The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.

Nurse competence profiles differed in both the level of and in frequency of using competencies between work environments. Context-specific knowledge of nurse competence from real work life situations provides direction on how to structure work environments and staff development interventions to provide qualified care.

The results shed useful light on the educational needs of nurses and provide important clues for the development of preceptorship programmes. The Nurse Competence Scale proved to be a reliable and valid instrument in assessing the competence of recently registered nurses. Implications for nursing management We recommend that management strategies be developed to enhance and support positive learning environments for competence development. We recommend preceptorship programmes based on systematic competence assessments made by nurses themselves, their preceptors and managers.

The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.

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Objective. Nurse competence became a relevant topic for discussion among nurse practitioners and nurse researchers. However, the factors connected with nurse competence need deeper exploring. The aim of this study was to explore nurse competence and factors associated with it from the perspective of nurses for predicting the possible ways for upgrading the nursing practice. Materials and Methods. A multicenter, descriptive study was performed in 11 surgical wards of 7 Lithuanian hospitals. Data were collected from November 2007 to January 2008. Lithuanian nurses (n=218) who were working with patients after abdominal surgery participated in this study. The response rate was 91%. Two instruments, both originally developed in Finland, were used: the Nurse Competence Scale and the Good Nursing Care Scale for Nurses. Results. The overall level of nurse competence and the frequency of using the competencies in practice as perceived by nurses were high. Nurses assessed the competencies in managing situations and work role the highest and in teaching-coaching and ensuring quality the lowest. Sociodemographic factors such as nurse education, experience, professional development, independence, and work satisfaction as well as the evaluation of quality of nursing care were identified as factors associated with nurse competence. Conclusions. The findings of study allow us to make the assumption that nurse education, nurse experience, and nurse professional development play a significant role in the evaluation of nurse competence as well as the evaluation of quality of nursing care. It is necessary to upgrade nursing education programs at all levels of nursing education in Lithuania: university, non-university, and professional development courses. The qualities of preconditions for nursing care, cooperation with relatives, caring and supporting initiative are related to nurse competence.

This study compares nurse and manager assessments of nurse competence in a university hospital setting. Although managers carry out annual reviews, few studies have examined the agreement between the competence assessments made by practising nurses and their managers. Using a pretested 73-item questionnaire, consisting of seven competence categories, we compared self-assessments and manager assessments of the level of nurse competence on a Visual Analogue Scale of 0-100 and the frequency of using competencies by using statistical analyses. Managers assessed the overall level of competence (70.8 +/- 19.3 vs. 63.9 +/- 13.7) (mean +/- SD) and the level of competence in five competence categories significantly higher than the nurses themselves. A high degree of agreement was found between the assessments for the frequency of using competencies. These results can be used to encourage nurses and to improve the quality of care in different hospital work environments.

Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses' work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers' ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses' views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams.