International journal of nursing education scholarshipTeresa Martins, Ana Paula Cantante, Pedro Melo, Sílvia Silva, Marta Valadar, Paula Santos, Carlos Pinto, Marta Sá, Diana Rodrigues, Elisabete Borges
OBJECTIVES: To develop and examine the content validity of a competency assessment tool for clinical teaching in community nursing, essential for high-quality nursing education, while addressing the lack of clarity and consistency in existing methods. METHODS: A qualitative, iterative methodological development and validation study was conducted with 10 clinical teachers. The process included: (1) identification of competency domains and competencies based on national nursing regulations and Vygotsky's sociocultural perspective (71 criteria); (2) refinement of the competency assessment criteria via focus groups (20 criteria); (3) development of a 5-point Likert scale with behavioural descriptors; and (4) creation of methodological guidelines for evaluators. RESULTS: The tool comprises 6 competency domains and 20 criteria, described across five performance levels (poor to excellent), considering performance quality, autonomy, and application in complex contexts. CONCLUSIONS: The instrument enhances fairness, consistency, and feedback, clarifies expectations, promotes student self-regulation, and provides a transparent tool for formative and summative assessment, with potential for adaptation in diverse community nursing settings involving individuals, families, groups, communities, and populations. Implications for an International Audience: Although developed within a Portuguese educational context, the tool addresses competencies relevant to community nursing education internationally. Its structured competency domains and behavioural descriptors provide a framework that can be adapted to different educational and clinical contexts to support transparent, consistent, and development-oriented assessment of nursing students.
British journal of community nursingSandra Lawton, Momodou Bojang
Skin infections and infestations represent a significant burden on public health, accounting for a substantial proportion of consultations in primary care and community settings. This article provides a comprehensive overview of common bacterial, viral, fungal and parasitic skin conditions, covering their definitions, clinical features, recommended investigations, management principles and evidence-based treatment options. Emphasis is placed on the critical role of infection prevention and control protocols in reducing transmission, alongside the importance of patient education in minimising recurrence and safeguarding public health. The article also highlights the necessity of multidisciplinary collaboration and adherence to clinical guidelines to optimise outcomes. In the context of rising antimicrobial resistance and evolving epidemiological trends, ongoing vigilance and robust community interventions are essential for effective management and prevention of skin infections and infestations.
The government's first Men's Health Strategy outlines a comprehensive framework for improving health outcomes among men by addressing preventable morbidity, reducing health inequalities and enhancing engagement with health services. Within community settings, the strategy emphasises early intervention, accessible care pathways and the promotion of health-seeking behaviours among diverse male populations. This article discusses how community-based provision delivered through primary care, public health initiatives, outreach programmes and multidisciplinary collaboration supports the implementation of the Men's Health Strategy in practice.
British journal of community nursingKaren Harrison Dening
Oral health is recognised as an essential component of a person's overall wellbeing, increasingly so in people with dementia. As dementia progresses, a person diagnosed with the condition may become more dependent on the support of the family carer to meet their personal care needs. Similarly, community nurses may be one of the first health professionals that a family carer may call on when difficulties in maintaining good oral care become a concern. An understanding of some of the main concerns and resources available can be helpful for community nurses in helping their patients and their carers. This article discusses some of the common issues using case examples to illustrate possible rationales and considerations for further action.
British journal of community nursingCrystal Oldman
This article discusses the opportunities and challenges of neighbourhood working, and the important role district nurses can play in understanding and improving the health of local communities.
With an increasing focus on shifting care into community and home settings, it is crucial that the community and home nursing workforce is adequately equipped to meet growing demand and complexity. Nursing education must reflect the changing landscape of care delivery, ensuring that community and home nursing are strongly and consistently represented and that nurses are prepared for the evolving demands of practice. The Caring Beyond Walls international conference provided an important opportunity to share learning, innovation and research, while bringing the nursing community together at a critical point in the development of community and home nursing, both nationally and internationally.
