The Impact of Nurse Practitioner Role in Emergency Departments
A Mixed Studies Systematic Review Protocol
DOI :
https://doi.org/10.29173/cjen225Mots-clés :
Nursing, Nurse Practitioner, Emergency Department, Patient Care, Systematic ReviewRésumé
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
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
Téléchargements
Publié-e
Comment citer
Numéro
Rubrique
Licence
© Sarah A. Lartey, Matthew J. Douma, Megan Kennedy, Greta G. Cummings, Charlotte Pooler, Carmel L. Montgomery 2024
Cette œuvre est sous licence Creative Commons Attribution 4.0 International.
The Canadian Journal of Emergency Nursing is published Open Access under a Creative Commons CC-BY 4.0 license. Authors retain full copyright.
