methods: A blinded, random, descriptive, monocentric pilot study was conducted. The participants were adult patients in Day Hospital 1 of the National Cancer Institute Regina Elena, Rome, irrespective of illness stage. Tools used included a socio-demographic and clinical data form, distress thermometer (DT), and visual analogic scale (VAS). Patients were randomly divided into two groups: Group A, where questionnaires were administered by trained nurses, and Group B, where non-trained nurses administered questionnaires. Nurses indicated whether patients needed a psycho–oncology consultation. All patients were then seen by a psycho–oncology specialist to determine whether the nurse’s referral was appropriate. Patients and psycho–oncologists were all unaware of the nurses’ training status. The effectiveness of the training was measured by the degree of agreement between evaluators. Results: This study involved 20 patients and four nurses. The average DT score was 5, mainly related to physical and emotional problems. Agreement between evaluators was higher in the trained nurses’ group. Conclusions: Specific training on DT enabled nurses to acquire advanced skills to accurately refer patients for psychological consultations. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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20 pages, 630 KiB  
Article
Toward the Definition of a Repertoire of Technical Professional Specialist Competencies for Operating Room Nurses: An Ethnographic Study
by Francesca Reato, Alessia Bresil, Chiara D’Angelo, Mara Gorli, Dhurata Ivziku, Marzia Lommi and Giulio Carcano
Healthcare 2024, 12(17), 1774; https://doi.org/10.3390/healthcare12171774 - 5 Sep 2024
Viewed by 1312
Abstract
Registered nurses in the operating room require specialized competencies that surpass basic educational training. Existing national and international documents attempt to outline these competencies but often lack comprehensive details. To address this, a repertoire of technical and professional competencies for operating room nurses, [...] Read more.
Registered nurses in the operating room require specialized competencies that surpass basic educational training. Existing national and international documents attempt to outline these competencies but often lack comprehensive details. To address this, a repertoire of technical and professional competencies for operating room nurses, aligned with European and National Qualifications Frameworks, is proposed. Aim: Develop a repertoire of technical and professional competencies for perioperative and perianesthesiological specialist nursing roles. Methods: An at-home ethnography design was employed, utilizing participant observation, interviews to the double, and focus groups. Convenience sampling included 46 participants from a university and a public hospital in northern Italy. Data were collected from September 2021 to June 2023 and analyzed using inductive content analysis and data triangulation. Results: Identified 17 specialized technical professional competencies for perioperative and perianesthesiological nursing, divided into 6 areas of activity. These competencies encompass 19 learning outcomes, 152 tasks, 222 knowledge elements, and 218 skills. Conclusions: This competency repertoire aids in the public recognition of qualifications and serves as a valuable tool for identifying, validating, and certifying competencies. Future research should focus on exploring the competencies of central sterilization nurses and transversal competencies. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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14 pages, 256 KiB  
Article
Empowering Nurse Health Education: Linguistic and Cultural Validation of the Nurse Health Education Competence Instrument (NHECI) in the Italian Context
by Ippolito Notarnicola, Blerina Duka, Marzia Lommi, Emanuela Prendi, Elena Cristofori, Tiziana Mele, Dhurata Ivziku, Gennaro Rocco and Alessandro Stievano
Healthcare 2024, 12(14), 1445; https://doi.org/10.3390/healthcare12141445 - 19 Jul 2024
Viewed by 1502
Abstract
Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. [...] Read more.
Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)

Review

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14 pages, 1476 KiB  
Review
Models Used by Nurse Case Managers in Different Autonomous Communities in Spain: A Scoping Review
by Paula Villarreal-Granda, Amada Recio-Platero, Yara Martín-Bayo, Carlos Durantez-Fernández, Rosa M. Cárdaba-García, Lucía Pérez-Pérez, Miguel Madrigal, Alba Muñoz-del Caz, Elena Olea, Esther Bahillo Ruiz, Lourdes Jiménez-Navascués and Veronica Velasco-Gonzalez
Healthcare 2024, 12(7), 749; https://doi.org/10.3390/healthcare12070749 - 29 Mar 2024
Viewed by 2245
Abstract
(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of [...] Read more.
(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing’s role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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Other

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14 pages, 410 KiB  
Systematic Review
Exploring Influential Factors Shaping Nursing as a Profession and Science in Healthcare System—A Systematic Literature Review
by Vlora Ejupi, Allison Squires and Brigita Skela-Savič
Healthcare 2025, 13(6), 668; https://doi.org/10.3390/healthcare13060668 - 19 Mar 2025
Viewed by 1763
Abstract
Introduction: Nursing faces numerous challenges amidst broader socio-political transitions in many countries. Despite efforts to establish formal nursing education and legislative frameworks, the profession’s status remains relatively low within some healthcare systems. This study aims to examine the factors influencing nursing professionalism [...] Read more.
Introduction: Nursing faces numerous challenges amidst broader socio-political transitions in many countries. Despite efforts to establish formal nursing education and legislative frameworks, the profession’s status remains relatively low within some healthcare systems. This study aims to examine the factors influencing nursing professionalism and provide insights into strategies for its enhancement. Aim: The study seeks to summarize the existing literature on nursing professionalism, assess methodological quality, and derive recommendations for future research. Through a systematic review, the study explores various factors shaping nursing professionalism, including communication skills, resilience, education, and cultural perceptions. Methods: A systematic search was conducted across multiple electronic databases from 2014 to 2024 to identify relevant studies on nursing professionalism. The search strategy encompassed elements of professionalism, nursing, and exclusion criteria. Selected studies underwent methodological quality assessment using the Critical Appraisal Skills Programme Qualitative Checklist. Results: The review identified 421 records, yielding 72 eligible studies after screening and eliminating duplicates. Fourteen studies met the inclusion criteria, revealing a complex framework of factors influencing nursing professionalism. The key determinants include communication skills, resilience, education, and cultural perceptions. Studies emphasized the importance of effective communication, resilience in crisis management, quality education, and understanding psychological and cultural influences on professionalism. Conclusions: Nursing professionalism is influenced by multifaceted factors, including communication skills, resilience, education, and cultural perceptions. Recognizing these factors is vital for promoting high-quality nursing practice and ensuring patient safety. Addressing these elements can inform targeted interventions to enhance nursing professionalism and support nurses in delivering optimal healthcare. This study underscores the importance of investing in nursing education, fostering resilience, and considering cultural nuances to cultivate a culture of excellence and professionalism within healthcare systems. Full article
(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)
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