Nurse Practitioner Role Research Articles

AHP SO09 - Introduction of Registered Advanced Nurse Practitioner into Upper Gastrointestinal Cancer Surgical Service

Abstract Background The author whom is a nurse, works in a large University teaching hospital with a mission to deliver best quality care to patients, where its nursing philosophy ensures continued and consistent commitment in the provision of holistic patient centred care to the highest possible standard. The introduction of the new Registered Advanced Nurse Practitioner (RANP) role within the Upper GI Surgical Department is part of the expansion of the Upper Gastrointestinal cancer service within the hospital. Method At the nurse-led cancer surveillance clinic the RANP is authorised to assess, review and initiate diagnostic interventions for a specific agreed cohort of patients with Upper GI cancer. Results An Upper GI RANP has recently been recruited into the Upper Gastrointestinal cancer surgical service in the hospital and commenced reviewing patients on 11.09.23. The overall aim of the post is to deliver an advanced level of clinical nursing practice within the field of gastrointestinal cancer with the quality improvement objective to enhance patient experience within the hospitals Upper GI cancer service. Conclusion Cancer survivorship begins at the time of diagnosis and continues until the end of life (DOH; 2017). Optimising these patients’ quality of life is now a primary focus of the Irish Healthcare system. Focus has now shifted to living well with, through and beyond a cancer diagnosis (DOH; 2017). The National Cancer Strategy 2017- 2026 (DOH;2017) has highlighted that there is significant scope and need to expand the number of ANP’s in our cancer services particularly to run nurse-led clinics for follow-up and survivorship. This new ANP role within the Upper GI service will seek to address this need.

Decreased mortality in patients with fragility fracture of a fracture liaison service coordinated by Chile's first nurse practitioner.

Fragility fractures have significant sequelae, including pain, loss of mobility, and increased risk of mortality. Fracture liaison services (FLS) represent a coordinated, interdisciplinary approach to secondary prevention and reduce mortality. To investigate the effectiveness and patient outcomes regarding readmission and mortality of a newly developed, nurse practitioner (NP) coordinated FLS in Chile. Retrospective longitudinal analysis of 214 patients who agreed to participate in a FLS was conducted. Variables studied include patient age, gender, anatomical fracture site, dual x-ray absorptiometry scans, medication, readmission information, and mortality. Demographics and clinical data were collected and analyzed with bivariate and multivariate statistics. Kaplan-Meier curves and log-rank tests were performed to compare survival curves between those who did and did not participate in the FLS. The study sample was predominantly female (85%) with a mean age of 76 (SD: 12; range 41-101) years. The most frequently noted fracture sites were hip (n = 167), wrist (n = 132), and spine (n = 72). At one-year follow-up, the FLS group had a significantly lower mortality (5%, 10 patients) than those who did not participate in the program (12% [N = 50], p = .005). The Kaplan-Meier analysis indicated that patients who participated in the FLS had significantly better survival rates than those who did not participate. Significantly improved survival rates were observed in FLS patients. Chile's first FLS demonstrated improved patient outcomes, specifically a reduced mortality in patients who were enrolled in the FLS. The NP role was fundamental in the screening, diagnosis, and treatment of patients with osteoporosis.

Secondhand Smoke Exposure in Pediatric Patients: What Is the Nurse Practitioner's Role?

Secondhand Smoke Exposure in Pediatric Patients: What Is the Nurse Practitioner's Role?

Nurse Practitioners' Experiences of Transitioning to and Working in the Pioneering Nursing Role: An Interview Study.

