Introducing advanced practice nurses / nurse practitioners in health care systems: a framework for reflection and analysis
Swiss Medical WeeklyPublished 1 November 2008Open access
Philip Moons, B Callens, Chris Gut, Lyn S. Lindpaintner
Citations82
SJR quartileQ3
SJR score0.50
SNIP0.53
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system and outcomes research on Advanced Practice Nursing is presented.
Abstract
Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.
Keywords
Health Professions
Journal for Healthcare QualityCrossing the Quality Chasm: A New Health System for the 21st Century
8,568 Citations2002Committee on Quality of Health Care in America
Annals of Behavioral MedicineSelf-management education: History, definition, outcomes, and mechanisms
4,131 Citations2003Kate Lorig, Halsted R. Holman
Evidence of the effectiveness of self-management interventions is presented and a possible mechanism, self-efficacy, through which these interventions work are posited.
JAMAPatient Self-management of Chronic Disease in Primary Care
3,593 Citations2002Thomas Bodenheimer
Self-management education complements traditional patient education in supporting patients to live the best possible quality of life with their chronic condition, and may soon become an integral part of high-quality primary care.
JAMAImproving Primary Care for Patients With Chronic Illness
2,937 Citations2002Thomas Bodenheimer
The chronic care model is a guide to higher-quality chronic illness management within primary care and predicts that improvement in its 6 interrelated components can produce system reform in which informed, activated patients interact with prepared, proactive practice teams.
JAMAImproving Primary Care for Patients With Chronic Illness
2,421 Citations2002Thomas Bodenheimer, Edward H. Wagner +1 more
Research evidence shows to what extent the chronic care model can improve the management of chronic conditions and reduce health care costs and obstacles hinder its widespread adoption.
JAMAComprehensive Discharge Planning and Home Follow-up of Hospitalized Elders
1,766 Citations1999Mary D. Naylor, Dorothy Brooten +5 more
An advanced practice nurse-centered discharge planning and home care intervention for at-risk hospitalized elders reduced readmissions, lengthened the time between discharge and readmission, and decreased the costs of providing health care.
BMJSystematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors
1,248 Citations2002Sue Horrocks, Elizabeth Anderson +1 more
Patients are more satisfied with care from a nurse practitioner than from a doctor, with no difference in health outcomes Nurse practitioners provide longer consultations and carry out more investigations than doctors.
Redefining Health Care: Creating Value-based Competition on Results
1,206 Citations2006Michael E. Porter, Elizabeth Teisberg
Cochrane Database of Systematic ReviewsSubstitution of doctors by nurses in primary care
936 Citations2005Miranda Laurant, David Reeves +4 more
Evaluating the impact of doctor-nurse substitution in primary care on patient outcomes, process of care, and resource utilisation suggested that appropriately trained nurses can produce as high quality care as primary care doctors and achieve as good health outcomes for patients.
BMJRedefining Health Care: Creating Value-Based Competition on Results
481 Citations2006Julie A. Gray
It is argued that throughout the economy competition among private sector rivals is the most powerful force yet discovered for driving improvements in the quality and cost of products and services—except in health care in the United States.
Journal of Advanced NursingAdvanced practice nursing roles: development, implementation and evaluation
480 Citations2004Denise Bryant‐Lukosius, Alba DiCenso +2 more
Six issues influencing the introduction of advanced practice nursing (APN) roles are discussed: confusion about APN terminology, failure to define clearly the roles and goals, role emphasis on physician replacement/support, underutilization of all APN role domains, failures to address environmental factors that undermine the roles, and limited use of evidence-based approaches to guide their development, implementation and evaluation.
BMJSupport for self care for patients with chronic disease
318 Citations2007Anne Kennedy, Anne Rogers +1 more
Anne Kennedy, Anne Rogers, and Peter Bower argue that effective self care requires fundamental changes in professional attitudes and the way health care is delivered.
