Impact of community based nurse-led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review

Journal article


Randall, Sue, Crawford, Tonia, Currie, Jane, River, Jo and Betihavas, Vasiliki. (2017) Impact of community based nurse-led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review. International Journal of Nursing Studies. 73, pp. 24-33. https://doi.org/10.1016/j.ijnurstu.2017.05.008
AuthorsRandall, Sue, Crawford, Tonia, Currie, Jane, River, Jo and Betihavas, Vasiliki
Abstract

Background
The role and scope of nursing practice has evolved in response to the dynamic needs of individuals, communities, and healthcare services. Health services are now focused on maintaining people in their communities, and keeping them out of hospital where possible. Community based nurse-led clinics are ideally placed to work towards this goal. The initial impetus for these services was to increase patient access to care, to provide a cost-effective and high quality streamlined service.

Objectives
This systematic review aimed to identify the impact of nurse-led clinics in relation to patient outcomes, patient satisfaction, impact on patient access to services, and cost effectiveness.

Methods
A review of community based nurse-led clinic research in Medline, CINAHL and Embase was undertaken using MeSH terms: Nurse-managed centres, Practice, Patterns, Nurse, Ambulatory Care, keywords: nurse-led clinic, nurse led clinic, community and phrases primary health care and primary care. Papers were appraised using the Joanna Briggs Appraisal criteria.

Results
The final review comprised 15 studies with 3965 participants. Most studies explored patient satisfaction which was largely positive towards nurse-led clinics. Patient outcomes reported were typically from self-report, although some papers addressed objective clinical measures; again positive. Access was reported as being increased. Cost-effectiveness was the least reported impact measure with mixed results.

Conclusions
Nurse-led clinics have largely shown positive impact on patient outcomes, patient satisfaction, access to care and mixed results on cost-effectiveness. Future research evaluating NLCs needs to adopt a standardised structure to provide rigorous evaluations that can rationalise further efforts to set up community based nurse-led clinical services.

Keywordsambulatory care; community; nurse-led clinic; nurse-managed centres; practice patterns nurse; primary care; primary health care
Year2017
JournalInternational Journal of Nursing Studies
Journal citation73, pp. 24-33
PublisherElsevier Ltd
ISSN0020-7489
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijnurstu.2017.05.008
Scopus EID2-s2.0-85019573992
Research or scholarlyResearch
Page range24-33
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online11 May 2017
Publication process dates
Accepted10 May 2017
Deposited11 Jun 2021
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