Part one: Restoring patients to health—Outcomes and indicators of advanced nursing practice in adult critical care

Abstract

The key characteristics of advanced nursing practice have been a subject of international debate over the past decade. To address this debate, a grounded theory study was undertaken by one of the authors which sought to identify the key characteristics of advanced nursing practice in adult critical care. The outcome of the main study was a theory of legitimate influence in which enhancing patient stay and improving patient outcome represented the dual purpose of advanced nursing practice in critical care. Fundamental to these factors is strategic activity. This encompasses improving patient care, facilitating continuity of care and engaging in patient education. The outcome of these strategic activities can be evaluated through evidence of eased transition across complex hospital networks, patient satisfaction and enabling of independence. The findings reflect a change in the focus and delivery of care to the critically ill and their relatives by nurses practising at an advanced level. In the second paper of this series, the intervening conditions that affect the expression of legitimate influence will be discussed.

An ethnographic study exploring the role of ward‐based Advanced Nurse Practitioners in an acute medical setting

“…The diversity and implementation of advanced nursing practice roles has developed globally over the last decade, often in response to localized initiatives based on revised doctor/nurse skill mix (Ball & Cox 2003, Bryant‐Lukosius et al. 2004, Buchan & Calman 2005, Gardner et al.…”

Deriving Consensus on the Characteristics of Advanced Practice Nursing

“…In part, this has stemmed from extensive and ongoing international debate that has sought to differentiate the various classifications of advanced practice (Ball & Cox, 2003;Chang et al, 2012). In part, this has stemmed from extensive and ongoing international debate that has sought to differentiate the various classifications of advanced practice (Ball & Cox, 2003;Chang et al, 2012).…”

A systematic review of evidence on the professional practice of the nurse and developing and sustaining a healthy work environment in healthcare

“…. updating the patient’s care very frequently so that they don’t have long periods of time where nothing happens to them 41 Finding 10: The aim of collaboration between nurses and medical staff is to improve patient outcomes.…”

“…[E] Finding 10: The aim of collaboration between nurses and medical staff is to improve patient outcomes. Illustration 10: It was apparent that boundaries were usually crossed with the aim of improving patient care, not to make up a shortfall in medical presence 41 Finding 11: A key component of advanced practice nursing is effective listening.…”

“…. being able to care for the patient from start to finish – having someone come in with a specific complaint, addressing their issues, solving the puzzle so to speak, and moving them on to a better place 41 Finding 14: Advanced nurses who develop a strategic plan for patient care can assist in improving health outcomes.…”