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To provide a 10-year update on the best available evidence evaluating the impact of nurse practitioner services on cost, waiting times, patient satisfaction, representation rates, and length of stay in emergency and urgent care settings.
Systematic review.
The search was completed on January 28, 2025, in Embase (Elsevier), Medline (EBSCOhost), CINAHL (EBSCOhost), Cochrane Library (Wiley), Emcare (Ovid), Web of Science Core Collection (Clarivate) and Scopus (Elsevier). The data range (2014–2024) was used to limit the search.
The search was conducted with results imported into Covidence. In Covidence, two reviewers conducted screening, data extraction, and quality appraisal of articles, and findings were analysed using a narrative synthesis approach. Eligible studies examined nurse practitioner services in emergency or urgent care settings, reporting outcomes of cost, waiting times, patient satisfaction, representation rates, and length of stay.
Title and abstract screening were performed on 2329 records. Of these, 236 full-text articles were reviewed, and 17 underwent critical appraisal and data extraction. Narrative analysis of outcome measures yielded mixed results, with both favourable and unfavourable findings reported regarding nurse practitioner services.
Global evaluation of nurse practitioner services in emergency care remains inconsistent. Nevertheless, emerging evidence supports their positive impact, particularly in improving patient outcomes. To effectively inform policy, workforce planning and clinical integration, there is a need for professional benchmarks that provide clear frameworks for the evaluation of patient-centred outcomes and operational impacts in emergency departments.
Evidence related to nurse practitioner services in emergency and urgent care clinics highlights the positive impact of nurse practitioner services on patient wait times and satisfaction; however, there is limited and variable evidence of impact on health care costs and outcomes.
This paper recommends that evaluating emergency nurse practitioner services requires homogeneous research using consistent professional benchmarks and evaluation frameworks.
This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
PROSPERO 2025 CRD420250645148.
To establish research priorities for Australian Nurse Practitioners and develop a robust research agenda.
A descriptive, exploratory approach was used and conducted in two stages.
Data were collected over two stages. Data for Stage 1 were collected from 14 December 2023 to 16 February 2024. For the Delphi rounds (Stage 2), data were collected from 11 March to 24 March 2024 for Delphi Round 1 and from 12 June to 26 June 2024 for Delphi Round 2. An exploratory survey was used in Stage 1 to identify clinical challenges and research themes perceived as important for Australian Nurse Practitioners. In Stage 2, a two-phased modified Delphi survey was conducted to prioritise the research themes identified in Stage 1.
A total of 315 participants responded to the exploratory survey, with a majority being female (77%), aged between 30 and 75 years. Participants were primarily employed in the public healthcare sector (60%), the private sector (23%), while 17% practised across both sectors. A total of 1335 challenges facing Australian Nurse Practitioners were identified. Sixty-nine participants completed the first Delphi round, and 33 the second, giving response rates of 21% (69/315) and 48% (33/69), respectively. The first Delphi round yielded 11 research themes. Seven of these yielded Content Validity Indices of < 0.90. Four research priority areas remained and were ranked in order of importance.
The identified Australian Nurse Practitioner research priorities will play a pivotal role in shaping policies, fostering the efficient integration of Nurse Practitioners into the healthcare system and advancing research capacity.
Nurse Practitioners are established providers of high-quality care internationally; however, they face persistent integration challenges in Australia. This study delivers a nationally relevant, consensus-based research agenda that identifies key priorities across clinical, educational and leadership domains.
No patient or public contribution.
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