Nurse practitioners (NPs) play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare and reduced hospital admissions and cost-effectiveness. They usually hold a master's degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals. To explore how nurses who are or have been employed as NPs describe their experiences of transitioning to and working in the NP role in Sweden. A qualitative interview study. This study explores the experiences of 15 NPs in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews in April and May 2022 and analysed with inductive content analysis. The present study explores the experiences of NPs as they transition from experienced nurses to NPs, emphasising motivations, educational challenges, acceptance and autonomy. Transitioning into the NP role initially brought isolation that evolved into acceptance. They recognised their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescription rights and dependency on physicians, underscored the need for a protected professional title and national guidelines. This study enriches the evolution of the NP role in Sweden, offering vital insights into the ongoing national-level dialogues on NP role development in Sweden. The paper's relevance extends globally by providing valuable perspectives on NPs practicalities and fostering international understanding and advancement. Standards for reporting qualitative research. Not applicable.

The Role of Neonatal Nurse Practitioners in the Implementation of a Bedside Point-of-Care Ultrasound Program.

Point-of-care ultrasound (POCUS) in the neonatal intensive care unit (NICU) is becoming increasingly utilized, with the focus of training aimed at physicians. However, the role of neonatal nurse practitioners (NNPs) in the development of POCUS programs is not well described. To describe the NNP role in the implementation of a NICU POCUS program and exemplify the potential to expand the professional scope and educational advancement of NNPs. In 2018, a multidisciplinary team assembled to develop a POCUS program in the NICU at Lucile Packard Children's Hospital (LPCH). Three NNPs received formal POCUS training in order to provide onsite training, perform and supervise POCUS imaging, and participate in quality assurance sessions. NNPs also assisted with the development of a REDCap database and imaging protocols. The LPCH POCUS NNP providers contributed to the advancement of the profession by practicing to the full scope of their role, providing leadership in program development, research, and education. Incorporating NNPs into the programmatic structure of a POCUS program can be a model for others. With advancing skill set, NNPs can be positioned to be national leaders and educators. NICUs developing POCUS programs can benefit from the integration of NNPs to serve as consistent content experts to expand the number of trained providers while assuring the quality of image capture. POCUS is becoming increasingly essential to the care of newborns. NNPs can play a central role in performing POCUS, participating in quality improvement and research, and educating other NICU providers.

Defining the urology nurse practitioner in Australia and New Zealand: A Delphi study.

Nurse practitioners with roles in specialty environments face challenges including uncertain role expectations and achieve urology expertise with on-the-job training, mentoring, and independent study. This creates a wide variety of preparation and role descriptions. This study employed Delphi methodology to identify essential components of the urology nurse practitioner (NP) role in Australia and New Zealand, representing an inaugural description of the role. This Delphi study was completed in two rounds. Participants were a nonrandom panel of experts with experience as a full-time urology NP. A definition for the urology NP in Australia and New Zealand is proposed: "The urology nurse practitioner uses critical thinking, complex decision-making, clinical reasoning, advanced assessment skills and clinical expertise, offering acute and chronic care to individuals needing urologic health care, including office-based urology procedures as appropriate. This care is provided in an environment of autonomous practice, with a basis of graduate education and relevant specialty clinical experience, and this practice can extend across health care settings and serve as a model to the wider NP profession." Outpatient urology procedures were ranked highly and deemed integral to the Urology NP role. This may reflect the declining number of urologists and efforts to maintain urology access for local populations. Professional roles of the NP were given less weight by participants. The project offers a contemporary definition of the urology NP role that can be offered to educators and other stakeholders as the role continues to evolve in Australia and New Zealand.

The Role, Contribution and Impact of Independent Nurse Prescribers and Advanced Nurse Practitioners to the Children's Hospice Workforce

The care needs of babies, children and young people who use children's hospices have changed over the last decade, with children living for longer, with more complexity. Children's hospice workforces have evolved to continue to meet these needs, including a growth in the number of nurses working at specialist and advanced levels, particularly prescribing. A 15-question survey was sent to all 54 UK children's hospices, which aimed to explore the impact of independent nurse prescribing, and specialist and advanced level nursing practice in UK children's hospices. Forty-one organisations responded, representing 76% of UK children's hospices. Increased autonomy and the ability to respond to the dynamic needs of families, and enabling family choice was recognised and valued by prescribers. Challenges included the breadth of needs of children with life-limiting conditions, and the use of medicines that are either unlicenced or used off-licence. Access to clinical supervision and continuing professional development were highlighted as enablers of prescribing practice.

