Changing roles in nursing: a literature review of influences and innovations

A comprehensive picture of the range of recent nursing role developments in the UK is developed, and evidence of the effectiveness of such developments is presented, to provide enhanced information-giving and continuity of care.

Abstract

to develop a comprehensive picture of the range of recent nursing role developments in the UK, and to present evidence of the effectiveness of such developments. a review of the literature from January 1993 to May 1998 a large majority of the papers available are descriptive in nature, or report on small studies, often with poorly designed or described methodologies. Three main forces behind role developments in nursing are professional, managerial and policy forces. Changes have taken four forms: discrete new roles, 'creeping' role developments, specific interventions and policy-driven alteration in the focus or philosophy of care. Nursing staff have adapted and enhanced new roles which may be technically oriented, incorporating their professional imperatives (e.g. health promotion) and using philosophies of collaborative, holistic care to provide enhanced information-giving and continuity of care. Gaps in the evidence are highlighted. This paper arises from a report prepared for and funded by the Nursing and Midwifery Staffs Negotiating Council (Read & Shewan 1998).