Advanced practice nurses' evidence-based healthcare competence and associated factors: A systematic review.
advanced practice nurse
competence
evidence-based healthcare
evidence-based practice
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
27 Feb 2024
27 Feb 2024
Historique:
revised:
21
12
2023
received:
28
10
2023
accepted:
05
02
2024
medline:
28
2
2024
pubmed:
28
2
2024
entrez:
27
2
2024
Statut:
aheadofprint
Résumé
Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC. To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors. A systematic review. CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar. Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis. The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies. The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs. We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice. The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist. None.
Sections du résumé
BACKGROUND
BACKGROUND
Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC.
AIM
OBJECTIVE
To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors.
DESIGN
METHODS
A systematic review.
DATA SOURCES
METHODS
CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar.
METHODS
METHODS
Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis.
RESULTS
RESULTS
The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies.
CONCLUSION
CONCLUSIONS
The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs.
IMPLICATIONS FOR THE PROFESSION
UNASSIGNED
We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice.
REGISTRATION, AND REPORTING CHECKLIST
UNASSIGNED
The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist.
PATIENT/PUBLIC CONTRIBUTION
UNASSIGNED
None.
Types de publication
Journal Article
Review
Langues
eng
Informations de copyright
© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
Références
Alshammari, M. S., Alshurtan, R., Alsuliman, G., Alshammari, M., Alhamazani, H., Alshammry, S., Dayrit, R. D., & Alkwiese, M. (2021). Factors affecting the implementation and barriers to evidence-based practice among nurse practitioners in Hail region, Saudi Arabia. Nurse Media Journal of Nursing, 11(2), 187-196. https://doi.org/10.14710/nmjn.v11i2.38329
Anderson, L. W., Krathwohl, D. R., & Bloom, B. S. (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.
Aromataris, E., & Munn, Z. (2020). Chapter 1: JBI systematic reviews. In E. Aromataris & Z. Munn (Eds.), JBI manual for evidence synthesis. JBI. https://synthesismanual.jbi.global
Bhatarasakoon, P., Hanucharurnkul, S., Panpakdee, O., Sritanyaratana, W., Junprasert, S., & Pothimas, N. (2022). Use of evidence-based among advanced practice nurses in Thailand: A multisetting, cross-sectional study. Journal for Nurses Practitioners, 18(5), 529-533. https://doi.org/10.1016/j.nurpra.2022.02.008
Butler, K. D. (2011). Nurse practitioners and evidence-based nursing practice. Clinical Scholars Review, 4(1), 53-57. https://doi.org/10.1891/1939-2095.4.1.53
Campbell, T. D. (2012). Clinical nurse Specialists' role in promoting evidence based practice in Saskatchewan's health care settings. Dissertation in Faculty of Nursing. University of Alberta. https://doi.org/10.7939/R34W7Q
Casey, M., Cooney, A., O'Connell, R., Hegarty, J.-M., Brady, A. M., O'Reilly, P., Kennedy, C., Heffernan, E., Fealy, G., McNamara, M., & O'Connor, L. (2017). Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence. Journal of Advanced Nursing, 73(3), 653-664. https://doi.org/10.1111/jan.13171
De, W. J., Brazil, K., Passmore, P., Buchanan, H., Maxwell, D., McIlfactrick, S. J., Morgan, S. M., Watson, M., & Parsons, C. (2017). Nurses' experiences of pain management for people with advanced dementia approaching the end of life: A qualitative study. Journal of Clinical Nursing, 26(9), 1234-1244. https://doi.org/10.1111/jocn.13442
Donald, F., Martin-Misener, R., Carter, N., Donald, E. E., Kaasalainen, S., Wickson-Griffiths, A., Lloyd, M., Akhtar-Danesh, N., & DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long-term care. Journal of Advanced Nursing, 69(10), 2148-2161. https://doi.org/10.1111/jan.12140
Dowling, M., Beauchesne, M., Farrelly, F., & Murphy, K. (2013). Advanced practice nursing: A concept analysis. International Journal of Nursing Practice, 19(2), 131-140. https://doi.org/10.1111/ijn.12050
Feldacker, C., Jacob, S., Chung, M. H., Nartker, A., & Kim, H. N. (2017). Experiences and perceptions of online continuing professional development among clinicians in sub-Saharan Africa. Human Resources for Health, 15, 89. https://doi.org/10.1186/s12960-017-0266-4
Furuki, H., Sonoda, N., & Morimoto, A. (2023). Factors related to the knowledge and skills of evidence-based practice among nurses worldwide: A scoping review. Worldviews on Evidence-Based Nursing, 20(1), 16-26. https://doi.org/10.1111/wvn.12623
Gerrish, K., Guillame, L., Kirshbaum, M., McDonnell, A., Tod, A., & Nolan, M. (2011). Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: Findings from a cross-sectional survey. Journal of Advanced Nursing, 67(5), 1079-1090. https://doi.org/10.1111/j.1365-2648.2010.05560.x
Hamilton, K. E., Jones, S. J., & Gardner, C. L. (2022). Factors affecting nurse practitioners' integration of evidence into practice. Journal of the American Association of Nurse Practitioners, 34, 275-283. https://doi.org/10.1097/JXX.0000000000000615
