Background: Nursing competency frameworks describe the competencies; knowledge, skills and attitudes nurses should possess. Countries have their own framework. Knowledge of the content of professional competency frameworks in different countries can enhance the development of these frameworks and international collaborations. Objective: This study examines how competencies and task divisions are described in the current professional competency frameworks for registered nurses (RNs with a Bachelor’s degree) in the Netherlands, Belgium, the United Kingdom (UK), Canada and the United States (US). Methods: Qualitative document analysis was conducted using the most recently published professional competency frameworks for registered nurses in the above-mentioned five countries. Results: All the competency frameworks distinguished categories of competencies. Three of the five frameworks explicitly mentioned the basis for the categorization: an adaptation of the CanMEDS model (Netherlands), European directives on the recognition of professional qualifications (Belgium) and an adapted inter-professional framework (US). Although there was variation in how competencies were grouped, we inductively identified ten generic competency domains: (1) Professional Attitude, (2) Clinical Care in Practice, (3) Communication and Collaboration, (4) Health Promotion and Prevention, (5) Organization and Planning of Care, (6) Leadership, (7) Quality and Safety of Care, (8) Training and (continuing) Education, (9) Technology and e-Health, (10) Support of Self-Management and Patient Empowerment. Country differences were found in some more specific competency descriptions. All frameworks described aspects related to the division of tasks between nurses on the one hand and physicians and other healthcare professionals on the other hand. However, these descriptions were rather limited and often imprecise. Conclusions: Although ten generic domains could be identified when analysing and comparing the competency frameworks, there are country differences in the categorizations and the details of the competencies described in the frameworks. These differences and the limited attention paid to the division of tasks might lead to cross-country differences in nursing practice and barriers to the international labour mobility of Bachelor-educated RNs.

Prenatal nutrition is a key predictor of early-life development. However, despite mass campaigns to stimulate healthy nutrition during pregnancy, the diet of Dutch pregnant women is often suboptimal. Innovative technologies offer an opportunity to develop tailored tools, which resulted in the release of various apps on healthy nutrition during pregnancy. As midwives act as primary contact for Dutch pregnant women, the goal was to explore the experiences and perspectives of midwives on (1) nutritional counselling during pregnancy, and (2) nutritional mHealth apps to support midwifery care. Analyses of eleven in-depth interviews indicated that nutritional counselling involved the referral to websites, a brochure, and an app developed by the Dutch Nutrition Centre. Midwives were aware of the existence of other nutritional mHealth apps but felt uncertain about their trustworthiness. Nevertheless, midwives were open towards the implementation of new tools providing that these are trustworthy, accessible, user-friendly, personalised, scientifically sound, and contain easy-digestible information. Midwives stressed the need for guidelines for professionals on the implementation of new tools. Involving midwives early-on in the development of future nutritional mHealth apps may facilitate better alignment with the needs and preferences of end-users and professionals, and thus increase the likelihood of successful implementation in midwifery practice.

Aim: This study aims firstly to identify shifts in the execution of medical tasks by nurses in the past decade. Secondly, it aims to explore nurses' perspectives on task shifting: how they think task shifting affects the quality of care, the attractiveness of nursing practice and their collaboration with physicians. Design: A quantitative repeated cross‐sectional study. Methods: A nationwide survey was conducted among Dutch registered nurses (RNs) working in hospitals and home care, first in 2012 and again in 2022, with sample sizes of 359 and 362, respectively. Analyses were based on descriptive statistics and logistic and linear regressions. Results: Between 2012 and 2022, there was a significant increase in the execution of only one medical task by nurses, namely prescribing over‐the‐counter medication. The majority reported in both years that task shifting has positive impact on their professional autonomy and the attractiveness of nursing practice. However, most nurses also reported that task shifting increased their workload (72.7% in 2022) could lead to conflicts in care teams (20.9% in 2022 compared to 14.7% in 2012) and may cause physicians to feel threatened (32.8% in 2022 and 29.9% in 2012). There were no significant changes in nurses' perception of the impact of task shifting on quality of care, the attractiveness of nursing practice and the nurse–physician relationship. Conclusion: There was an increase in the execution of prescribing over‐the‐counter‐medication by nurses between 2012 and 2022. However, both in 2012 and in 2022, as the majority of nurses reported that task shifting increased their workload, there is reason to worry about this negative consequence of task shifting, e.g. with regard to labour market issues. Further research, also among the medical profession, is needed to better understand and address the implications of task shifting for the nursing profession. Implications for the Profession: Implications for the nursing profession include potential scope expansion with complex tasks, attracting more individuals to nursing careers, although an eye must also be kept on what that means for the workload of nurses and the relationship with physicians. Impact: Nurse prescribing medicines was more executed in 2022 compared to 2012. Nurses had a predominantly positive perspective on task shifting, but still felt it can cause conflicts in care teams, high workload and physicians feeling threatened. These results can help during implementation of task shifting and in monitoring the perceived effects of task shifting among nurses. Reporting Method: This study followed the STROBE reporting guideline for cross‐sectional studies. Patient or Public Contribution: No Patient or Public Contribution. This study focussed on the task shifting (perspectives) of nurses.

