An evaluation of the implementation of Advanced Nurse Practitioner (ANP) roles in an acute hospital setting

Ann Mcdonnell, Emma Goodwin, Fiona Kennedy, Kay Hawley, Kate Gerrish, Christine Smith

Research output: Contribution to journalArticle

37 Citations (Scopus)


Aim. To evaluate the impact of implementing Advanced Nurse Practitioner roles on patients, staff members and organizational outcomes in an acute hospital.

Background. The worldwide development of advanced practice roles in nursing has been influenced by increasing demands and costs of health care. A key issue in the UK has been the reduction in hours junior doctors can work.While there is evidence these roles can have a positive impact in a variety of clinical specialties, little is known about the impact advanced nurses substituting for junior doctors can have on patients, staff members and organizational outcomes in general hospital care settings.Design. Collective case study.

Methods. A collective case study in a district general hospital in England was undertaken in 2011–2012. Interviews with strategic stakeholders (n = 13) were followed by three individual case studies. Each case study represented the clinical area in which the roles had been introduced: medicine, surgery and orthopaedics and included interviews (n = 32) and non-participant observation of practice.Findings. The ANPs had a positive impact on patient experience, outcomes and safety. They improved staff knowledge, skills and competence and enhanced quality of working life, distribution of workload and team-working. ANPs contributed to the achievement of organizational priorities and targets and development of policy.

Conclusion. ANPs undertaking duties traditionally performed by junior doctors in acute hospital settings can have a positive impact on a range of indicators relating to patients, staff members and organizational outcomes which are highly relevant to nursing.
Original languageEnglish
Pages (from-to)789-799
Number of pages11
JournalJournal of Advanced Nursing
Issue number4
Early online date22 Oct 2014
Publication statusPublished - Apr 2015
Externally publishedYes


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