What is the impact of advanced primary care nursing roles on patients, nurses and their colleagues? A literature review
Section snippets
What is already known about the topic?
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The expansion of nursing roles in primary care appears set to continue as policy makers juggle cost containment and work force shortages along side the need to improve the quality of health services.
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Nurses substituting for, or complementing, some areas of work traditionally undertaken by family physicians, including first contact care, provide care comparable to that of doctors and patient satisfaction is consistently high.
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Some nurses working in advanced primary care nursing roles experience
What this paper adds
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Evidence on the cost-effectiveness of advanced primary care nursing services is inconclusive and complex factors such as patient satisfaction, different dimensions of access, and workload require further exploration.
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Potential effect mediators such as the organisational characteristics and practice culture, experience and educational level of advanced nurses and service ‘maturation’ are often ignored in the research evidence.
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The introduction of a national UK post-registration competency
Aim and methods
The aim of the review was to identify and collate the research evidence from the international literature to provide an overview of the impact of nurse-led first contact care and other APCN services in primary care for a range of outcomes.
The search strategy included studies on the effectiveness of APCN services, including dimensions of accessibility and acceptability to patients, safety, costs, workload impact, recruitment, retention and related workforce issues. Electronic databases, websites
Results and discussion
Although the aim was to provide a comprehensive overview of the evidence, not a systematic review, we used established methods (Centre for Reviews and Dissemination, 2001) to ensure the process was systematic and transparent. Our search strategy was inclusive and we are confident that most relevant studies were located; however, we cannot claim to have identified all the research in the field. It was not our aim to provide an evidence synthesis given the broad scope of the review and the range
Conclusion
This review provides an overview of the impact of APCN roles in primary/community care for a range of outcomes. Given the broad nature of this research area, a ‘systematic review’ of the literature was not undertaken. However, failure to identify studies is unlikely as a systematic and transparent approach was used.
The expansion of nursing roles in primary care appears set to continue as policy makers juggle cost containment and work force shortages along side the need to improve the quality of
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