Access to Competence Development Among Nurses in Telenursing services: Does It Matter? – a comparative cross-sectional study with an embedded mixed-method approach

Background The nursing profession is continually adapting to changing population health needs and rapid medical advancements, underscoring the importance of ongoing competence development. Nurses have a professional responsibility to maintain updated knowledge; however, participation in continuing professional development (CPD) is often constrained by high workloads, staffing shortages, limited resources, and insufficient organizational support. Telenursing represents an expanding area of practice shaped by technological change and may require increased CPD to ensure safe and high-quality care. Despite this, previous research indicates that nurses in these services often work under demanding conditions and have restricted opportunities for professional development. Given the relevance of CPD for competence maintenance, well-being, and care quality, further evidence is needed regarding its availability, its association with work-related outcomes, and nurses’ specific CPD needs. Aim The study aimed to compare nurse-rated quality of working life and satisfaction with given care among nurses who had participated in CPD during the previous year and those who had not. A further aim was to explore nurses’ preferences and perceived needs related to CPD activities. Methods A cross-sectional survey was conducted among nurses in Sweden’s national healthcare advisory service (SHD 1177), involving participants from fourteen regions. Data were collected through a web-based questionnaire in autumn 2023. Of 465 invited nurses, 187 responded (40.2%). Quality of working life and satisfaction with given care were assessed using validated instruments. Access to CPD was measured with a single item, and CPD needs and preferences were collected through free-text responses. Results Nurses with access to CPD reported significantly higher levels of emotional thriving compared with those without CPD. They also gave significantly higher ratings for ‘management and colleagues’ and ‘growth opportunities’. No significant group differences emerged for satisfaction with given care. Desired CPD components included strengthened clinical knowledge, opportunities for reflective and self-directed learning, and improved communication skills. Conclusion Access to CPD was associated with more positive work-related outcomes, including higher thriving and stronger perceptions of managerial and collegial support. These findings highlight the importance of regular competence development to support sustainable telenursing services.