MOD006278 Research Design Proposal: Nurse Practitioners in Healthcare

This report presents a postgraduate research design proposal focusing on the role of Advanced Nurse Practitioners (ANPs) in the development of Care Management Systems. The research, a systematic review, aims to evaluate the influence of ANPs on patient care, particularly in primary, secondary, and tertiary healthcare settings. The rationale highlights the increasing use of ANPs and their potential to improve patient outcomes and reduce healthcare costs. The research questions address the impact of ANPs on treatment quality, patient satisfaction, and caregiver work satisfaction. The methodology involves using the Cochrane Collaboration criteria and PRISMA guidelines for data collection from databases like PubMed and CINHAL. Inclusion criteria will be used to ensure the relevance and validity of the study. The research seeks to determine whether ANPs enhance patient care, improve standards, and increase job satisfaction among caregivers, contributing to the advancement of nursing practice.

MOD006278
Postgraduate Research Design
Proposal Form
Notes:
a) This form should be completed following discussion with your Module Tutor
b) Your Module Tutor should approve the completed form.
c) Once you have approval then the Stage 1 Ethics form will be completed
Proposal forms will not be accepted unless supported by your Supervisor.
1. Student Name
2. Student Identification Number
3. Student e-mail address
4. Name of Course
Postgradute research design
5 Supervisor Name
6. Module Code
006278 TRI2 D01NON

7. Subject area for the project and brief rationale for choice
Title of research
The Role of Advanced Nurse Practitioners in the Development of Care Management System
- A Systematic Review
Rationale:
According to the International Council of Nurses, an advanced nurse practitioner is a
registered nurse with advanced education and clinical experience who can make difficult
clinical decisions in various settings (ICN, 2002). According to the Royal College of
Nursing (RCN), specific credentials are required to practise as an advanced nurse
practitioner in the United Kingdom. The criteria include a master's degree in a clinical or
research field and the ability to administer medications independently (RCN, 2018). As a
result of their master's or doctoral degrees in one of the four pillars of advanced practice,
nurse practitioners are qualified for employment in these four professions (RCN, 2018).
70% of the world's health care systems use advanced nurse practitioners due to their high
level of efficiency and efficacy (Parker and Hill, 2017; Sheer and Wong, 2018). As a
consequence of their ubiquity, advanced nurse practitioners improve patient care and
outcomes, decrease hospital admissions and readmissions, lower overall healthcare costs,
and boost efficiency in primary and secondary care settings (Parker and Hill, 2017).
Research gap:
The evaluation of prevailing studies have shown that several RCTs and research reviews
have identified the nurse-led care as the potential substitute of physician-led care. The
course of analysis of the studies have ensured that the nurse –led care is observed to enhance
the overall care services provided to the patients within the primary of secondary health care
settings. The previous studies were effectively focused on the terms of exploring the impacts
of nursing-led care. Observing the stance, this systematic review is designed with the
purpose of analysing the reliability of literature evidence related to the role and capacity of
Advanced Nurse Practitioners in the Development of Care Management System for the
primary, secondary or tertiary health care settings. The collection of evidence will viably
help in assessing and comparing the nursing-led care with the interventional approach

associated physician-led care.
Aim:
The primary aim of this research is to evaluate the influences of care provided by physicians
and nurses.
Objectives:
In light of the primary aim, the major objectives of this research are;
 To determine whether advanced practice registered nurses are the only ones who
make a difference in their patients' health.
 To examine a framework for enhancing advanced nursing practice in high-income
countries by analysing the proper use of advanced nurse practitioners (ANPs) to
address the increasing complexity and expectations of service-user populations in
high-income countries.
 To contribute to advanced nurse practitioners employed in primary and secondary
care settings to the progress of advanced nursing practice.
Questions:
Above mentioned objectives have been based on creating three specific research questions.
1. In what ways does the presence of advanced practice nurses in long-term care
institutions enhance the treatment quality, residents' health and well-being, and their
satisfaction?
2. When advanced practice nurses are present in the care facilities of elderly patients,
their family members report more satisfaction and a higher quality of life?
3. What are the presence of advanced practice nurses associated with enhanced patient
care, better standards of care, and greater work satisfaction among long-term care
caregivers?
Methodology
The criteria established by the Cochrane Collaboration will be used to compile credible

