Perceptions of the effectiveness of Advanced Practice Nurses on a neurosurgery unit in a Canadian Tertiary Care Centre: A pre-and-post implementation design.
Alanna M Keenan, Erin E Mutterback, Kristi M Velthuizen and 2 others
PMID 31406815WHAT IT FOUND
Nurses and residents reported better communication, care coordination, and learning opportunities after two Advanced Practice Nurses joined a neurosurgery unit.
Total calls to on-call residents decreased, but daytime calls remained stable. Length of stay did not improve.
Key findings
01Nursing staff reported significant increases in perceptions of effective care delivery across all seven measured aspects, including communication and discharge delays.
02The total number of patient-related calls to on-call residents decreased significantly, but the proportion of daytime calls remained stable.
03Length of stay for neurosurgery patients increased slightly but not significantly after the Advanced Practice Nurse implementation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relied on staff perceptions rather than direct patient outcomes for its primary findings. The sample size was small and recruitment occurred at a single site, limiting generalizability. The APN role was new and staff were still adjusting to the scope of practice during the study period. It was not possible to separate patient satisfaction scores for neurosurgery from neurology patients.
The easy way to misread this
Do not conclude that Advanced Practice Nurses improved patient clinical outcomes. The study measured staff perceptions and administrative metrics like call volume and length of stay, neither of which showed clear clinical improvement for patients.