A Quality Improvement Project: ANP Role in Saudi Primary Care
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Project
AI Summary
This capstone project explores the introduction of the Advanced Nurse Practitioner (ANP) role within a primary care setting in Saudi Arabia. The project highlights the current healthcare challenges in Saudi Arabia, including physician shortages and increasing healthcare demands, and proposes the implementation of ANPs as a solution to improve patient care, increase patient safety, and enhance access to medical services. The project provides background information on the healthcare system in Saudi Arabia, identifies the purpose and objectives of the quality improvement project, and poses a research question to evaluate the benefits of introducing ANPs. It emphasizes the potential of ANPs to address healthcare shortages, reduce costs, and improve the quality of care, drawing on existing literature and research to support its claims. The project aims to provide evidence of improved patient care and outcomes through the introduction of the ANP role, addressing challenges such as disagreements over autonomy and leadership, and suggesting the positive impact on staff, patients, and nurses' organizational skills. Overall, the project advocates for the integration of ANPs as a key strategy for the future of primary care in Saudi Arabia, given the growing demands and aging population.
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Amaal Capstone Project Submitted for the Master of Science in Nursing: Advanced Practice
Month and Year of Submission
Quality Improvement Project
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Amaal Capstone Project Submitted for the Master of Science in Nursing: Advanced Practice
Month and Year of Submission
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Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Contents
Introduction......................................................................................................................................3
Background Information..................................................................................................................5
Purpose of the QI project.................................................................................................................6
Objective and Aim...........................................................................................................................6
Research Question...........................................................................................................................7
References........................................................................................................................................8
Quality Improvement Project
Contents
Introduction......................................................................................................................................3
Background Information..................................................................................................................5
Purpose of the QI project.................................................................................................................6
Objective and Aim...........................................................................................................................6
Research Question...........................................................................................................................7
References........................................................................................................................................8
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Introduction
The healthcare scheme in Saudi Arabia has not implemented the employment/ use of ANPs
to reduce the shortages experienced and meets the healthcare demands in the country
(ABoshaiqah 2015). Thus, the MOH needs to clearly define the different roles of nurses
(Hibbert, et al., 2017). Additionally, the number of hospitals and patients in the country is high,
against a small number of physicians, clinicians, and specialized nurse practitioners (Oliver, E.
2017). Consequently, the nursing shortage and lack of postgraduate specialist nursing education
are significant factors that contribute to the weak implementation of ANPs. Also, poor financial
and career incentives add to the small number of nursing specialists (Hibbert, Al-Sanea, and
Balens 2012).
The introduction of Advanced Nurse Practitioners (ANPs) in primary care settings leads to
improved patient care, increased patient safety, and continuous care and access to medical care
by patients (Kooienga and Carryer, 2015). That is, nursing practitioners are willingly working in
rural areas who only does require prime care providers (Barratt &Thomas, 2018). There are
likely to assist less privileged civilians with overall fewer costs. Most importantly, advanced
nurse practitioners will provide better quality just like physicians (Bergman et al, 2013). Patients
consider advanced nurses to be competent caregivers through high rates of reported patient
satisfaction (Swan et al, 2015). Additionally, the staff does express trust and confidence in
advanced nurse practitioners. Still, advanced nurse practitioners are able to deliver clinical
outcomes equivalent to GPS specifically when undertaking emergency home visits (McDonnell
et al, 2012). Thus, the introduction of ANPs has been identified as key to the future of primary
care, as the demand for medical services grows, due to an elderly populace and enlarged health
insurance coverage against the low number of general practitioners (Oliver, 2017).
There is an urgent call by healthcare policy leaders to reform the current strategies and
policies. The healthcare policymakers have realized that the provision of free services in public
health is an inefficient and unsustainable strategy. Thus, the introduction of ANPs has been
identified as key to the future of primary care, as the demand for medical services grows, due to
an aging population and increased health insurance coverage against the low number of general
practitioners (Oliver, 2017).
