The Impact of Nurse Practitioner Role in Emergency Departments

A Mixed Studies Systematic Review Protocol

Auteurs-es

DOI :

https://doi.org/10.29173/cjen225

Mots-clés :

Nursing, Nurse Practitioner, Emergency Department, Patient Care, Systematic Review

Résumé

Background

Overcrowding and long wait times in the emergency department (ED) have resulted in decreased patient satisfaction and quality of care. One of the solutions proposed to address wait times is the introduction of the nurse practitioner (NP) role in the ED. We present a systematic mixed studies review protocol that aims to gather and analyze available knowledge on the impact of the NP role in the ED on patients, other healthcare providers, and organizations.

Methods

The review will employ a mixed studies analysis approach. Data will be gathered from peer-reviewed and grey literature in English with no time limit. All international publications on the impact of NP role implementation that meets the inclusion criteria in the ED setting will be included. Each study will be appraised for quality using the mixed methods appraisal tool and data extracted by two independent authors. In the presence of conflict, a third author will provide a resolution. Study characteristics and findings will be synthesized using descriptive analysis, meta-analysis, and a three-stage thematic analysis approach. The review results will be presented using the PRISMA checklist for systematic reviews.

Conclusions

The systematic review will present current evidence on the impact of NP role implementation in the ED setting. The results are anticipated to support decisions and policymakers in their quest to decrease ED wait times and improve the quality of patient care in healthcare settings.

Keywords: Nursing, Nurse Practitioner, Emergency Department, Patient Care, Systematic Review

Bibliographies de l'auteur-e

Sarah A. Lartey, University of Alberta

Sarah A. Lartey, RN, BScN, MN is a registered nurse working as a nurse manager and completing her PhD in Nursing at the University of Alberta. Her research focus is on nursing leadership and healthcare policy. Her research explores nursing leadership roles, including NPs, charge nurses, and managers, and examines how they and health policy impact patients, organizations, and communities.

Carmel Montgomery

Carmel L. Montgomery, RN, PhD is an assistant professor in the Faculty of Nursing at the University of Alberta. Her program of research is focused on outcomes of critical illness in patients living with frailty as well as the impact of advanced practice nursing roles in the health care system.

Références

Bennett D. (2022, January 26). Patient dies while waiting for treatment in Central Alberta hospital emergency ward. The Canadian Press. https://www.theglobeandmail.com/canada/article-patient-dieswhile-waiting-for-treatment-in-central-alberta-hospital/

Bernstein, S. L., Aronsky, D., Duseja, R., Epstein, S., Handel, D., Hwang, U., McCarthy, M., McConnell, K. J., Pines, J. M., Rathlev, N., Schafermeyer, R., Zwemer, F., Schull, M., & Asplin, B. R. (2009). The effect of emergency department crowding on clinically oriented outcomes. Academic Emergency Medicine, 16(1), 1–10. https://doi.org/10.1111/j.1553-2712.2008.00295.x

Boutron, I., Page, M. J., Higgins, J. P. T., Altman, D. G., Lundh, A., & Hróbjartsson, A. (2022). Considering bias and conflicts of interest among the included studies. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions. Cochrane. www.training.cochrane.org/handbook

Butler, A., Hall, H., & Copnell, B. (2016). A guide to writing a qualitative systematic review protocol to enhance evidence-based practice in nursing and health care. Worldviews on Evidence-Based Nursing, 13(3), 241–249. https://doi.org/10.1111/wvn.12134

Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without metaanalysis (SWiM) in systematic reviews: Reporting guideline. BMJ 368, l6890. http://doi.org/10.1136/bmj.l6890

Canadian Nurses Association. (2010). Canadian Nurse Practitioner core competency framework. https://www.cno.org/globalassets/for/rnec/pdf/competencyframework_en.pdf

Canadian Nurses Association. (2016). The nurse practitioner: Position statement. https://hl-prod-ca-oc-download.s3-ca-central-1.amazonaws.com/CNA/2f975e7e-4a40-45ca-863c-5ebf0a138d5e/UploadedImages/documents/The_Nurse_Practitioner_Position_Statement_2016.pdf

