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A systematic review of experiences of advanced practice nursing in general practice

Citation

Jakimowicz, M and Williams, Danielle and Stankiewicz, G, A systematic review of experiences of advanced practice nursing in general practice, Bmc Nursing, 16 Article 6. ISSN 1472-6955 (2017) [Refereed Article]


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The Author(s). 2017 Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1186/s12912-016-0198-7

Abstract

Background: Despite efforts to achieve conceptual clarity, advanced practice nursing continues to reside in a liminal space, unable to secure ongoing recognition as a viable means of healthcare delivery. This is particularly evident in general practice where advanced practice role development is more fluid and generally less supported by the hierarchical structures evident in the hospital system. This review synthesises published qualitative studies reporting experiences of advanced practice nursing in general practice. The panoramic view provided by patients, nurses and doctors within this novel context, offers a fresh perspective on why advanced practice nurses have struggled to gain acceptance within the healthcare milieu.

Methods: We conducted a systematic review of qualitative studies that explored the experiences of patients, nurses and doctors who had contact with advanced practice nurses working in general practice. Published work from 1990 to June 2016 was located using CINAHL and PubMed. The full text of relevant studies was retrieved after reading the title and abstract. Critical appraisal was undertaken and the findings of included studies were analysed using the constant comparative method. Emergent codes were collapsed into sub-themes and themes.

Results: Twenty articles reporting the experiences of 486 participants were included. We identified one major theme: legitimacy; and three sub-themes: (1) establishing and maintaining confidence in the advanced practice nurse, (2) strengthening and weakening boundaries between general practitioners and advanced practice nurses and (3) establishing and maintaining the value of advanced practice nursing.

Conclusions: We set out to describe experiences of advanced practice nursing in general practice. We discovered that general practitioners and patients continue to have concerns around responsibility, trust and accountability. Additionally, advanced practice nurses struggle to negotiate and clarify scopes of practice while general practitioners have trouble justifying the costs associated with advanced practice nursing roles. Therefore, much work remains to establish and maintain the legitimacy of advanced practice nursing in general practice.

Item Details

Item Type:Refereed Article
Keywords:Advanced practice, General practice, Systematic review, Qualitative research
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Primary Health Care
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Nursing
Author:Jakimowicz, M (Mr Michael Jakimowicz)
Author:Williams, Danielle (Dr Danielle Williams)
Author:Stankiewicz, G (Dr Grace Stankiewicz)
ID Code:113812
Year Published:2017
Deposited By:Health Sciences
Deposited On:2017-01-23
Last Modified:2017-03-30
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