Clinical nurse competence and its effect on patient safety culture: a systematic review

Unsafe health practices are one of the leading causes of disability and even death. Competent nurses are crucial to ensure safe and high-quality healthcare services. The patient safety culture is concerned with internalizing safety beliefs, values, and attitudes, translating them into healthcare practices, and committing to maintaining an error-free health environment. A high level of competence ensures the achievement and compliance with the safety culture goal. This systematic review aims to identify the relationship between the level of nursing competence and the safety culture score and perception among nurses at their workplace.

Four international online databases were searched to find relevant studies published between 2018 and 2022. Peer-reviewed articles using quantitative methods, targeting nursing staff, and written in English were included. After reviewing 117 identified studies, 16 full-text studies were included. The PRISMA 2020 checklist for systematic reviews was used.

Evaluation of the studies indicates safety culture, competency, and perception were assessed using various instruments. Safety culture was generally perceived as positive. No unique and standard tool has been developed to investigate the effect of safety competency on the perception of the safety culture in a standardized way.

Existing research provides evidence of a positive correlation between nursing competence and patient safety score. Future research is recommended to investigate ways to measure the effect of nursing competency level on safety culture in healthcare institutions.