Nursing Within Primary Care Settings in Atlantic Canada: A Scoping Review

Abstract

To address the prevalence of chronic diseases in Newfoundland and Labrador, the province has committed to primary health care reform, including implementing interdisciplinary primary care (PC) teams. To inform discussions regarding integrating nurse practitioners (NPs), registered nurses (RNs), and licensed practical nurses (LPNs) into these teams, better understanding of their roles in PC is needed. A scoping review was conducted to examine and synthesize existing evidence related to nursing roles and resources in PC settings across Atlantic Canada (Newfoundland and Labrador, New Brunswick, Nova Scotia, Prince Edward Island), and associated contributions to patient care. Joanna Briggs Institute scoping review methodology was used. The Nursing Role Effectiveness Model guided the review. Twenty articles met inclusion criteria. Roles of RNs and NPs in PC included chronic disease management, education, and health promotion. No literature focused on LPNs. Interdisciplinary collaboration was evident across studies. However, nurses’ functions within teams were limited by institutional constraints and other providers. PC settings with nurses had positive clinical outcomes, improved access to services, and high patient satisfaction. The prevalence of nursing in PC throughout Atlantic Canada and how nurses’ roles are enacted is unclear. There is opportunity for future inquiry into specific attributes of nursing and PC teams that result in positive patient and system outcomes.