Nursing staff competence assessment instruments: a scoping review with implications for long-term care

Competence assessment is essential for professional growth, workforce planning, and quality improvement in long-term care (LTC). However, the wide range of instruments, their limited differentiation based on various qualification levels, and the lack of standardized frameworks hinder effective use. This scoping review aimed to map international evidence on competence assessment instruments used in residential LTC nursing, broadening the scope to include acute care, community-based, and mixed-care settings to enhance the relevance and transferability of findings.

A scoping review was conducted following the Joanna Briggs Institute guidelines. Peer-reviewed and grey literature in English and German were searched across two databases (PubMed and CINAHL) between 2014 and 2024. Inclusion criteria focused on instruments assessing nursing competence through self-assessment or external evaluation, targeting various qualification levels and care contexts.

Twenty instruments were identified. The review addressed two key research questions: (1) A wide range of self-assessment tools with generally sound psychometric properties were found, predominantly developed for registered nurses and validated in acute settings; however, few differentiated by qualification level, and no validated instruments were identified for healthcare assistants. (2) Validated peer or external evaluation instruments were scarce, highlighting a reliance on self-perception and a lack of objective assessment. Instruments for specialized domains (e.g., dementia, palliative care) demonstrated higher contextual relevance but lacked robust testing in LTC.

This review highlights significant variability and identifies a crucial gap in tools available for healthcare assistants and multi-method assessments. Future efforts should focus on creating modular, theory-informed, and context-sensitive instruments that are validated across various qualification levels and care sectors. These tools are essential to support individualized learning, ensuring equitable staffing, and fostering sustainable quality improvements in long-term care.