Carter, E. J., Pouch, S. M., & Larson, E. L. (2014). The relationship between emergency department crowding and patient outcomes: A systematic review. Journal of Nursing Scholarship, 46(2), 106–115. https://doi.org/10.1111/jnu.12055

Deeks, J. J., Higgins, J. P. T., & Altman, D. G. (2022). Analysing data and undertaking meta-analyses. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions. Cochrane. www.training.cochrane.org/handbook

Fry, M. (2011). Literature review of the impact of nurse practitioners in critical care services. Nursing in Critical Care, 16(2), 58–66. https://doi.org/10.1111/j.1478-5153.2010.00437.x

Geary, A. (2017, September 18). Ignored to death: Brian Sinclair’s death caused by racism, inquest inadequate, group says. CBC News. https://www.cbc.ca/news/canada/manitoba/winnipeg-brian-sinclair-report-1.4295996

Hammer, C., DePrez, B., White, J., Lewis, L., Straughen, S., & Buchheit, R. (2022). Enhancing hospital-wide patient flow to reduce emergency department crowding and boarding. Journal of Emergency Nursing, 48(5), 603–609. https://doi.org/10.1016/j.jen.2022.06.002

Health Canada. (2023). Canada Health Act: Annual Report. https://www.canada.ca/content/dam/hc-sc/documents/services/publications/health-system-services/canada-health-act-annualreport-2021-2022/canada-health-act-annual-report-2021-2022-eng.pdf

Higgins, J. P. T., Li, T., & Deeks, J. J. (2022). Choosing effect measures and computing estimates of effect. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions. Cochrane. www.training.cochrane.org/handbook

Hilbrecht, M., Baxter, D. G., Dorris, C. S., & Vaska, M. (n.d.). GreyLitGuides.com: A revised resource for grey literature education and training. https://www.springshare.com/libguides/

Hong, Q. N., Pluye, P., Fabregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M. P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M. C., & Vedel, I. (2018). Mixed methods appraisal tool (MMAT), version 2018 user guide. Canadian Intellectual Property Office, Industry Canada. http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/fetch/127916259/MMAT_2018_criteriamanual_2018-08-01_ENG.pdf

Javidan, A. P., Hansen, K., Higginson, I., Jones, P., Lang, E., on behalf of the IFEM Task Force on Emergency Department Crowding and Access Block, Javidan, A., Hansen, K., Higginson, I., Jones, P., Petrie, D., Bonning, J., Judkins, S., Revue, E., Lewis, D., Holroyd, B., Mazurik, L., Graham, C., Carter, A., & Lee, S. (2021). The International Federation for Emergency Medicine report on emergency department crowding and access block: A brief summary. International Journal of Emergency Medicine, 14(1), 1–3. https://doi.org/10.1186/s12245-020-00312-x

Jennings, N., Clifford, S., Fox, A. R., O’Connell, J., & Gardner, G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International Journal of Nursing Studies, 52(1), 421–435. https://doi.org/10.1016/j.ijnurstu.2014.07.006

Kellermeyer, L., Harnke, B., & Knight, S. (2018). Covidence and Rayyan. Journal of the Medical Library Association, 106(4). https://doi.org/10.5195/jmla.2018.513

Keough, V. A., Tell, D., Andreoni, C., & Tanabe, P. (2016). Unique educational needs of emergency nurse practitioners. Advanced Emergency Nursing Journal, 38(4), 300–307. https://doi.org/10.1097/TME.0000000000000120

Li T., Higgins J. P. T., & Deeks J. J. (2022). Collecting data. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions. Cochrane. www.training.cochrane.org/handbook

Mahood, Q., van Eerd, D., & Irvin, E. (2014). Searching for grey literature for systematic reviews: Challenges and benefits. Research Synthesis Methods, 5(3), 221–234. https://doi.org/10.1002/jrsm.1106

