Jul 2026· Journal of Clinical Nursing· 0 citations· 65 references
Medicine
TL;DR
The scoping review highlights that large language models can only serve as assistive tools in the development of nursing care plans, while nurses remain the primary decision-makers, and underscores the need to enhance nurses' AI literacy to strengthen human-AI collaboration.
Abstract
Aim
To examine the overall performance of large language models (LLMs) in generating nursing care plans, clarify their role in nursing practice and identify directions for future research.
Design
This study conducted a scoping review in accordance with Arksey and O'Malley's methodological framework.
Methods
Five electronic databases were systematically searched: Web of Science Core Collection, PubMed, Scopus, CINAHL and IEEE Xplore. The search was limited to studies published between 1 June 2018 and 5 April 2026.
Results
Fifteen studies were included. Existing studies primarily used nonreal patient cases and evaluated the textual quality of model-generated nursing care plans across a range of specialties. None examined LLM use within real-world clinical nursing workflows. Evaluation criteria mainly focused on accuracy, information quality and reliability, and readability. The strengths of LLMs in nursing care planning were concentrated in text organization, standardized terminology matching, and the initial drafting of nursing goals and interventions. However, important challenges remain, including privacy, hallucination, and bias.
Conclusions
LLMs may serve as assistive tools for generating initial drafts of nursing care plans, but they cannot yet replace nurses' clinical judgement. Future research should further refine evaluation frameworks and examine the impact of LLM-generated nursing care plans within real-world nursing workflows. Nurse-led human-AI collaboration should be emphasized to support the responsible translation of LLM-assisted nursing care planning into practice.
IMPACT
This scoping review highlights that, at present, LLMs can only serve as assistive tools in the development of nursing care plans, while nurses remain the primary decision-makers. It also underscores the need to enhance nurses' AI literacy to strengthen human-AI collaboration and facilitate the integration of LLMs as valuable supportive tools in nursing practice.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution.
AIM
To examine the current state of large language model (LLM) evaluation in clinical nursing, synthesize the evaluation dimensions and metrics reported in the literature, and develop a preliminary evaluation framework for LLMs in clinical nursing through expert consultation.
BACKGROUND
The advancement of artificial intelligence products, exemplified by LLMs, has generated excitement about their potential applications in clinical nursing practice, but their effectiveness remains uncertain.
METHODS
A scoping review was conducted in accordance with Arksey and O'Malley's framework and incorporated experts' consultation. A literature search was conducted across Web of Science, PubMed, Embase, and the Cochrane Library, from their inception to June 21, 2025. Three expert meetings involving eight experts were conducted between August and October 2025 to synthesize evaluation frameworks and scenarios.
RESULTS
A total of 42 studies were included, and the GPT family was the most frequently evaluated. Thirty-seven evaluation metrics were extracted and refined through expert consultation into six primary domains: performance and accuracy, clinical validity and safety, workflow integration and efficiency, usability and user experience, model reliability and ethical considerations, and competency development. A scenario classification and a proposed minimum technical reporting checklist were also developed to support the transparent and comparable evaluation of LLMs in clinical nursing.
CONCLUSION
This study used a scoping review and expert consultation to summarize contemporary literature on LLM evaluations in clinical nursing practice. It provides a preliminary, structured basis for developing and refining a standardized evaluation framework.
IMPLICATIONS FOR NURSING MANAGEMENT
This study highlights the need for systematic and context-sensitive evaluation of LLMs in clinical nursing. The findings provide nursing managers with a structured reference for identifying core evaluation dimensions, interpreting evidence, and planning the evaluation and deployment of nursing-specific LLM applications.
Ying-Zhuo Ma, Shang-Qin Liu, Jing-Yan Song et al.· Journal of Nursing Managemen...· 0 citations
Background: Nurses play a crucial role in improving the quality of care through standardized nursing practices. Standardized Nursing Language (SNL) provides as structured and systematic approach to articulating nursing care, facilitating accurate communication and promoting consistency in nursing documentation.
Purpose: This scoping review aimed to identify the implementation of SNL in nursing documentation.
Methods: A scoping review was conducted using four electronic databases: Garuda, PubMed, ScienceDirect, and Wiley. Eligible studies full text-original articles published in English or Indonesian between 2020 and August 2025 that examined SNL implementation in documentation within healthcare settings. Studies conducted in educational contexts, case reports, editorial commentaries, conference proceedings, and study protocols, were excluded.
Results: Across the 10 included studies, SNL implementation was associated with improvements nursing documentation quality. Five studies (50%) reported improved documentation accuracy and readability, while five (50%) reported more appropriate nursing diagnoses and interventions. The main implementation barriers were inadequate EHR support, limited nurses’ familiarity with SNL, and lack of standardized documentation formats, each reported in five studies (50%).
