ArticleBMC nursing2026
Nurse's scope of practice in home-based care: a qualitative descriptive design - the DECIDE project.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Registered nurses' clinical reasoning in home-based care: a retrospective think-aloud design - the DECIDE project.International journal of nursing studies advances · 2026Article
- Self-Leadership Based on Caring in Primary Nursing: Developing and Validating a Conceptual Model Through a Delphi Study.Journal of nursing management · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNurses’ understanding of their scope of practice is essential for coordinating safe and optimal home-based care for older people with complex needs. Contextual modulators, workload pressures, and limited opportunities for clinical leadership may hinder enactment of core aspects of this scope. Uncertainty regarding nurses’ scope of practice persists, particularly in home-based care. The aim of this study was to explore how nurses experience their own and each other’s scopes of practice, and what characterises their scope of practice in home-based care.
methodsA qualitative descriptive design using focused individual interviews was employed with eight registered nurses and eight non-registered nurses from three home-based nursing teams in south-east Norway. Although interviews were conducted individually, data were analysed dyadically using an adapted Framework Method to enable systematic comparison of perspectives.
resultsNurses’ scope of practice was characterised by ongoing clinical observation, assessment, and response to change, supported by continuity of visits and in-depth knowledge of service users. Activities ranged from household chores and basic care to advanced clinical procedures, with substantial overlap between the nurses. Registered nurses articulated greater analytic depth and system-level accountability. Despite shared conceptual understandings, nurses experienced a parallel scope of practice with divergent responsibilities. Registered nurses assumed primary accountability in acute, complex, and transitional care situations, and tensions were evident regarding responsibility distribution and decision-making.
conclusionsScope of practice in home-based care was dynamic and context-dependent, enacted through an embodied nursing process reflecting rapid, experience-based cognition and analytic decision-making. Although nurses described shared understandings, enactment involved overlapping activities alongside distinct responsibilities. Registered nurses’ scope of practice extended beyond direct care to coordination, clinical leadership, and accountability for care completion. These findings highlight risks of implicit responsibility shifting and emphasise the need to clearly define and empirically ground nurses’ scope of practice to support safe practice, leadership, workforce sustainability, and future research on continuity, responsibility, and decision-making in complex care settings.
trial registrationNot applicable.
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