Systematic review of the impact of nurse interventions on patients' experiences receiving medical care

Abstract

Background
Nurses, making up 59% of the global healthcare workforce, play a crucial role in delivering primary healthcare and achieving the Sustainable Development Goals (SDGs). Integrating evidence-based practices into nursing is essential to enhance patient care and reduce health inequities. Despite progress, implementing these practices faces challenges from individual, social, and environmental factors.
Methods
This systematic review evaluated the effects of healthcare professional-level implementation strategies on nursing practices and patient outcomes, using the Cochrane Effective Practice and Organisation of Care (EPOC) Taxonomy. Searches were conducted across multiple databases, and 204 studies were included, comprising randomized controlled trials, cluster trials, and non-randomized studies. The primary outcome was adherence to clinical practices, while secondary outcomes included attitudes, knowledge, and patient health indicators. Data were analyzed using meta-analytic techniques, and the certainty of evidence was assessed with the GRADE approach.
Results
Implementation strategies significantly improved adherence to clinical practices . Positive effects were observed in nurses’ knowledge, skills, and attitudes. Multifaceted strategies combining education, feedback, and tailored interventions demonstrated the most consistent improvements. However, patient outcomes showed limited gains, with moderate to low certainty of evidence. Most studies originated from high-income settings, highlighting a gap in research within low- and middle-income countries.
Conclusion
Implementation strategies effectively enhance nursing practices, particularly when tailored and multifaceted. However, their direct impact on patient outcomes remains modest. Future research should explore diverse healthcare settings, emphasize sustainability, and expand the use of underutilized strategies to advance global nursing practices.