Conclusion: SNL implementation is associated with improved quality and consistency of nursing documentation. Further research using implementation science frameworks is warranted to systematically examine context specific barriers and facilitators of SNL implementation.
Salsabila Fiqrotu Tsauroh, Ariani Arista, Putri Pertiwi et al.· Journal of Nursing and Pract...· 0 citations
Purpose Advanced Practice Nurse roles are increasingly adopted to address health system challenges; however, theoretical approaches guiding Advanced Practice Nurse role management remain fragmented. This scoping review aimed to synthesize international theories, models, and frameworks related to Advanced Practice Nurse role management and to identify shared and category-specific core elements to support stage-specific role development. Methods A scoping review was conducted following Arksey and O’Malley’s framework and Joanna Briggs Institute (JBI) guidance, and reported in accordance with the PRISMA-ScR checklist. Five databases (Web of Science, CINAHL, PubMed, Cochrane Library, and Embase) were searched from inception to August 2025. Two reviewers independently screened studies and extracted data. Data were synthesized using a combined approach of word frequency analysis and iterative cross-framework content mapping to identify shared and framework-specific elements. Results In the final review, 22 Advanced Practice Nurse role management models and frameworks were included. They were categorized into four purpose-based groups: comprehensive frameworks (n = 2), role definition (n = 7), role implementation (n = 8), and role evaluation (n = 5). Twenty shared core elements were identified within role definition frameworks, 20 within role implementation frameworks, and 21 within role evaluation frameworks, with substantial overlap across categories. Shared elements consistently emphasized advanced patient-centered practice, theoretical and professional foundations, and evidence-informed role development, while category-specific elements reflected stage-related priorities. Conclusion Advanced Practice Nurse role management frameworks form a coherent continuum across role definition, implementation, and evaluation. Shared core elements highlight universal foundations for Advanced Practice Nurse role development, whereas category-specific elements provide stage-sensitive guidance. This synthesis offers a theoretical resource to support policy development, organizational implementation, and sustainable integration of Advanced Practice Nurse roles, particularly in settings where Advanced Practice Nurse roles are emerging.
Shifan Han, Xuan Duan, Wenjing Dong et al.· International Journal of Nur...· 0 citations
AIM
To identify and examine evaluation methods and metrics used for specialist cancer nursing.
DESIGN
A scoping review of published and grey literature on evaluation approaches for specialist cancer nursing roles and models of care.
METHODS
Comprehensive searches were conducted across CINAHL, Cochrane Library, Medline, PsycINFO and Google Scholar for English-language published and grey literature published between January 2014 and November 2025. Two reviewers independently screened and extracted data. Findings were synthesised narratively and mapped to the Strong Model of Advanced Practice Nursing and Quintuple Aim.
RESULTS
Of 3360 records screened, 23 sources met the inclusion criteria: 14 published articles, and 9 grey literature sources (conference abstracts, theses, textbooks). Most sources originated from the USA (n = 12, 52%) or high-income countries (n = 22, 96%), and focused on nurse navigator roles (n = 9, 39%). Five themes emerged in the sources: (1) purpose of evaluation; (2) development of methods and metrics; (3) selection and implementation; (4) data collection approaches; and (5) challenges and considerations. Evaluation was primarily used to demonstrate value and drive quality improvement through pragmatic methods. Metrics varied widely and were concentrated in the Strong Model domains of Direct Comprehensive Care and Support of Systems, with fewer addressing Education, Research and Professional Leadership. Key challenges to evaluation included role variability and lack of standardised tools.
CONCLUSION/IMPLICATIONS
Despite the lack of standardised evaluation practices for specialist cancer nursing, the five themes synthesised in this review can guide evaluation of specialist cancer nursing roles and models of care in real-world settings. Opportunity exists for international collaboration to develop a comprehensive, context-sensitive set of metrics, relevant in diverse healthcare settings, that capture both excellence in service delivery and nursing scholarship.
