International practice settings, interventions and outcomes of nurse practitioners in geriatric care: A scoping review.

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State: Public
Version: Final published version
Serval ID
serval:BIB_BB2AAC1C4532
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
International practice settings, interventions and outcomes of nurse practitioners in geriatric care: A scoping review.
Journal
International journal of nursing studies
Author(s)
Chavez K.S., Dwyer A.A., Ramelet A.S.
ISSN
1873-491X (Electronic)
ISSN-L
0020-7489
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
78
Pages
61-75
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
To identify and summarize the common clinical settings, interventions, and outcomes of nurse practitioner care specific to older people.
Scoping review of the international published and grey literature.
A structured literature search was conducted of CINAHL, EMBASE, MEDLINE, Google Scholar, and Cochrane Collaboration and Joanna Briggs Institute databases.
Following the Arksey and O'Malley framework, randomized controlled and quasi-experimental studies of Masters-prepared nurse practitioners providing care for patients over 65 years were included. Studies were reviewed independently by two investigators. Data were extracted, collated by setting, summarized in tables and synthesized for analysis.
In total, 56 primary research studies from four countries and 23 systematic reviews were identified. Primary studies were conducted in primary care (n=13), home care (n=14), long-term care (n=10), acute/hospital care (n=9), and transitional care (n=10). Nurse practitioner interventions included substitutive as well as a supplementation NP role elements to meet specific unmet patient care needs. Studies examined six main outcome measures: service utilization (n=41), cost (n=24), length of stay (n=14), health indices (n=44), satisfaction (n=14) and quality of life (n=7). Cumulatively, nurse practitioners demonstrated enhanced results in 83/144 (58%) of outcomes compared to physician-only or usual care. The most commonly measured financial-related outcome was service utilization (n=41) and benefits were frequently reported in home care (8/9, 89%) and long-term care (7/10, 70%) settings. Among patient and care-related outcomes health indices were most frequently measured (n=44). Primary care most frequently reported improved health indices (11/13, 85%). Transitional care reported improved outcomes across all measures, except for service utilization.
This review demonstrates improved or non-inferiority results of nurse practitioner care in older people across settings. More well-designed, rigorous studies are needed particularly in relation to costs. The results of this review could be used for future systemic review of effectiveness of NP care specific to older people. Despite the demonstrated NP role value, barriers to implementing the nurse practitioner role persist internationally and more work is needed to develop and promote these roles.
Keywords
Aged, Health Services for the Aged/trends, Humans, Internationality, Nurse Practitioners/statistics & numerical data, Advanced practice nursing, Continuity of patient care, Diffusion of innovation, Geriatric nursing, Home care services, Long term care, Nurse practitioner, Primary care, Transitional care
Pubmed
Web of science
Open Access
Yes
Create date
14/05/2018 17:24
Last modification date
20/08/2019 16:29
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