Harper, M. G., Gallagher-Ford, L., Warren, J. I., Troseth, M., Sinnott, L. T., & Thomas, B. K. (2017). Evidence-based practice and U.S. healthcare outcomes: Findings from a National Survey with nursing professional development practitioners. Journal of Nurses in Professional Development, 33(4), 170-179. https://doi.org/10.1097/NND.0000000000000360
Hellier, S., & Cline, T. (2016). Factors that affect nurse practitioners' implementation of evidence-based practice. Journal of the American Association of Nurse Practitioners, 28(11), 612-621. https://doi.org/10.1002/2327-6924.12394
Holloway, K., Arcus, K., & Orsborn, G. (2018). Training needs analysis-The essential first step for continuing professional development design. Nurse Education in Practice, 28, 7-12. https://doi.org/10.1016/j.nepr.2017.09.001
Immonen, K., Tuomikoski, A.-M., Kääriäinen, M., Oikarinen, A., Holopainen, A., Kuivila, H., Männistö, M., Mikkonen, K., Mattila, O., Vesterinen, S., Päätalo, K., Koivunen, K., Ylimäki, S., & Mikkonen, K. (2022). Evidence-based healthcare competence of social and healthcare educators: A systematic review of mixed methods. Nurse Education Today, 106, 105190. https://doi.org/10.1016/j.nedt.2021.105190
Janson, A. L., Opheim, R., & Hellesø, R. (2023). Advanced practice nurse education in its infancy: An exploratory study of Norwegian higher education institutions' program descriptions. Scandinavian Journal of Educational Research, 1-13. https://doi.org/10.1080/00313831.2023.2185810
Jean, S. C., & Briana, L. W. (2019). The clinical nurse educator role: A snapshot in time. The Journal of Continuing Education in Nursing, 50(5), 228-232. https://doi.org/10.3928/00220124-20190416-09
Jokiniemi, K., Suurtala, A., Meretoja, R., Kotila, J., Flinkman, M., Heikkinen, K., & Fageström, L. (2020). Evidence-informed policymaking: Modelling nurses' career pathway from registered nurse to advanced practice nurse. International Journal of Nursing Practice, 26(1), e1-e11. https://doi.org/10.1111/ijn.12777
Jordan, Z., Lockwood, C., Munn, Z., & Aromataris, E. (2019). The updated Joanna Briggs institute model of evidence-based healthcare. International Journal of Evidence-Based Healthcare, 17(1), 58-71. https://doi.org/10.1097/XEB.0000000000000155
Koivunen, K., Kaakinen, P., Mattila, O., Oikarinen, A., Jansson, M., Mikkonen, K., Pölkki, T., Meriläinen, M., Kääriäinen, M., Holopainen, A., Tuomikoski, A.-M., & Kanste, O. (2023). Frontline nurse leaders' competence in evidence-based healthcare: A scoping review. Journal of Advanced Nursing, 2023, 1-21. https://doi.org/10.1111/jan.15920
Maier, C. B., Aiken, L. H., & Busse, R. (2017). Nurses in advanced roles in primary care: Policy levers for implementation. OECD health working papers, No. 98. OECD Publishing. https://doi.org/10.1787/a8756593-en
Malik, G., McKenna, L., & Plummer, V. (2015). Perceived knowledge, skills, attitude and contextual factors affecting evidence-based practice among nurse educators, clinical coaches and nurse specialists. International Journal of Nursing Practice, 21(2), 46-57. https://doi.org/10.1111/ijn.12366
Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. https://doi.org/10.1111/wvn.12021
Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Ta'n, A. (2018). The first U.S. study on Nurses' evidence-based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence-Based Nursing, 15(1), 16-25. https://doi.org/10.1111/wvn.12269
Moola, S., Munn, Z., Tufanaru, C., Aromataris, E., Sears, K., Sfetcu, R., Currie, M., Qureshi, R., Mattis, P., Lisy, K. M., & Mu, P. F. (2020). Chapter 7: Systematic reviews of etiology and risk. In E. Aromataris & Z. Munn (Eds.), JBI manual for evidence synthesis. JBI. https://synthesismanual.jbi.global.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Molrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Journal of Clinical Epidemiology, 134, 178-189. https://doi.org/10.1016/j.jclinepi.2021.03.001
Profetto-McGrath, J., Negrin, K. A., Hugo, K., & Smith, K. B. (2010). Clinical nurse specialists' approaches in selecting and using evidence to improve practice. Worldviews on Evidence-Based Nursing, 7(1), 36-50. https://doi.org/10.1111/j.1741-6787.2009.00164.x
Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., Roussel, J., & Stewart, D. (2020). Guidelines on advanced practice nursing 2020. International Council of Nurses report. International Council of Nurses. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf
Smith, S. A. (2012). Nurse competence: A concept analysis. International Journal of Nursing Knowledge, 23(3), 172-182. https://doi.org/10.1111/j.2047-3095.2012.01225.x
Van Roper, S. (2011). Evidence based practice among primary care nurse practitioners. Dissertation in Faculty of the College of Nursing. The University of Arizona. https://hdl.handle.net/10150/217049
Wilkinson, S., & Hayward, R. (2017). Band 5 nurses' perceptions and experiences of professional development. Nursing Management-UK, 24(2), 30-37. https://doi.org/10.7748/nm.2017.e1537
Woo, B. F. Y., Zhou, W., Toon, W., & Tam, W. W. S. (2019). Practice patterns and role perception of advanced practice nurses: A nationwide cross-sectional study. Journal of Nursing Management, 27(5), 992-1004. https://doi.org/10.1111/jonm.12759