Effectiveness of nurse‐led clinics on healthcare delivery: An umbrella review

Abstract

Background Healthcare provision remains challenging leading to a focus on health service redesign including the development of nurse‐led clinics. While there is a belief that nurse‐led services positively impact on healthcare delivery, it is necessary to inform development through examination of the evidence. Methods A search was conducted of Cumulative Index of Nursing and Allied Health Literature, MEDLINE, EMBASE, Scopus and the Cochrane Library for systematic reviews evaluating the effectiveness of nurse‐led clinics when compared with usual care published between 2015 and 2020. Outcomes of interest were clinical outcomes, patient satisfaction and patient access to health care. Study quality was appraised using the AMSTAR 2 tool (A MeaSurement tool to Assess Systematic Reviews). A narrative analysis was conducted. Results From 681 identified studies, nine were included, with reporting quality rated from very low to high quality. Patient clinical outcomes were reported as equal to or better than usual care across all studies included. There was evidence of high levels of patient satisfaction with nurse‐led clinics across the included systematic reviews. While access to health care was the least reported variable, there were reports that access to health care increased or patient reliance on other healthcare providers reduced due to nurse‐led clinics. Conclusions Despite the heterogeneous nature of the systematic reviews, along with some quality issues in reporting, there was evidence that nurse‐led services provided comparable or superior care to usual care with high levels of patient satisfaction. There was a lack of reporting on the impact of nurse‐led clinics on patient access to health care; further research is required on this area. Health service managers should consider nurse‐led clinics an effective innovation in health service provision.

Outcomes of Patient Education in Nurse-led Clinics: A Systematic Review

“…8 Despite growing evidence supporting the value of patient education in NLCs, no comprehensive synthesis of the evidence has been conducted. A previous review of NLCs revealed on health care delivery, 9 care of cancer patients 10 and early discharge, 11 and the overall evidence about outcomes of patient education in NLCs is limited. This review aimed to exploring the outcomes of patient education in NLCs based on NOC.…”

Nurses leading male lower urinary tract symptom (LUTS) clinics: A scoping review

“…Depending on local service, the nurse‐led clinics may be led by a clinical nurse specialist (CNS) working autonomously or in a supportive role alongside the consultant urologist. It is well documented that nurse‐led services within other specialities are beneficial to the patient, are patient‐centred and improve outcomes 5,6 . A recently published guide addressed the benefit of ‘one‐stop’ clinics within urology services and the benefit of a CNS carrying out investigations, giving time to the patient to discuss results and ensuring the patient understands the information provided 7 .…”

“…It is well documented that nurse-led services within other specialities are beneficial to the patient, are patient-centred and improve outcomes. 5,6 A recently published guide addressed the benefit of 'one-stop' clinics within urology services and the benefit of a CNS carrying out investigations, giving time to the patient to discuss results and ensuring the patient understands the information provided. 7 This scoping review aims to understand the role of the nurse within a male LUTS clinic and identify any barriers and enablers to the nurses' role in leading a male LUTS clinic.…”

Increasing Medicare Annual Wellness Visit Utilization

“…17,19,21,22 Studies demonstrate that RN-led models of care in the management of chronic disease yield considerable improvements in outcomes, including hypertension, diabetes, and hyperlipidemia, 23,24 and generate higher patient satisfaction than the usual standard of care. [25][26][27][28][29] Findings from a recent retrospective chart review showed that using a dedicated RN improved office visit, time, and access. 30 RN-led AWVs are associated with increased adherence to screening for colon cancer, breast cancer, hepatitis C virus, bone density, and depression, as well influenza and pneumococcal vaccination.…”

“…Studies demonstrate that RN-led models of care in the management of chronic disease yield considerable improvements in outcomes, including hypertension, diabetes, and hyperlipidemia, 23,24 and generate higher patient satisfaction than the usual standard of care 25-29 . Findings from a recent retrospective chart review showed that using a dedicated RN improved office visit, time, and access 30 .…”