Journal of Christian nursing : a quarterly publication of Nurses Christian FellowshipDeborah Ziebarth, Yvonne D Askew, Mary Beaman, Cari Moodie, Deb Fell-Carlson, Beverly Bateman, Mary Lynne Knighten, Pamela Spach Hurley, Nancy Romanchek
A major barrier to faith community nurse (FCN) program success is the lack of financial support; however, a current knowledge gap exists regarding FCN compensation. The current study explored FCN compensation through a three-step approach: examination of professional guiding documents for nursing and FCN practice, a standalone literature review, and development of a national FCN compensation survey. Seventy-six percent (76%) of the 97 survey respondents (n = 74) reported not being compensated. Study results underpinned the creation of a Westberg Institute position statement: Compensating the Faith Community Nurse.
The International Home Care Nurses Organization (IHCNO) emerged in response to a recognized need for a dedicated international professional organization focused on nursing care in the home and community. This historical narrative review examines the organization's development from its early origins in 2008 through 2026. It analyzes how a volunteer-led specialty network contributed to the global advancement of home healthcare nursing. Archival records, peer-reviewed publications, conference materials, organizational documents, and oral-history feedback from founding and current leaders were reviewed and synthesized. Findings highlight IHCNO's progression from a journal-anchored grassroots initiative into an incorporated international professional association with five global conferences, international guidelines and standards, a research grant program, and strategic partnerships supporting education, research, and professional recognition. The organization's history illustrates how distributed volunteer leadership, strategic publication partnerships, and deliberate infrastructure development can strengthen specialty identity and foster international collaboration. As care increasingly shifts into homes and communities worldwide, IHCNO offers an example of how nursing organizations can support practice, research, and policy in evolving models of home-based care.
Home healthcare nowSusan Burt, Kathleen Eid-Heberle, Mary Frances Stapleton
Home care nurses occupy a unique position in the health care system, observing patients in their living environments and coordinating care across multiple delivery sites. Social determinants of health (SDoH), encompassing economic stability, education, health care access, neighborhood conditions, and social context, account for an estimated 30% to 90% of health outcomes, far exceeding the contribution of medical care alone. This article examines the historical, organizational, and clinical foundations of SDoH within the context of home care nursing, underscoring the critical need for systematic assessment in patient care to ensure positive health outcomes. Drawing on the upstream, midstream, and downstream framework, this article describes how home care nurses can intervene at multiple levels: advocating for systemic change, connecting patients to community resources, and managing individual clinical and behavioral needs. The article also examines evolving policy and documentation requirements, including mandatory SDoH screening and the underutilized ICD-10-CM Z-codes, while highlighting gaps in social work utilization. The article further explores emerging models such as social prescribing as promising multilevel approaches to meeting patients' social needs. Ultimately, addressing SDoH is both a professional and ethical obligation for nurses, one that demands interdisciplinary collaboration and sustained commitment across all levels of care.
Home healthcare nowAnne Hutchinson, Emma L Green, Sarah A Sobotka
Parents of children requiring invasive home mechanical ventilation (IMV) rely on, and are expected to manage, complex home health nursing care teams. However, ubiquitous shortages in the pediatric home healthcare workforce leave most families with incomplete nursing support, with negative impacts on child and family well-being. Parents report feeling stressed, overwhelmed, and unsupported by community healthcare services. Parent-to-parent support programs in other populations of children with disabilities have been shown to embolden parents with practical solutions, emotional support, and social connectedness. We designed a novel parent-to-parent coaching model for parents of children with IMV who did not have established home health nursing to empower parents to expand and manage new home health nursing teams. Ten mothers of children awaiting hospital discharge or home without complete nursing support were recruited through a state-wide program. Mothers participated in telephone coaching sessions with experienced family caregivers that included topics related to establishing and managing home health teams and preparing the home for home health nursing. Families were in the program on average 6 months with a median of 11.5 calls with their coach. At the study exit, the majority of families expanded nursing staff and had their child in the family home with the support of home health nursing. Two themes were identified in exit interviews: (1) mothers appreciated specific resources shared by coaches and (2) mothers felt grateful for the emotional support coaches provided, including sharing common experiences and feeling validated. Parents reported that coaches provided unique education and support not provided through existing systems. Parent-to-parent coaching for families of children with IMV may potentially help to reduce home health nursing gaps while also empowering and supporting socially-isolated parents.
