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A systematic review of experiences of advanced practice nursing in general practice


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Jakimowicz, M ORCID: 0000-0002-3122-4176, Williams, DM ORCID: 0000-0002-5697-1848 and Stankiewicz, G ORCID: 0000-0003-1545-9466 2017 , 'A systematic review of experiences of advanced practice nursing in general practice' , Bmc Nursing, vol. 16 , pp. 1-12 , doi: 10.1186/s12912-016-0198-7.

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Background: Despite efforts to achieve conceptual clarity, advanced practice nursing continues to reside in aliminal space, unable to secure ongoing recognition as a viable means of healthcare delivery. This is particularlyevident in general practice where advanced practice role development is more fluid and generally less supportedby the hierarchical structures evident in the hospital system. This review synthesises published qualitative studiesreporting experiences of advanced practice nursing in general practice. The panoramic view provided by patients,nurses and doctors within this novel context, offers a fresh perspective on why advanced practice nurses havestruggled to gain acceptance within the healthcare milieu.Methods: We conducted a systematic review of qualitative studies that explored the experiences of patients,nurses and doctors who had contact with advanced practice nurses working in general practice. Published workfrom 1990 to June 2016 was located using CINAHL and PubMed. The full text of relevant studies was retrieved afterreading the title and abstract. Critical appraisal was undertaken and the findings of included studies were analysedusing the constant comparative method. Emergent codes were collapsed into sub-themes and themes.Results: Twenty articles reporting the experiences of 486 participants were included. We identified one majortheme: legitimacy; and three sub-themes: (1) establishing and maintaining confidence in the advanced practicenurse, (2) strengthening and weakening boundaries between general practitioners and advanced practice nursesand (3) establishing and maintaining the value of advanced practice nursing.Conclusions: We set out to describe experiences of advanced practice nursing in general practice. We discovered thatgeneral practitioners and patients continue to have concerns around responsibility, trust and accountability. Additionally,advanced practice nurses struggle to negotiate and clarify scopes of practice while general practitioners have troublejustifying the costs associated with advanced practice nursing roles. Therefore, much work remains to establish andmaintain the legitimacy of advanced practice nursing in general practice.

Item Type: Article
Authors/Creators:Jakimowicz, M and Williams, DM and Stankiewicz, G
Keywords: Advanced practice, General practice, Systematic review, Qualitative research
Journal or Publication Title: Bmc Nursing
Publisher: BioMed Central Ltd.
ISSN: 1472-6955
DOI / ID Number: 10.1186/s12912-016-0198-7
Copyright Information:

© The Author(s). 2017 Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

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