Researchers: Limor Chen¹, Efrat Shadmi²

Background: Nurse Practitioner (NP) roles have been integral to global healthcare systems for several decades, including in Israel since 2013. Despite their widespread incorporation, there has been a notable absence of comprehensive evaluations assessing the outcomes of integrating specialty roles, particularly within the realm of surgery.

Objectives: The primary objective of this study is to examine the contributions of surgical NPs and their correlation with key quality and service indicators.

Method: Employing a multifaceted approach, this research encompasses both retrospective and prospective arms, utilizing a multi-center design. Data was sourced through various methods, including computerized systems, patient surveys, and reports provided by NPs.

Findings: Variations in the implementation of NP roles across different units and their diverse activities throughout the pre-operative, hospitalization, and post-discharge phases were observed. Noteworthy was the absence of significant differences in most hospitalization outcomes when comparing periods before and after NP implementation. However, a prospective analysis revealed improved continuity of care and reduced patient anxiety in units when a NP was presence.

Conclusions: The study highlights substantial diversity in the performance of NP roles, contingent on unit characteristics and individual nurse attributes. Furthermore, treatment outcomes in units where NP roles are established are comparable, and in some measures, superior to those in periods and units without NP implementation.

Recommendations: Based on our findings, we advocate for the expansion of Surgical NP roles in Israel's healthcare system. Policymakers are urged to regulate the specialization areas of surgical NPs, delineating job definitions, scopes, and the practical exercise of powers to enhance the efficacy and impact of these roles in practice.

Research end date: 06/2024