[Clinical leadership competencies in advanced nursing practice : Scoping review]

The competencies of advanced practice nurses (APN) include clinical activity in a special field, coaching and consulting, collaboration, leadership, ethical decision-making, and research competence. Clinical leaders initiate and implement changes in the healthcare system and respond to the needs of patients and healthcare institutions. Clinical leadership based on advanced nursing practice can challenge existing management and care structures.

The aim of the review is to provide an overview of clinical leadership competencies based on advanced nursing practice. The investigated question deals with which roles and competencies of APN are associated with clinical leadership from a national and international perspective.

A systematic search in MEDLINE®(US National Center for Biotechnology Information (NCBI))/PubMed, CINAHL and the Cochrane Library as well as a hand search in library catalogs and journals (April 2019 to January 2020) produced a total of 235 hits. Eight studies were included in the review and analyzed.

Clinical leadership competencies are increasingly a topic of international studies and can be described and recognized in clinical practice on the basis of leadership models, and the role and leadership domains of APNs. Clinical leadership in nursing practice is recognized when APNs independently control treatment processes in complex nursing situations, exert influence, develop and implement change strategies, consult, coach, train, collaborate, and establish a connection to other health professionals and management. In order for clinical leadership competencies to be effective in nursing care processes, broad support in the multiprofessional team, structural support of the organization and legal legitimation are required.

There are hardly any studies in the German-language literature on the relevance, interpretation, and legitimacy of APN clinical leadership. Further research is needed on the interpretation of the roles of APNs, especially clinical leadership competencies, their influence on nursing care processes, leadership structures, and their interaction within the organizational culture.