{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:04:16Z","timestamp":1784783056699,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Nurses' scope of practice is central to healthcare delivery. While scope of practice is well described conceptually, there is limited empirical research capturing how it is enacted in everyday clinical practice. This study aimed to describe scope of practice in home\u2010based care, focusing on care activities, clinical decision\u2010making, professional autonomy and contextual modulators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A multi\u2010method observational design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three nursing teams within home healthcare services in a Norwegian municipality\u2014the DECIDE project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quantitative and qualitative data were collected through structured observations guided by a conceptual framework. Data were analysed using descriptive statistics and qualitative categorisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 827 care activities were observed across 239 observations. Care activities most often addressed physical and medical needs, while psychosocial needs were less frequently observed. Registered nurses more often engaged in both direct and indirect care and primarily delivered compensatory care. Clinical decision\u2010making was most frequently observed during assessment, while other phases of the nursing process, particularly evaluation, were less evident. These patterns were consistently associated with contextual modulators observed during care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nurses' scope of practice in home\u2010based care is enacted through care activities and emerges as a context\u2010sensitive, system\u2010level phenomenon shaped by contextual modulators. Registered nurses frequently performed tasks beyond planned visits, while non\u2010registered nurses concentrated on activities of daily living. Both groups showed limited engagement with the evaluation phase of the nursing process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Strengthening clinical leadership, decision\u2010making autonomy, and organisational support may support enactment of scope of practice and improve care quality in home\u2010based settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The study followed reporting standards for mixed\u2010methods research and was appraised using the Mixed Methods Appraisal Tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patient and public involvement was incorporated at the DECIDE project level but not in this observational study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70451","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:59:19Z","timestamp":1784782759000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurses' Scope of Practice in Home\u2010Based Care: An Observational Study of Care Activities, Clinical Decision\u2010Making, and Contextual Modulators\u2014The\n                    <scp>DECIDE<\/scp>\n                    Project"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-4245","authenticated-orcid":false,"given":"Ida R\u00f8ed","family":"Flyum","sequence":"first","affiliation":[{"name":"Department of Undergraduate Studies Lovisenberg Diaconal University College  Oslo Norway"},{"name":"Department of Nursing, Faculty of Health, Nature and Technical Science, Institute of Health Sciences Karlstad University  Karlstad Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7934-6949","authenticated-orcid":false,"given":"Gunilla","family":"Borglin","sequence":"additional","affiliation":[{"name":"Department of Undergraduate Studies Lovisenberg Diaconal University College  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1192-9697","authenticated-orcid":false,"given":"Anna Josse","family":"Eklund","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health, Nature and Technical Science, Institute of Health Sciences Karlstad University  Karlstad Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2084-6284","authenticated-orcid":false,"given":"Veronica","family":"Pavedahl","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health, Nature and Technical Science, Institute of Health Sciences Karlstad University  Karlstad Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9656-522X","authenticated-orcid":false,"given":"Edith Roth","family":"Gjevjon","sequence":"additional","affiliation":[{"name":"Department of Undergraduate Studies Lovisenberg Diaconal University College  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.mnl.2023.04.001","article-title":"Finding Commonality: An Integrated Model for Nursing Leadership","volume":"21","author":"Begley R.","year":"2023","journal-title":"Nurse Leader"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010022\u201001068\u2010w"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME9212"},{"issue":"4","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.mnl.2021.12.017","article-title":"Nurse Leader: A Definition for the 21st Century","volume":"20","author":"Cline D.","year":"2022","journal-title":"Nurse Leader"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.7748\/ns.2017.e10836"},{"key":"e_1_2_13_7_1","volume-title":"Nye VIPS\u2010boken: Velv\u00e6re, integritet, profylakse, sikkerhet","author":"Ehnfors M.","year":"2015"},{"key":"e_1_2_13_8_1","volume-title":"Discovering Statistics Using IBM SPSS Statistics","author":"Field A.","year":"2024"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pecinn.2022.100036"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nin.12375"},{"key":"e_1_2_13_11_1","volume-title":"Unskilled Personnel, Skill Mix, Quality of Care and Patient Safety in the Healthcare Services: A Mapping Review (Report No. 8280828885)","author":"Flodgren G. 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