Middle nurse management: role definition and competency assessment to create value in healthcare

Background The ability of middle nurse managers (MNMs) to achieve advanced management competencies is presently the most important approach for the success of health organizations. Effective management constitute the cornerstone of success and efficiency in healthcare organisations. Competent nurse management fosters the quality of patient care and contributes to favourable employee morale and engagement, reducing turnover rates and cultivating a positive workplace culture. Literature lacks the establishment of a unique core of competencies and job description for MNMs and an instrument that comprehensively evaluates them. Aim The project aims to identify the competencies of MNMs and reach a consensus on the core competencies needed to perform this role in healthcare today. Methods For this doctoral thesis, different research methodologies were used. At first, a brief report to explore the current state of the art of the Middle Nurse Manager role in Italy was conducted. Secondly, a systematic review of the literature was performed to collect evidence on the most used and better-designed instruments to evaluate competencies. Following the review results, the instrument that better performed on completeness and methodological rigour was validated into Italian. Therefore, we performed a qualitative study on middle nurse managers inner perceptions about the role. Results Following the studies conducted, this thesis identified main areas of middle nurse managers competencies such as Communication and Technology, Staff and Resource Management, Financial Management and Leadership and Teamwork. Inside each one of these areas, sub-competencies with more specific definitions were individuated. Also, our consecutive qualitative findings support and integrate 2 the literature on competencies required, performance evaluation and educational needs. Conclusion In this study, consensus was reached on the competencies necessary for establishing a core curriculum for middle nurse managers adapted to current health policies, economic necessities and the sustainability of the organizations and healthcare. As a result, nurse managers can be chosen based on these capabilities and their level of growth by utilizing the most-cited competencies as a starting point. This ensures the most qualified people are assigned to managerial roles.