Abstract
The objective of this study is to describe the impact of the Advanced Practice Nurse role on the clinical practice and patient benefit, as well as to provide reasons for its implementation and expansion in Spain. Through the scoping review method, this study has been carried out according to five thematic blocks: life quality, cost-effectiveness, health results, satisfaction, and accessibility. The critical appraisal was performed with the Critical Appraisal Skills Programme (CASP) tool and the level of evidence and strength of recommendation have been analysed following the Oxford Centre for Evidence-Based Medicine (OCEBM) system. The results show that it is possible to formally implement advanced practice nursing in the Spanish context. The analysis of the Spanish regulatory framework reveals that the generalisation of the Case Manager Nurse is the starting point for the development of advanced practice nursing in Spain. This implementation would have a positive impact on patients in terms of health results, satisfaction, and life quality, given that the advanced practice nurse performs a more effective follow-up of chronic patients with a better control of risk factors, symptoms and health outcomes, and an earlier detection of complications. Considering these results, regional governments should promote the role of the Advanced Practice Nurse to contribute to its expansion.
Highlights
The International Council of Nurses defines the Advanced Practice Nurse (APN) as “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” [1].A master’s degree is recommended for entry level, so the APN has educational preparation at an advanced level, formal recognition of educational programmes training nurse practitioners/advanced practice nurses that are accredited or approved, and a formal system of regulation, accreditation, registration, certification, and credentialing
Considering all the above, the objective of this study is to describe the impact of APN in clinical practice and patient benefit, to provide evidence that serves as an argument for its implementation and expansion in Spain, the role of the nurse case manager in Primary Care
The results showed a meaningful decrease of the emergency service demand after the creation of an APN clinic in Primary Care (PC), no significant differences in workload were found for family physicians [22]
Summary
The International Council of Nurses defines the Advanced Practice Nurse (APN) as “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” [1].A master’s degree is recommended for entry level, so the APN has educational preparation at an advanced level, formal recognition of educational programmes training nurse practitioners/advanced practice nurses that are accredited or approved, and a formal system of regulation, accreditation, registration, certification, and credentialing. The International Council of Nurses defines the Advanced Practice Nurse (APN) as “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” [1]. This term replaced the previous “specialisation” and was defined for four different nursing fields of action: midwife, nurse anaesthetist, clinical nurse specialist, and nurse practitioner [6]. The two first professional roles related to the APN in the United States emerged in response to different needs. The Clinical Nurse Specialist met the increasing population’s demands and the need for nurse managers to have someone to help them train their staff in quality of care. It stands out as a formula for more cost-effective organisational systems that guarantee the access to quick, coordinated, and qualified services for all users [7]
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