Advanced nursing care was first introduced globally in the 1960s to reduce the demand
for primary care physicians and to meet the healthcare needs of the rural populations (Kooienga
Quality Improvement Project
Introduction
The healthcare scheme in Saudi Arabia has not implemented the employment/ use of ANPs
to reduce the shortages experienced and meets the healthcare demands in the country
(ABoshaiqah 2015). Thus, the MOH needs to clearly define the different roles of nurses
(Hibbert, et al., 2017). Additionally, the number of hospitals and patients in the country is high,
against a small number of physicians, clinicians, and specialized nurse practitioners (Oliver, E.
2017). Consequently, the nursing shortage and lack of postgraduate specialist nursing education
are significant factors that contribute to the weak implementation of ANPs. Also, poor financial
and career incentives add to the small number of nursing specialists (Hibbert, Al-Sanea, and
Balens 2012).
The introduction of Advanced Nurse Practitioners (ANPs) in primary care settings leads to
improved patient care, increased patient safety, and continuous care and access to medical care
by patients (Kooienga and Carryer, 2015). That is, nursing practitioners are willingly working in
rural areas who only does require prime care providers (Barratt &Thomas, 2018). There are
likely to assist less privileged civilians with overall fewer costs. Most importantly, advanced
nurse practitioners will provide better quality just like physicians (Bergman et al, 2013). Patients
consider advanced nurses to be competent caregivers through high rates of reported patient
satisfaction (Swan et al, 2015). Additionally, the staff does express trust and confidence in
advanced nurse practitioners. Still, advanced nurse practitioners are able to deliver clinical
outcomes equivalent to GPS specifically when undertaking emergency home visits (McDonnell
et al, 2012). Thus, the introduction of ANPs has been identified as key to the future of primary
care, as the demand for medical services grows, due to an elderly populace and enlarged health
insurance coverage against the low number of general practitioners (Oliver, 2017).
There is an urgent call by healthcare policy leaders to reform the current strategies and
policies. The healthcare policymakers have realized that the provision of free services in public
health is an inefficient and unsustainable strategy. Thus, the introduction of ANPs has been
identified as key to the future of primary care, as the demand for medical services grows, due to
an aging population and increased health insurance coverage against the low number of general
practitioners (Oliver, 2017).
Advanced nursing care was first introduced globally in the 1960s to reduce the demand
for primary care physicians and to meet the healthcare needs of the rural populations (Kooienga
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Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
& Carryer, 2015). Advanced nursing practice is governed by contemporary health care demands
and its underlying factors such as increasing life expectancy, promoting population growth,
inadequate family planning programs, and health-related behaviors such as smoking, diabetes,
and hypertension (Kralewski et al., 2015). Additionally, over the years, the role of ANPs has
been extended to different healthcare settings, such as in acute care where the patients require
emergency and critical care (Kralewski et al., 2015). ANPs have various unique roles in primary
care settings, including the diagnosis of patients, physical, psychological, functional and
developmental examinations on patients, requests, and interpretation of results and differential
diagnoses (Hibbert, Al-Sanea and Balens 2012). Similarly, ANPs play a part in the provision of
preventive care and health education to different populations (Hibbert, Al-Sanea & Balens,
2012).
Different studies have shown that the introduction and use of ANPs in primary care
settings has led to improved patient care and outcomes. The results indicated that the availability
of ANPs led to reduced health care costs and improved quality of healthcare due to the
incorporation of new health technologies and treatment. Similarly, Kralewski et al. (2015)
concluded that ANPs contribute positively to primary care settings, and should be employed to
meet the high healthcare demands.
Similarly, Swan et al. (2015) carried out a systematic review to determine the safety and
effectiveness of introducing ANPs in primary care settings. This review evaluated the ANPs
possibility to reduce shortages of healthcare services in primary care settings. The results by
Swan et al. (2015) showed that the value of services provided by ANPs was high and ANPs are
well-positioned to provide safe and valuable care that reduces the shortages experienced.
Martinez-Gonzalez et al. (2014) showed that the substitution of physicians by ANPs is common
in care settings with a low number of physicians necessitating a need for high quality and
affordable care. Similarly, a study by McDonnell et al., (2014) shows that if ANPs assume tasks
done by junior doctors in a primary care settings, a positive outcome from staff members,
patients, and nurses’ organizational skills is realized.