OECD health working papersThe Supply of Physician Services in OECD Countries
316 Citations2006Steven Simoens, Jeremy Hurst
There are signs that a higher density of physicians is found in countries which have left the supply of physicians mainly to the market whereas lower density is finding in countries who have planned the intake to medical schools centrally over many years.
PubMedA randomized clinical trial of early hospital discharge and home follow-up of very-low-birth-weight infants.
308 Citations1987Dorothy Brooten, Savitri Kumar +6 more
BMJNurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial
307 Citations2002Sally Moore, Jessica Corner +6 more
Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes and no significant differences were seen in survival or rates of objective progression.
JAMAA Systems Approach to Patient-Centered Care
285 Citations2006Steven C. Bergeson, John Dean
This Commentary proposes 4 specific changes that should help the medical profession meet patients’ needs and expectations and suggests the chronic care model is an example of an evidence-based system approach that includes selfmanagement support and care coordination as key components.
BMJSecondary prevention clinics for coronary heart disease: four year follow up of a randomised controlled trial in primary care
281 Citations2003Peter Murchie, Neil C Campbell +3 more
Improved medical and lifestyle components of secondary prevention produced by nurse led clinics seem to lead to fewer total deaths and coronary events, and secondary prevention clinics should be started sooner rather than later.
HeartSecondary prevention in coronary heart disease: a randomised trial of nurse led clinics in primary care
260 Citations1998Neil Campbell, Lewis Ritchie +4 more
Most patients gained at least one effective component of secondary prevention and, for them, future cardiovascular events and mortality could be reduced by up to a third.
OECD health working papersTackling Nurse Shortages in OECD Countries
216 Citations2005Steven Simoens, Mike Villeneuve +1 more
BMJPreparing the 21st century global healthcare workforce
206 Citations2005Sheri D. Pruitt, JoAnne E. Epping‐Jordan
To meet the growing global demands of caring for the increasing numbers of patients with chronic conditions, there needs to be a new approach to training to include a new set of core competencies that prepare 21st century health workers to manage today's most prevalent health problems.
Journal of Advanced NursingMulticomponent intervention strategies for managing delirium in hospitalized older people: systematic review
201 Citations2005Koen Milisen, Joke Lemiengre +2 more
Intervention strategies to prevent delirium proved to be the most efficacious in reducing its incidence, both with surgical and medical patients and should be implemented through synergistic cooperation between the various healthcare disciplines.
Diabetes CareSpecialist Nurse-Led Intervention to Treat and Control Hypertension and Hyperlipidemia in Diabetes (SPLINT)
164 Citations2003John P. New, James Mason +6 more
Good evidence is provided to support the use of specialist nurse-led clinics as an effective adjunct to hospital-based care of patients with diabetes and if the standards of care recommended in the National Service Framework for Diabetes are to be achieved, then such proven methods for delivering care must be adopted.
Medical Entomology and ZoologyAdvanced Nursing Practice: An Integrative Approach
157 Citations2000Ann B. Hamric, Judith A. Spross +1 more
This paper discusses historical and developmental aspects of Advanced Nursing Practice, as well as issues in the Continuing Evolution of Advanced nursing Practice.
BMC Health Services ResearchInterventions designed to improve the quality and efficiency of medication use in managed care: A critical review of the literature – 2001–2007
137 Citations2008Christine Y. Lu, Dennis Ross‐Degnan +2 more
There is good evidence for the effectiveness of several strategies in changing drug use in the managed care environment, including one-to-one academic detailing, computerized alerts and reminders, pharmacist-led collaborative care, and multifaceted disease management.
Journal of Clinical NursingAn overview of patients’ preference for, and satisfaction with, care provided by general practitioners and nurse practitioners
136 Citations2008Miranda Laurant, Rosella Hermens +4 more
European Journal of Cardiovascular NursingHeart Failure Management Programmes in Europe
135 Citations2006Tiny Jaarsma, Anna Strömberg +9 more
Only a few European countries have a large number of organised programmes for HF care and follow up, and to improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes.