What are the attitudes and perceptions of general practitioners about the role of nurse practitioners in the community care setting: A scoping review

BackgroundThe Nurse Practitioner role in Australia is slowly expanding, with a well-established body of evidence supporting their introduction. Yet, there is a lack of consistent support from the medical profession for this role. Nurse Practitioners wishing to work in the community setting may, therefore, experience resistance from General Practitioners. ObjectiveTo identify and explore the attitudes and perceptions of Australian General Practitioners about Nurse Practitioners' community settings. To explore what is the view of GPs outside of Australia on this topic. MethodA scoping review of the Cochrane, MEDLINE, Psych INFO, and CINHAL databases was undertaken from 1995 to April 2023 and reported using PRISMA. Quality evaluation tools devised by Dixon-Woods et al. (2005) and previously used by Paterson et al. (2015) were used to evaluate the included studies. A narrative synthesis was then undertaken using the method described by Whittemore and Knafl (2005). FindingsThe scoping review identified 1623 potential publications. After a comparison of the title and abstract to the inclusion and exclusion criteria, 20 publications underwent an in-depth review, eight publications met the inclusion criteria for a full review. The review did not identify a publication from Australia. Elsewhere the attitudes of General Practitioners were influenced by the lack of definition of the Nurse Practitioner role, a lack of knowledge of the Nurse Practitioner skill level, fear of service duplication, deterioration in patient relationships, who had responsibility for the role and funding for the role. ConclusionThere is a lack of evidence in an Australian context to determine if General Practitioners in Australia have similar views to their international counterparts. Careful planning needs to be undertaken to overcome potential issues and to enable the Nurse Practitioner role to be effectively implemented in an Australian community setting.

Enhancing Hepatitis C Care in Primary Care: A Nurse Practitioner–Led Intervention

This quality improvement (QI) project at a Federally Qualified Health Center explores enhancing hepatitis C (HCV) treatment in primary care settings. It focuses on nurse practitioner (NP)-led interventions to improve sustained viral response (SVR) rates among high-risk groups. The project, conducted from June 2021 to January 2023, identified challenges in treatment uptake and continuity, emphasizing the role of NPs in bridging care gaps. Innovative approaches, including simplified treatment algorithms and integrated behavioral health services, were implemented. The project highlights the potential of primary care settings in managing HCV, aligning with the World Health Organization’s goal of eliminating HCV by 2030.

Improving the evaluation of novice advanced practice nurse transition.

Novice advanced practice registered nurses (RNs) experience decreased self-confidence, anxiety, and identity confusion in their first year of practice, which leads to poor job satisfaction and turnover. Advanced practice RN fellowship programs, developed to bridge the gap from the RN to the advanced practice role, lack standardized measures for program evaluation. A large Midwestern pediatric hospital's advanced practice nurse fellowship program lacks a structured program evaluation. A quasi-experimental evidence-based improvement project was implemented to evaluate fellowship program outcomes for novice nurse practitioner transition and retention. All novice advanced practice RNs (APRNs) were enrolled in the site's 12-month APRN fellowship program. The transition experiences of enrollees who completed the fellowship program were assessed using the novice nurse practitioner role transition scale. In addition, role transition scores were compared for two subgroups: fellows in acute care and fellows in primary care roles. Fellowship participant retention 1 year after hire was measured. Postintervention data showed that most fellowship graduates had a positive transition experience as evidenced by at least a 4.33/6.0 mean total novice nurse practitioner role transition score. There was not a statistically significant difference between the transition scores of the acute care fellows and primary care fellows. The APRN fellowship program was effective in promoting a successful role transition from RN to novice APRN. Similar APRN fellowship programs may benefit from using this tool for program evaluation.

The Evolution of the Emergency Nurse Practitioner Role: A Historical Review.

