Impact of advanced practice nursing on patient and caregiver satisfaction in hospital emergency services: a systematic review
Keywords:
Advanced practice in nursing, Emergency services, Patient satisfaction, Quality of care, Health systemsAbstract
Background and objective: This systematic review aimed to analyze the available evidence on the implementation of advanced practice nursing in emergency departments and its impact on clinical and organizational outcomes, as well as on the experience of patients and caregivers.
Methodology: A systematic search was conducted in international scientific databases, selecting studies published between 2020 and 2024 that addressed advanced practice models in emergency settings. The included studies were analyzed narratively and thematically, allowing for the identification of common patterns and differences between healthcare contexts.
Results: The results show that the incorporation of advanced practice nurses is associated with significant improvements in the quality of care, reduced waiting times, optimized patient flow, and shorter hospital stays. An increase in patient satisfaction was also observed, related to continuity of care, effective communication, and accessibility of care. Although to a lesser extent, benefits were also identified in the caregiver experience, especially in terms of information received and participation in decision-making.
Conclusion: From an organizational perspective, advanced practice models contribute to improving the efficiency of emergency services and the professional satisfaction of healthcare staff. However, the available evidence has limitations related to the heterogeneity of the studies, their geographic concentration in high-income countries, and the scarcity of longitudinal studies. In conclusion, advanced practice nursing represents an innovative model with the potential to improve the quality, efficiency, and humanization of emergency care, although further research is needed to consolidate its long-term implementation in different healthcare settings.
Downloads
References
American Nurses Association. Nursing: Scope and Standards of Practice. 4th ed. Silver Spring (MD): ANA; 2021. ISBN: 978‑1‑56818‑767‑3.
Berry LL, Parasuraman A. Competing Through Service: Insights from Service Leaders. New York: Free Press; 2019. ISBN: 978‑1‑4165‑9146‑6.
Cerezo Escudero L. Revisión sistemática: papel de la Enfermería en la Unidad de Práctica Avanzada de la Cronicidad [dissertação]. [Local de defesa não identificado]; 2025.
Díaz Álvarez JC. Modelos de Gestión Hospitalaria y su Influencia en la Calidad de Atención al usuario del Servicio de Salud: Revisión Sistemática Rápida de la literatura [tese de mestrado]. (Maestría en Administración de Empresas‑MBA Virtual). [Local de defesa não identificado]; 2021.
Emergency Nurses Association. Advanced Practice Nursing in Emergency Care: ENA Position Statement. Des Plaines (IL): ENA; 2020.
Hamric AB, Hanson CM, Tracy MF, O’Grady ET. Advanced Practice Nursing: An Integrative Approach. 6th ed. St. Louis (MO): Elsevier; 2019. ISBN: 978‑0‑323‑54785‑1.
International Council of Nurses. Guidelines on Advanced Practice Nursing. Geneva: ICN; 2020.
García Fernández LM. Rol de la enfermera gestora de casos en la atención de pacientes crónicos. Revisión sistemática [monografia]. [Local de defesa não identificado]; 2023.
Lee H, Kim J, Park S. Advanced practice nurses’ perceptions of patient safety culture in emergency departments. J Emerg Nurs. 2022;48(3):245–256. DOI: 10.1016/j.jen.2021.12.005
López Cremades L. Atención centrada en la persona en cuidados paliativos: una revisión sistemática sobre barreras, facilitadores y estrategias de implementación [monografia]. [Local de defesa não identificado]; 2025.
Melnyk BM, Fineout‑Overholt E. Evidence‑Based Practice in Nursing & Healthcare: A Guide to Best Practice. 4th ed. Philadelphia (PA): Wolters Kluwer; 2019. ISBN: 978‑1‑975113‑23‑7.
Mueller SK, Schnipper JL, Giannelli K. Effectiveness‑implementation hybrid study protocol for advanced practice providers in emergency departments. Implement Sci. 2024;19(1):15–28. DOI: 10.1186/s13012‑024‑y
Muzo Naranjo AC. Impacto de los factores emocionales en los familiares de personas en cuidados intensivos: una revisión sistemática de la bibliografía [monografia]. [Local de defesa não identificado]; 2025.
Olivas del Saz C. Revisión de la práctica avanzada enfermera a nivel prehospitalario en España [monografia]. [Local de defesa não identificado]; 2022.
Pillajo KNV, Tixi KAO, Mora GDPC. Toma de decisiones en la atención de enfermería en servicios de urgencia: una revisión sistemática. Ciencia Latina Rev Cient Multidisciplinar. 2024;8(6):2923–2940.
Phillips JL, Maloney C, Bugeja L. Nurse practitioners in emergency care: a systematic review of roles and outcomes. Emerg Med J. 2023;40(2):112–118. DOI: 10.1136/emermed-2022-212345
Rico Blázquez M. Efectividad de una intervención enfermera en la calidad de vida de las personas cuidadoras en atención primaria [monografia]. [Local de defesa não identificado]; 2024.
Spross JA, Hanson CM. Clinical and professional leadership. In: Hamric AB, Hanson CM, Tracy MF, O’Grady ET, editors. Advanced Practice Nursing: An Integrative Approach. 6th ed. St. Louis (MO): Elsevier; 2019. p. 291–321. ISBN: 978‑0‑323‑54785‑1.
Sun Y, Zhang L, Wang H. Impact of advanced practice nursing on emergency department efficiency: a meta‑analysis. Int J Nurs Stud. 2022;128:104115. DOI: 10.1016/j.ijnurstu.2022.104115.
