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Intervention

Organisational Intervention: Revision of professional roles - nursing

Definition

The expansion of nursing roles to include new tasks

Effectiveness

Six high quality reviews (Buckley, Laurant, Lemmens, Patterson, Royal, Schadewaldt) were identified. Findings from one review (Laurant) show that the revision of professional roles (nurses substituting doctor care) is generally ineffective for improving appropriate care and prescribing behaviours. Five high quality reviews (Buckley, Lemmens, Patterson, Royal, Schadewaldt) had an insufficient number of studies to draw any conclusions about the effectiveness of the intervention.

Summary of Overall Findings from Reviews

14 reviews that evaluated the effectiveness of the revision of professional nursing roles were identified. Of these, 0/1 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

0/1 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Patterson SM, Hughes C, Kerse N, Cardwell CR, Bradley MC. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews 2012 5:CD008165. 9 (High)
Buckley BS, Byrne MC, Smith SM. Service organisation for the secondary prevention of ischaemic heart disease in primary care. Cochrane Database of Systematic Reviews 2010 3:CD006772. 8 (High)
Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database of Systematic Reviews 2005 2:CD001271. 8 (High)
Lemmens KMM, Nieboer AP, Huijsman R. A systematic review of integrated use of disease-management interventions in asthma and COPD. Respiratory Medicine 2009 103 (5):670-91. 8 (High)
Royal S, Smeaton L, Avery AJ, Hurwitz B, Sheikh A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Quality and Safety in Health Care 2006 15 (1):23-31. 8 (High)
Schadewaldt V, Schultz T. Nurse-led clinics as an effective service for cardiac patients: results from a systematic review. International Journal of Evidence-Based Healthcare 2011 9 (3):199-214. 8 (High)
Brown SA, Grimes DE. A meta-analysis of nurse practitioners and nurse midwives in primary care. Nursing Research 1995 44 (6):332-9. 7 (Medium)
French J, Bilton D, Campbell F. Nurse specialist care for bronchiectasis. Cochrane Database of Systematic Reviews 2003 1:CD004359. 7 (Medium)
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database of Systematic Reviews 2010 3:CD005182. 7 (Medium)
Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ 2002 324 (7341):819-23. 7 (Medium)
Clark CE, Smith LF, Taylor RS, Campbell JL. Nurse-led interventions used to improve control of high blood pressure in people with diabetes: a systematic review and meta-analysis. Diabetic Medicine 2011 28 (3):250-261. 6 (Medium)
Christensen A, Osterberg LG, Hansen EH. Electronic monitoring of patient adherence to oral antihypertensive medical treatment: a systematic review. Journal of Hypertension 2009 27 (8):1540-51. 5 (Medium)
Hodgkinson B, Koch S, Nay R, Nichols K. Strategies to reduce medication errors with reference to older adults. International Journal of Evidence-Based Healthcare 2006 4 (1):15008. 5
Summary Pending
Schlenk EA, Bernardo LM, Organist LA, Klem ML, Engberg S. Optimizing medication adherence in older patients: a systematic review. Journal of Clinical Outcomes Management 2008 15 (12):595-606. 5 (Medium)
Hagell P. Nursing and multidisciplinary interventions for Parkinson's disease: what is the evidence? Parkinsonism & Related Disorders 2009 13 (Suppl 3):S501-8. 4 (Medium)
Van Camp YP, Van RB, Elseviers MM. Nurse-led interventions to enhance adherence to chronic medication: systematic review and meta-analysis of randomised controlled trials. European Journal of Clinical Pharmacology 2013 69 (4):761-770. 4
Summary Pending
Barbui C, Girlanda F, Ay E, Cipriani A, Becker T, Koesters M. Implementation of treatment guidelines for specialist mental health care. Cochrane Database of Systematic Reviews 2014 1:CD009780. Summary Pending
Health QO. Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis. Ontario Health Technology Assessment Series 2013 13 (10):24108. Summary Pending
Mdege ND, Chindove S, Ali S. The effectiveness and cost implications of task-shifting in the delivery of antiretroviral therapy to HIV-infected patients: a systematic review. Health Policy & Planning 2013 28 (3):223-236. Summary Pending