The history of emergency nurse practitioners (ENPs) is one of evolution and adaptation in response to changing healthcare demands. The role of nurse practitioners (NPs) in emergency departments (EDs) has undergone significant evolution since the 1970s. This historical narrative traces the historical development of ENPs, focusing on their roles, training, and impact on patient care. It explores early experimental programs, academic training, and the increasing integration of NPs into emergency care settings.

Co‐Designing Nurse Practitioner Roles in a Tertiary Hospital: A Qualitative Exploration of Patterns and Underlying Dynamics

ABSTRACTAimsTo explore patterns and dynamics during the co‐design process of nurse practitioners' role development in three departments in a Belgian tertiary hospital.DesignParticipatory action research was utilised in conjunction with principles of a Grounded Theory approach to explore patterns and dynamics.MethodsSixteen meetings were conducted between January and June 2021 with interdisciplinary teams to develop the roles. Thirteen exploratory interviews were held with the stakeholders involved between March and June 2022. All meetings and interviews were recorded and transcribed verbatim. Data were systematically analysed using researcher triangulation and thematic analysis.ResultsStakeholders' initial conception of the nurse practitioner roles affected development. A dynamic interplay of individual, team‐related and contextual (e.g., financial and legal) factors shaped these conceptions. Through co‐design, stakeholders' conception evolved as insights were shared, misconceptions challenged and perspectives broadened. Physicians generally the developmental process, while nursing leadership was more fragmented.ConclusionThis study identifies patterns and dynamics in interdisciplinary teams during the developmental process. The key findings underpin the crucial role of stakeholders' conceptions, use of co‐design and leadership in this process. Therefore, a thorough understanding of initial conceptions is ess, and efforts should be directed towards providing sufficient knowledge and experience to prevent misconceptions. Additionally, this study emphasises the significance of a balanced team composition that incorporates diverse conceptions of the role. Finally, actions should be taken to empower leadership among nurses.ImpactIdentified dynamics offer insights for healthcare organisations developing nurse practitioner roles. Educational institutions can use these insights to enhance healthcare professionals' curricula, preparing healthcare professionals for evolving advanced nursing roles and leadership. Additionally, it emphasises the necessity for policy work to establish a legal framework for nurse practitioners in Belgium.Reporting MethodThe ‘Standards for Reporting Qualitative Research’ were used for reporting.Patient or Public ContributionThis study did not involve direct participation from patients or the public.

Assessment of nurse practitioners’ capacity of using the ABC/2 formula for intracranial lesion volume measurement

BackgroundThis study investigates the precision of nurse practitioners (NPs) in measuring intracranial lesion volumes using the ABC/2 method, a simple yet widely used technique in neurosurgical practices. Amidst physician workforce shortages, the role of NPs in clinical practice, including specialized tasks like lesion volume estimation, is gaining importance.MethodsWe conducted a retrospective study involving patients treated for intracranial meningiomas. NPs estimated tumor volumes using the ABC/2 method, which was then compared with automated ABC/2 estimations considered as the gold standard. Statistical analyses, including paired sample t-tests, Bland-Altman analysis, and Intraclass Correlation Coefficient (ICC) analysis, were employed to assess measurement accuracy and consistency.ResultsAmong the 265 meningioma patients included, NPs measured the average tumor volume as 36.95 ml, generally underestimating it compared to the 39.57 ml average obtained by the automated ABC/2 method. This underestimation, however, was clinically modest, indicated by an average percentage difference of 6.59% and a Cohen’s d value of 0.08. Consistency in measurements, assessed using Bland-Altman and ICC analyses, demonstrated a high level of agreement between NPs measurements and the automated method. Additionally, no significant differences in measurement accuracy were observed either among different NPs or across NPs with varying levels of work experience.ConclusionsNurse practitioners can effectively employ the ABC/2 method for estimating intracranial lesion volumes with reasonable accuracy and consistency, irrespective of their work experience. This finding is pivotal in enhancing the role of NPs in neurosurgical practices and could be significant in alleviating the strain caused by the global shortage of physicians. Future research may explore extending NPs’ roles in other clinical diagnostic and therapeutic tasks.