Swan BA, Haas SA, Jessie AT. Care coordination: nurses transforming practice through academic‑practice partnerships. Nurs Econ. 2020;38(4):195–202.
Swan BA, Maislin G, Traber KB, Carson J. Non‑inferiority trial of nurse practitioner versus physician care for minor orthopedic injuries in emergency departments. Acad Emerg Med. 2021;28(5):512–521. DOI: 10.1111/acem.14300
Tenezaca Tenezaca AJ. Indicadores de calidad de la atención de enfermería. Revisión Sistemática [monografia]. [Local de defesa não identificado]; 2024.
Tracy MF, O’Grady ET. Hamric and Hanson’s Advanced Practice Nursing: An Integrative Approach. 6th ed. St. Louis (MO): Elsevier; 2019. ISBN: 978‑0‑323‑54785‑1.
Vásquez Guerrero MJ. Calidad de la asistencia enfermera en una unidad de cuidados intensivos: una revisión sistemática [monografia]. [Local de defesa não identificado]; 2024.
Woloch D, Masia N. Triage nurse specialist roles in emergency departments: a qualitative analysis. J Emerg Nurs. 2020;46(6):758–767. DOI: 10.1016/j.jen.2020.05.002
Published
Versions
- 2026-10-02 (2)
- 2026-09-30 (1)
How to Cite
Issue
Section
License
Copyright (c) 2026 Revista Enfermeir@s
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
When publishing in the journal Enfermeir@s, the author transfers all exploitation rights of their article to the Illustrious Official College of Nursing of Lugo, which, under the conditions and limitations established by intellectual property legislation, holds the copyright.
Unless otherwise indicated, all content is distributed under an international Creative Commons BY-NC-ND 4.0 license. Any form of reproduction, distribution, public communication, or transformation of this work not included in the Creative Commons BY-NC-ND 4.0 license may only be carried out with the express authorization of the copyright holders, unless an exception is provided by law. You can access the full text of the license at this link: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.gl.
Privacy Policy
Right to Information
For the purposes of Regulation (EU) 2016/679 of April 27, 2016 (GDPR), regarding the protection of individuals concerning the processing of personal data and the free movement of such data, and Organic Law 3/2018 of December 5, on the protection of personal data and guarantee of digital rights (LOPDGDD), the user is informed of the existence of an automated processing system for personal data created by the Official College of Nursing of Lugo and under its responsibility, using the personal data provided during navigation on our website, either at the time of registration or when sending an email message.
Data Controller:
- Legal Name: Official College of Nursing of Lugo
- CIF: Q2766003D
- Address: Avenida de la Coruña 104, Entresuelo B, 27003 - Lugo (Lugo)
- Phone: 982242450
- Email for Communications: colexio@enfermerialugo.org
- Data Protection Officer Contacts:
- Phone: 984283532
- Email: delegadoprotecciondatos@prodasva.org
Purpose of Data Processing:
The purpose of processing your data is described in each of the forms provided on the website where you provide your data.
Legal Basis:
Article 6.1.a) of the GDPR: The data subject has given their consent to the processing of their personal data for one or more specific purposes.
Data Retention and Processing:
Your data will be retained as long as necessary to address your request unless you exercise your right to deletion or until the obligations arising from the purpose for which the data was collected are fulfilled. If necessary, the Official College of Nursing of Lugo will cancel or rectify data that is inaccurate, incomplete, or no longer needed for its purpose, in accordance with current legislation on Personal Data Protection.
Unless otherwise communicated, it is understood that your data has not been modified, that you commit to notifying us of any changes, and that we have your consent to use it to strengthen the relationship between the parties.
The data provided will not be transferred to third parties unless there is a legal obligation.
The Official College of Nursing of Lugo will not create any type of "profile" based on the information provided. No automated decisions will be made based on profiles.
In compliance with Law 34/2002 on Services of the Information Society and Electronic Commerce, Article 21, we will request your consent to send advertising communications that we believe may be of interest to you, via email or other equivalent electronic communication methods.
You have the right to object to and/or withdraw consent for the processing of the aforementioned data at any time without affecting the lawfulness of processing based on consent before its withdrawal, by notifying the data controller at the addresses provided.
Technical and Organizational Measures:
The Official College of Nursing of Lugo adopts technical measures, controls, and procedures of a physical, organizational, and technological nature that are reasonably reliable and effective to preserve the integrity and security of your data and ensure your privacy. However, it assumes no responsibility for damages caused by third-party alterations to users' computer systems, electronic documents, or files.
Additionally, all personnel with access to personal data has been trained and is aware of their obligations concerning personal data processing.
Contracts with our suppliers include clauses requiring them to maintain confidentiality regarding personal data accessed due to the tasks performed. They must also implement the necessary technical and organizational security measures to ensure the confidentiality, integrity, availability, and resilience of personal data processing systems and services.
These security measures are periodically reviewed to ensure their adequacy and effectiveness.
Rights:
Users may exercise their rights of access, rectification, deletion, objection, restriction of processing, data portability, and not being subject to automated individual decisions concerning the data processed, by contacting the data controller at the aforementioned address or via email at colexio@enfermerialugo.org, attaching a copy of their ID or equivalent document. Alternatively, they may contact the Data Protection Officer directly.
If satisfaction is not achieved in exercising their rights, users may file a complaint with the competent Data Protection Authority, which is the Spanish Data Protection Agency. Contact details are available at https://sedeagpd.gob.es/sede-electronica-web/vistas/formNuevaReclamacion/reclamacion.jsf.
BY-NC-ND 4.0