Leadership Competencies and Attributes of Advanced Practice Nurses in Hospital Management: A Scoping Review Protocol

This research project aims to systematically examine and synthesize the existing body of knowledge on leadership competencies and attributes of Advanced Practice Nurses (APNs) within hospital management contexts through a scoping review methodology. Nursing leadership has been consistently identified as a central determinant of healthcare quality, patient safety, team performance, and organizational effectiveness. In increasingly complex hospital environments—characterized by high clinical acuity, interprofessional collaboration, and resource constraints—the leadership role of nurses with advanced clinical and decision-making responsibilities has become particularly strategic. Advanced Practice Nurses are internationally recognized as professionals with graduate-level education, advanced clinical expertise, and expanded autonomy, often combining direct patient care with responsibilities related to service coordination, quality improvement, and organizational leadership. Despite the global expansion of advanced nursing roles, there remains substantial conceptual dispersion in the literature regarding which leadership competencies and personal attributes are most relevant for APNs operating in hospital management and administrative settings. Existing studies and reviews frequently address leadership in nursing in broad terms or focus on clinical outcomes of advanced practice roles, without offering an integrated and context-specific synthesis of leadership competencies applicable to hospital management. The primary purpose of this project is to map, describe, and organize leadership competencies and attributes attributed to APNs working in hospital management. Specifically, the study seeks to identify technical–managerial, relational, ethical, and communication-related competencies; to explore how these competencies are conceptualized and operationalized across different healthcare systems; and to examine the methods and instruments used to assess leadership in advanced nursing practice. Additionally, the review will identify reported barriers and facilitators influencing leadership practice among APNs in hospital settings. Methodologically, the project adopts a scoping review design following the frameworks proposed by Arksey and O’Malley and the Joanna Briggs Institute, with reporting guided by the PRISMA-ScR checklist. A comprehensive search strategy will be applied to major international databases and grey literature sources, with no time restrictions and inclusion of studies published in English, Portuguese, and Spanish. The use of a scoping review approach is particularly appropriate given the heterogeneity of study designs, theoretical models, and professional contexts addressed in the literature. The expected outcomes of this project include: (1) a comprehensive mapping of leadership competencies and attributes associated with APNs in hospital management; (2) a descriptive synthesis of theoretical models, assessment approaches, and contextual factors related to leadership practice; and (3) the development of an integrative conceptual framework that organizes leadership competencies into coherent domains relevant to complex hospital environments. This framework is expected to support advanced nursing education, inform organizational leadership development strategies, and contribute to policy discussions on the regulation and implementation of advanced practice nursing roles, particularly in contexts where such roles are still emerging. By consolidating fragmented evidence and highlighting knowledge gaps, this research will contribute to strengthening the scientific basis for leadership development in advanced nursing practice and provide a reference point for future empirical studies, curriculum design, and health system planning.