Experiences of Patients With Heart Failure With Providers in Saudi Arabia

This study explores the experiences of patients with heart failure with providers in Saudi Arabia. Most participants were men (64.8%) and 45 to 74 years old (68%). The overall mean score of patient experience was 82.81 ± 18.46, with the highest domain being the overall rating of providers at 89.36 ± 19.42. Nurse practitioners were rated higher than physicians across both sites and within each site. The difference in the ratings between nurse practitioners across the 2 sites was not significant. The study findings highlight the importance of adopting the nurse practitioner role in integrated patient-centered health care teams.

Exploring a pilot alcohol and other drug (AOD) nurse practitioner mentoring program: Empirical research mixed methods: A pilot nurse practitioner mentoring program.

To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). Mixed method evaluation. Two-phase evaluation comprising survey (demographics, pre- and post-program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self-reported clinical improvements are noted. Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. What problem did the study address? The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings? Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact? The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. Good Reporting of a Mixed Methods Study (GRAMMS) checklist. No patient or public contribution.

Enhancing orthopedic care: The impact of introducing nurse practitioners

IntroductionOrthopedic surgery constitutes a significant portion of surgical interventions globally, driven by aging populations (Spence et al., 2019). Nurse practitioners (NPs) have emerged as essential team members in orthopedic surgery, offering expertise and advanced training. PurposeThis paper describes a practice development initiative that saw the integration of NPs to the orthopedic team to provide postoperative care to patients undergoing hip and knee arthroplasty procedures. MethodsAggregate data was collected from electronic health records and from online surveys. ResultsUsing descriptive and inferential statistics our data analysis revealed significant improvements post-NP implementation. Monthly surgeries increased by 41.6%, indicating enhanced access to care. The average length of stay decreased statistically for both hip and knee surgeries (p < 0.001), resulting in substantial cost savings and streamlined resource utilization. The readmission rate post-discharge also decreased by 41.6%, reflecting improved continuity of care facilitated by NPs. Surveys among healthcare staff demonstrated positive feedback regarding NP integration, highlighting improved accessibility, bed utilization, and timely treatment of medical issues. ConclusionThis study underscores the multifaceted benefits of NP integration in orthopedic care, including enhanced patient outcomes, improved healthcare efficiency, and positive impacts on the healthcare team dynamics. Continued investment in NP programs in orthopedic settings is crucial for further optimizing care delivery and patient outcomes. Advocating for the expansion of the NP role in orthopedic surgery will contribute to elevating the standard of care in this specialty.

Exploring nurse practitioners’ collaboration with general practitioners in Norwegian homecare services: a qualitative study

Objective Nurse practitioners (NPs) have recently been introduced in Norwegian homecare services. The NP role is still in an early implementation phase without standardized role descriptions. NPs are dependent on collaborating with general practitioners (GPs) in the care and treatment of patients. However, little is known about how NPs in Norway experience this collaboration. This study aims to explore how NPs working in homecare services describe their collaborative experiences with GPs, and what influence this collaboration. Design The study had a qualitative descriptive design, applying individual, semi structured interviews to generate data from five Norwegian nurse practitioners working in homecare services. Data were analyzed using systematic text condensation. Findings The NPs had varied experiences regarding the collaboration with GPs. NPs stated their role as unclear, lacking standards and job descriptions. The NPs experienced that some GPs were uncertain about the NPs competence, which inhibited collaboration and restricted the NPs utilization of their full capability. NPs experienced a higher degree of collaboration with GPs they knew, and they indicated that trust was the key to facilitate collaboration. The NPs also noted the challenges of establishing relationships with GPs due to the lack of formal meetings and the physical separation of their workplaces. Conclusion Interpersonal dynamics, organizational structures and systemic frameworks influenced the collaboration between GPs and NPs in homecare services. Trust was identified as an important prerequisite for collaboration.

