Exploring nursing competence to care for older patients in municipal in-patient acute care: A qualitative study

 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 system, bridging health care as close as possible to where people live and work” (p. 38). MAUs are parts of the primary healthcare services. In this study, in-patient care refers to medical treatment provided in a municipal facility and which requires at least one overnight stay.