Nurse Manager Competency on the Clinical Nurse Performance in High Acuity Units of a Level 2 Hospital

High-quality clinical nurse performance directly reduces medical errors and improves patient recovery rates. Furthermore, strong nursing performance optimizes hospital workflows and lowers healthcare costs through efficient resource management. There is a scarcity of studies on clinical nurse performance being influenced by perceptions on nurse managers competency at the local level. This quantitative research made use of the descriptive, correlational design to assess the relationship between nurse managers competency and clinical nurse performance as perceived by nurses in a private level 2 hospital in Mactan, Cebu, during the first half of 2026. Findings of the study revealed that the perceptions on the nurse manager’s competency were high. Specifically, there was a very high competency in terms of communication and collaboration, quality monitoring and pursuance, and personal mastery while they only had a high competency in terms of staff advocacy and development and change and resource management as perceived by the staff nurses. The clinical nurse performance of the nurses was very good. Specifically, contextual, clinical skill, interpersonal communication, problem solving, and teamwork were very good while professional skill, professional ethics, and leadership were excellent. There was a correlation between the nurse managers competency and clinical nurse performance. The better the nurse manager’s competency, the better the clinical nurse performance. To address the findings of the study, a clinical performance enhancement plan was proposed.

Clinical Nurse Performance; Nurses; Nurse Managers Competency; High Acuity Units; Private Hospital

1. Ahmed, A., Khuwaja, F. M., Brohi, N. A., & Othman, I. (2022). Organizational support and employee performance in healthcare organizations. Healthcare, 10(3), 498. https://doi.org/10.3390/healthcare10030498 [Google Scholar] [Crossref]

2. Alsadaan, N., Salameh, B., Reshia, F. A. A. E., Alruwaili, R. F., Alruwaili, M., Awad Ali, S. A., Alruwaili, A. N., Hefnawy, G. R., Alshammari, M. S. S,. Alrumayh, A. G. R., Alruwaili, A. O., & Jones, L. K. (2023). Impact of nurse leaders behaviors on nursing staff performance: A systematic review of Literature. Inquiry, 60, 469580231178528. https://doi.org/10.1177/00469580231178528 [Google Scholar] [Crossref]

3. American Hospital Association (2026). AONL Nurse leader core competencies. https://www.aonl.org/resources/nurse-leader-competencies [Google Scholar] [Crossref]

4. Arani, N., Adib-Hajbaghery, M., & Azizi-Fini, I. (2023). Clinical competence and clinical performance of nurses: A cross-sectional study. Medical-Surgical Nursing Journal, 11. Ttps://doi.org/h10.5812/msnj-132816. [Google Scholar] [Crossref]

5. Ariga, R. A., Aurelia, R., Anak Ampun, P. T. D., Hutabarat, C. P., & Panjaitan, F. B. (2024). Enhancing nursing excellence: Exploring the relationship between nurse deployment and performance. International Journal of Environmental Research and Public Health, 21(10), 1309. https://doi.org/10.3390/ijerph21101309 [Google Scholar] [Crossref]

6. Chin, M., Balang, R. V., Wider, W., Tanucan, J. C. M., Sim, H. Y., & Janjuy, C. (2024). Leadership competencies and managerial competencies of nurse managers in Kuala Lumpur Hospital, Malaysia. Jurnal Ners. https://doi.org/10.20473/jn.v19i3.49986S [Google Scholar] [Crossref]

7. Choi, P. P., Lee, W. M., Wong, S. S., & Tiu, M. H. (2022). Competencies of nurse managers as predictors of staff nurses' job satisfaction and turnover intention. International Journal of Environmental Research and Public Health, 19(18), 11461. doi.org [Google Scholar] [Crossref]

8. Cui, K., Xie, Q., Liu, J., Xi, Z., & Xiang, C. (2024). Evaluation of the effectiveness of the Competency Model for nursing managers in the training of newly appointed head nurses. Journal of Clinical and Nursing Research, 8, 202-207. http://doi,org/10.26689/jcnr.v8i10.8700. [Google Scholar] [Crossref]

9. Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The job demands-resources model of burnout. Journal of Applied Psychology, 86 (3), 499–512. https://doi.org/10.1037/0021-9010.86.3.499 [Google Scholar] [Crossref]

10. García, A. G., Pinto-Carral, A., Villorejo, J. S., Marqués-Sánchez, P. (2020). Nurse manager core competencies: A proposal in the Spanish health system. International Journal of Environmental Research and Public Health, 17(9), 3173. https://do.org/10.3390/ijerph17093173 [Google Scholar] [Crossref]

