Therapeutic Inertia in Nursing: A Scoping Review

Objective: The objective of this scoping review is to systematically map and synthesize the literature regarding therapeutic inertia in nursing context, specially identifying clinical settings, study designs, outcomes and strategies to reduce inertia, whit a focus on categorizing determinants using the Theoretical Domains Framework (TDF). Introduction: Therapeutic inertia, also called clinical inertia, is the failure or delay of healthcare professionals to initiate, modify or escalate care despite clinical indications. Although well-defined in medical practice, its application within nursing remains conceptually underdeveloped and empirically fragmented. Given nurses’ expanding autonomy and responsability in patient care process, understanding how therapeutic inertia manifests in nursing practice is essential to improve care quality and patient outcomes. However, existing studies employ specific contexts, heterogeneous definitions and measures and often focus on nurses’ role in mitigating physician inertia rather than examining inertia as a behavior enacted by nurses themselves. Inclusion criteria: This review will include studies involving nurses or nurse practitioners, focusing on therapeutic inertia within nursing practice across all healthcare settings. Quantitative, qualitative, mixed-methods studies, reviews, and grey literature in English or Italian will be considered, without temporal and geographical limitations. Methods: The review will be conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. A three-step search will be conducted in PubMed, CINAHL, Cochrane Library, Embase, Scopus, Web of Science, PsycINFO and grey literature. Study selection, data extraction, and synthesis will be performed by independent reviewers. Findings will be presented using descriptive statistics, narrative analysis and mapping determinants of therapeutic inertia to the TDF.