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Scoping review : Scope of practice of nurse-led services and access to care for people experiencing homelessness
McWilliams, Lucy Paisi, Martha Middleton, Sandra Jane Shawe, Jill Thornton, Anna Larkin, Matthew Taylor, Joanne Currie, Jane
McWilliams, Lucy
Paisi, Martha
Middleton, Sandra Jane
Shawe, Jill
Thornton, Anna
Larkin, Matthew
Taylor, Joanne
Currie, Jane
Abstract
Aims: To investigate the scope of practice of nurse-led services for people experiencing homelessness, and the influence on access to healthcare.
Design: A scoping review.
Data sources: On 20 November 2020, the following databases were searched: CINAHL, Embase, MEDLINE, PubMed and Scopus.
Review methods: Included studies focused on people experiencing homelessness aged 18 years and over, nurse-led services in any setting and described the nursing scope of practice. Studies were peer-reviewed primary research, published in English from the year 2000. Three authors performed quality appraisals using the mixed methods assessment tool. Results were synthesized and discussed narratively and reported according to the PRISMA-ScR 2020 Statement.
Results: Nineteen studies were included from the United States (n = 9), Australia (n = 4), United Kingdom (n = 4) and Canada (n = 2). The total participant sample size was n = 6303. Studies focused on registered nurses (n = 10), nurse practitioners (n = 5) or both (n = 4), in outpatient or community settings. The nursing scope of practice was broad and covered a range of skills, knowledge and attributes. Key skills identified include assessment and procedural skills, client support and health education. Key attributes were a trauma-informed approach and building trust through communication. Important knowledge included understanding the impact of homelessness, knowledge of available services and the capacity to undertake holistic assessments. Findings suggest that nurse-led care facilitated access to healthcare through building trust and supporting clients to access services.
Conclusion: Optimized nursing scope of practice can facilitate access to healthcare for people experiencing homelessness. Key factors in enabling this include autonomy in nursing practice, organizational support and education.
Impact: The broad range of skills, knowledge and attributes reported provide a foundation from which to design an educational framework to optimize the nursing scope of practice, thereby increasing access to healthcare for people experiencing homelessness.
Keywords
access to healthcare, health services accessibility, homeless persons, homelessness, nurse-led, nurses, nursing service, practice patterns, scope of practice, scoping review
Date
2022
Type
Journal article
Journal
Book
Volume
78
Issue
11
Page Range
3587-3606
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open
Notes
© 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.