British journal of community nursingAlison Holbourn
The NHS 10-year plan re-emphasises the long-standing policy aspiration for population and place-based approaches to health improvement. The Fit for the Future: 10 Year Health Plan sets out a neighbourhood health service as the practical mechanism for shifting care from hospital to community and from sickness to prevention. There is a gap between known evidence-based approaches to health improvement in community settings and local adoption in service delivery. One of the most underserved populations in any neighbourhood will be those affected by a lower limb condition, people with these conditions are likely to also experience a range of co-morbidities and health inequalities. The Lindsay Leg Club Model is a long-established evidence-based approach that may be implemented in a neighbourhood setting to deliver positive outcomes. Using methods outlined in recent government guidance, integrated commissioning boards can implement the Model within neighbourhood service pathways as a cost-effective high impact approach that expands patient choice, addresses inequalities and facilitates prevention and self-care.
Enteral tube feeding provides nutritional stability for individuals unable to meet requirements orally. However, the psychosocial consequences of enteral tube feeding, particularly loneliness arising from disrupted social eating practices, remain under-recognised in community care. Eating is a socially and culturally embedded activity linked to identity, belonging and relational connection. For individuals receiving long-term enteral tube feeding, altered participation in shared mealtimes and social rituals may increase vulnerability to isolation despite physiological stability. This article critically appraises district nursing interventions in enteral tube feeding management and examines the leadership role of the district nurse in addressing loneliness as a determinant of health. A review of contemporary literature highlights a predominance of biomedical focus during routine visits and identifies limited structured assessment of psychosocial wellbeing. The integration of the University of California Los Angeles Loneliness Scale is proposed as a pragmatic service innovation to strengthen holistic review processes and facilitate psychosocial assessment in enteral tube feeding management. It represents a district nurse-led opportunity to align nutritional care with broader wellbeing, reinforcing holistic, person-centred community practice.
British journal of community nursingMyra Robson, Amarachi Olu
Incontinence is a highly stigmatised condition that can significantly impact an individual's quality of life, yet few people seek proper assessment and treatment. Therefore, outreach events aimed at specific or general patient groups can play a crucial role in creating awareness of the condition. This article discusses some of the principles behind health promotion and outreach activities, and the importance of health literacy. It suggests some questions to consider when planning outreach activities and ideas of possible events. Two case studies from the authors' community service have been included as examples.
British journal of community nursingChristina Hayward
Haematoma management in community settings presents a clinical challenge because of the absence of standardised national guidance. Haematomas, defined as localised collections of clotted or partially clotted blood within tissues, can result in complications such as skin necrosis, infection and delayed healing if not managed appropriately. This article outlines the assessment and management of closed, open-bleeding and open-clotted haematomas, with emphasis on timely escalation and risk identification, based on the haematoma clinical decision guide designed by the author to address hesitation and poor confidence among nurses in dealing with haematomas in the community. The importance of holistic assessment is highlighted, including comorbidities, coagulation status and recognition of complications such as compartment syndrome. Particular consideration is given to lower limb haematomas, where vascular assessment is essential before initiating compression therapy. Appropriate debridement options for community practice such as autolytic, mechanical and biological are discussed. This approach aims to improve clinical decision making and optimise patient outcomes.
