Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.
We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.
Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.
While individuals living in rural areas often have poorer health outcomes and reduced access to healthcare services compared with those in urban areas, there is a disproportionate gap in research examining rural health issues and identifying solutions to healthcare challenges. This is likely due to the numerous barriers to conducting rural health research, including the centralisation of research in urban areas and limited trained personnel and resources to conduct research in rural communities. This realist review aims to identify articles focused on building rural health research capacity and develop an evidence-based framework to be used by researchers, clinicians and policymakers to improve rural health services and well-being for rural populations.
We will conduct a realist review using the following steps: (1) develop a search strategy, (2) conduct article screening and study selection, (3) perform data extraction, quality appraisal and synthesis, (4) engage stakeholders for feedback on our findings and (5) report our findings and engage in knowledge translation. Search terms include variations of the terms ‘research’, ‘capacity building’ and ‘rural’. Databases include (since inception) Ovid MEDLINE, Embase, CINAHL Plus, APA PsycINFO, ERIC and Scopus. A separate search of the same databases was also designed to identify relevant theories or frameworks related to research capacity building, using variations of the terms ‘research’, "‘capacity building’, ‘theory’ and ‘framework’. Studies will be screened by title and abstract and full text by two research team members and included based on their relevance to rural health research capacity building. We will exclude articles not published in English. We will also search the grey literature to identify rural health research centres, networks or training programmes that have not been described in the academic literature. Two research team members will extract relevant data from included studies and perform a qualitative analysis based on guidelines for realist reviews.
This review does not require ethical approval as it draws on secondary data that is publicly available. The findings will be disseminated at academic conferences, published in peer-reviewed journals and summarised in a lay report for individuals interested in developing strategies, programmes or policies to improve rural health research. The results will inform individuals developing rural health research training programmes, establishing rural research centres, or others interested in building rural health research capacity.
CRD42023444072.