McKenzie, J. E., & Brennan, S. E. (2022). Synthesizing and presenting findings using other methods. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions. Cochrane. www.training.cochrane.org/handbook

Meline, T. (2006). Selecting studies for systematic review: Inclusion and exclusion criteria. Contemporary Issues in Communication Science and Disorders, 33, 21–27. http://pubs.asha.org/36.255.113.214

Middleton, S., Gardner, G., Gardner, A., Considine, J., Fitzgerald, G., Christofis, L., Doubrovsky, A., Della, P., Fasugba, O., & D’Este, C. (2019). Are service and patient indicators different in the presence or absence of nurse practitioners? The EDPRAC cohort study of Australian emergency departments. BMJ Open, 9(7), 1–11. https://doi.org/10.1136/bmjopen-2018-024529

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., & PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1). https://doi.org/10.1186/2046-4053-4-1

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 372(71). http://doi.org/10.1136/bmj.n71

Pearce, S., Marchand, T., Shannon, T., Ganshorn, H., & Lang, E. (2023). Emergency department crowding: An overview of reviews describing measures causes, and harms. Internal and Emergency Medicine: Official Journal of the Italian Society of Internal Medicine, 18(4), 1137–1158. https://doi.org/10.1007/s11739-023-03239-2

Petrie, D. A., & Comber, S. (2020). Emergency department access and flow: Complex systems need complex approaches. Journal of Evaluation in Clinical Practice, 26(5), 1552–1558. https://doi.org/10.1111/jep.13418

Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L.A., & the PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ 349, 7647. http://doi.org/10.1136/bmj.g7647

Shand, W., Klemmer, D., Grubb, S., Chesney, S., Olsen, B., & So, L. (2020). Research to action: Nurse practitioners in the emergency department, emergency department transition clinic and intravenous therapy clinic at Strathcona community hospital. Canadian Journal of Emergency Nursing, 43(1), 23–27. https://doi.org/10.29173/cjen44

Systematic Reviews. (n. d.). CRD’s guidance for undertaking reviews in health care. Centre for Reviews and Dissemination. University of York, UK. https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf

Thabane, L., Thomas, T., Ye, C., & Paul, J. (2009). Posing the research question: Not so simple. Canadian Journal of Anesthesia, 56(1), 71–79. https://doi.org/10.1007/s12630-008-9007-4

Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology 8(45). https://doi.org/10.1186/1471-2288-8-45

Thomas. J., Kneale, D., McKenzie, J. E., Brennan, S. E., & Bhaumik, S. (2021). Determining the scope of the review and the questions it will address. In: J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). www.training.cochrane.org/handbook

Tricco, A. C., Tetzlaff, J., & Moher, D. (2011). The art and science of knowledge synthesis. Journal of Clinical Epidemiology, 64(1), 11–20. https://doi.org/10.1016/j.jclinepi.2009.11.007

Tucker, A., & Bernard, M. (2015). Making the case for nurse practitioners in the emergency department: A clinical case study. Advanced Emergency Nursing Journal, 37(4), 308–312. https://doi.org/10.1097/TME.0000000000000081

Van der Linden, M. C., Van Ufford, H. M. E., de Beaufort, R. A. Y., Grauss, R. W., Hofstee, H. M. A., Hoogendoorn, J. M., Meylaerts, S. A. G., Rijsman, R. M., de Rooij, T. P. W., Smith, C., de Voeght, F. J., Warffemius, O. J. G., van Woerden, G., & van der Linden, N. (2019). The impact of a multimodal intervention on emergency department crowding and patient flow. International Journal of Emergency Medicine, 12(21), 1–12. https://doi.org/10.1186/s12245-019-0238-7

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Publié-e

2024-04-18

Comment citer

Lartey, S. A., Douma, M., Kennedy, M., Cummings, G., Pooler, C., & Montgomery, C. (2024). The Impact of Nurse Practitioner Role in Emergency Departments: A Mixed Studies Systematic Review Protocol. Canadian Journal of Emergency Nursing, 47(1), 6–13. https://doi.org/10.29173/cjen225

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Peer Reviewed Articles