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International Journal of Nursing Studies Advances

The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review

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Open access

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What is already known most this topic?

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Previous randomized control trials and systematic reviews identify that nurse-led care (as a substitute for physician-led intendance) can improve overall patient care and service outcomes delivery.

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Consistently reported positive outcomes include greater patient satisfaction, improved admission to health advice, and better chronic disease cocky-management.

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Previous reviews, of this nature, take focused on evaluating the touch of nurses working every bit substitutes for doctors in the master intendance setting. This review differs in that it explores the role and capacity of Advanced Nurse Practitioners (ANPs) - in chief, secondary and specialist care settings involving both adult and pediatric populations.

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Previous reviews focus on the study outcomes of specific nurse-led care interventions. This review evaluates studies that explore the comparable effect of advanced nurse practitioners-led intendance programes every bit they directly compare to physician-led/usual care programes.

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This paper highlights the need for more high-quality randomized control trials design studies to further explore this clinical concept - given the notable existence of methodological flaws in the current research literature.

Abstract

Aim

To evaluate the effectiveness of the part of avant-garde nurse practitioners compared to physicians-led/ usual care (care managed by medical doctors or not-advanced nurse practitioners)

Background

Avant-garde nurse practitioners contribute to the improvement of quality patient care and have substantial potential to optimise the health of people globally. Since the formal recognition of advanced nurse practitioners by the International Council of Nurses, among others, the role has been adopted across most departments and clinical specialties, particularly in loftier-income countries.

Pattern

Systematic review of primary research evidence

Data Source

MEDLINE, EMBASE, CINAHL, Cochrane registry, Cochrane trials, and Cochrane EPOC (PDQ Prove) were searched for randomised controlled trials (RCTs) of patient care and health resource utilisation outcomes associated with advanced nurse practitioners.

Review Methods

The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) argument. The called articles were restricted to full-text English language trials published in the terminal 20 years, incorporating comparators of usual care. Search terms were limited to variations of advanced nurse practitioner function and do. The eligible studies were bias risk assessed and quality assessed using the Grading of Recommendations, Assessment, Development and Evaluation (Course). Clinical and service outcomes were analysed using narrative synthesis as the marked heterogeneity between studies precluded meta-analysis.

Results

Xiii RCTs were reviewed. All of them were conducted across high-income countries inside primary care and hospital settings involving paediatric and adult patients. 5 trials were assessed as high quality, and eight were of low to moderate quality. Positive effects were demonstrated for the touch on of advanced nurse practitioners on usual intendance; for indigestion, mean difference [Md] two.iii: 95% CI 1.4, 3.1]), perceptions of health status [ (Doctor –140.6; 95% CI –184.viii, –96.5)], satisfaction levels [ (Doc ranged from –8.79; 95% CI –xiii.59, –3.98 to 0.61; 95% CI –4.84, 6.05)], concrete function (1.58 [SD 0.76] v. 1.81 [SD 0.90]), and claret force per unit area command (systolic [133 [SD 21] five. 135 [SD xix] mmHg p = 0.04] and diastolic [77 [SD x] v. 80 [SD 11] mmHg p = 0.007]) were looked at. Positive furnishings related to service provision included improved patient satisfaction and reductions in waiting times and costs, which significantly favored advanced nurse practitioners (all p < 0.05).

Determination

The evidence of this review supports the positive impact of avant-garde nurse practitioners on clinical and service-related outcomes: patient satisfaction, waiting times, control of chronic disease, and toll-effectiveness especially when directly compared to medical practitioner-led intendance and usual care practices - in primary, secondary and specialist care settings involving both adult and pediatric populations.

Keywords

Advanced nursing practice

Avant-garde nurse practitioner

Clinical bear upon

Service improvement

Care quality

Patient care

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© 2021 The Author(s). Published past Elsevier Ltd.