Background: Healthcare services, also those provided by nurses, are challenged by the increasing care demands of an ageing population and people with chronic conditions. To improve care efficiency and quality, now and in the future, nurses must have competencies regarding self-management support of patients, electronic communication, preventive care, and engaging relatives in care. This study aimed to assess primary care registered nurses’ (RNs) time allocation to these competencies and their perceived needs for further development of these competencies. Methods: A mixed methods design was used, involving a nationwide survey (n = 303) and focus groups (12 participants), both with RNs working in community care services or general practitioners (GPs) practices. Survey data were analysed descriptively, and focus group transcripts underwent qualitative thematic analysis. Results: The majority of RNs invest significant time in client self-management support (90%), preventive care (82%), and involving relatives in care (74%). RNs also recognized an increasing demand for these competencies in the future and the need to motivate patients and relatives to self-manage their health. Furthermore, RNs reported that competencies regarding electronic communication skills will become extra important in the future, yet currently only 37% dedicate substantial time to this. RNs face challenges in effectively utilizing electronic communication with patients and thus need opportunities to improve digital skills. Additionally, RNs desire enhanced collaboration with other healthcare professionals, such as GPs and medical specialists. Conclusions: RNs’ limited time allocation and perceived inadequacy in electronic patient communication, underscore the importance of targeted training in this area, and prioritizing this by healthcare organizations. In addition, fostering collaboration between nursing staff and other healthcare professionals could support future proof nursing in primary care. Key messages: • Nurses demonstrate resilience in addressing healthcare challenges, emphasizing client care, prevention and family engagement. • Training nurses in competencies for electronic communication with patients is essential to meet the anticipated increase in demand for this aspect in their practice.

Background: Advanced Practice Nurses (APNs) have become established professionals in many healthcare systems. APNs combine nursing with medical expertise, bridging the boundaries of traditional professions in nursing and medicine. This study focuses on the content of professional competency frameworks for APNs in different countries to determine (1) how these frameworks define the competencies of APNs and (2) address the division of tasks between APNs and physicians. Methods: An inductive content analysis is conducted of the competency frameworks for APNs in Belgium, Canada, the Netherlands, the United Kingdom, and the United States. Results: In Belgium, the Netherlands and the US, the framework is based on an existing model, while in Canada and UK, frameworks do not refer to a model. The analysis revealed twelve generic competency domains for APNs: 1. Clinical Care in Practice, 2. Independent Practitioner, 3. Professional Attitude, 4. Scientific Research & Evidence-Based Practice Care, 5. Leadership, 6. Health Promotion and Public Healthcare, 7. Communication and Collaboration, 8. Organisation of Care and Policy, 9. Support of Self-Management and Patient Empowerment, 10. Quality and Safety of Care, 11. Teaching and (continuing) Education, 12. Technology and E-Health. There are some differences in explicitly to which high-risk procedures are described per country. The frameworks provide limited descriptions of task division and delegation from physicians to APNs, except for the frameworks from Belgium and the Netherlands. Conclusions: Despite variations in the basis of professional competency frameworks per country and country-specific influences, twelve generic competency domains with similar competencies were identified. It is recommended to stimulate the development of a global standardised competency framework for APNs, including clear descriptions of task division and delegation, to optimise their role in delivering high-quality healthcare services. Key messages: • Similar APN competency expectations suggest the need for an international competency framework, including roles and tasks for APNs, to function as a basis for individual country frameworks. • Nursing associations can use this study to learn from other countries and enhance their development of country-specific competency frameworks for advanced practice nurses.