Additionally, this review indicates that clinical effectiveness and healthcare costs when
physicians are substituted by ANPs enhance patient satisfaction and is effective in promoting the
follow-up episodes. Also, the rates of hospital admissions and deaths when compared with the
rates by physicians were less, although not significant (Martinez-Gonzalez et al., 2014).
Quality Improvement Project
& Carryer, 2015). Advanced nursing practice is governed by contemporary health care demands
and its underlying factors such as increasing life expectancy, promoting population growth,
inadequate family planning programs, and health-related behaviors such as smoking, diabetes,
and hypertension (Kralewski et al., 2015). Additionally, over the years, the role of ANPs has
been extended to different healthcare settings, such as in acute care where the patients require
emergency and critical care (Kralewski et al., 2015). ANPs have various unique roles in primary
care settings, including the diagnosis of patients, physical, psychological, functional and
developmental examinations on patients, requests, and interpretation of results and differential
diagnoses (Hibbert, Al-Sanea and Balens 2012). Similarly, ANPs play a part in the provision of
preventive care and health education to different populations (Hibbert, Al-Sanea & Balens,
2012).
Different studies have shown that the introduction and use of ANPs in primary care
settings has led to improved patient care and outcomes. The results indicated that the availability
of ANPs led to reduced health care costs and improved quality of healthcare due to the
incorporation of new health technologies and treatment. Similarly, Kralewski et al. (2015)
concluded that ANPs contribute positively to primary care settings, and should be employed to
meet the high healthcare demands.
Similarly, Swan et al. (2015) carried out a systematic review to determine the safety and
effectiveness of introducing ANPs in primary care settings. This review evaluated the ANPs
possibility to reduce shortages of healthcare services in primary care settings. The results by
Swan et al. (2015) showed that the value of services provided by ANPs was high and ANPs are
well-positioned to provide safe and valuable care that reduces the shortages experienced.
Martinez-Gonzalez et al. (2014) showed that the substitution of physicians by ANPs is common
in care settings with a low number of physicians necessitating a need for high quality and
affordable care. Similarly, a study by McDonnell et al., (2014) shows that if ANPs assume tasks
done by junior doctors in a primary care settings, a positive outcome from staff members,
patients, and nurses’ organizational skills is realized.
Additionally, this review indicates that clinical effectiveness and healthcare costs when
physicians are substituted by ANPs enhance patient satisfaction and is effective in promoting the
follow-up episodes. Also, the rates of hospital admissions and deaths when compared with the
rates by physicians were less, although not significant (Martinez-Gonzalez et al., 2014).
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Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Similarly, according to Alghamdi & Urden (2015), ANPs have the potential of transforming the
healthcare setting in SA leading to patient-oriented healthcare provision. Additionally, Barrat
and Thomas (2018) also indicated that the satisfaction of patients with the services by ANPs is
high. The study shows high levels of enablement compared with when the same patients
consulted with other clinicians. Barrat and Thomas (2018) highlighted the need for the inclusion
of ANPs in the provision of healthcare services, in a bid to reduce shortages and meet the high
demands (Alomi, 2015).
Despite their role in lowering physician shortages in health care settings and meeting
care demands, there are barriers and facilitators to the introduction and implementation of the
ANP's roles. A scoping review by Torrens et al. (2019) identified the obstacles to the positive
impact of ANPs in primary care settings. The study showed that disagreements over their level of
autonomy and their roles, supervision, and leadership, and funding and planning for their
integration were potential barriers to their employment in primary care settings.
Background Information
The health care system in Saudi Arabia is managed and controlled by government
agencies. The ministry of health manages the government which only manages the healthcare
sector of KSA. There are many medical and hospital services which are operated by the semi-
public organization (Al-jedai, et al., 2016). The healthcare quality services are also provided by
the private sectors which also supervise the general plans. The government made rules and
regulations which were enforced and supervise to provide public health services.
