Journal of Education and Health Promotion

Clinical competence of Iranian nurses: A systematic review and meta‑analysis

Authors

. Amir Emami Zeydi
. Mohammad Javad Ghazanfari 1
. Ehsan Azizi 2
. Hadi Darvishi‑Khezri 3
. Hamed Mortazavi 4
. Joseph Osuji 5
. Samad Karkhah 6

1 Department of Medical‑Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran

2 Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

3 Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran

4 Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran

5 School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Alberta, Canada

6 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran, Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran

Abstract
BACKGROUND: One of the most important steps in increasing the nurses’ professional competence 
and consequently improving the quality of nursing care is to evaluate nurses’ clinical competency 
and then take effective actions to enhance it. This study aimed at exploring the clinical competence 
of Iranian nurses and factors related to it.
MATERIALS AND METHODS: In this systematic review and meta‑analysis, PubMed, Scopus, Web 
of Science, Scientific Information Database, and Iranmedex databases and Google Scholar search 
engine were searched to February 14, 2020.
RESULTS: After screening, a total of 25 articles were included. In general, the level of clinical 
competence of Iranian nurses was at a desirable level. After meta‑analysis of the mean score of nurses’ 
clinical competence, the combined mean was 161.13 (95% confidence interval [CI]: 137.78–184.48;
P < 0.001; I
2 = 99.8%; P value for heterogeneity = P < 0.001) by the Competency Inventory for 
Registered Nurses (CIRN) questionnaire. The summarized mean of clinical competency measured 
by the Nurse Competence Scale (NCS) questionnaire was 70.75 (95% CI: 60.80–80.70; P < 0.001; 
I
2 = 99.9%; P value for heterogeneity = P < 0.001). Factors affecting nurses’ clinical competence were 
age ≥33 years, nursing work experience ≥9 years, and a master’s degree in nursing. However, the 
clinical competence of nurses had a significant negative relationship with job stress.
CONCLUSION: The level of clinical competence of Iranian nurses was desirable. Studies that used 
the CIRN, reported the highest and lowest clinical competence in clinical care and professional 
development dimensions, respectively. Studies that used the NCS, reported the highest and lowest 
clinical competence in dimensions of work role and ensuring quality, respectively.

Keywords

Clinical competence
Iran
meta‑analysis
nurses
systematic review
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Journal of Education and Health Promotion
Volume 12, Issue 3
March 2022
Pages 1-12

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