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A systematic literature review shows that six competence areas play a key role in enabling health personnel to give patients and service users good outcomes from self-management programmes.  

PEWS promotes a systematic approach to monitoring and better communication in paediatric departments, but there is a need to follow up and improve guidelines and quality-assurance activities.

Surgical departments and educational institutions lack an organisational structure and culture that supports evidence-based practice. This may affect patient safety.

Nurses can experience moral stress and feel a sense of shame when they are torn between a patient’s needs and the requirements of the treatment system. Ethical reflection in supervision can help.

The study’s informants were particularly apprehensive about critical emergencies and unsure how to use medical equipment such as bag valve masks.

Although there are procedures for medication reconciliation, the process is challenging to implement and the allocation of responsibility is unclear.

Public health nurses consider themselves to be adept at finding and assessing national guidelines, but feel less proficient at assessing research-based knowledge.

The study suggests that if evidence-based practice is taught systematically, it affects the students' learning outcome.