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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.
Venous leg ulcers occur due to chronic venous insufficiency in the lower extremities and are often difficult to heal. Platelet-rich plasma and platelet-rich fibrin are products that contain high concentrations of platelets. This systematic review evaluated the effectiveness, safety and cost-effectiveness of these products for the treatment of venous leg ulcers. Guided by the 2020 Joanna Briggs Institute systematic review of effectiveness guideline, this review included original studies that investigated platelet-rich plasma and platelet-rich fibrin in the treatment of venous leg ulcers from databases including the Cochrane Library, Embase, Medline, CINAHL, PubMed, World Health Organisation International Clinical Trials Registry, Clinical Trials.gov and Australian New Zealand Clinical Trials Registry. Methodological quality was assessed using relevant appraisal checklists. Information related to general characteristics of included articles and relevant outcomes of interest were extracted and synthesised narratively. Of thirty-six eligible studies, 24 studies used platelet-rich plasma, eleven investigated fibrin-rich plasma and one study used both platelet-rich plasma and fibrin-rich. Most studies reported these products were effective in promoting wound healing, reducing other symptoms, and were safe to use. The use of platelet-rich plasma and platelet-rich fibrin resulted in significantly higher healed venous leg ulcers compared to control using conventional treatment (RR: 2.93, 95% CI, 1.90–4.53, p = 0.01). These products were safe to used topically and promoted to wound healing, reduced pain, either along or combined with other treatments. Platelet-rich plasma and fibrin-rich plasma improves wound healing and appears to be safe to use in the treatment of venous leg ulcers.
FreshRSS 