Over the years, however, Saudi Arabia has increased healthcare infrastructures that have
improved the healthcare services provided to its citizenry in the primary healthcare setting
(Hibbert, Al-Sanea and Balens 2012). Despite these improvements, some challenges remain
unresolved, and these affect the quality of services offered. Al-ASmri et al. (2018) carried out an
investigation to identify the problems within the Saudi Arabia healthcare system and noted that
high demand for services, increased costs, a growing burden of chronic diseases that require
more care, management and leadership issues and concern over the quality and safety of services
provided are some challenges experienced.
Certain issues can be solved by the inclusion of ANPs in the provision of medical
services in primary healthcare (Alghamdi & Urden 2015). Aboshaiqah (2013) indicates the
importance of nurses in primary healthcare settings in Saudi Arabia to enhance positive patient
Quality Improvement Project
Similarly, according to Alghamdi & Urden (2015), ANPs have the potential of transforming the
healthcare setting in SA leading to patient-oriented healthcare provision. Additionally, Barrat
and Thomas (2018) also indicated that the satisfaction of patients with the services by ANPs is
high. The study shows high levels of enablement compared with when the same patients
consulted with other clinicians. Barrat and Thomas (2018) highlighted the need for the inclusion
of ANPs in the provision of healthcare services, in a bid to reduce shortages and meet the high
demands (Alomi, 2015).
Despite their role in lowering physician shortages in health care settings and meeting
care demands, there are barriers and facilitators to the introduction and implementation of the
ANP's roles. A scoping review by Torrens et al. (2019) identified the obstacles to the positive
impact of ANPs in primary care settings. The study showed that disagreements over their level of
autonomy and their roles, supervision, and leadership, and funding and planning for their
integration were potential barriers to their employment in primary care settings.
Background Information
The health care system in Saudi Arabia is managed and controlled by government
agencies. The ministry of health manages the government which only manages the healthcare
sector of KSA. There are many medical and hospital services which are operated by the semi-
public organization (Al-jedai, et al., 2016). The healthcare quality services are also provided by
the private sectors which also supervise the general plans. The government made rules and
regulations which were enforced and supervise to provide public health services.
Over the years, however, Saudi Arabia has increased healthcare infrastructures that have
improved the healthcare services provided to its citizenry in the primary healthcare setting
(Hibbert, Al-Sanea and Balens 2012). Despite these improvements, some challenges remain
unresolved, and these affect the quality of services offered. Al-ASmri et al. (2018) carried out an
investigation to identify the problems within the Saudi Arabia healthcare system and noted that
high demand for services, increased costs, a growing burden of chronic diseases that require
more care, management and leadership issues and concern over the quality and safety of services
provided are some challenges experienced.
Certain issues can be solved by the inclusion of ANPs in the provision of medical
services in primary healthcare (Alghamdi & Urden 2015). Aboshaiqah (2013) indicates the
importance of nurses in primary healthcare settings in Saudi Arabia to enhance positive patient
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
outcomes. Similarly, Al-Hanawi, Khan & Al-Borie (2019) necessitate the introduction of ANPs
in Saudi Arabia, which will in turn, increase the number of nurses in the country and reduce the
shortages experienced and meet the healthcare needs of the population.
Purpose of the QI project
The purpose of QI project is to evaluate the role of the ANP in the KSA to aid in treatment
and to make the effective decisions. The purpose of ANP in KSA is to see the patients with the
undiagnosed conditions and also makes the complex decisions. ANP does not only take care of
the acute and the chronic disease but also use clinical reasoning and manages the uncertainty.
Their purpose in KSA is to make the long term relationship with the patients so that optimum
level of health can be achieved.
Primary care at a hospital in Saudi Arabia is facing a potential crisis due to a shortage in
the number of physicians providing safe, affordable, and quality healthcare. (Kralewski et al.
2015). The chronic care can be easily managed as the nurses have done the extra training so they
have the treated, examined the patient undiagnosed problem. They took several decisions on the
basis of the interpretation of the test results and on the diagnosis (Hibbert, et al., 2017). Their
role is to refer the patient to some other specialist if it is needed and also prescribe appropriate
medication to the patient. The changing health care needs are also responded by the nurse and
their role is hybrid. ANP also makes the contribution to the NHS and they also support the
clinical mentor.