British journal of community nursingGiovanni Cangelosi
An ageing population, increasingly frail and affected by multiple chronic conditions and the impact of COVID-19 on overall health, has necessitated the acceleration of international territorial healthcare reorganisation. Responses have been adapted to several care settings highlighting the central role of nurses, both in terms of direct care and in organisational and clinical views. Urgent community response initiatives are based on key principles of multidisciplinarity and interprofessional collaboration, which are significant in the context of European healthcare, and could serve as a model for the potential implementation of care processes in other post-COVID-19 crisis scenarios of assistance.
Hu li za zhi The journal of nursingJhe-Jun Wu, Hsin-Pei Feng, Kai-Jo Chiang, Wen-Chii Tzeng
Mental health recovery, a core concept in contemporary mental health care, emphasizes that service users can pursue meaningful life goals by rebuilding hope, identity, and purpose even as related symptoms persist. As care has shifted from a biomedical focus on symptom control toward person-centered and community-oriented approaches, the mental health recovery process has presented challenges to traditional nursing roles and practices. Moreover, misperceptions of these approaches as psychiatric rehabilitation or illness management interventions have led to gaps between principles and practice. In this article, the relevant literature is reviewed to describe the meaning of recovery and its influencing factors, and measurement tools widely used to support nurses' understanding of recovery processes are summarized. In addition, the authors integrate their practical experiences in community psychiatric rehabilitation to reflect on challenges related to role positioning, intervention flexibility, and organizational support when implementing recovery-oriented care in practice.
British journal of community nursingAmanda Secular, Alexandra Bartlett
Final-year student nurses were offered aspirant nurse roles to support busy clinical teams within district nursing services as part of the response to the COVID-19 pandemic. Student nurses in their final year of training had the opportunity to work as an aspirant nurse (paid band 4 position) for a 12-week period, as per the emergency education standards delivered by the Nursing and Midwifery Council in an effort to help out during the pandemic. This gave the students additional responsibilities to allow them to work autonomously but still under the supervision of the registered nurse. This role was separate to their student nurse role, becoming part of the clinical team where they were placed. Building on this concept, a collaboration between higher education institutions and the Essex Partnership University Trust resulted in the development of a structured pilot student autonomous visit programme, at the time referred to as non-direct supervision students. This initiative aimed at improving student learning and enhancing professional identity and confidence, while addressing challenges in recruitment and retention in community nursing roles. This article outlines the development and implementation of the pilot programme, evaluates its impact and discusses its implications for nurse education and workforce planning. Results indicate enhanced student preparedness and improved staff retention in district nursing, strengthening interprofessional collaboration between universities and NHS teams.
British journal of community nursingSaman Agad Hashim, Mohd Yusof Barakatun-Nisak, Mohammed Younus Naji Al Atbee
BACKGROUND/AIMS: Significant gaps in nutritional knowledge exist among haemodialysis patients, representing a critical opportunity for community nursing intervention. This study aimed to assess renal-specific nutrition knowledge among haemodialysis patients in Southern Iraq, with implications for community nursing practice. METHODS: A cross-sectional study was conducted with 240 haemodialysis patients (median age 52 years) in Basrah, selected via Stratified random sampling. Knowledge was assessed using a piloted questionnaire, focusing on phosphorus, potassium and sodium intake. IBM SPSS Statistics 25 was used to analyse data. Data were summarised using means and percentages, and examined for group differences and correlations. RESULTS: Low knowledge levels were prevalent among haemodialysis patients (64.2%). Patients aged 40 years or older demonstrated significantly higher knowledge scores than their younger counterparts (P<0.001). Furthermore, higher income was positively correlated with greater knowledge (r=0.165, P=0.011), indicating the influence of socioeconomic status. CONCLUSIONS: Significant gaps in nutritional knowledge exist among haemodialysis patients, particularly younger individuals and those with lower incomes. These findings highlight a critical opportunity for community nurses and nutritionists to take a proactive role in dietary education and support. IMPLICATIONS FOR PRACTICE: Community nurses can substantially improve dietary management and patient outcomes in renal failure by integrating routine nutritional assessments during home visits, developing tailored educational strategies for different age groups and advocating for resources to support patients with financial constraints.
