Department of Intensive Care, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
Department of Neurology, Copenhagen University Hospital Rigshospitalet Glostrup, Denmark.
Nurse Educ Pract. 2021 Jul;54:103142. doi: 10.1016/j.nepr.2021.103142. Epub 2021 Jul 5.
Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy.
We performed a scoping review including papers published in 1992-2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin).
Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search.
The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking.
This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. Task-shifting from physician to nurse needs to be more clearly defined and patient outcomes described. Given the scarcity of papers in our target area, we believe it might be too early to conduct a systematic review at this time.
由于人口老龄化、合并症和复杂性的增加，危重症患者的管理正在发生变化。为了适应这些变化，对高级实践护士的需求不断增加。需要更多了解欧洲国家高级实践重症监护护士的角色。本研究的目的是回顾描述欧洲高级实践重症护理护士所需技能和能力的文献，并调查相关政策。
我们进行了范围界定审查，包括 1992 年至 2019 年期间发表的针对政策和高级实践护理（实践水平）、重症监护护理（专业领域）和欧洲（地理来源）交叉点的论文。
主要证据来源是 PubMed、EMBASE、PsycINFO、CINAHL、Cochrane 图书馆、SweMed+、Scopus、ERIC 和社会科学引文索引。我们还搜索了灰色文献、网页、参考文献，并进行了手工搜索。
搜索确定了 11478 篇论文/参考文献，其中 42 篇被纳入。确定了四个实践水平，界限不明确：专业护士、专业护士、高级实践护士和高级重症护理从业者（护士或其他）。文献中描述的大多数技能和能力都是高级实践的通用技能，只有少数是重症护理的特定技能。由于缺乏教育、支持性政策和立法，高级实践重症护理护士往往无法履行其职责。
本范围界定审查为决策者和 INACTIC 研究提供了欧洲重症护理中现有高级实践的信息。重症护理中的高级角色在政策、教育、职称、角色、实践范围、技能和能力方面不一致。实践水平和专业领域需要澄清。确定的大多数技能和能力都是高级实践护理的通用技能，许多都是任何专业的通用技能。从医生到护士的任务转移需要更明确的定义，并描述患者的结果。鉴于我们目标领域的论文稀缺，我们认为目前可能还为时过早，无法进行系统评价。