evaluations of primary literature on patient outcomes related to the effectiveness of
advanced nurse practitioners (ANPs) for this study (Higgins and Thomas, 2018).
Research Philosophy
The Cochrane Collaboration will use Research Philosophy for systematic quantitative
reviews to develop inclusion and exclusion criteria, locate relevant articles, evaluate the
quality of the study, and synthesise results (Higgins and Green, 2017). Inclusion and
exclusion criteria of studies are necessary to develop high-quality research methods.
Inclusion criteria refer to the principal characteristics of the study's target group (Sanfilippo,
et al., 2020). Common factors include age, gender, ethnicity, and geography. Exclusion
criteria remove potential research studies who match inclusion criteria but have different
traits that might compromise the study's efficacy or enhance their chance of a negative
result. Standard exclusion criteria include individuals who are likely to be lost to follow-up,
fail to appear at their data collection visits, or provide inaccurate data, which may skew
research findings or increase their risk of adverse outcomes. For this study to have external
validity, researchers must first establish suitable inclusion and exclusion criteria. It is
selecting variables as inclusion criteria that are irrelevant to addressing the research
question, ignoring crucial variables required to make a statement about the study's external
validity (Shum, et al., 2020). Instead of randomised controlled trials (RCTs), we
investigated non-randomised quantitative research with a comparison group. This has been
endorsed by the Cochrane Effective Practice and Organization of Care Review Group
(EPOC, 2022).
Research Approach
Deductive approach is considered suitable where the investigation of scientific study is
required. It helps in reading the theories that are in existence already. That is why deductive
approach will be used for this research work.
Research Strategy
The importance of research strategy in the collection of appropriate and authentic data
cannot be set aside. It helps in the analysis of the entire procedure. That is why it is of prime
significance to choose right research strategy (Gatchel et al. 2018). The research strategy
that will be used for this research work is PRISMA. The reason behind choosing this
strategy lies in the fact that this research is based on the systematic review. When the

systematic review is involved, PRISMA strategy for the research is considered effective
(Rethlefsen et al. 2021). PRISMA stands for Preferred Reporting Items for Systematic
Reviews and Meta-Analysis. It involves the checklist of 27 items that helps in improving the
transparency in the systematic reviews. PRISMA involves all the important aspects for the
systematic review such as manuscript etc. For the collection of data, the articles will be
taken from the electronic database because the guideline that will be followed in this
research work is PRISMA. Also, the PubMed and CINHAL database would be used for the
extraction of data because it provides more than 34 million citations and biomedical
literature which would be useful considering the nature of the topic.
Screening Identification Eligibility Included
Research criteria
The research criteria that will be used for this study is the inclusion criteria. The reason
behind the choosing the inclusion criteria lies in the fact that when the medical research is
involved inclusion criteria is considered to be the vital option (Ibrahim et al. 2020).
Inclusion criteria helps in specifying the characteristics required to initiating the study such
as by providing the stage of a disease or particular pathophysiological characteristics. Since
this study revolves around finding the role of advanced nurse practitioners in the
development of care management system, inclusion criteria seem right choice. The usage of
inclusion criteria in this research will help in increasing the radiality of the systematic

