Abstract
Background: The role and contribution of advanced nurse practitioners (ANP) has been well researched and found to be of great value for improving quality patient care and enhancing patient outcomes through education and health promotion. However, the role and the contribution of the ANP to gastroenterology nursing have not been evaluated either nationally or internationally. A review to determine the role and contribution of the ANP in gastroenterology nursing will inform on the contribution of the role and whether the role makes a difference to patient outcomes and cost effectiveness of patient care. Objective: This review aims to investigate the nursing role and contribution of the advanced nurse practitioner in gastroenterology. Furthermore, improved understanding of the underlying causal mechanisms explaining how the ANP role in gastroenterology nursing works, will provide a deeper understanding of how, why, for whom and in what contexts the role and contribution of the ANP to gastroenterology nursing are most successful. Methods: A realist review will consolidate evidence on how, when why and where the ANP role in gastroenterology works or fails through identifying programme theories underlying to the role’s introduction. The following steps will be operationalised; locating existing theories, searching the literature, documenting literature selection, engaging in data extraction and synthesis and refining programme theory. As an iterative approach, review cycles will uncover explanatory and contingent theories through context-mechanism-outcome configurations (CMOCc). Due to the variation in context and mechanisms, different outcomes will be likely across different clinical settings although similar patterns may be identified. Conclusions: Due to the theory-oriented approach of realist reviews, the pragmatic consequences of the review, will lend itself to deeper understanding of how the role and contribution of the ANP in gastroenterology nursing works in practice.
Highlights
The role of the advanced nurse practitioners (ANP) in gastroenterology nursing embodied an alternative model of care to meet global health needs coupled with the demand to circumvent costly health care
Review aims To conduct a realist review that involves a synthesis of the international literature, that will generate programme theories to determine an understanding of the role and contribution of the ANP in gastroenterology
The ANP in gastroenterology nursing facilitates comprehensive care access within a complex healthcare system influenced by aging populations, chronic illnesses and increased gastrointestinal cancer prevalence
Summary
The role of the ANP in gastroenterology nursing embodied an alternative model of care to meet global health needs coupled with the demand to circumvent costly health care. In the case of the ANP in gastroenterology nursing, protocol-driven activities and supervision by the gastroenterology physician is advancing task shifting to role expansion The latter involves the transfer of previous specific task-oriented technical skill sets from medical staff to an ANP. Other RCTs centered on the effectiveness of gastroenterology ANPs through determining the frequency of missed polyps (Schoenfeld et al, 1999), and the impact and diagnosis associated with caecal intubation and complication rates (Dwarakanath et al, 2004) These authors outlined that well-trained ANPs in gastroenterology perform colonoscopy safely with noticed improvements in throughput and waiting times of patients treated by the ANP and found no statistically significant difference in clinical effectiveness for diagnostic endoscopy between doctors and ANPs (Dwarakanath et al, 2004). A very recent evaluation of the nurse endoscopist role in Australia concluded that a nurse endoscopist model of care is a safe and acceptable model to introduce (Cusack et al, 2018)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
