Effectiveness of advanced practice nursing interventions in older people: protocol for a systematic review and qualitative study.
OBJECTIVE
This protocol outlines a review and qualitative study to determine the models and effectiveness of Advanced Practice Nursing developed for the health care of people over 65 years in different settings (hospital care, home care, outpatients' care, and nursing homes) and to identify the ingredients of the interventions developed by Advanced Practice Nursing in the field of geriatric care.


BACKGROUND
Numbers of nurses in advanced roles have increased internationally in conjunction with research to determine their effectiveness. Nevertheless, in older people, evidence of advanced practice roles remains scattered, and there is little synthesis of evidence, and therefore it is not easy to visualize the different practice models, their components, and their impact.


METHODS
Study protocol with two phases: a systematic review and a qualitative study.


METHODS
First phase: Depending on comparability of studies, meta-analysis will be undertaken. If so, results will be summarized in relative and absolute measures or mean difference, depending on the type of outcome. Sensitivity and heterogeneity analyses will be performed. Second phase: a content analysis will be carried out of the interventions identified in the systematic review, and they will be contrasted with the contents of the Nursing Interventions Classification. Finally, this matching will be submitted to expert consensus using a Delphi technique. Approval from the Ethics Committee was obtained in July 2010 and funding was obtained in March 2011.


CONCLUSIONS
The identification of components of Advanced Practice Nursing models and evidence of their effectiveness will contribute to designing more grounded nursing services for older people. Additionally, the categorization of Advanced Practice Nursing interventions through Nursing Interventions Classification would permit comparisons to be made between settings or between healthcare systems.
Director of the Home Nursing Unit and Primary Health Care District of Málaga; Faculty of Health Sciences, University of Málaga, Spain.
Juan Carlos
JC
Morilla-Herrera
José Miguel
JM
Morales-Asencio
Francisco Javier
FJ
Martín-Santos
Silvia
S
Garcia-Mayor
Mónica
M
Rodríguez-Bouza
Fernando
F
González-Posadas
D057179:Advanced Practice Nursing; D000368:Aged; D003697:Delphi Technique; D005851:Geriatric Nursing; D006801:Humans; D015201:Meta-Analysis as Topic; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D036301:Qualitative Research; D012107:Research Design; D000078202:Systematic Reviews as Topic