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Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis
INTRODUCTION: To realise universal health coverage in an ageing society, adequate provision of appropriately trained human resources is essential. The nurse practitioner (NP) is an autonomous and independent, advanced practice nurse capable of providing treatment and care that can be substituted for...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480018/ https://www.ncbi.nlm.nih.gov/pubmed/26105030 http://dx.doi.org/10.1136/bmjopen-2014-006670 |
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author | Kanda, Mikiko Ota, Erika Fukuda, Hiromi Miyauchi, Shinji Gilmour, Stuart Kono, Yuko Nakagama, Erika Murashima, Sachiyo Shibuya, Kenji |
author_facet | Kanda, Mikiko Ota, Erika Fukuda, Hiromi Miyauchi, Shinji Gilmour, Stuart Kono, Yuko Nakagama, Erika Murashima, Sachiyo Shibuya, Kenji |
author_sort | Kanda, Mikiko |
collection | PubMed |
description | INTRODUCTION: To realise universal health coverage in an ageing society, adequate provision of appropriately trained human resources is essential. The nurse practitioner (NP) is an autonomous and independent, advanced practice nurse capable of providing treatment and care that can be substituted for some aspects of a medical doctor's (MD's) role, especially in a community setting. Previous systematic reviews found higher levels of patient satisfaction with services provided by NPs than those provided by MDs. As non-communicable diseases become a major health burden requiring long-term healthcare in community settings, this systematic review aims to assess the equivalence of NP services to standard care provided by MDs, and to determine whether their practice is an effective alternative to that of MDs in community settings. METHODS AND ANALYSIS: Relevant randomised controlled trials (RCTs) and cluster RCTs will be searched in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and the British Nursing Index. We will assess patient and health system utilisation outcomes of interventions comparing treatment and care provided by NPs in community settings with that provided by MDs. Two authors will independently screen studies for inclusion, consulting with a third author where necessary to resolve discrepancies. The risk of bias of included studies will be assessed using the Cochrane Collaboration risk of bias tool, and quality of evidence using the GRADE approach. Meta-analysis of included studies will be conducted using fixed-effect or random-effects models depending on the degree of between-study heterogeneity. Results will be presented using risk ratios with 95% CI for dichotomous outcomes and standardised mean differences with 95% CI for continuous outcomes. ETHICS AND DISSEMINATION: This systematic review and meta-analysis protocol does not require ethical approval. We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: PROSPEROCRD42014009627. |
format | Online Article Text |
id | pubmed-4480018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-44800182015-07-02 Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis Kanda, Mikiko Ota, Erika Fukuda, Hiromi Miyauchi, Shinji Gilmour, Stuart Kono, Yuko Nakagama, Erika Murashima, Sachiyo Shibuya, Kenji BMJ Open Health Services Research INTRODUCTION: To realise universal health coverage in an ageing society, adequate provision of appropriately trained human resources is essential. The nurse practitioner (NP) is an autonomous and independent, advanced practice nurse capable of providing treatment and care that can be substituted for some aspects of a medical doctor's (MD's) role, especially in a community setting. Previous systematic reviews found higher levels of patient satisfaction with services provided by NPs than those provided by MDs. As non-communicable diseases become a major health burden requiring long-term healthcare in community settings, this systematic review aims to assess the equivalence of NP services to standard care provided by MDs, and to determine whether their practice is an effective alternative to that of MDs in community settings. METHODS AND ANALYSIS: Relevant randomised controlled trials (RCTs) and cluster RCTs will be searched in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and the British Nursing Index. We will assess patient and health system utilisation outcomes of interventions comparing treatment and care provided by NPs in community settings with that provided by MDs. Two authors will independently screen studies for inclusion, consulting with a third author where necessary to resolve discrepancies. The risk of bias of included studies will be assessed using the Cochrane Collaboration risk of bias tool, and quality of evidence using the GRADE approach. Meta-analysis of included studies will be conducted using fixed-effect or random-effects models depending on the degree of between-study heterogeneity. Results will be presented using risk ratios with 95% CI for dichotomous outcomes and standardised mean differences with 95% CI for continuous outcomes. ETHICS AND DISSEMINATION: This systematic review and meta-analysis protocol does not require ethical approval. We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: PROSPEROCRD42014009627. BMJ Publishing Group 2015-06-23 /pmc/articles/PMC4480018/ /pubmed/26105030 http://dx.doi.org/10.1136/bmjopen-2014-006670 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Health Services Research Kanda, Mikiko Ota, Erika Fukuda, Hiromi Miyauchi, Shinji Gilmour, Stuart Kono, Yuko Nakagama, Erika Murashima, Sachiyo Shibuya, Kenji Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title | Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title_full | Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title_fullStr | Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title_full_unstemmed | Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title_short | Effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
title_sort | effectiveness of community-based health services by nurse practitioners: protocol for a systematic review and meta-analysis |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480018/ https://www.ncbi.nlm.nih.gov/pubmed/26105030 http://dx.doi.org/10.1136/bmjopen-2014-006670 |
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