11. González-García, A., Pinto-Carral, A., Pérez-González, S., Marqués-Sánchez, P. (2021). Nurse managers competencies: A scoping review. Journal of Nursing Management, 29(6), 1410-1419. https://doi:.org/0.1111/jonm.13380 [Google Scholar] [Crossref]

12. Hagos, T. H., Tesfamichael, S. A., Kidane, H. A., Andemeskel, Y. M. (2024).. Factors affecting performance of nurses at selected health facilities: A ctoss-sectional study in Eritrea. Fortune Journal of Health Sciences, 7(2024), 544-558. [Google Scholar] [Crossref]

13. Kahya, E., & Oral, N. (2018). Measurement of clinical nurse performance: Developing a tool including contextual items. Journal of Nursing Education and Practice, 8, 112. https://doi.org/10.5430/jnep.v8n6p112. [Google Scholar] [Crossref]

14. Khosravi, S., Dehkourdi, N. J., Dezfouli, S. M. M., Javid, A., Hemmati, S., Delavar, M. A., Nasersaeed, M., Koudarzi, M. (2022). Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing. Journal of Family Medicine and Primary Care, 11(9), 5609-5614. https://doi.org/10.4103/jfmpc.jfmpc_461_22 [Google Scholar] [Crossref]

15. Lu, H., Zhao, Y., & While, A. (2019). Job satisfaction among hospital nurses: A literature review. International Journal of Nursing Studies, 94, 21–31. https://doi.org/10.1016/j.ijnurstu.2019.01.011. [Google Scholar] [Crossref]

16. McCombes, S. (2023). Descriptive research. Definition, types, methods and examples. https://www.scribbr.com/methodology/descriptive-research/ [Google Scholar] [Crossref]

17. Mirzaei, A., Imashi, R., Saghezchi, R.Y. et al. (2024). The relationship of perceived nurse manager competence with job satisfaction and turnover intention among clinical nurses: an analytical cross-sectional study. BMC Nursing, 23, 528. https://doi.org/10.1186/s12912-024-02203-5 [Google Scholar] [Crossref]

18. Putri, L., Rezani, M., & Hermina, D. (2025). Correlational research design. Jurnal Riset Multidisiplin Edukasi, 2, 306-317. https://doi.org/10.71282/jurmie.v2i6.456. [Google Scholar] [Crossref]

19. Real, A. (2025). Patricia Benner Nursing Theory: Guide to Today’s Nurses. IntelyCare. https://www.intelycare.com/career-advice/patricia-benner-nursing-theory-guide-for-todays-nurses/ [Google Scholar] [Crossref]

20. Sandehang, P. M., & Muthmainnah (2018). Improving nurse managers competencies: A systematic review. ICINNA 2018-The 1st International Conference of Indonesian National Nurses Association [Google Scholar] [Crossref]

21. Subih, M., Al-Amer, R., Bani Saleh, E. G, & Thulth,ee. I. N. (2024). Predictors of clinical performance among emergency nurses: A cross-sectional study. SAGE Open Nursing, 10, 23779608241281468. https://doi.org/10.1177/23779608241281468 [Google Scholar] [Crossref]

22. Supri, A., Rachmawaty, R., & Syahrul, S. (2019). Nurses performance assessment based on nursing clinical Authority: A qualitative descriptive study. Journal Of Nursing Practice, 2(2), 80–90. https://doi.org/10.30994/jnp.v2i2.48 [Google Scholar] [Crossref]

23. Wang, S., Tong, J., Wang, Y., Zhang, D. (2022). A study on nurse manager competency model of tertiary general hospitals in China. International Journal of Environmental Research and Public Health, 19(14), 8513. https://doi.org/10.3390/ijerph19148513 [Google Scholar] [Crossref]

24. Warshawsky, N. E., Pascale, A., Doucette, J. N. (2025_. Measuring the impact of high-performing nurse managers on nurse outcomes across clinical settings. Journal of Nursing Administration, 55(10), 595-600. https://doi:.org/10.1097/NNA.0000000000001638 [Google Scholar] [Crossref]

25. Warshawsky, N. E., Cramer, E., Grandfield, E. M., & Schlotzhauer, A. E. (2022). The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals. Journal of Nursing Management, 30(6), 1981-1989. [Google Scholar] [Crossref]

• Knowledge and Attitude of Undergraduate Nursing Students towards Organ Donation
• Cold Hip Bath Therapy for Labor Pain Management: A Review of Non-Pharmacological Interventions in Women's Health
• Work Settings Utilizing the S.C.O.R.E Model on the Psychological Empowerment of Hospital Nurses in Cebu City
• An Assessment on the Quality of Life of PLHIV Residents in Digos City Barangays: Basis for Health Teaching Program
• Work-Related Stress and Its Psychodermatological Impact on Nursing Professionals