Competencies and tasks of nursing staff in home and outpatient primary care: a scoping review

Germanyʼs growing care need and nursing shortages require new strategies to optimize outpatient and home care resources. Structural and organizational changes demand expanded nursing roles and competencies. These developments are linked to recent reforms promoting a more person-centered, cross-sectoral approach to care and call for better utilization of nursing expertise. This scoping review provides a comprehensive overview of the roles, responsibilities, and qualification requirements of nursing professionals in outpatient and home care settings. It incorporates international experiences and identifies educational and structural conditions to systematically present current practices and developments. The impact of these roles on care provision and job satisfaction was analyzed. The scoping review followed PRISMA-ScR guidelines, searching MEDLINE, Embase, and Cochrane for studies published during 2012–2023 in German or English on nursing professionals in community, home, or outpatient primary care. Roles were identified from study descriptions and grouped into clusters. Task areas were extracted and assigned to overarching domains. In total, 74 nursing practice scopes identified in 67 references were categorized into five roles. Most roles were nursing professionals with extended competencies (43.2%), followed by (specialized) community nursing (18.9%). Most studies focused on home/community-based care (58.2%). Qualifications and requirements varied by country. The most frequent tasks were in the domains “coordination and management of nursing care” (49.1%), followed by preventive activities (26.8%) and leadership tasks (12.0%). These roles positively impacted care quality and job satisfaction. This scoping review highlights the relevance of expanded nursing roles, competencies, and tasks in outpatient and home care. Future efforts must address regulatory inconsistencies and invest in training to fully realize the potential of advanced nursing roles.