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OBJECTIVE: The aims of this study were to describe nurses' perceptions of nursing activities and analyze for consistency with top-of-license (TOL) practice. BACKGROUND: The Advisory Board Company expert panel proposed 8 TOL core nursing responsibilities representing practice at its potential. Thus far, no empirical work has examined nursing practices relative to TOL, from staff nurses' points of view. METHODS: This qualitative study used focus groups to explore perceptions of typical nursing activities. We analyzed activities for themes that described nurses' work during typical shifts. RESULTS: Nurses' full scope of work included TOL-consistent categories, as well as categories that did not exemplify TOL practice, such as nonnursing care. A proposed model was developed, which depicts nurses' total scope of work, inclusive of all activity categories. In addition, hindrances to TOL practice were also identified. CONCLUSIONS: Findings from this study can inform leadership imperatives and the development of innovative, sustainable nursing practice models that support nursing practice at TOL.
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Buck et al. (2018) studied this question.
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