Edinburgh Napier University

  Aim
To critically appraise and synthesise the current evidence related to the advanced practice nurse (APN) in the children and young people's healthcare setting.

Background
A complex landscape of demand and change has influenced the healthcare delivery for children and young people. In the United Kingdom and internationally, governments have endorsed the need for workforce innovation with APN roles introduced to counter these challenges. However, little is known about the impact of these initiatives in the context of children and young people's health care.

Design
Systematic review and narrative summary.

Data sources
CINAHL, MEDLINE, DARE, PubMed, Prospero and Cochrane Database of Systematic Reviews were searched for studies published in English language from July 1998 to 2018. Studies were selected based on key search terms and eligibility criteria.

Review methods
The selected studies were appraised using the Effective Public Health Practice Project for quantitative studies. An adapted version of the JBI data extraction tool for experimental/observational studies was used to extract the relevant key findings. This was conducted independently by two researchers.

Results
Nine studies were included in the review. The review demonstrated roles were comparable in their clinical practice to medics yet offered higher levels of patient satisfaction, role modelling for staff and led practice initiatives to improve health literacy.

Conclusion
This review demonstrates that APN roles in children and young people's health care provide clinical, organizational and professional benefits, with added value to organizations and patients, acting as role models and educators.

Impact
The findings from this review indicate further research is required to ascertain contextual issues that may influence the implementation of APNs. This research will impact APNs working with children and young people. Equally, it supports the evidence base for service commissioners outlining areas for future research.