APN nurses' core competencies for general clinical health assessment in primary health care. A scoping review.

Background: The field of Advanced Practice Nursing (APN) has developed over the past six decades. However, the definition of roles and responsibilities of APN nurses seem to be contested due to both a lack of a clear definition of the concept and to institutional and cultural barriers that restrict the nurses' opportunities to practise to the full extent of their competencies.

Aim: The objective of this scoping review was to identify, examine and conceptually map the available literature on APN nurses' core competencies for general health assessment in primary health care.

Method: We performed a scoping review, following the methodological guidance for reporting as it is described by the Joanna Briggs Institute (JBI). Furthermore, the PRISMA-ScR statement and checklist for reporting scoping reviews were followed. Guiding the initial process for the search, we used the Population, Concept and Context mnemonic (PCC) to clarify the focus and context of the review.

Results: We found three areas of core competencies on which APN nurse draw in performing general health assessments in primary health care: (1) 'Collaborative, leadership and management skills' (2) 'Person-centred nursing care skills' and (3) 'Academic and educational skills'. Furthermore, we found that the three areas are interrelated, because it is crucial that APN nurses draw on collaborative competencies related to leadership and management to meet the service users' needs and deliver high-quality and person-centred care.

Conclusion: There is a need for a more specific investigation into how APN nurses' core competencies play a role during general health assessments of patients in primary care. We suggest an evaluation of what works for whom in what circumstances looking into the interrelation between competencies, skills and knowledge when an APN nurse performs a general health assessment in a primary healthcare setting.