Patterns, Evidence, Gaps and Recommendations Across Studies of Non-Nursing Tasks: Findings From a Scoping Review

The increasing demand for healthcare services raises concerns about the sustainability of the nursing workforce. The high prevalence of non-nursing tasks (NNTs) performed by nurses further exacerbates this issue. However, despite the growing body of research, available evidence has not yet been systematically mapped, limiting healthcare policymakers, leaders and researchers in developing targeted, evidence-based strategies to mitigate their occurrence and in prioritising research according to the main gaps.

To map and summarise: (a) concepts, characteristics, antecedents and consequences of NNTs; and (b) gaps in the available evidence and recommendations for future research and policy, as documented in published studies.

A scoping review was registered in Open Science Framework, conducted using updated Arksey and O'Malley methodology and reported in accordance with PRISMA-ScR guidelines. Four electronic databases were searched using a predefined search string and eligibility criteria. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework was used to organise extracted data, which were analysed using two different methodologies according to the research question: narrative synthesis and thematic analysis. Strategies to ensure rigour were applied.

Twenty-eight studies published over the last 40 years were retrieved, primarily aimed at measuring the occurrence of NNTs, their consequences and associated factors. Studies were mainly conducted in Europe and the United States and predominantly used cross-sectional designs based on self-reported data. Different concepts and definitions of NNTs have been used over time, encompassing administrative and auxiliary work, housekeeping activities and tasks typically performed by other healthcare professionals, which account for approximately 20%-30% of nursing time. Antecedents at the unit level (e.g. staffing shortages) have been most frequently documented, alongside those at the interprofessional level (lack of role clarity and overlapping responsibilities) and at the individual level (issues with role clarity, delegation skills and the desire to provide best possible care for patients). Performing NNTs has negative consequences for patients, nurses and healthcare organisations. The mapped key knowledge gaps and recommendations may inform future research and policies.

The map of knowledge produced to date, together with the identified gaps and documented research recommendations, provides a blueprint for future action. Key priorities include reconceptualising and standardising terminology and measurement approaches in the field, shifting research towards the development and evaluation of strategies to prevent or mitigate NNTs and advancing policies that protect nurses' time for activities within their professional scope of practice. Addressing these priorities is essential to ensure that nurses' time is primarily devoted to patient care and to support efficient, sustainable and safe healthcare delivery.

These findings inform management by ensuring appropriate staffing and skill mix, clarifying roles and task allocation, redesigning workflows and strengthening the use of support staff and technology.