A systematic review and meta‐synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants

Humphreys, Ann; Johnson, Sarah; Richardson, Janet; Stenhouse, Elizabeth; Watkins, Mary

doi:10.1111/j.1365-2702.2007.01757.x

Cited by 54 publications

(49 citation statements)

References 31 publications

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“…Taking into account the limitations of self-report, the consultant nurses reported that patients received a higher standard of care, care that better met their needs and better follow up care. This finding is supported by Humphreys et al (2007), who found in a meta-synthesis of 14 studies evaluating consultant roles that there were consistent findings of their impact on practice and service development.…”

Section: Patientssupporting

confidence: 79%

The impact of nursing innovations in the context of governance and incentives

Ross

Redfern

Harris³

et al. 2011

Journal of Research in Nursing

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This discursive paper is a structured analysis of four completed national and regional studies carried out in the UK. It sets out retrospectively to explore the impact of key contextual, professional and personal features and mechanisms on innovation and outcomes in nursing and the extent to which these are common or diverge across the studies (cases).As successive governments across the world turn their attention to developing nursing as a means of increasing productivity and effectiveness in health care, there is a need for evidence to inform workforce policy and planning about the circumstances that enable positive levers and mechanisms, which influence outcomes to operate. This analysis takes advantage of recent conceptual work on organisational governance and incentives by asking new questions of established data to illuminate our understanding of the pathway to innovation in nursing.Data from the four evaluations (cases) were aggregated and explored thematically within Davies et al.'s framework (Studying health care organisations -links between governance, incentives and outcomes: a review of the literature. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). Downloaded from 2005) of governance, incentives and outcomes. The themes were grouped into three categories: contextual, professional and personal, and interrogated by inter-researcher scrutiny.Taking account of the limitations of comparing studies carried out for different purposes and in different policy circumstances, there are compelling messages emerging about the organisational support, professional leadership and factors that motivate change and innovation in nursing. The analysis suggests that separating governance from incentives oversimplifies what is a complex interplay between organisational governance and the professional and personal enabling factors supporting innovation. The nature of these relationships deserves further study.

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Section: Patientssupporting

confidence: 79%

The impact of nursing innovations in the context of governance and incentives

Ross

Redfern

Harris³

et al. 2011

Journal of Research in Nursing

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“…I nternationally, a large number of studies have sought to examine the characteristics of advanced practice nursing, which, at the broadest level, refers to nursing practice characterized by use of a population-or setting-specific expert knowledge base, complex decision-making skills, and clinical competencies for expanded practice (Currey, Considine, & Khaw, 2011;Fairley & Closs, 2006;Horrocks, Anderson, & Salisbury, 2002;Humphreys, Johnson, Richardson, Stenhouse, & Watkins, 2007;International Council of Nurses, 2012;Jokiniemi, Pietilä, Kylmä, & Haatainen, 2012;Mantzoukas & Watkinson, 2007;Mullen, Gavin-Daley, Kilgannon, & Swift, 2011). The most common research method has been workforce surveys employing behavior and task description questionnaires, and in recent decades, many such surveys have been undertaken in various settings (Jokiniemi et al, 2012).…”

mentioning

confidence: 99%

Deriving Consensus on the Characteristics of Advanced Practice Nursing

Hutchinson

East²,

Stasa³

et al. 2014

Nursing Research

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“…Early and more recent studies of the establishment of the new nurse consultant posts suggested that factors such as supportive workplaces, realistic workloads and continuing education were important for the consultant nurses to perceived they were effective in their roles [22-25]. There have been no studies of effectiveness or cost effectiveness [23]. …”

Section: Introductionmentioning

confidence: 99%

Sustaining innovation in the health care workforce: A case study of community nurse consultant posts in England

Drennan

Goodman

2011

BMC Health Serv Res

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BackgroundRecruiting, retaining and meeting increasing demand for experienced, qualified nurses is an issue of concern for all health care systems. The UK has been creating clinical career structures for nurses that include innovative posts known as nurse consultants. While the numbers overall appear to have grown over the last eleven years, there is evidence that in some specialities and regions the numbers are decreasing. This paper considers the factors that sustain or curtail workforce innovations through the case example of a cohort of nurse consultants established in one community health service in England.MethodsA mixed method case study evaluation was undertaken over three years, using interviews, observations, documentary analysis and questionnaires. The final element of data collection was obtained three years later. Data was anonymised, analysed using a framework method and then integrated using a narrative synthesis.ResultsTen nurse consultant posts were created over a period of two years (2002-2004). Within two years only five posts remained and within five years (2009) only two part time posts, with the original appointees, remained. When the nurse consultants left their posts, these were not replaced. In exploring the interaction between the innovation (the nurse consultant posts), the adoptees (the senior staff in the organisation) and the context (the immediate service colleagues, the service organisation and commissioners as well as the broader NHS policy context) three key factors were identified as influential in the demise of the posts. These were: a) the extent to which there was support for individual nurses rather than the post, b) the extent to which there was an unambiguous and uncontested clinical service requirement for a nurse consultant and c) the extent to which finances for the post were judged as being used to best effect in a service setting.ConclusionsThis case study example demonstrates how tantalisingly close the nurse consultant initiative came to achieving a clinical career pathway for nurses in community services but more work was required to normalise clinician and managers' beliefs in the relevance and need for the role. Those looking to embed these types of nursing workforce innovations should pay due regard to these issues.

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A systematic review and meta‐synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants

Cited by 54 publications

References 31 publications

The impact of nursing innovations in the context of governance and incentives

The impact of nursing innovations in the context of governance and incentives

Deriving Consensus on the Characteristics of Advanced Practice Nursing

Sustaining innovation in the health care workforce: A case study of community nurse consultant posts in England

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