Bárcenas-Villegas Daniel, Cáceres-Matos Rocío, Vázquez-Santiago Soledad
Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Avenzoar, 6 Street, Seville 41009, Spain.
J Nurs Manag. 2025 Mar 19;2025:3332688. doi: 10.1155/jonm/3332688. eCollection 2025.
To analyze the existing evidence on the contribution of the nursing profession to efficiency and healthcare sustainability in the hospital setting. Promoting economic efficiency in hospital centers is a key factor in ensuring their long-term sustainability. In this regard, nursing professionals with caregiving roles could emerge as valuable contributors to the survival of the existing hospital model. A systematic review was conducted following PRISMA guidelines. This review has been registered with PROSPERO under the registration number: CRD42023481140. A search was conducted across four international databases (CINAHL, PubMed, Scopus, and WOS) from 2013 to the present for studies in English and Spanish. Primary studies on economic evaluations and systematic reviews were included. The study selection was carried out in three stages, with two reviewers independently analyzing the data and resolving disagreements through discussion and consensus. The quality assessment utilized the CASP tool, the CHEERS checklist, and the STROBE statement. Out of 3058 records identified, nine were deemed eligible, comprising one longitudinal study, four descriptive studies, two systematic reviews, two randomized controlled trials, one cohort study, and two case-control studies, with a total of 333,597 patients. The studies varied in sample size, intervention strategy, content, measurement scales, and statistical analysis of the primary outcome. The studies indicate that health education provided by hospitals is cost-effective, potentially generating costs below 100,000 dollars per quality-adjusted life year. Investing in nursing specialty, advanced practice nurses, and clinical safety reduces the number of admissions and decompensations. This review highlights that health education and clinical safety are the areas where nursing tasks have the most significant economic impact. Nursing specialty and the inclusion of advanced practice nurses are proving to be fields towards which health systems should focus to promote a more economically sustainable model.
分析护理专业对医院环境中效率和医疗保健可持续性贡献的现有证据。提高医院中心的经济效率是确保其长期可持续性的关键因素。在这方面，承担护理职责的专业护理人员可能成为现有医院模式生存的重要贡献者。按照PRISMA指南进行了系统评价。该评价已在PROSPERO注册，注册号为：CRD42023481140。在2013年至目前期间，对四个国际数据库（CINAHL、PubMed、Scopus和WOS）进行了检索，以查找英文和西班牙文的研究。纳入了关于经济评价的原始研究和系统评价。研究选择分三个阶段进行，由两名评审员独立分析数据，并通过讨论和协商解决分歧。质量评估采用了CASP工具、CHEERS清单和STROBE声明。在识别出的3058条记录中，有9条被认为符合要求，包括1项纵向研究、4项描述性研究、2项系统评价、2项随机对照试验、1项队列研究和2项病例对照研究，共有333597名患者。这些研究在样本量、干预策略、内容、测量量表以及主要结局的统计分析方面存在差异。研究表明，医院提供的健康教育具有成本效益，每质量调整生命年潜在产生的成本低于10万美元。投资于护理专业、高级实践护士和临床安全可减少入院人数和失代偿情况。本评价强调，健康教育和临床安全是护理任务具有最显著经济影响的领域。护理专业以及纳入高级实践护士正被证明是卫生系统应关注的领域，以促进更具经济可持续性的模式。
