Nursing competence is emphasised as a valuable resource to promote equitable access to quality care worldwide (WHO, 2016 ). A competent workforce prepared to accomplish appropriate work performance is crucial to meet quality requirements and achieve positive outcomes in health services (Flinkman, Leino-Kilpi, Numminen, Jeon, & Kuokkanen, 2017 ; Sandberg & Pinnington, 2009 ). Due to the demographic changes, health reforms have been implemented in several EU countries to strengthen primary health care and to reduce the use of hospitalisation (OECD/EU, 2016 ). These health reforms have often led to increasingly complex primary healthcare services, making nursing competence a critical issue of concern for health authorities (Maier & Aiken, 2016 ; Maier, Aiken, & Busse, 2017 ). OECD ( 2016 ) refers to the 1978 Alma-Ata declaration and defines primary care as the “first level of contact for the population with the health care syste...