Mapping Nursing Roles in Long-Term Care: A Systematic Review With Network Analysis.

Abstract

AIM To synthesise evidence on nurses' roles in long-term care settings and map their interactions. DESIGN Systematic review with network analysis. METHODS Thematic synthesis was used to identify nurses' roles, and network analysis mapped their interactions across domains. DATA SOURCES Six databases-Cumulative Index to Nursing and Allied Health Literature, PubMed, Embase, Cochrane Library, Research Information Sharing Service and Database of Periodical Information Academic-were searched for peer-reviewed articles from 2014 to 2024. The Mixed Methods Appraisal Tool assessed study quality. RESULTS Fifteen studies were included. Nurses' roles spanned six domains: collaboration, education, leadership, resident-centred care, quality improvement and resource management. Network analysis revealed collaboration and leadership as the most central, each with a degree centrality of five, acting as bridges across domains. Three thematic clusters emerged: collaboration and resource management focused on operational teamwork; leadership and quality improvement centred on systemic care enhancements; and education and resident-centered care emphasised training and resident-focused care. A technological competence gap was identified, alongside barriers like staffing shortages and role ambiguity. CONCLUSIONS Nurses' interconnected roles are critical for resident-centered care; however, they require systemic support to address barriers and technological gaps. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Enhanced interprofessional training, leadership development and digital skill integration can improve care quality and nurse well-being in long-term care settings. IMPACT This study addressed the complexity of nurses' roles in long-term care and their structural interactions, finding collaboration and leadership as pivotal with three role clusters and a technological gap, impacting long-term care nurses, educators and policymakers to inform workforce strategies. REPORTING METHOD This study adhered to the PRISMA 2020 guidelines and was preregistered in PROSPERO (CRD42024588422). PATIENT OR PUBLIC CONTRIBUTION This study did not include patient or public involvement in its design, conduct or reporting. TRIAL REGISTRATION PROSPERO: CRD42024588422.