Factors Related to the Clinical Competence of Registered Nurses: Systematic Review and Meta‐Analysis

PURPOSE: To determine the factors associated with the clinical competence of registered nurses. METHODS: Systematic review and meta-analysis was used. The search strategy was limited to 10 years, ranging from January 2009 to December 2019, in Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Google Scholar. A meta-analysis was performed using R Studio with the metafor package (Boston, MA, USA; https://rstudio.com/products/rstudio/older-versions/). RESULTS: A total of 22 studies were included, representing 33,961 nurses. There were 28 factors associated with clinical competence. Of those, 13 factors were significantly supported and included for meta-analysis, grouped into (a) individual-related factors, (b) job satisfaction, (c) bullying, (d) burnout, and (d) specific knowledge. The effect size of those factors ranged from -0.14 to 0.50. CONCLUSIONS: Among individual-related factors, salary has the largest effect size on competence and is considered important. Clinical competence is positively affected by job satisfaction, but negatively influenced by bullying and burnout. Although specific knowledge has a large effect size, it does not significantly affect the clinical competence of registered nurses. CLINICAL RELEVANCE: It is critical to understand factors related to the clinical competence of registered nurses to maintain quality care and patient outcomes in clinical settings. The findings serve as data to help nurse managers find effective ways to improve the knowledge, skill, attitudes, and performance of registered nurses.