However, the role of ANPs in primary care settings has not been implemented in Saudi
Arabia, and this poses challenges to the healthcare system in Saudi Arabia due to the growing
demand for affordable, quality and safe healthcare services and a shortage of physicians and
general practitioners (Kleinpell, et al., 2014).
The purpose of this QI project is to show evidence of improved patient care and outcomes
by introducing the ANP role to a primary care setting in Saudi Arabia.
Objective and Aim
Objective:
To measure the impact of the introduction of an ANP to a primary care setting
To meet the demands of health care services and to reduce the shortage of nurses
Aim: To evaluate the role of ANP in KSA so that patient care and safety can be improved.
Quality Improvement Project
outcomes. Similarly, Al-Hanawi, Khan & Al-Borie (2019) necessitate the introduction of ANPs
in Saudi Arabia, which will in turn, increase the number of nurses in the country and reduce the
shortages experienced and meet the healthcare needs of the population.
Purpose of the QI project
The purpose of QI project is to evaluate the role of the ANP in the KSA to aid in treatment
and to make the effective decisions. The purpose of ANP in KSA is to see the patients with the
undiagnosed conditions and also makes the complex decisions. ANP does not only take care of
the acute and the chronic disease but also use clinical reasoning and manages the uncertainty.
Their purpose in KSA is to make the long term relationship with the patients so that optimum
level of health can be achieved.
Primary care at a hospital in Saudi Arabia is facing a potential crisis due to a shortage in
the number of physicians providing safe, affordable, and quality healthcare. (Kralewski et al.
2015). The chronic care can be easily managed as the nurses have done the extra training so they
have the treated, examined the patient undiagnosed problem. They took several decisions on the
basis of the interpretation of the test results and on the diagnosis (Hibbert, et al., 2017). Their
role is to refer the patient to some other specialist if it is needed and also prescribe appropriate
medication to the patient. The changing health care needs are also responded by the nurse and
their role is hybrid. ANP also makes the contribution to the NHS and they also support the
clinical mentor.
However, the role of ANPs in primary care settings has not been implemented in Saudi
Arabia, and this poses challenges to the healthcare system in Saudi Arabia due to the growing
demand for affordable, quality and safe healthcare services and a shortage of physicians and
general practitioners (Kleinpell, et al., 2014).
The purpose of this QI project is to show evidence of improved patient care and outcomes
by introducing the ANP role to a primary care setting in Saudi Arabia.
Objective and Aim
Objective:
To measure the impact of the introduction of an ANP to a primary care setting
To meet the demands of health care services and to reduce the shortage of nurses
Aim: To evaluate the role of ANP in KSA so that patient care and safety can be improved.
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Trusted by 1+ million students worldwide
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
Research Question
There were the shortages of nurses in the KSA so after introducing an Advanced Practice Nurse
to a primary care setting is there any benefit which was received in this research proposal?
Quality Improvement Project
Research Question
There were the shortages of nurses in the KSA so after introducing an Advanced Practice Nurse
to a primary care setting is there any benefit which was received in this research proposal?
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Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
References
1. Aboshaiqah, A. (2015) ‘Nursing work environment in Saudi Arabia’, Journal of Nursing
Management, 23(4), pp.510-520.
2. Al Asmri, M., Almalki, M., Fitzgerald, G. and Clark, M. (2019) ‘The public healthcare
system and primary care services in Saudi Arabia: a system in transition’, Eastern
Mediterranean Health Journal.
3. Alghamdi, M. and Urden, L. (2015) ‘Transforming the nursing profession in Saudi Arabia.
Journal of Nursing Management’, 24(1), pp.E95-E100.
4. Al-Hanawi, M., Khan, S. and Al-Borie, H. (2019) ‘Healthcare human resource development
in Saudi Arabia: emerging challenges and opportunities—a critical review’, Public Health
Reviews, 40(1).
5. Al-jedai, A., Qaisi, S. and Al-meman, A. (2016) ‘Pharmacy Practice and the Health Care
System in Saudi Arabia’, The Canadian Journal of Hospital Pharmacy, 69(3).
6. Al-jedai, A., Qaisi, S. and Al-meman, A., (2016) ‘Pharmacy practice and the health care
system in Saudi Arabia’, The Canadian journal of hospital pharmacy, 69(3), p.231.
