Advanced practice nursing results in positive outcomes for elderly patients in long-term care settings

Morilla-Herrera JC, Garcia-Mayor S, Martin-Santos FJ, et al.  A systematic review of the effectiveness and roles of advanced practice nursing in older people  International Journal of Nursing Studies. 2015 October;69(10):2148-2168.

Review question

Is advanced practice nursing effective in improving care and health outcomes (e.g. functionality, mortality, quality of life, morbidity, satisfaction, adverse effects) for older patients in different settings?

Background

With the aging population, more individuals are likely to suffer from multiple and complex chronic diseases, and are more likely to have frequent hospital admissions, increased use of health services, and lack of personal autonomy.

Many of these older adults will require increasingly complex care, and advanced practice nursing which maximizes the use of specialized skills and nursing knowledge, can fill gaps in services traditionally carried out by physicians.

This review aims to develop a greater understanding of the scope and effectiveness of advanced practice nurses in delivering care for seniors.

How the review was done

A detailed search of several electronic databases for studies published from 1990 to 2014 was conducted. Studies that focused on any interventions provided by advanced practice nurses for patients over the age of 65 were included in the review.

A total of 2,692 studies were identified in searches, and 15 were included in the review after assessments for eligibility.

This review was funded by the Regional Health Ministry of Andalusia: PI-0703-2010.

What the researchers found

The review found that advanced practice nursing services generally benefited patients in two ways: through evidence-based interventions to care for specific diseases, and by providing care that increases patient autonomy.

In long-term care settings, advanced practice nursing services had positive results for outcomes including reduction of mortality, frequency of hospital admissions, improvement in patient self-management, and increased patient satisfaction.

Effectiveness of advanced practice nursing services in short-term care settings could not be conclusively determined due to a lack of literature.

Conclusion

Advanced practice nursing services have positive outcomes for older patient populations in long-term care settings. Evidence of effectiveness in short-term care settings is lacking, however, and results regarding improvement in quality of life are inconclusive. Further research should be focused on the cost-effectiveness of advanced practice nursing services.