Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada.
J Adv Nurs. 2013 Oct;69(10):2148-61. doi: 10.1111/jan.12140. Epub 2013 Mar 25.
To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long-term care residential settings.
Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted.
Quantitative systematic review.
Twelve electronic databases were searched (1966-2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group.
Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria.
Four prospective studies conducted in the USA and reported in 15 papers were included. Long-term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services.
Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff.
报告高级实践护理角色、临床护理专家和执业护师在满足长期护理居住环境中老年人医疗保健需求方面的有效性的定量证据。
尽管已经研究了在这种环境中高级执业护士的有效性，但尚未对该证据进行系统审查。
定量系统评价。
检索了 12 个电子数据库（1966-2010 年）；联系了该领域的领导者；并搜索了个人档案、参考文献、相关期刊和网站，以寻找具有对照组的前瞻性研究。
使用 Cochrane 有效实践和护理组织审查组风险偏倚评估标准的修改版本，对符合纳入标准的研究进行质量评估。
纳入了四项在美国进行的前瞻性研究，并在 15 篇论文中报告。有高级执业护士的长期护理机构的抑郁、尿失禁、压疮、约束使用和攻击性行为发生率较低；更多的居民在满足个人目标方面有所改善；家属对医疗服务的满意度更高。
高级执业护士与长期护理环境中老年人的健康状况和行为以及家庭满意度的几个衡量标准的改善有关。需要进一步探索高级执业护士对卫生服务使用、居民对护理和生活质量的满意度以及卫生保健人员的技能、护理质量和工作满意度的影响。
