The concept of role ambiguity, despite its wide application in nursing research, lacks a clear definition and conceptualization, resulting in inconsistencies about how it is defined, operationalized, and applied in research. The purpose of this paper was to analyze and define the concept of role ambiguity among hospital nurses providing nursing care, using the concept analysis method developed by Walker and Avant. The three defining attributes of role ambiguity were lack of information (information deficiency), lack of clarity, and unpredictability. Antecedents included lack of clear role definitions, lack of education/training, communication problems, supervisory behaviors and support, organizational culture, practice environment conditions, experience, group cohesiveness, and preferred work setting. The consequences of role ambiguity included increased stress, lack of organizational commitment, job dissatisfaction, burnout, and increased intent to leave. This concept analysis provides a clear conceptual definition to better understand role ambiguity among hospital nurses along with implications for nurse leaders, educators, clinicians, and researchers to support nurses and guide future research. This paper further emphasizes the importance of nurse-manager relationships in reducing the experience of role ambiguity among hospital nurses.

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Background Nurses are in key positions in the healthcare system to provide, monitor, and manage the care delivered to their patients. In 2005, the Quality and Safety Education for Nurses (QSEN) initiative was launched to redefine quality and safety competencies for pre‐licensure nursing education. It is imperative that nurses are graduating with the full spectrum of the QSEN competencies to practice in today’s healthcare environments. Aims The purpose of this systematic review was to evaluate the research about student nurses’ perceptions of their abilities to perform the six QSEN competencies and to determine the effect of integrating the QSEN content in their courses, clinical placements, or simulation experiences. Method A systematic review of the literature was conducted to retrieve published studies from CINAHL, PubMed, Web of Science, and ERIC using the search terms of Quality and Safety Education for Nurses, QSEN, QSEN competencies, nursing student, and student nurse. The studies that were included in this review were assessed by both authors independently using standardized critical appraisal tools. Results Seven studies met the inclusion criteria: four descriptive, one quasi‐experimental, and two mixed‐methods designs. Overall, pre‐licensure nursing students perceived patient‐centered care as the most discussed and quality improvement as the competency least reviewed in their curricula. Students reported to be most prepared to perform patient‐centered care skills and least prepared to perform quality improvement skills. Linking Evidence to Action Revisiting the integration of the quality improvement competency into nursing curricula can increase nursing students’ understanding of this QSEN competency. More research with sufficiently powered sample sizes, valid and reliable tools measuring outcomes of interventional studies, and attention to quality and rigor is needed to assess graduating students’ understanding of the QSEN competencies.

Background The lack of evidence‐based practice (EBP) knowledge and inability to implement EBP among nurses is a major barrier to quality nursing care. The literature shows that nurses highly value the use of EBP, however, they lack necessary EBP competencies. Although medical‐surgical nurses were included in studies examining cross‐sections of the nursing workforce, no studies exist specifically investigating their EBP beliefs and EBP competencies. Aims The purpose of this study was to describe medical‐surgical nurses’ self‐reported EBP beliefs and competencies. Method A descriptive, cross‐sectional design employing survey methodology was used. Results A total of 1,709 medical‐surgical nurses participated for a response rate of 13%. The findings revealed that medical‐surgical nurses had positive beliefs about EBP. However, they rated themselves competent in only 2 EBP competencies of 24. Medical‐surgical nurses working in units or organizations that had a special designation such as Academy of Medical‐Surgical Nurses Premier Recognition in the Specialty of Med‐Surg (AMSN PRISM; p = .001) or Pathway to Excellence (p = .006) reported greater EBP competency scores. Also, nurses educated at the master's level or higher had better EBP competency scores (p < .0001). Linking Evidence to Action Medical‐surgical nurses need support at the personal and organizational levels to improve their EBP competence and increase uptake of EBP in their practice. Therefore, individual nurses must reflect on their EBP competence level and pursue opportunities to develop these essential attributes. Leaders must also create practice environments where EBP is valued, and barriers to EBP implementation are eliminated. Faculty in prelicensure and graduate programs should integrate EBP into their curricula and assess students’ EBP competencies.

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