Managing stomas in the community requires a knowledge of stoma products, what the products are, when the products should be used and how to effectively use them. This articles discusses the products in detail and the possible complications associated with improper use. Diet also plays a crucial role and community nurses are often asked for advice by their patients. The author also explore the role of community nurses in ensuring that people living with a stoma do not feel isolated and that their quality of life is not impacted.
Frontiers in public healthManar Fayez Alruwaili, Ugwu Okechukwu Paul-Chima
Substantial yet preventable maternal and neonatal mortality persists across low- and middle-income countries (LMICs), where shortages of skilled maternal and child health (MCH) nurses, inadequate infrastructure and socioeconomic inequalities continue to limit access to quality care. Artificial intelligence (AI), particularly machine-learning-driven decision-support and predictive systems, is increasingly proposed to strengthen MCH services through risk stratification, early diagnosis and clinical decision-making. However, evidence supporting its equitable, contextually appropriate and sustainable implementation in resource-constrained settings remains limited. Existing literature has inadequately addressed the structural, ethical and relational dimensions of AI adoption from a nursing perspective, and there is a lack of frameworks integrating equity, nurse-led governance and contextual adaptation for LMICs. Drawing on a purposive narrative review, this Perspective proposes an equity-centred, nurse-led framework for AI-assisted MCH nursing in low-resource settings. The framework comprises six interdependent domains: contextual algorithm validation, humanised and relational nursing care, community co-design and engagement, digital equity and inclusion, transparent data governance, and longitudinal monitoring and evaluation. Its novelty lies in positioning equity as a prerequisite for deployment, identifying the nurse-patient relationship as the principal mechanism through which AI influences outcomes, and assigning governance authority to nurses and communities. A phased implementation pathway is proposed to guide responsible deployment. The framework remains conceptual and requires prospective empirical validation. Responsible AI integration in MCH nursing demands equity-centred governance, investment in nursing capacity, community participation and locally grounded validation strategies.
Home healthcare nowMerly Chirayil, Shalini Shrikanth
Home healthcare agencies, like other healthcare organizations, continue to face challenges with nurse burnout. Improved well-being has been shown to reduce burnout and support nurse retention. The purpose of this quality improvement project was to enhance nurse well-being through the introduction of a structured well-being bundle. The bundle included three low-cost, evidence-based strategies: breathing exercises, gratitude training, and a self-selected spiritual reading or practice. Sixteen home health nurses participated in this 6-week pre- and post-intervention project. The World Health Organization-Five Well-Being Index (WHO-5), a validated and reliable tool, was used to measure changes in well-being. Nurses attended a virtual training session on how to use the three interventions. Weekly reminders and a mid-point check-in email were sent to support continued engagement. Results showed a statistically significant improvement in well-being scores following the intervention. Qualitative feedback from three participants indicated plans to continue using the strategies beyond the project period. Participants described the interventions as simple, practical, and easy to incorporate into their workday. Findings suggest that a well-being bundle with simple, evidence-based strategies may support nurse well-being in home healthcare. Given the ongoing challenges of burnout, especially in independent care settings, this approach offers a practical way to support nurses. Future projects with larger samples are recommended.
British journal of community nursingBeverley Bostock
Chronic obstructive pulmonary disease is a progressive, multisystem condition associated with substantial morbidity, mortality and healthcare burden. In the UK, and worldwide, it remains a leading cause of death, with smoking and environmental exposures as primary risk factors. Community nurses play a pivotal role in coordinating integrated care, supporting self‑management, addressing polypharmacy and acting as a key conduit between patients, families and multidisciplinary teams.
