Clinical Competence of Nurses and Its Association with Patient Safety Indicators

Abstract

Background: Clinical competence is a key factor in the determination of nursing quality and patient safety, but its differential effect on patient safety indicators (PSIs) is not fully understood.

Objective: This research study investigated the association between clinical competence of nurses and significant PSIs through correlation analysis, regression analysis, and subgroup analysis.

Methods: Spearman correlation was used to measure the relationships between the Clinical Competence Score and five PSIs, including hospital-acquired infections (HAI), medication errors, patient falls with injury, pressure ulcers, and hand hygiene compliance. Independent effects were assessed using multivariable regression models (OLS and Poisson) using the adjustment of demographic and workplace confounders. Subgroup results were made based on results in the various departments and the various levels of experience.

Results: The clinical competence showed statistically significant negative relation with HAI  (ρ = −0.145, p = 0.012) and statistically significant positive relation with hand hygiene compliance (ρ = 0.279, p < 0.001). These findings were validated by regression analysis, which indicated that greater competence independently predicted better hand hygiene compliance (β = 4.209, p < 0.001) and low HAI rates (β = −0.243, p = 0.0085). Results indicated that there were marginal associations with medication errors, although there was no significant relationship between patient falls or pressure ulcers. Subgroup analysis showed that there are no significant differences in competence or PSI rates between departments or experience levels.

Conclusion: The impact of clinical competence on the infection-related safety outcomes is the primary reason to highlight its significance in infection control practices compared to more general physical safety events.