7. Almomani, I. and AlSarheed, A. (2016) ‘Enhancing outpatient clinics management software
by reducing patients’ waiting time’, Journal of Infection and Public Health, 9(6), pp.734-743.
8. Alomi, Y.A., (2015) ‘National pharmacy practice programs at ministry of health in Saudi
Arabia’, J Pharm Pharm Scien, 1(2), pp.17-8.
9. Anderson, H., Adamson, J. and Birks, Y. (2018) ;Presenting the primary care team to the
public: a qualitative exploration of general practice websites’, British Journal of General
Practice, 68(668), pp.e178-e186.
10. Barratt, J. and Thomas, N. (2018) ‘Nurse practitioner consultations in primary health care: a
case study-based survey of patients’ pre-consultation expectations, and post-consultation
satisfaction and enablement’, Primary Health Care Research & Development, 20B.
11. Bergman, K., Perhed, U., Eriksson, I., Lindblad, U. and Fagerström, L. (2013) ‘Patients'
satisfaction with the care offered by advanced practice nurses: A new role in Swedish
primary care’, International Journal of Nursing Practice, 19(3), pp.326-333.
12. Carnwell, R. and Daly, W. (2003) ‘Advanced nursing practitioners in primary care settings:
an exploration of the developing roles’, Journal of Clinical Nursing, 12(5), pp.630-642.
Quality Improvement Project
References
1. Aboshaiqah, A. (2015) ‘Nursing work environment in Saudi Arabia’, Journal of Nursing
Management, 23(4), pp.510-520.
2. Al Asmri, M., Almalki, M., Fitzgerald, G. and Clark, M. (2019) ‘The public healthcare
system and primary care services in Saudi Arabia: a system in transition’, Eastern
Mediterranean Health Journal.
3. Alghamdi, M. and Urden, L. (2015) ‘Transforming the nursing profession in Saudi Arabia.
Journal of Nursing Management’, 24(1), pp.E95-E100.
4. Al-Hanawi, M., Khan, S. and Al-Borie, H. (2019) ‘Healthcare human resource development
in Saudi Arabia: emerging challenges and opportunities—a critical review’, Public Health
Reviews, 40(1).
5. Al-jedai, A., Qaisi, S. and Al-meman, A. (2016) ‘Pharmacy Practice and the Health Care
System in Saudi Arabia’, The Canadian Journal of Hospital Pharmacy, 69(3).
6. Al-jedai, A., Qaisi, S. and Al-meman, A., (2016) ‘Pharmacy practice and the health care
system in Saudi Arabia’, The Canadian journal of hospital pharmacy, 69(3), p.231.
7. Almomani, I. and AlSarheed, A. (2016) ‘Enhancing outpatient clinics management software
by reducing patients’ waiting time’, Journal of Infection and Public Health, 9(6), pp.734-743.
8. Alomi, Y.A., (2015) ‘National pharmacy practice programs at ministry of health in Saudi
Arabia’, J Pharm Pharm Scien, 1(2), pp.17-8.
9. Anderson, H., Adamson, J. and Birks, Y. (2018) ;Presenting the primary care team to the
public: a qualitative exploration of general practice websites’, British Journal of General
Practice, 68(668), pp.e178-e186.
10. Barratt, J. and Thomas, N. (2018) ‘Nurse practitioner consultations in primary health care: a
case study-based survey of patients’ pre-consultation expectations, and post-consultation
satisfaction and enablement’, Primary Health Care Research & Development, 20B.
11. Bergman, K., Perhed, U., Eriksson, I., Lindblad, U. and Fagerström, L. (2013) ‘Patients'
satisfaction with the care offered by advanced practice nurses: A new role in Swedish
primary care’, International Journal of Nursing Practice, 19(3), pp.326-333.
12. Carnwell, R. and Daly, W. (2003) ‘Advanced nursing practitioners in primary care settings:
an exploration of the developing roles’, Journal of Clinical Nursing, 12(5), pp.630-642.
Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
Quality Improvement Project
13. Carroll, C., Booth, A. and Cooper, K. (2011) ‘A worked example of "best fit" framework
synthesis: A systematic review of views concerning the taking of some potential
chemopreventive agents’, BMC Medical Research Methodology, 11(1).
