Other Titles
Who Leads Nursing? Developing & Validating a Nursing Leadership Competency Framework for Hospital Nurse Managers [Title Slide]
Abstract
Background: Nursing leadership competencies are essential for ensuring care quality, organizational performance, and professional advancement. However, in Taiwan, leadership development has been limited by the absence of a validated, tiered competency framework that reflects both local practice contexts and global standards.
Purpose: To develop and validate a nursing leadership competency framework for hospital nurse managers in Taiwan.
Methods: A three-phase design was employed. Phase 1 involved a systematic review of international and domestic literature to generate preliminary competency domains. Phase 2 used focus group interviews with nurse executives, managers, and educators to refine and contextualize the framework. Phase 3 conducted a two-round Delphi survey with 30 experts to evaluate the appropriateness and clarity of each competency item. Data were analyzed using descriptive statistics and the coefficient of dispersion, with consensus defined as a mean score ≥ 4.0, median = 5, interquartile range [IQR] ≤ 1, and at least 80% of experts rating each item as 4 or 5 on a 5-point Likert scale.
Results: Thirty experts were invited to participate in two Delphi rounds. Consensus was achieved across six domains encompassing clinical leadership, professional leadership, relationship and collaborative leadership, adaptive leadership, governance, and health policy advocacy. The validated framework includes 17 core competencies distributed across three hierarchical levels (frontline, mid-level, and senior nurse managers), reflecting the progressive development of leadership competencies within hospital settings. All items met the consensus criteria (mean ≥ 4.7, median = 5, IQR ≤ 1), with ≥ 92.3% achieving full agreement. The Delphi process confirmed the framework’s clarity, structural logic, and contextual relevance to Taiwan’s healthcare system.
Conclusions / Implications for Practice: The validated six-domain nursing leadership competency framework offers a comprehensive, evidence-based model for strengthening leadership competencies across career stages. The framework provides a foundation for curriculum design, self-assessment, and policy development, aligning with international frameworks while addressing Taiwan’s healthcare context. Implementing this framework may enhance leadership preparation, improve organizational performance, and advance the strategic influence of nursing in healthcare systems.
Notes
References:
1. Chen, Y. M., Chang, T. H., Chang, T. F., & Tzeng, W. C. (2024). Nursing department directors' perspectives on leadership training programme: A descriptive qualitative study. Nurse Education Today, 143, 106405. https://doi.org/10.1016/j.nedt.2024.106405
2. Filomeno, L., Forte, D., Di Simone, E., Di Muzio, M., Tartaglini, D., Lommi, M., & Ivziku, D. (2024). Systematic review and psychometric properties analysis of first-, middle-, and top-level nurse manager's core competencies instruments. Journal of Nursing Management, 2024, 2655382. https://doi.org/10.1155/2024/2655382
3. Perez-Gonzalez, S., Marques-Sanchez, P., Pinto-Carral, A., Gonzalez-Garcia, A., Liebana-Presa, C., & Benavides, C. (2024). Characteristics of leadership competency in nurse managers: A scoping review. Journal of Nursing Management, 2024, 5594154. https://doi.org/10.1155/2024/5594154
4. Tzeng, W.-C., Chen, Y.-M., Yen, M., Chang, T.-H., Chang, T.-F., Chen, L.-C., & Hsu, Y.-C. (2025). The impact of the Nightingale nursing leadership institute's training program on core competencies in program participants: A convergent parallel mixed-methods study. The Journal of Nursing, 72(3), 33–46. https://doi.org/10.6224/JN.202506_72(3).06
5. Ylitalo, A., Laukka, E., Heponiemi, T., & Kanste, O. I. (2022). Primary healthcare managers' perceptions of management competencies at different management levels in digital health services: Secondary analysis. Leadership in Health Services, 36 (2), 247–260. https://doi.org/10.1108/LHS-07-2022-0078
Sigma Membership
Lambda Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Competence, Global Leadership, Succession Planning, Leadership, Nurse Managers, Hospital Nursing Staff
Recommended Citation
Tzeng, Wen-Chii; Chien, Ling-Yu; and Chen, Yao-Mei, "Developing and Validating a Nursing Leadership Competency Framework for Hospital Nurse Managers" (2026). International Nursing Research Congress (INRC). 84.
https://www.sigmarepository.org/inrc/2026/presentations_2026/84
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-28
Developing and Validating a Nursing Leadership Competency Framework for Hospital Nurse Managers
Toronto, Ontario, Canada
Background: Nursing leadership competencies are essential for ensuring care quality, organizational performance, and professional advancement. However, in Taiwan, leadership development has been limited by the absence of a validated, tiered competency framework that reflects both local practice contexts and global standards.
Purpose: To develop and validate a nursing leadership competency framework for hospital nurse managers in Taiwan.
Methods: A three-phase design was employed. Phase 1 involved a systematic review of international and domestic literature to generate preliminary competency domains. Phase 2 used focus group interviews with nurse executives, managers, and educators to refine and contextualize the framework. Phase 3 conducted a two-round Delphi survey with 30 experts to evaluate the appropriateness and clarity of each competency item. Data were analyzed using descriptive statistics and the coefficient of dispersion, with consensus defined as a mean score ≥ 4.0, median = 5, interquartile range [IQR] ≤ 1, and at least 80% of experts rating each item as 4 or 5 on a 5-point Likert scale.
Results: Thirty experts were invited to participate in two Delphi rounds. Consensus was achieved across six domains encompassing clinical leadership, professional leadership, relationship and collaborative leadership, adaptive leadership, governance, and health policy advocacy. The validated framework includes 17 core competencies distributed across three hierarchical levels (frontline, mid-level, and senior nurse managers), reflecting the progressive development of leadership competencies within hospital settings. All items met the consensus criteria (mean ≥ 4.7, median = 5, IQR ≤ 1), with ≥ 92.3% achieving full agreement. The Delphi process confirmed the framework’s clarity, structural logic, and contextual relevance to Taiwan’s healthcare system.
Conclusions / Implications for Practice: The validated six-domain nursing leadership competency framework offers a comprehensive, evidence-based model for strengthening leadership competencies across career stages. The framework provides a foundation for curriculum design, self-assessment, and policy development, aligning with international frameworks while addressing Taiwan’s healthcare context. Implementing this framework may enhance leadership preparation, improve organizational performance, and advance the strategic influence of nursing in healthcare systems.
Description
This study developed and validated a six-domain Nursing Leadership Competency Framework for hospital nurse managers in Taiwan through a three-phase modified Delphi process. The framework encompasses clinical, professional, relational, adaptive, governance, and policy competencies, comprising 17 core competencies differentiated across three hierarchical levels—frontline, mid-level, and senior nurse managers—providing a structured roadmap for progressive leadership development in healthcare.