COMPETENCY AMONG NURSES AND ITS ASSOCIATED FACTORS: A NARRATIVE REVIEW

Background: Nursing competency is a critical determinant of patient safety, quality of care, and overall health outcomes within healthcare systems. Competent nursing practice integrates clinical knowledge, technical skills, ethical judgment, and professional behavior to reduce adverse events and improve patient outcomes. Variability in competency levels across healthcare settings has been linked to differences in education, organizational support, and professional development opportunities. Understanding current competency levels and the factors influencing them is essential for strengthening nursing practice, particularly in complex tertiary care environments. Objective: To assess the level of competency and identify factors associated with competency among nurses working in tertiary care hospitals. Methods: A structured narrative review was conducted using multiple electronic databases, including CINAHL, PubMed, Google Scholar, and ResearchGate. The search strategy applied Boolean operators, relevant keywords, and Medical Subject Headings to retrieve studies published in English within the last five years. From an initial yield of 21,700 records, duplicates were removed and titles and abstracts were screened for relevance. Full-text evaluation was performed based on predefined inclusion criteria, resulting in the selection of 16 studies from diverse geographical regions. Data were systematically extracted and synthesized using a narrative approach due to heterogeneity in study designs and assessment tools. Results: Across the included studies, overall nursing competency levels ranged from moderate to high. Approximately 55–80% of nurses demonstrated moderate-to-high competency across different healthcare contexts. Higher competency was more frequently reported among nurses with stable employment, day-shift duties, and access to structured training programs. Variations in competency were also associated with workload, organizational support, and opportunities for continuing professional development, while sociodemographic factors showed limited and inconsistent influence. Conclusion: Nurses working in tertiary care settings generally exhibit moderate to high levels of competency, influenced predominantly by organizational and professional factors. These findings emphasize the importance of supportive work environments, standardized competency assessment, and continuous professional development to sustain and enhance nursing competency.