Nursing innovation: a comprehensive definition and framework for implementation

Innovation has moved from the margins to the core of nursing's professional identity. In the process, the profession has matured in its innovation competency level while the scope of influence has expanded across diverse domains. As a result, existing definitions and frameworks no longer capture the full breadth of nursing's innovative functions and contributions. The purpose of this concept analysis was to systematically refine the definition and conceptual framework of nursing innovation to improve clarity.

We conducted an expanded concept analysis of nursing innovation, combining a scoping review of definitions and typologies with Walker and Avant's eight-step framework. Innovation literature was identified using a search of five electronic databases, historical documents, professional organization and government reports, and hand searches from 1850 to 2025. Data were extracted and synthesized from 50 sources (i.e., 39 peer-reviewed articles and books, 11 professional and government sources) to compare nursing, health, and general innovation definitions. These sources were then used to identify attributes, antecedents, consequences, and model cases.

The analysis yielded five defining attributes of nursing innovation that refine and clarify the concept: nursing agency, contextual novelty, purposeful orientation, implementation, and value creation. Nursing innovation was defined as the exercise of nursing agency to design, implement, and evaluate contextually novel and purposefully oriented approaches that create value and address challenges across the profession's broad and expanding domains of influence. Antecedents and consequences were extracted at six levels, and 124 unique empirical referents were noted across the defining attributes. Model cases were presented for both traditional and non-traditional roles, innovation typologies, and settings. Gaps were identified in existing frameworks, and a divergence between nursing and general innovation paradigms was noted.

This revised definition provides conceptual foundations for advancing nursing innovation while acknowledging the profession's evolving influence in healthcare transformation. This analysis expanded the concept's boundaries beyond organizational settings, integrating the dual moral and economic imperatives that drive nursing innovation, and situating innovation across the novice-to-expert continuum. By clarifying attributes, typologies, and methods specific to nursing, it provides a novel framework that positions nursing innovation as a distinct, testable construct, establishing new directions for research, practice, and policy.