British journal of community nursingStacey Louise Finlay, Adam Milligan, Stephanie Craig
Frailty and falls are highly prevalent among community-dwelling older adults and are linked through a bidirectional relationship that increases the risk of injury, hospitalisation, functional decline and mortality. Community nurses play a central role in early identification and prevention. This article examines the relationship between frailty and falls, and outlines practical approaches to risk assessment and management in community nursing practice. The authors present a clinically focused synthesis of contemporary evidence and national guidance relating to frailty and falls in community-dwelling older adults. The evidence indicates that frailty is a modifiable and independent risk factor for falls and adverse outcomes. Integrating frailty assessment within multifactorial falls risk assessment, including assessment of orthostatic hypotension and medication-related risk, enables more targeted and person-centred interventions. Comprehensive Geriatric Assessment offers a practical framework for addressing shared risk factors. Addressing frailty should be regarded as a core strategy for effective falls prevention in community-dwelling older adults.
Nursing leadership (Toronto, Ont.)Karen Curry, Cheryl Reid-Haughian, Barbara Chyzzy, Leinic Chung-Lee, Benedicte Franquien, Nancy Lefebre, Jennifer Little, Corey MacKenzie, Margaret Saari
Home health nursing in Canada is evolving to meet the growing demand for community-based care, driven by an aging population and pressures shifting care from acute settings to home. This commentary describes the collaboration between the Community Health Nurses of Canada and Saint Elizabeth Health Care to revise the 2010 Home Health Nursing Competencies through two distinct work streams. A comprehensive Dissemination Resource Package was designed to support the integration of updated competencies into practice. Ongoing engagement of nursing leaders and organizations is essential to ensure that these competencies remain relevant and effective in improving care quality in home health settings.
F1000ResearchAkhmadi Akhmadi, Muhamad Abi Zakaria, Ayu Anita, Eiren Hotdi Huriana Siregar, Berliando Toro Betty Runesi, Arif Annurahman, Dhiana Ayu Novitasari
BACKGROUND: Climate change is a key factor exacerbating the incidence of stunting in children. Various climate events, such as droughts, floods, extreme temperatures, and disruptions to the growing season, lead to reduced food security, lower agricultural productivity, and diminished access to nutritious food and clean water. In this context, strengthening community-based health services is crucial, given their role in monitoring child growth, providing nutritional counseling, and facilitating referrals-all of which contribute to efforts to reduce stunting. AIM: This review aims to synthesize scientific evidence regarding the relationship between exposure to climate change and the risk of stunting, as well as the recommended policies. This will subsequently be reflected in community-based nurse services to support the development of more integrated and climate-responsive public health strategies. METHODS: A scoping review was conducted using the PCC framework: Population (children under five years old), Concept (climate-related determinants of stunting), and Context (within a global scope). Searches were conducted across PubMed, ScienceDirect, Scopus, ProQuest, and Web of Science, supplemented by manual searches in January 2026. Of the 5,113 identified articles, 763 articles were screened based on title and abstract, and ten articles met the inclusion criteria after full-text review. Included studies were original research published between 2016 and 2026 that addressed climate change and stunting. Study quality was assessed using the Joanna Briggs Institute checklist, and thematic analysis was applied to synthesize the findings. RESULTS: Three principal themes were identified: the direct impact of climate change on child growth and stunting; the indirect impact through food security, environmental conditions, socioeconomic determinants, health, and regional variations; and policies and climate change adaptation strategies for child nutrition. CONCLUSION: Overall, climate change contributes to child stunting through interconnected pathways, highlighting the essential role of community health nurses.
