What is the impact of professional nursing on patients’ outcomes globally? An overview of research evidence

Abstract

There is evidence that adequate numbers of well-educated nurses working in acute care areas can reduce the risk of patient mortality, although the evidence for this is confined to studies in high income countries and the evidence is not sufficiently robust to draw up definitive nurse: patient ratios. There is also moderate evidence that well trained nurses can produce health outcomes that are equivalent to those of doctors for patients with a range of chronic health problems, particularly for those patients managed in primary care, and that nurse-led care may be more effective than medical care in promoting patient adherence to treatment and patient satisfaction. There is low to moderate evidence for the benefits of parenting support programmes delivered by nurses on a range of health outcomes; and for the impact of home visiting on improving function and other health service outcomes for older people. The wider societal benefits of home visiting by nurses and the impact of this on long term outcomes and related cost-effectiveness of home visiting has not been established. There is limited available information regarding the wider global impact of increasing the numbers of nurses and their contribution to healthcare through improved education. Moreover there is very little evidence for the cost-effectiveness of changing care providers from doctors to nurses and as the majority of cost data available has tended to come from studies based in higher income countries, their external validity in terms of applicability to settings in low and middle income countries is questionable. In addition to effectiveness, cost and safety, future research needs to address how implementing expanded nursing roles and task shifting impacts on the morale, retention, and professional development of nurses and the other workforces, and the longer term implications of these developments both locally and internationally.

Perceptions, attitudes, and expectation of baccalaureate nurses toward position of nursing in Bosnia and Herzegovina

“…13 Retention of baccalaureate nurses decreases the risk of patient mortality, while expended nursing role in the management of noncommunicable diseases significantly impacts adherence to treatment, patient outcomes, and patient satisfaction. 14 Role ambiguity, gaps between the real and ideal, unmet payment incentives, or failed expectations to undertake more responsibilities after graduation in the process of care are the sources of frustration for many baccalaureate nurses and reasons for nurse turnover. 15,16 Analyzing the factors that influence these attitudes and perceptions could create an opportunity for reform-related job restructuring and the encouragement need for change to occur.…”

“…In addition to fair and just career advancement, valuing of nurse's role within the health care system is associated with retention of nurses and intent to leave . Retention of baccalaureate nurses decreases the risk of patient mortality, while expended nursing role in the management of noncommunicable diseases significantly impacts adherence to treatment, patient outcomes, and patient satisfaction . Role ambiguity, gaps between the real and ideal, unmet payment incentives, or failed expectations to undertake more responsibilities after graduation in the process of care are the sources of frustration for many baccalaureate nurses and reasons for nurse turnover …”

Registered nurses' perceptions towards advanced practice nursing: A nationwide cross‐sectional study

“…Since the inception of advanced nursing practice, the role has been implemented across various health care settings and medical specialities. International studies have reported the positive impacts that advanced nursing practice implementations made to patient outcomes and health care access (Coster, Watkins, & Norman, ; Woo, Lee, & Tam, ).…”

Practice patterns and role perception of advanced practice nurses: A nationwide cross‐sectional study

“…Of late, much research has been underway examining the impacts of APNs across different settings. International studies have demonstrated positive impacts contributed by APN utilisation to patient outcomes (Coster, Watkins, & Norman, 2018). APN-led primary-care services have been reported to be comparable to those by physicians in terms of safety and effectiveness (Swan, Ferguson, Chang, Larson, & Smaldone, 2015).…”