Advanced practice providers: An evolution of scope of practice and clinical integration across the surgical healthcare landscape

Advanced practice providers (APPs) have become an integral part of surgical practice over the past 50 years. Understanding the clinical roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) provides insight into practice norms, collaborative opportunities, the nuances of APP independent practice trends, billing practices, and current practice challenges.Exploring the history, education, and current practice environment of APPs allows a sophisticated understanding of their roles in the inpatient/facility and outpatient/office settings. This article explores the impact of APPs on access to care, and their role across the overall healthcare landscape in the United States particularly as government and healthcare continue to intersect.The aim of this work is to provide the reader with a nuanced understanding of the factors influencing the current practice of APPs working in surgical fields in the United States and to foster an authentic appreciation of the existing complexities of APPs practicing in the field of surgery in the context of the current evolving national healthcare landscape.

Patient perspectives on the role of orthopedic nurse practitioners: a cross-sectional study

BackgroundThe inclusion of nurse practitioners (NPs) specializing in orthopedics shows potential for improving the quality of care for orthopedic patients. A critical aspect of assessing the feasibility and acceptance of introducing NPs into orthopedic settings involves understanding patients’ perspectives on this role. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic Nurse Practitioners (NPs). Additionally, it investigates potential associations between patients’ willingness to engage with NPs, their familiarity with the NPs role, perceptions of nursing, and satisfaction with orthopedic nursing care.MethodsThis cross-sectional study involved patients admitted to an orthopedic department in a central Israeli hospital between January and February 2023. Data was collected using a questionnaire consisting of five sections, validated by content experts. Statistical analyses, performed using SPSS, included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression.ResultsOrthopedic patient participants demonstrated a moderate willingness to undergo treatment by orthopedic NPs, with over two-thirds expressing strong openness. Patients displayed a high willingness for NPs to engage in various clinical tasks, albeit showing lesser enthusiasm for medication management and preoperative evaluation. Positive attitudes towards nurses and familiarity with the NP’s role emerged as significant predictors of patient receptiveness to NPs’ treatment.ConclusionPatient acceptance of orthopedic NPs varies across different aspects of care. While there is overall willingness to receive care from NPs, these nuanced preferences should be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions play crucial roles in shaping patients’ willingness to receive care from these NPs.Trial registrationThe research doesn’t report the results of a health care intervention.

Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

Background/ObjectiveInitially established to improve access to healthcare, particularly for primary care, the full potential of the nurse practitioner role is yet to be realised in most countries. Despite this, most countries are working to meet an ageing population’s increasing healthcare needs and reduce healthcare costs and access disparities. Achieving these outcomes requires reform at multiple levels, including nurse practitioner practice pathways, education and regulation, and identifying the barriers and facilitators to optimising their primary care role.MethodsA rapid scoping review of nurse practitioner practice pathways, education and regulation inclusive of: (1) a systematic search of Medline and CINAHL for peer-reviewed English language articles, including opinion pieces published between January 2015 and February 2022; and (2) a web-based search of nurse practitioner program entry requirements of International Nurse Regulator Collaborative country members with a protected nurse practitioner title and prescribing rights, plus the Netherlands. The individually summarised search data was integrated and synthesised using Popay’s narrative approach.ResultsEmerging evidence from the included nurse practitioner courses (n = 86) and articles (n = 79) suggests nurse practitioners working in primary care provide safe, effective care and improve healthcare efficiencies. However, different regulatory and educational models are required if the primary care nurse practitioner is to meet growing demand.ConclusionsInternational variations in entry criteria, curriculum, and regulation shape the global profile of the nurse practitioner primary care workforce and their practice setting. For countries to grow their primary care nurse practitioner workforce to meet unmet needs, different entry requirements, program content and accredited post-registration transitional programs must be urgently considered.