Annals of the Rheumatic DiseasesCost effectiveness and cost utility analysis of multidisciplinary care in patients with rheumatoid arthritis: a randomised comparison of clinical nurse specialist care, inpatient team care, and day patient team care
132 Citations2003Wilbert B. van den Hout, G J Tijhuis +3 more
Clinical nurse specialist care was shown to provide equivalent quality of life and utility, at lower costs, than inpatient and day patient team care, and for patients with health conditions that allow for any of the three types of care, the preferred treatment from a health-economic perspective is the care provided by the clinical nurse specialist.
Journal of Nursing ScholarshipLessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care
129 Citations2002Dorothy Brooten, Mary D. Naylor +8 more
To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.
OECD health working papersSkill-Mix and Policy Change in the Health Workforce
118 Citations2005James Buchan, Lynn Calman
An important potential contribution to the efficient use of the health workforce, is the possibility of ‘skill mix’ changes which may involve enhancement of skills among a particular group of staff, substitution between different groups, delegation up and down a unidiscipliniary ladder, and innovation in roles.
European Journal of Heart FailureEffects of a Nurse-Led, Clinic and Home-Based Intervention on Recurrent Hospital Use in Chronic Heart Failure
113 Citations2005David R. Thompson, Alun Roebuck +1 more
Few studies have examined the potential benefits of specialist nurse‐led programs of care involving home and clinic‐based follow-up to optimise the post‐discharge management of chronic heart failure (CHF).
BMJNurses as leaders in chronic care
113 Citations2005Thomas Bodenheimer, Kate MacGregor +1 more
The healthcare literature and the experience of many efforts to improve chronic care indicate that nurses, not doctors, are the key to implementing the chronic care model in a patient centred care team.
PubMedA randomized trial of nurse specialist home care for women with high-risk pregnancies: outcomes and costs.
112 Citations2001Dorothy Brooten, JoAnne M. Youngblut +4 more
This model of care provides a reasoned solution to improving pregnancy and infant outcomes while reducing healthcare costs through 1 year after delivery.
Cochrane Database of Systematic ReviewsEffectiveness of intermediate care in nursing-led in-patient units
111 Citations2007Peter Griffiths, Phil Edwards +3 more
There is some evidence that patients discharged from a NLU are better prepared for discharge but it is unclear if this is a product of an increased length of inpatient stay and the possibility of increased early mortality cannot be discounted.
Cochrane Database of Systematic ReviewsHome care by outreach nursing for chronic obstructive pulmonary disease
97 Citations2012Christopher X. Wong, Kristin Carson‐Chahhoud +1 more
Outreach nursing programmes for COPD improved disease-specific heath-related quality of life and the effect on hospitalisations was heterogeneous, reducing admissions in one study, but increasing them in others, therefore it could not draw firm conclusions for this outcome.
Medical Entomology and ZoologyInternational Council of Nurses: Advanced Nursing Practice
96 Citations2006Madrean Schober, Fadwa A. Affara
This work focuses on the development of a model for a Regulatory System for Advanced Nursing Practice, and the role of the Credentialing Framework in that system.
PubMedPatient satisfaction and quality of care in walk-in clinics, family practices and emergency departments: the Ontario Walk-In Clinic Study.
91 Citations2003Brian Hutchison, Truls Østbye +8 more
Overall quality-of-care scores were higher in walk-in clinics and emergency departments than in family practices, and satisfaction with waiting time was highest among family practice patients.
PubMedComparing the cost of nurse practitioners and GPs in primary care: modelling economic data from randomised trials.
86 Citations2006Sandra Hollinghurst, Sue Horrocks +2 more
Employing a nurse practitioner in primary care is likely to cost much the same as employing a salaried GP according to currently available data, which suggests that skill-mix decisions should depend on the full range of roles and responsibilities rather than cost.