Journal of nursing managementCornelia Feichtinger, Helmut Beichler, Elisabeth Rappold, Igor Grabovac
AIM: To explore what motivates nurses to enter and remain in community nursing within Austria's national pilot project and to examine how autonomy, competence and relatedness shape their professional experiences and retention intentions. BACKGROUND: Community nursing has been introduced in Austria as an innovative, preventive, community-based model of care. As nursing systems face growing workforce shortages, understanding why nurses choose to transition into and remain in new nursing roles is critical for workforce sustainability and effective service implementation. METHODS: A qualitative study guided by self-determination theory was conducted. Semistructured interviews were carried out with 15 community nurses working in Austria's community nursing pilot project. Data were analysed using qualitative content analysis, combining inductive coding with a theory-informed analytical framework. RESULTS: Nurses reported high levels of motivation when their needs for autonomy, competence and relatedness were met. Autonomy was supported through flexible scheduling, independent decision-making and opportunities to shape emerging service structures. Competence was strengthened through direct client contact, diverse responsibilities, interprofessional collaboration and professional development. Relatedness emerged from strong connections with local communities, professional networks and interdisciplinary partners. While intrinsic motivation was driven by meaningful work and contribution to preventive care, extrinsic motivation was strongly influenced by dissatisfaction with previous working conditions. CONCLUSIONS: Community nursing offers an attractive alternative career pathway for nurses by providing working conditions that support psychological needs and professional fulfilment. However, the discontinuation of the pilot project threatens the long-term sustainability of this role. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers and policymakers should prioritize work environments that support autonomy, competence and relatedness to enhance nurse retention. Integrating community nursing into long-term workforce and primary care strategies may strengthen workforce stability and support sustainable, community-based care delivery.
Journal of nursing managementFadiyah Jadid Alanazi, Amal Ahmed Elbilgahy, Mohamed Yehia Ali Mohamed, Bindu Bharathi, Fathia Ahmed Mersal
AIM: This study aimed to examine the associational role of the nursing practice environment (NPE) in the relationship between nursing management practices (NMP) and community health nursing competency (CCNC) among primary healthcare (PHC) nurses in Saudi Arabia. BACKGROUND: Although the NPE is established as a determinant of care quality and patient safety in hospital settings, its function as an organizational mechanism linking managerial practice to nursing competency in community and PHC contexts remains underinvestigated, particularly within administratively peripheral regions undergoing health-system transformation. METHODS: A descriptive, cross-sectional, correlational survey was conducted with 205 registered nurses working in PHC centers across the Northern Border Region (Arar), Saudi Arabia. Data were collected using a structured questionnaire incorporating an adapted quality of nursing work life subscale set, the practice environment scale of the nursing work index (PES-NWI), and the community care nursing competence (CCNC) scale. Reporting followed the STROBE guidance. Normality was assessed via the Shapiro-Wilk test; parametric analyses were supplemented with nonparametric checks. Pearson correlations, hierarchical multiple regression, and bias-corrected bootstrap mediation analysis (5000 resamples) were performed. Common method bias was assessed using Harman's single-factor test and a marker-variable procedure; variance inflation factors (VIFs) were computed for all regression models. RESULTS: All three constructs were strongly and positively associated (r = 0.76-0.79, p < 0.001). The NMP and NPE composites jointly explained 71.5% of the variance in CCNC (F [10, 191] = 44.62, p < 0.001), with NMP (beta = 0.47) and NPE (beta = 0.38) as substantial independent predictors. VIF values did not exceed 4.2, indicating acceptable multicollinearity. Harman's single-factor test extracted a first factor accounting for 43.6% of the total variance, below the 50% threshold, and the marker-variable test yielded a change in fit of delta R2 = 0.002, suggesting that common method variance did not critically inflate observed associations. The NPE significantly and partially mediated the NMP-CCNC pathway (indirect effect = 0.33, 95% CI [0.11, 0.52]; Sobel Z = 6.15, p < 0.001), accounting for approximately 38.4% of the total effect. Consistent with the cross-sectional design, these findings reflect association rather than causal pathways. CONCLUSIONS: CCNC is associated with both NMP and the practice environment, with the NPE serving as a significant statistical intermediary in this pathway. These associations are consistent with organizational frameworks positing that work context conditions translate managerial inputs into professional capability. IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening unit-level management capacity and the practice environment represents a potentially feasible and evidence-informed strategy for advancing community nursing competency in PHC settings, particularly in geographically peripheral regions undergoing reform. Longitudinal and experimental designs are needed to establish directionality.