Experience of being an advanced practice nurse within Australian acute care settings : a systematic review of qualitative evidence

Ramis, Mary-Anne, Wu, Chiung-Jung (Jo), & Pearson, Alan (2013) Experience of being an advanced practice nurse within Australian acute care settings : a systematic review of qualitative evidence. International Journal of Evidence-based Healthcare, 11(3), pp. 161-180.

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Nationally and internationally, advanced practice nurses are working under various titles and in different contexts to address gaps within healthcare systems. Analysis of advanced practice roles in different countries has been undertaken, but due to variations in cultural, geographical and professional factors, it is difficult and perhaps ineffectual to compare roles between countries. Contextual factors may also affect the actual experience of being an advanced practice nurse. A systematic review was therefore undertaken of qualitative evidence on the experience of being an advanced practice nurse in Australia, to provide deeper understanding of the role in the defined context.


The review followed the method for qualitative synthesis as per the Joanna Briggs Institute. An extensive search was undertaken of databases and online resources to find published and unpublished studies. Papers from 1990 to October 2011 which met specified inclusion criteria were appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument.


Three published studies and one unpublished dissertation were included in the review. From these studies, 216 findings were extracted and these were formed into 18 categories. Six meta-syntheses grouped under the headings of expert knowledge, confidence, education, relationships, negative experiences and patient-centred experience were created. Organisational factors impact greatly on the experience, professionally and personally.


Heterogeneity of role titles makes synthesis a difficult process, but contextualising the population provides a pragmatic approach to informing the status of the advanced practice nurse discourse. The review identifies positive and negative experiences of being an advanced practice nurse in Australian acute care settings with overlapping and intertwining findings that reinforce the complexity of the role.

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4 citations in Scopus
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ID Code: 66202
Item Type: Journal Article
Refereed: Yes
Keywords: advanced practice, Australia, clinical nurse consultant, clinical nurse specialist, nurse practitioner, qualitative synthesis
DOI: 10.1111/1744-1609.12029
ISSN: 1744-1609
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2013 The Authors. International Journal of Evidence-Based Healthcare Copyright 2013 The Joanna Briggs Institute
Deposited On: 15 Jan 2014 23:53
Last Modified: 16 Jan 2014 22:26

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