A systematic review and meta-synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants
Article first published online: 18 SEP 2007
Journal of Clinical Nursing
Volume 16, Issue 10, pages 1792–1808, October 2007
How to Cite
Humphreys, A., Johnson, S., Richardson, J., Stenhouse, E. and Watkins, M. (2007), A systematic review and meta-synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants. Journal of Clinical Nursing, 16: 1792–1808. doi: 10.1111/j.1365-2702.2007.01757.x
- Issue published online: 18 SEP 2007
- Article first published online: 18 SEP 2007
- Submitted for publication: 16 December 2005 Accepted for publication: 24 April 2006
- consultant role;
- expert practice;
- systematic review
Aim. This paper presents the findings of a systematic review and meta-synthesis, which was undertaken to identify and assess studies that evaluated the nurse/midwife/allied health professional consultant role.
Background. As part of the modernization agenda in the National Health Service the United Kingdom government proposed ‘Consultant’ posts for nurses/midwives and allied health professionals as an opportunity for experienced practitioners to extend their roles. Four key functions were identified as being significant to this role development: expert practice, leadership, education and research. Explicit within the proposal was a requirement of these new roles to be evaluated.
Method. Inclusion criteria focussed on studies where an aspect of the role had been evaluated or where the consultant carried out the research. A total of 1931 citations was filtered to reveal 107 studies that possibly met the inclusion criteria. Of these 107, 14 studies were critically appraised and subjected to thematic analysis. Study methodology varied but of the 14 studies, 10 involved some form of measurement. The others adopted a literature review or descriptive approach.
Conclusions. The extent to which consultants were involved in all aspects of the ‘four pillars’ was assessed in only a small number of studies. However, a number of studies implicitly implied active engagement in expert practice and leadership by focussing on specific service developments.
Relevance to clinical practice. To date, a number of studies evaluating service developments, education, expert practice and leadership have been carried out. However although a number of studies have assessed perceived impact of the consultant role, no measure of actual benefit has been published to date. Studies that evaluate the cost benefit/outcomes of these roles in relation to both activity and quality of service are required.