In order to provide the best service to patients, effective and high-quality health systems include a wide variety of professionals. Regardless of the health condition, each patient should be integrally treated with the help of a multidisciplinary team that includes not only medical doctors, but also nurse practitioners. Even if every member of the team –including doctors and nurses- is essential, it is always in the best interest of the health system and patient care to evaluate how effective are professionals regarding others. Effectiveness could be defined as the degree to which something successfully produces the desired results (Stevenson, 2010). Some evidence indicates that including nurse practitioners as part of the multidisciplinary team improves clinical and laboratory outcomes, while lowering costs and follow-up visits (Stanik-Hutt, Newhouse, White, Johantgen, Bass, Zangaro et al., 2013; Donald, Martin-Misener, Carter, Donald, Kaasalainen, Wickson-Griffiths et al., 2013; Albers-Heitner, Lagro-Janssen, Joore, Berghmans, Nieman, Venema et al., 2011; Dierick-van Daele, Steuten, Metsemakers, Derckx, Spreeuwenberg & Vrijhoef, 2010; Schuttelaar, Vermeulen & Coenraads, 2011). Therefore, a PICOT question has been elaborated as following: Is patient care more effective when children or adult patients suffering from either acute or chronic diseases such as urinary incontinence, metabolic diseases or eczema are treated including nurse practitioners in the care team, as opposed to teams consisting only of medical doctors or lacking nurse practitioners? The individual components of the PICOT question are as follows:
Population: children or adult patients suffering from either acute or chronic diseases (Urinary incontinence, metabolic diseases, eczema).
Intervention: Nurse practitioners.
Comparison: Medical doctors or lack of nurse practitioners in the team.
Outcome: Effectiveness (defined as lower costs, less follow-up consultations, better clinical and laboratory outcomes).
Effectiveness will be defined as lower costs, less follow-up consultations and better clinical and laboratory outcomes for patients. In order to answer this research question, randomized controlled trials, systematic reviews, qualitative studies, and meta-analyses will be taken into account.
References
Albers‐Heitner, C. P., Lagro‐Janssen, A. L. M., Joore, M. A., Berghmans, L. C. M., Nieman, F., Venema, P. L., & Winkens, R. A. G. (2011). Effectiveness of involving a nurse specialist for patients with urinary incontinence in primary care: results of a pragmatic multicentre randomised controlled trial. International journal of clinical practice, 65(6), 705-712. http://www.ncbi.nlm.nih.gov/m/pubmed/21564445/
Dierick-van Daele, A. T., Steuten, L. M., Metsemakers, J. F., Derckx, E. W., Spreeuwenberg, C., & Vrijhoef, H. J. (2010). Economic evaluation of nurse practitioners versus GPs in treating common conditions. British Journal of General Practice, 60(570), e28-e35. http://www.ncbi.nlm.nih.gov/m/pubmed/20040165/
Donald, F., Martin‐Misener, R., Carter, N., Donald, E. E., Kaasalainen, S., Wickson‐Griffiths, A., & DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long‐term care. Journal of advanced nursing, 69(10), 2148-2161. http://www.ncbi.nlm.nih.gov/m/pubmed/23527481
Schuttelaar, M. L. A., Vermeulen, K. M., & Coenraads, P. J. (2011). Costs and cost‐effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist: results of a randomized, controlled trial and a review of international costs. British Journal of Dermatology, 165(3), 600-611. http://www.ncbi.nlm.nih.gov/m/pubmed/21692770/
Stevenson, A. (Ed.). (2010). Oxford dictionary of English. Oxford University Press.
Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., & Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. The Journal for Nurse Practitioners, 9(8), 492-500. http://www.sciencedirect.com/science/article/pii/S1555415513004108