PubMedInterventions led by nurse continence advisers in the management of urinary incontinence: a randomized controlled trial.
74 Citations2002Michael Borrie, Mary Bawden +2 more
Behavioural and lifestyle counselling provided by specialized nurses with training in managing incontinence reduces incontinent events and incontaining pad use in an outpatient population.
Journal of the American Geriatrics SocietyA Model for Management of Delirious Postacute Care Patients
61 Citations2005Margaret A. Bergmann, Katharine M. Murphy +3 more
Concern about delirium can no longer be confined to acute care; after an acute hospitalization, many older people are discharged to postacute care facilities—rehabilitation hospitals and skilled nursing facilities.
International Journal of Nursing PracticeAn evaluation of the effectiveness and acceptability of nurse practitioners in an adult emergency department
60 Citations2008Anne Wilson, Fathimath Shifaza
It was noted that the flow of patients through the department was improved, resulting in medical resources concentrated to higher priority presentations, and patients are satisfied with management of small injury presentations by nurse practitioners in the emergency department.
The Nurse PractitionerClient Characteristics and Practice Patterns of Nurse Practitioners and Physicians
49 Citations1999Nancy B. Moody, Patricia L. Smith +1 more
Differences included the tendency of NPs to care for more younger and female clients, to perform fewer office surgical procedures, and to provide more health teaching/counseling interventions.
Journal of Wound CareLeg ulcer management in a nurse-led, hospital-based clinic
46 Citations1997Kathryn Vowden, Amy Barker +1 more
This paper describes the clinical outcomes from a nurse-led leg ulcer clinic over a period of three and a half years, involved retrospective analysis of 159 patients with 180 venous leg ulcers, where healing rates varied with previous ulcer duration, ulcer size and patient mobility.
Cochrane Database of Systematic ReviewsHome care by outreach nursing for chronic obstructive pulmonary disease
42 Citations2001Brian J Smith, Sarah Appleton +3 more
Patients with moderate COPD may have mortality and health related quality of life gains from a nursing outreach programme, but there are no data about reductions in hospital utilisation.
Journal of the American Geriatrics SocietyAdvanced Practice Nursing in the Care of Frail Older Adults
41 Citations2002Meg Bourbonniere, Lois K. Evans
This paper identifies, describes, and analyzes common functions and skills of APNs in published gerontologic care models; examines the strength of the evidence for the effect ofAPNs on outcomes of care; and identifies areas for further study.
Accident and Emergency NursingA time for international standards?: Comparing the Emergency Nurse Practitioner role in the UK, Australia and New Zealand
32 Citations2007Jane Currie, Liza Edwards +2 more
The aim of this paper is to compare the Emergency Nurse Practitioner (ENP) role in the UK, Australia and New Zealand to progress towards international standards for regulation, education and core components of practice.
European Journal of Emergency MedicineRisk stratification of chest pain patients in the emergency department by a nurse utilizing a point of care protocol
29 Citations2008Andrew J. Hamilton, L Swales +5 more
Risk stratification by a specialist nurse utilizing a point of care (POC) protocol is an appropriate means of assessing patients with chest pain.
AJN American Journal of NursingAdvanced Nursing Practice: An Integrative Approach
27 Citations1997&NA;
Current Opinion in Critical CareThe evolving role of the acute care nurse practitioner in critical care
19 Citations2006Jill Howie‐Esquivel, Dorrie K. Fontaine
The role of acute care nurse practitioners in critical care is increasing worldwide and most countries are experimenting with this latest nurse practitioner as an extended-role healthcare provider with many potential benefits to patients and their families, as well as the healthcare system.
BMJNurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial
15 Citations2002
Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes and no significant differences were seen in survival or rates of objective progression.
