An Integrative Review of Quality Improvement Competence and Engagement Among Frontline Nurses

Nurses providing direct care have firsthand knowledge of gaps in practice and thus must actively engage in quality improvement (QI) to enhance patient outcomes.

This integrative review evaluated QI competence and engagement among frontline nurses.

Using Souza et al's 6-step framework, literature on QI engagement and competence was synthesized using a rigorous search strategy and quality assessment.

Sixteen studies revealed generally low QI engagement and competence. Factors such as education, experience, and role influenced engagement, with higher levels of education and experience linked to higher QI involvement. Nurse leaders had higher engagement, underscoring the need for strong leadership in creating a culture of improvement.

Successful and sustainable QI programs and supportive environments enhance QI engagement and competence among frontline nurses.