Influence of organizational attributes on registered nurse contributions to well-child care: a scoping review research practicum

Background: Well-child care (WCC) is a vital component of preventative care for children within primary care settings. WCC commonly consists of a series of primary care visits that encompass growth and development assessments, health screenings and education, immunizations, care coordination, and anticipatory guidance. Although Registered Nurses (RNs) are well-positioned to deliver WCC, substantial variation exists in how their roles are enacted across primary care practice environments. Ongoing challenges in primary care workforce capacity necessitate a critical analysis of professional contributions to ensure primary care provision is optimized. Current literature offers limited clarity regarding the organizational attributes that influence how, and to what extent, RNs contribute to WCC in primary care settings. Purpose: As a Master of Nursing student, the objective of this practicum was to develop research competencies aligned with the advanced nursing practice (ANP) role. This was achieved by conducting a scoping review to describe the scope and characteristics of the literature involving organizational attributes that act as barriers or facilitators to RN contributions to WCC in high-income economies. A secondary objective was to engage in knowledge translation (KT) activities to support the dissemination of scoping review findings. Methods: The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) scoping review methodology. Data were extracted in alignment with the Nursing Care Organization Framework (NCOF), and the ‘best fit’ framework was utilized to guide data analysis and synthesis. Data reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR) approach. A manuscript was prepared for submission to the special edition of BMC Primary Care focusing on the primary care workforce. To facilitate KT, two abstracts were developed and accepted for electronic poster presentations at the Trillium Primary Health Care Research Day 2025 and the Memorial University of Newfoundland Faculty of Nursing 2025 Research Exchange. Findings: Thirteen articles representing a range of high-income countries were included in the scoping review. Findings suggest a close alignment between organizational attributes derived from the NCOF and RN contributions to WCC. Specific findings include clear gaps in the education and training of primary care nurses, structural constraints that inhibit nurse contributions to WCC, and potential opportunities to expand nursing roles beyond core WCC functions. Conclusions: Future research should focus on identifying how organizational attributes can be leveraged or mitigated to optimize nursing contributions to WCC. Targeted exploration of these aspects will inform strategies that strengthen nursing roles in WCC provision, enhancing the quality of preventative care as evidenced by patient and system-level outcomes, and amplifying primary care workforce capacity.