reviews (Sanfilippo, Tigano, Palumbo, Astuto and Murabito, 2020). It helps in producing
the accurate results that will help the cause of the research work.
References
Barrett, J., P.S., 2021. A nurse-coordinated model of care versus usual care for stage 3/4
chronic kidney disease in the community: a randomized controlled trial. Clin. J. Am.
Soc. Nephrol. 6 (6), 1241–1247. https:// doi.org/10.2215/CJN.07160810. Available
from: https://doi.org/. [Accessed on 07 May 2022].
Campbell, L., 2018. The clinical effectiveness and cost-effectiveness of telephone triage for
managing same-day consultation requests in general practice: A cluster randomised
controlled trial comparing general practitioner-led and nurse-led management systems
with usual care (the ESTEEM trial). Health Technol. Assess. 19 (13), 1–212.
https://doi.org/10.3310/hta19130. Available from: https://doi.org. [Accessed on 07 May
2022].
Dierick-van Daele, T., Metsemakers, F., Derckx, W., Spreeuwenberg, C., Vrijhoef, J., 2019.
Nurse practitioners substituting for general practitioners: randomized controlled trial.
J Adv. Nurs. 65 (2), 391–401. https://doi.org/10.1111/j.1365-2648.2008.04888.x.
Available from: https://doi.org/. [Accessed on 07 May 2022].
Gatchel, J., Reuben, B., Dagenais, S., Turk, C., Chou, R., Hershey, D., Hicks, E.,
Licciardone, J.C. and Horn, D., 2018. Research agenda for the prevention of pain and
its impact: report of the work group on the prevention of acute and chronic pain of the
Federal Pain Research Strategy. The journal of pain, 19(8), pp.837-851. [Accessed on
07 May 2022].
Ibrahim, E., Burnett Jr, .C., Butler, J., Camacho, A., Felker, M., Fiuzat, M., O’Connor, C.,
Solomon, D., Vaduganathan, M., Zile, M.R. and Januzzi Jr, J.L., 2020. Natriuretic

peptides as inclusion criteria in clinical trials: a JACC: heart failure position paper.
Heart Failure, 8(5), pp.347-358. [Accessed on 07 May 2022].
Kamps, W., Brand, L., Kimpen, L., Maille, R., Overgoor-van de Groes, W., van Helsdingen-
Peek, C., Roorda, J., 2019. Outpatient management of childhood asthma by
pediatrician or Asthma nurse: randomized controlled study with one year follow up.
Thorax 58 (11), 968–973. Available from:
https://www.ncbi.nlm.nih.gov/pubmed/14586050. [Accessed on 07 May 2022].
Rethlefsen, L., Kirtley, S., Waffenschmidt, S., Ayala, P., Moher, D., Page, J. and Koffel, B.,
2021. PRISMA-S: an extension to the PRISMA statement for reporting literature
searches in systematic reviews. Systematic reviews. 10(1), pp.1-19. [Accessed on 07
May 2022].
Sanfilippo, F., Tigano, S., Palumbo, G.J., Astuto, M. and Murabito, P., 2020. Importance of
inclusion criteria in systematic reviews. British Journal of Anaesthesia. 125(5),
pp.e398-e399. [Accessed on 07 May 2022].
Shum, C., Humphreys, A., Wheeler, D., Cochrane, M.-A., Skoda, S., Clement, S, 2020.
Nurse management of patients with minor illnesses in general practice: multicentre,
randomised controlled trial. BMJ 320 (7241), 1038–1042. Available from:
http://www.bmj.com/content/320/7241/1038.abstract. [Accessed on 07 May 2022].
Venning, P., Durie, A., Roland, M., Roberts, C., Leese, B, 2022. Randomised controlled trial
comparing cost effectiveness of general practitioners and nurse practitioners in
primary care. BMJ 320 (7241), 1048–1053. Available from:
https://www.ncbi.nlm.nih.gov/pubmed/10764367. [Accessed on 07 May 2022].
8. Specific research question to be addressed (Or title of work-based project)
 What are the presence of advanced practice nurses associated with enhanced patient
care, better standards of care, and greater work satisfaction among long-term care

caregivers?
9. Methodology (tick as appropriate)
 Primary data collection
 Systematic Review
 Work-based Project
 Theoretical Review (only available for those students on the MSc International
Social Welfare and Social Policy)
10. Primary Data Collection projects ONLY - Governance approval requirements
Where will you be applying for Ethical Approval? Please tick as applicable/
Will you require approval from R&D? Please tick as appropriate
R&D
 IRAS
 FREP
 Other: Please specify………
11. Systematic Review Projects ONLY
Please indicate whether you have carried out the following preparation for your project.
Scoping: Is there sufficient evidence available on the topic?
Yes.
Have you searched to establish the need for this Systematic Review?
Yes.
Checking the SR databases – Has the proposed question been the subject of a previous
systematic review?
Yes.
Signature of student Date: …./…../…..