State of the art on advanced practice nursing role management international theories, models and frameworks: A scoping review

Abstract

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.