The Required Competencies of Bachelor- and Master-Educated Nurses in Facilitating the Development of an Effective Workplace Culture in Nursing Homes: An Integrative Review

Abstract

Background: Nursing home care is undergoing significant changes. This requires innovative teams operating in an effective workplace culture characterized by person-centeredness and offering evidence-based care. A pivotal role for bachelor- and master-educated nurses (BNs/MNs) is foreseen to facilitate such cultures; however, there is currently no comprehensive overview of what competencies this requires.

Objectives: To identify what competencies are required from BNs/MNs in facilitating the development of an effective workplace culture in nursing homes.

Methods and design: We conducted an integrative review (IR) using Whittemore and Knafl's method. We searched the PubMed, CINAHL, and PsycINFO databases for studies published between January 2010 and December 2021 in English. Two independent reviewers determined whether studies met inclusion: bachelor- or master-educated nurse; nursing home; professional competencies; and mixed methods or qualitative and qualitative studies. We applied the CASP appraisal tool and analyzed the data by applying content analysis.

Results: Sixteen articles were included. Five themes were identified representing required competencies for BNs/MNs facilitating: (1) learning cultures in nursing practice; (2) effective work relationships within teams; (3) leadership capability within teams; (4) implementation of guidelines, standards, and protocols; (5) a work environment acknowledging grief and loss of residents within teams.

Conclusions: It shows that the BN/MN applies five competencies associated with a facilitator role to promote the development of an effective workplace culture to achieve a safe, high-level quality of care, satisfaction, and well-being. An overarching leadership as a change champion will support teams to achieve a quality that should guide the transformation in nursing care.

Keywords: bachelor nurse; competency; evidence-based practice; facilitating; integrative review; leadership; master nurse practitioner; nursing homes; person-centered practice; work environment; workplace culture.

Figure 1

Flow Diagram showing the article selection process [41].

Figure 2

CASP Assessment [42], summary review of the assessment of the included studies [43,44,45,46,47,48,49,50,51,52,53,54,55,56,57]. Green-coded box indicates that the study satisfactorily met the respective quality criterion, yellow-coded box indicates that the study partially met the respective quality criterion, and the red-coded box indicates that the study did not meet the respective quality criterion.