Nursing Competence and its Associated Workplace Factors in a Resource-limited Setting in Garo Hills, Meghalaya, India: A Cross-sectional Study

Introduction: Nursing competence is a cornerstone of highquality patient care, yet there is limited empirical evidence from rural regions of Northeast India, particularly Meghalaya. These areas face unique systemic challenges, including workforce shortages, high patient loads and limited resources, which may further impede the delivery of effective healthcare services. Aim: To assess the level of nursing competence among nurses employed in secondary healthcare centres in the Garo Hills region of Meghalaya and to examine whether selected workplace factors predict variations in competence. Materials and Methods: A cross-sectional study was carried out in 16 Secondary Healthcare Centres (District Hospitals and Community Health Centres) across the Garo Hills region of Meghalaya, from 11th July 2023 to 19th August 2023. Using purposive sampling facilitated by Institutional gatekeepers, 226 nurses were approached, with 222 responding to the questionnaire. Data were collected using the validated Nurse Professional Competence Scale – Short Form (NPC-SF), which assesses multiple domains of nursing competence. Prior to data collection, ethical approval was obtained, and written informed consent was secured from all the participants. Descriptive statistics summarised demographic, workplace characteristics and competence data, while multiple linear regression analysis was applied to identify predictors of competence. Results: The mean overall competence score was 5.34±1.28, indicating a moderate level of nursing competence. Among the competence domains, documentation and administration of nursing care scored highest (5.51±1.27), while nursing care scored lowest (5.03±1.16). The majority of nurses (96.85%) reported working more than 50 hours a week, with 82.88% frequently involved in overtime duties. Regression analysis revealed that workplace factors such as overtime involvement and departmental distribution did not significantly predict competence {(R²=0.018, F (4,217)=0.99, p-value=0.413)}. Conclusion: Nurses in the Garo Hills, Meghalaya, demonstrated a moderate level of competence across all assessed domains. The findings suggested that nursing competence may be influenced by broader organisational, educational, and psychosocial factors not captured in the present study.