School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.
J Adv Nurs. 2020 Jan;76(1):135-146. doi: 10.1111/jan.14243. Epub 2019 Nov 8.
To critically appraise and synthesise the current evidence related to the advanced practice nurse (APN) in the children and young people's healthcare setting.
A complex landscape of demand and change has influenced the healthcare delivery for children and young people. In the United Kingdom and internationally, governments have endorsed the need for workforce innovation with APN roles introduced to counter these challenges. However, little is known about the impact of these initiatives in the context of children and young people's health care.
Systematic review and narrative summary.
CINAHL, MEDLINE, DARE, PubMed, Prospero and Cochrane Database of Systematic Reviews were searched for studies published in English language from July 1998 to 2018. Studies were selected based on key search terms and eligibility criteria.
The selected studies were appraised using the Effective Public Health Practice Project for quantitative studies. An adapted version of the JBI data extraction tool for experimental/observational studies was used to extract the relevant key findings. This was conducted independently by two researchers.
Nine studies were included in the review. The review demonstrated roles were comparable in their clinical practice to medics yet offered higher levels of patient satisfaction, role modelling for staff and led practice initiatives to improve health literacy.
This review demonstrates that APN roles in children and young people's health care provide clinical, organizational and professional benefits, with added value to organizations and patients, acting as role models and educators.
The findings from this review indicate further research is required to ascertain contextual issues that may influence the implementation of APNs. This research will impact APNs working with children and young people. Equally, it supports the evidence base for service commissioners outlining areas for future research.
批判性评价和综合当前与儿童和青少年保健环境中的高级实践护士（APN）相关的证据。
需求和变化的复杂格局影响了儿童和青少年的医疗保健服务。在英国和国际上，政府都认可需要创新劳动力，引入 APN 角色以应对这些挑战。然而，对于这些举措在儿童和青少年健康护理中的影响知之甚少。
系统评价和叙述性总结。
CINAHL、MEDLINE、DARE、PubMed、Prospéro 和 Cochrane 系统评价数据库，从 1998 年 7 月至 2018 年 7 月，以英文发表的研究为基础进行了搜索。研究是根据关键搜索词和资格标准选择的。
使用有效公共卫生实践项目对定量研究进行评估。使用实验/观察性研究的 JBI 数据提取工具的改编版本提取相关的关键发现。这是由两名研究人员独立进行的。
综述纳入了 9 项研究。综述表明，这些角色在临床实践中与医生相当，但能提供更高水平的患者满意度、为员工树立榜样，并开展实践举措以提高健康素养。
该综述表明，儿童和青少年保健中的 APN 角色提供了临床、组织和专业效益，为组织和患者带来了附加价值，作为榜样和教育者。
本综述的结果表明，需要进一步研究以确定可能影响 APN 实施的背景问题。这项研究将影响与儿童和青少年一起工作的 APN。同样，它支持服务专员的证据基础，为未来的研究确定了领域。