International Journal of Nursing PracticeIdentifying measures for evaluating new models of nursing care: A survey of NSW nurse practitioners
14 Citations2007Sandy Middleton, Jane Allnutt +4 more
The authors' results provide a unique set of indicators with which to evaluate process and outcome measures of NP services and enable NPs to evaluate their service efficiently and to benchmark against other NPs.
Journal of the American Academy of Nurse PractitionersImproving Compliance in Your Dyslipidemic Patient: An Evidence‐based Approach
14 Citations2001Diane M. Becker, Jerilyn K. Allen
The evidence from landmark clinical studies of lipid‐lowering pharma‐cotherapy and nurse management of hyperlipidemia is synthesized, issues related to nonadherence are discussed, and strategies for achieving long‐term cholesterol control are proposed.
Nursing Clinics of North AmericaThe Collaboration of Public Health Nursing and Primary Care Nursing in the Development of a Nurse Managed Health Center
13 Citations2005Anne Ferrari, Barbara Rideout
Sexually Transmitted InfectionsSuccess of a nurse led community based genitourinary medicine clinic for young people in Liverpool: review of the first year
10 Citations2006Karen E. Jones
Nurse led community based GUM services, such as the one provided at the Merseyside Brook Centre, appeal to young people and their success should encourage others to consider similar ventures.
The Journal of Laryngology & OtologyNurse-led ‘one stop’ clinic for elective tonsillectomy referrals
9 Citations2007Kwan‐Dun Wu, E.M. Walker +1 more
A trained nurse practitioner can safely and effectively facilitate the complete process of managing a routine pre-operative tonsillectomy patient, from primary care referral to arranging admission for surgery.
QJMLong-term effectiveness of a multifaceted intervention on pain management in a walk-in clinic
8 Citations2007Noëlle Junod Perron, Valérie Piguet +1 more
The intervention improved adherence to recommended procedures, even in the longer term, but did not result in better patient outcomes.
Nursing StandardThe development of a nurse-led complex wound clinic
6 Citations2005Mark Collier, Kathy Radley
A nurse-led complex wound clinic in Lincolnshire in April 2003 is described and one patient's experience of the service is described, and the benefits of collaborative initiatives that have the potential to improve patient outcomes are explored.
Journal of Pediatric Oncology NursingDevelopment of the Role of the Pediatric Oncology Nurse Practitioner in the Netherlands
6 Citations2005Corry van den Hoed‐Heerschop
The role of the nurse practitioner is rather new in the Netherlands and the NPPO role is filling a gap in care for children and parents due to the shift of care to the home environment following early discharge.
PubMedA successful nurse-led model in the elective orthopaedic admissions process.
5 Citations2007Jennifer M Truscott, Joanne Townsend +1 more
The nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age, was safe; it improved the patient journey and job satisfaction among house surgeons; and it extended the skill base andjob satisfaction of the nurses.
Das GesundheitswesenDas Pflegestudium an der Universität Basel/Schweiz
3 Citations2006Wolf von Klitzing, A Kesselring
The structure, content, faculty and students of this BSN-MSN curriculum are described and an evaluation study assesses strengths and weaknesses of this new education.
International Journal of Health Care Quality AssuranceChange of heart
3 Citations2007Sue Jackson, Gillian Morgan
An original case study is described into how nurses applied RADAR, which gives insight into the team's experiences during their 18-month journey and enables others to adopt a similar approach in their pursuit of excellence.
Australasian Emergency Nursing JournalTime for international standards? Comparing the emergency nurse practitioner role in the UK, Australia and New Zealand
3 Citations2007Jane Currie, Liza Edwards +2 more
PubMedRegional nurse led call center, a new public health service in Finland.
2 Citations2006Eija Martikainen, Kaija Saranto +1 more
A regional, speedy, nurse led, 24/7 response service in North Karelia Hospital District to change call center into a health consultancy as well as a regional health care appointment center is presented.
Nursing StandardThe development of a nurse-led complex wound clinic
1 Citations2005Mark Collier, Kathy Radley