Ten-Year Update of Nurse Practitioner Service Impact on Patient and Health Service Outcomes in Emergency Care Settings-A Systematic Review.

No included study measured cost or economic impact, so the review cannot say whether nurse practitioner services save money. The 17 studies used different designs, settings, countries, and outcome definitions, which makes direct comparison difficult. Patient satisfaction was measured in only four studies and in different ways, including survey scores and comments in notes. Some length of stay and discharge findings did not account for patient severity or acuity, so lower admission rates may not be due only to nurse practitioner care. The review included only English full-text studies from settings with title-protected nurse practitioners, so results may not apply to other health systems or non-title-protected roles. Most studies were retrospective cohorts, so they can show associations rather than prove that nurse practitioner services caused the outcomes.

The authors report nothing to declare for funding and no conflicts of interest.

Do not read this review as proof that emergency nurse practitioner services save money or consistently reduce waiting time and length of stay. No included study measured cost, and waiting time and length of stay results were mixed. Some studies found no significant difference or longer waits.