Humphreys Ann, Johnson Sarah, Richardson Janet, Stenhouse Elizabeth, Watkins Mary
School of Nursing and Community Studies, Faculty of Health and Social Work, University of Plymouth, Devon, England, UK.
J Clin Nurs. 2007 Oct;16(10):1792-808. doi: 10.1111/j.1365-2702.2007.01757.x.
This paper presents the findings of a systematic review and meta-synthesis, which was undertaken to identify and assess studies that evaluated the nurse/midwife/allied health professional consultant role.
As part of the modernization agenda in the National Health Service the United Kingdom government proposed 'Consultant' posts for nurses/midwives and allied health professionals as an opportunity for experienced practitioners to extend their roles. Four key functions were identified as being significant to this role development: expert practice, leadership, education and research. Explicit within the proposal was a requirement of these new roles to be evaluated.
Inclusion criteria focussed on studies where an aspect of the role had been evaluated or where the consultant carried out the research. A total of 1931 citations was filtered to reveal 107 studies that possibly met the inclusion criteria. Of these 107, 14 studies were critically appraised and subjected to thematic analysis. Study methodology varied but of the 14 studies, 10 involved some form of measurement. The others adopted a literature review or descriptive approach.
The extent to which consultants were involved in all aspects of the 'four pillars' was assessed in only a small number of studies. However, a number of studies implicitly implied active engagement in expert practice and leadership by focussing on specific service developments.
To date, a number of studies evaluating service developments, education, expert practice and leadership have been carried out. However although a number of studies have assessed perceived impact of the consultant role, no measure of actual benefit has been published to date. Studies that evaluate the cost benefit/outcomes of these roles in relation to both activity and quality of service are required.
本文介绍了一项系统评价和元综合分析的结果，该分析旨在识别和评估那些对护士/助产士/专职医疗专业顾问角色进行评估的研究。
作为英国国家医疗服务体系现代化议程的一部分，英国政府提议为护士/助产士和专职医疗专业人员设立“顾问”职位，为有经验的从业者提供拓展其角色的机会。确定了对这一角色发展具有重要意义的四项关键职能：专家实践、领导力、教育和研究。该提议中明确要求对这些新角色进行评估。
纳入标准聚焦于那些对该角色的某个方面进行了评估或顾问开展了相关研究的研究。总共筛选了1931条引文，以找出107项可能符合纳入标准的研究。在这107项研究中，对14项进行了严格评估并进行了主题分析。研究方法各不相同，但在这14项研究中，有10项涉及某种形式的测量。其他研究采用了文献综述或描述性方法。
只有少数研究评估了顾问在“四大支柱”各方面的参与程度。然而，一些研究通过关注特定的服务发展，隐含地暗示了在专家实践和领导力方面的积极参与。
迄今为止，已经开展了一些评估服务发展、教育、专家实践和领导力的研究。然而，尽管有一些研究评估了顾问角色的感知影响，但迄今为止尚未发表关于实际益处的衡量标准。需要开展研究来评估这些角色在活动和服务质量方面的成本效益/结果。