IMPACT
What problem did the review address? ○ Specialist cancer nurses perform a diverse range of interventions and roles that are complex in nature, leading to challenges in their accurate evaluation. ○ Effective and efficient approaches to evaluation of specialist cancer nursing roles are crucial to demonstrate their value. ○ A significant body of literature has demonstrated the efficacy of specialist cancer nursing roles and models of care in a research framework; however, evaluation is needed to better understand the impact of translating this evidence into real-world settings. What were the main findings? ○ A scoping review exploring evaluation methods and metrics of specialist cancer nursing revealed five key themes: (1) purpose of evaluation; (2) development of evaluation methods and metrics; (3) selection and implementation of evaluation methods and metrics; (4) methods of data collection; and (5) challenges and considerations. ○ Evaluation of specialist cancer nursing is important, however variation in nurses' roles and responsibilities and lack of standardised measurement tools were key challenges. ○ Evaluation metrics varied widely and were specific to specialist cancer nursing roles; predominantly reported under the domains of Direct Comprehensive Care and Support of Systems, with fewer reported under Education, Research and Professional Leadership. Where and on whom will the research have an impact? ○ Nursing and health service leaders can use the identified themes and subthemes as a framework to guide evaluation of specialist cancer nursing. The predominance of English-language and high-income country evidence limits the global applicability of these findings. ○ Gaps in knowledge can drive the future work of cancer nursing organisations to collaboratively develop a comprehensive list of evaluation metrics that can be contextualised for specific roles across diverse health care settings. ○ Specialist cancer nurses in all roles and models of care should have metrics for Research, Leadership and Professional Leadership to support the scholarship of nursing. ○ Consistent national role definitions, shared competency frameworks and standardised outcome measures should be embedded in policy and commissioning to enable systematic evaluation, appropriate resourcing, and integration into workforce and service planning of specialist cancer nurses.
REPORTING METHOD
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews PRISMA-ScR checklist.
PATIENT OR PUBLIC INVOLVEMENT
Employees of a cancer patient advocacy group were involved in the design of the study, interpretation of the data and the preparation of the manuscript. No patients were involved in the conduct of this scoping review.
Elise Button, Carla Thamm, Megan Crichton et al.· Journal of Advanced Nursing· 0 citations
Background & Purpose: Critical care nursing demands high professional standards to safeguard patient outcomes. The Canadian Association of Critical Care Nurses (CACCN) publishes national standards to define and guide the practice of Canadian critical care nurses (CCNs). To ensure credibility, transparency, and methodological rigor in revising these standards, this scoping review was conducted as the first phase of a standardized protocol to inform the sixth edition of CACCN’s Standards for Critical Care Nursing Practice.
Methods & Procedures: Guided by the JBI methodology for scoping reviews, the research protocol was developed a priori and executed across Medline, CINAHL, and Nursing & Allied Health databases. Peer-reviewed articles and grey literature from 2017–2022 were screened using Covidence software in a two-stage process by independent reviewers. Grey literature was sourced through targeted searches of critical care associations globally. Inclusion criteria required documents to contain published or public-facing standards related to critical care nursing practice.
Results: The review included 15 sources: 5 peer-reviewed studies and 10 grey literature documents. Standards were identified from 12 countries and federations. Key topics varied widely, encompassing educational requirements, ethical practice, clinical competencies, advocacy, leadership, communication, staffing, and safety. Most sources described the frameworks used to develop their standards.
Discussion: Results revealed variation across regions, highlighting the lack of a universal framework. This variation underscores the need for standardized methodologies to ensure consistency in CCN practice.
Conclusion: This review lays the foundation for evidence-based revision of CACCN’s standards and supports the development of a structured approach to future updates.
Keywords: critical care nursing, practice standards, scoping review, evidence-based practice
Sarah Crowe, Brandi Vanderspank-Wright, A. Ross‐White· The Canadian journal of crit...· 0 citations
Purpose: This scoping review identified the core components of nursing competence required for general ward nurses to recognize and manage clinical deterioration and examined how this competence has been conceptualized in previous studies. It also synthesized individual- and system-level factors associated with competence and identified research gaps relevant to nursing education, future research, and patient safety initiatives. Methods: This scoping review was conducted using Arksey and O’Malley’s framework and reported in accordance with the PRISMA-ScR guidelines. Six databases—PubMed, CINAHL, Embase, the Cochrane Library, Scopus, and Web of Science—were searched for studies published between January 2016 and December 2025 using search terms related to clinical deterioration and nursing competence. Results: Twenty-one studies met the inclusion criteria. The findings were organized into two domains: nursing competencies and factors associated with competence. Technical competencies included physical assessment, vital-sign monitoring, surveillance, information analysis, and application of escalation protocols. Non-technical competencies included situational awareness, clinical decision-making, intuition, leadership, interprofessional communication, and teamwork. Individual-level factors included clinical experience, self-confidence, skill acquisition, and clinical judgment. System-level factors included education and training, relationship-building with physicians, supportive work environments, electronic tools, organizational support, and teamwork culture. Conclusion: Nursing competence in managing clinical deterioration is multidimensional and reflects the interaction of individual capabilities with system-level supports. Future research should develop educational strategies that strengthen both technical and non-technical skills while reinforcing organizational systems that support timely and effective responses to deterioration.
Unknown authors· Korean Journal of Adult Nurs...· 0 citations
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