Abstract

Background: Evidence for Nurse Practitioners (NP) hospital based roles positively impacting patient care exists. Enabling changes have authorized a broader scope of practice. There is limited understanding of the NP role from the Most Responsible Provider (MRP) lens during care across the hospital trajectory focusing on admission, treatment and discharge.
Aim: To identify how the NP as the Most Responsible Provider affects care in seniors over the age 65 admitted to Ontario Hospitals.
Methods: A comprehensive literature search methodology was utilized to identify studies. Electronic databases searched CINAHL, Embase, MEDLINE, PubMed, Evidence Based Medicine, Cochrane, Google Scholar and Digital dissertations. Studies describing NP models of care anchored in assuming MRP roles with a focus on caring for seniors were targeted.
Results: Seventeen studies met inclusion criteria: three randomized controlled trials, three systematic literature reviews, two mixed methods, two descriptive surveys, one cross-sectional, one pilot, one retrospective and four descriptive case studies.
Conclusion: A critical research opportunity exists to fully explore Nurse Practitioner role contributions as the Most Responsible Provider for hospitalized seniors.
What we know already: Information on the NP in the MRP role exists in pockets of primary care in Canada and the United States. NP hospital roles have only been evaluated in the context of consultation and shared care with physicians and teams.
What we can learn: Enabling, empowering and embracing NP maximal scope of practice contributions as the MRP can be valuable across the continuum of hospital experiences. Bridging and synergizing NP care to meet complex senior care is a timely, safe and innovative care solution.