[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-160269-en":3,"doc-seo-160269-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},160269,962085564807,"Rizky","https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8",7,"Healthcare","Competency Model for the Middle Nurse Manager (MCGE-Logistic Level)","Healthcare systems face transformative pressures driven by economic shifts, social uncertainty, and health instability. In this context, the middle nurse manager is pivotal, responsible for translating organizational strategy, values, and objectives into actionable work. This study aimed to propose a competency model for middle nurse managers in the Spanish healthcare system. Using the Delphi method to reach consensus and principal component analysis to assess construct validity, the study identified 51 competencies, emphasizing decision-making, leadership, and communication.","Article  \nCompetency Model for the Middle Nurse Manager (MCGE-Logistic Level)  \nAlberto Gonz¡lez-Garc½a 1, Arrate Pinto-Carral 1,*, Jesós Sanz Villorejo 2 and Pilar Marqu²s-S¡nchez 1  \n􀀁􀀂􀀃􀀁􀀄 􀀆􀀇􀀈  \n􀀁􀀂􀀃􀀄􀀅􀀆􀀇  \nCitation: González-García, A.;  \nPinto-Carral, A.; Villorejo, J.S.; Marqués-Sánchez, P. Competency Model for the Middle Nurse Manager (MCGE-Logistic Level) . Int. J. Environ. Res. Public Health 2021, 18, 3898 . [https://doi.org/10.3390/ijerph1808](https://doi.org/10.3390/ijerph1808)[ ](https://doi.org/10.3390/ijerph1808)3898  \nAcademic Editor: Dimitris Zavras  \nReceived: 8 March 2021  \nAccepted: 7 April 2021  \nPublished: 8 April 2021  \nPublisher's Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional afﬁliations.  \nCopyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Nursing and Physiotherapy, Leon University, 24071 Leân, Spain; [agong@unileon.es](agong@unileon.es) (A.G.-G.); pilar.marques@unileon.es (P.M.-S.)  \n2 University Dental Clinic, European University of Madrid, 28045 Madrid, Spain; jesus.sanz@universidadeuropea.es  \n* Correspondence: arrate.pcarral@unileon.es  \nAbstract: Healthcare systems are immersed in transformative processes, inﬂuenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The objective of this study was to propose the model of competencies to be developed by the middle nurse manager in the Spanish healthcare system. Our methodology consisted in the application of the Delphi method in order to reach an agreement on the necessary competencies, and principal component analysis (PCA) was used to determine the construct validity, reducing the dimensionality of the set of data. Fifty-one competencies were identiﬁed for the deﬁnition of the model, highlighting decision-making, leadership and communication. The PCA pointed out the structural validity of the proposed model through the saturation of the main components (􀀋 Cronbach > 0.631) . The results show the model of competencies which the middle nurse manager in the Spanish healthcare system must develop. Middle nurse managers may use these as criteria to plan their professional strategies in the context of management. This model of competencies can be applied to establishing selection processes or training programs for the role of middle nurse manager.  \nKeywords: model of competencies; competency; middle nurse manager; nurse manager; logistic level; health policy; healthcare services; healthcare affordability; Hospital efﬁciency  \n1. Introduction  \nHealthcare systems are immersed in processes of global transformation, inﬂuenced by economic and social changes, changes in health technology and structural alterations in systems for the provision of healthcare [1–5] . In this uncertain context, nurses are under pressure to improve quality of care [6] . It thus seems logical that nurses should form part of the nucleus of healthcare so that organizations are able to deal with these changes successfully [7–9] . Thus, as highlighted by Witt et al. [10], when the nurse takes part in the healthcare process (management and nursing care) organizations achieve better performances [11,12] . Within health organizations, nurse managers are a key part of any healthcare attention team. Nurse managers are responsible for introducing changes and creating environments in which nurses are able to provide quality attention, at the same time as guaranteeing the achievement of the objectives of the organization under sustainability and efﬁ","cbCaijrMrtK1grD7","https://ap.wps.com/l/cbCaijrMrtK1grD7","pdf",1172595,1,13,"English","en",105,"# Abstract\n# Introduction\n## Transformations in healthcare systems\n## Role of nurse managers\n## Need for managerial competencies\n# References","[{\"question\":\"What was the objective of the study?\",\"answer\":\"To propose a competency model for middle nurse managers in the Spanish healthcare system.\"},{\"question\":\"How were the competencies identified and validated?\",\"answer\":\"The Delphi method was used to reach agreement on necessary competencies, and principal component analysis was applied to determine construct validity.\"},{\"question\":\"Which competency areas were highlighted as most important?\",\"answer\":\"Decision-making, leadership, and communication were emphasized among the identified competencies.\"}]","Competency Model for the Middle Nurse Manager (MCGE-Logistic Level) | PDF",1788053106,33,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"competency-model-for-the-middle-nurse-manager-mcge-logistic-level","",{"@graph":36,"@context":85},[37,54,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/competency-model-for-the-middle-nurse-manager-mcge-logistic-level/160269/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":62,"encodingFormat":61,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-08-30",true,{"@type":65,"interactionType":66,"userInteractionCount":4},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What was the objective of the study?","Question",{"text":75,"@type":76},"To propose a competency model for middle nurse managers in the Spanish healthcare system.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"How were the competencies identified and validated?",{"text":80,"@type":76},"The Delphi method was used to reach agreement on necessary competencies, and principal component analysis was applied to determine construct validity.",{"name":82,"@type":73,"acceptedAnswer":83},"Which competency areas were highlighted as most important?",{"text":84,"@type":76},"Decision-making, leadership, and communication were emphasized among the identified competencies.","https://schema.org",{"og:url":52,"og:type":87,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":89,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,118,123,128,131,135],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":116,"slug":117},40,"healthcare",{"id":119,"doc_module":4,"doc_module_name":46,"category_name":120,"show_sort_weight":121,"slug":122},8,"Research & Report",30,"research-report",{"id":124,"doc_module":4,"doc_module_name":46,"category_name":125,"show_sort_weight":126,"slug":127},9,"Religion & Spirituality",20,"religion-spirituality",{"id":126,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":126,"slug":130},"World Cup","world-cup",{"id":132,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":132,"slug":134},10,"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":106,"slug":138},19,"General","general"]