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- Title
The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review.
- Authors
Fong Yeong Woo, Brigitte; Xin Yu Lee, Jasmine; Wai San Tam, Wilson; Woo, Brigitte Fong Yeong; Lee, Jasmine Xin Yu; Tam, Wilson Wai San
- Abstract
<bold>Background: </bold>The prevalence of chronic illness and multimorbidity rises with population aging, thereby increasing the acuity of care. Consequently, the demand for emergency and critical care services has increased. However, the forecasted requirements for physicians have shown a continued shortage. Among efforts underway to search for innovations to strengthen the workforce, there is a heightened interest to have nurses in advanced practice participate in patient care at a great extent. Therefore, it is of interest to evaluate the impact of increasing the autonomy of nurses assuming advanced practice roles in emergency and critical care settings on patient outcomes.<bold>Objectives: </bold>The objectives of this study are to present, critically appraise, and synthesize the best available evidence on the impact of advanced practice nursing on quality of care, clinical outcomes, patient satisfaction, and cost in emergency and critical care settings.<bold>Review Methods: </bold>A comprehensive and systematic search of nine electronic databases and a hand-search of two key journals from 2006 to 2016 were conducted to identify studies evaluating the impact of advanced practice nursing in the emergency and critical care settings. Two authors were involved selecting the studies based on the inclusion criteria. Out of the original search yield of 12,061 studies, 15 studies were chosen for appraisal of methodological quality by two independent authors and subsequently included for analysis. Data was extracted using standardized tools.<bold>Results: </bold>Narrative synthesis was undertaken to summarize and report the findings. This review demonstrates that the involvement of nurses in advanced practice in emergency and critical care improves the length of stay, time to consultation/treatment, mortality, patient satisfaction, and cost savings.<bold>Conclusions: </bold>Capitalizing on nurses in advanced practice to increase patients' access to emergency and critical care is appealing. This review suggests that the implementation of advanced practice nursing roles in the emergency and critical care settings improves patient outcomes. The transformation of healthcare delivery through effective utilization of the workforce may alleviate the impending rise in demand for health services. Nevertheless, it is necessary to first prepare a receptive context to effect sustainable change.
- Subjects
CHRONIC diseases; POPULATION aging; CRITICAL care medicine; EMERGENCY medical services; PHYSICIANS; MEDICAL care standards; MEDICAL care; MEDICAL quality control; MEDICAL care costs; NURSE practitioners; NURSING specialties; PATIENT satisfaction; SYSTEMATIC reviews; OCCUPATIONAL roles
- Publication
Human Resources for Health, 2017, Vol 15, p1
- ISSN
1478-4491
- Publication type
journal article
- DOI
10.1186/s12960-017-0237-9