Aim: To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long-term care facilities (LTCF) for older adults.

Design And Methods: This was a cross-sectional study. The competence test, 'the Ms. Olsen test', was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non-experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables.

Results: The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff.

Conclusion: This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish-speaking RNs working in institutional care homes caring for patients according to national practice standards.

Implications: These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings.

Impact: Caring according to national practice standards and caring for severely ill patients are associated with clinical competence.

Reporting Method: The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross-sectional studies.

Patient Or Public Contribution: Registered and PNs completed a questionnaire for the data collection.

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