Fluid role boundaries: exploring the contribution of the advanced nurse practitioner to multi‐professional palliative care

Abstract

The advanced nurse practitioner roles were regarded as providing a unique contribution to service delivery and were characterised by fluid role boundaries which crossed the traditional disciplinary boundaries between nursing and medicine.

Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis

“…The included articles presented research that had been performed in the United States (n = 8), 39,45,[50][51][52][53][54][55] the United Kingdom (n = 3), 41,42,47 Sweden (n = 2), 37,43 Belgium (n = 1), 40 Canada (n = 1), 36 China (n = 1), 44 Brazil (n = 1), 48 Netherlands (n = 1), 46 Colombia (n = 1), 56 and two in multiple countries (n = 2) 38,49 between 2001 and 2018. A quantitative design was applied in seven of these studies, 38,40,49,[50][51][52]54 while nine studies employed a qualitative design.…”

“…A quantitative design was applied in seven of these studies, 38,40,49,[50][51][52]54 while nine studies employed a qualitative design. 36,37,41,42,44,46,47,53,55 Finally, two studies used the Delphi design 43,48 while three studies had a mixed-methods design. 39,45,56 The sample sizes in the included studies ranged from 2 to 2275 participants.…”

“…41,44 Another study included nurses, stakeholders, patients and family members. 42 The studies were performed in various healthcare settings, namely hospices, 47,55,56 hospital wards, 40,[44][45][46] home care, 36,37,48 acute care environments 38,39,54 and nursing homes. 49 The included studies investigated nursing competencies in palliative care through different perspectives.…”

“…For example, one study aimed to describe which competencies are relevant to the nurse-patient relationship in palliative care or when palliative care specialist nurses share knowledge with other nurses. 36,37,44 Competencies were also studied in relation to the professional role of advanced nurse practitioners, for example, some of the identified studies explored the clinical competencies of nurses working in palliative care multidisciplinary teams, 42 psychiatric nurses, 50 and expert or specialist palliative care nurses. 41,53 Competencies related to a specific condition or interventions (e.g., kidney disease, advance directives or sedation) 38,43,46,56 were also studied, as well as competencies related to providing care to patients from different cultures.…”

Advanced practice for children and young people: A systematic review with narrative summary

“…However, frequent attempts to compare nurses versus medics as appose to scrutinizing the unique contribution nurses make has fuelled concerns roles may be viewed as a substitution, (Nelson et al, ; Rolfe, ; Rushforth, ). Contemporary evidence is shifting from this approach, establishing the value add of roles such as promoting health literacy, leading practice initiatives and supporting staff development, (Donald et al, ; Gerrish et al, ; Kennedy et al, ; Morilla‐Herrera, Garcia‐Mayor, & Martin‐Santos, et al, ; Tsiachristas, Wallenburg, & Bond, et al, ). Two of the included studies offered a glimpse of this potential.…”