14. Cowley, A., Cooper, J. and Goldberg, S. (2016) ‘Experiences of the advanced nurse
practitioner role in acute care’, Nursing Older People, 28(4), pp.31-36.
15. Duke, N. (2012) ‘Exploring advanced nursing practice: past, present and future’, British
Journal of Nursing, 21(17), pp.1026-1030.
16. Finfgeld-Connett, D. (2013) ‘Use of content analysis to conduct knowledge-building and
theory-generating qualitative systematic reviews’, Qualitative Research, 14(3), pp.341-352.
17. Ghosh, Palash. (2011) “Top Five U.S. Counties with Largest Asian Populations.”
International Business Times [online] 22 February. Available at:
<https://www.ibtimes.com/top-five-us-counties-largest-asian-populations-photos-706132>
[Accessed 23 January 2020].
18. Graham, I. and Tetroe, J. (2007) ‘Some Theoretical Underpinnings of Knowledge
Translation’, Academic Emergency Medicine, 14(11), pp.936-941.
19. Graham, I., Logan, J., Harrison, M., Straus, S., Tetroe, J., Caswell, W. and Robinson, N.
(2006) Lost in knowledge translation: Time for a map?. Journal of Continuing Education in
the Health Professions, 26(1), pp.13-24.
20. Harmon, T., Liss, L., Umbricht, M., and Flesher, J. (2014) ‘Process improvement &
evaluation’, Champaign, IL: Office of Community College Research and Leadership,
University of Illinois at Urbana-Champaign.
21. Hibbert, D., Aboshaiqah, A.E., Sienko, K.A., Forestell, D., Harb, A.W., Yousuf, S.A.,
Kelley, P.W., Brennan, P.F., Serrant, L. and Leary, A., (2017) ‘Advancing nursing practice:
The emergence of the role of advanced practice nurse in Saudi Arabia’, Annals of Saudi
medicine, 37(1), pp.72-78.
22. Hibbert, D., Al-Sanea, N. and Balens, J. (2012) ‘Perspectives on Specialist Nursing in Saudi
Arabia: A National Model for Success’, Annals of Saudi Medicine, 32(1), pp.78-85.
23. Jenkins, J., Docherty, M. and Cain, J. (2018) ‘Advanced Nurse Practitioners impact across
Primary Care’, International Journal of Integrated Care, 18(s2), p.340.
Quality Improvement Project
13. Carroll, C., Booth, A. and Cooper, K. (2011) ‘A worked example of "best fit" framework
synthesis: A systematic review of views concerning the taking of some potential
chemopreventive agents’, BMC Medical Research Methodology, 11(1).
14. Cowley, A., Cooper, J. and Goldberg, S. (2016) ‘Experiences of the advanced nurse
practitioner role in acute care’, Nursing Older People, 28(4), pp.31-36.
15. Duke, N. (2012) ‘Exploring advanced nursing practice: past, present and future’, British
Journal of Nursing, 21(17), pp.1026-1030.
16. Finfgeld-Connett, D. (2013) ‘Use of content analysis to conduct knowledge-building and
theory-generating qualitative systematic reviews’, Qualitative Research, 14(3), pp.341-352.
17. Ghosh, Palash. (2011) “Top Five U.S. Counties with Largest Asian Populations.”
International Business Times [online] 22 February. Available at:
<https://www.ibtimes.com/top-five-us-counties-largest-asian-populations-photos-706132>
[Accessed 23 January 2020].
18. Graham, I. and Tetroe, J. (2007) ‘Some Theoretical Underpinnings of Knowledge
Translation’, Academic Emergency Medicine, 14(11), pp.936-941.
19. Graham, I., Logan, J., Harrison, M., Straus, S., Tetroe, J., Caswell, W. and Robinson, N.
(2006) Lost in knowledge translation: Time for a map?. Journal of Continuing Education in
the Health Professions, 26(1), pp.13-24.
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Introducing the Advanced Nurse Practitioner Role to a Primary Care Setting in Saudi Arabia: A
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Quality Improvement Project
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