Table 3 Findings of the overall impact of five nursing processes on reported outcomes
Nursing process | First author of review | Magnitude of positive effects | Overall risk of bias score as reported by authors of reviews |
|---|---|---|---|
Case management | Backhouse | • Caregiver quality of life - interventions using a nurse case manager vs. other provider: SMD = 0.94 vs. 0.03 respectively; p < 0.001 | Moderate to high |
Ekers | • Depression symptom level: Moderate improvement d = 0.43; 95% CI 0.34 - 0.52 p < 0.001 heterogeneity I2 = 36.68% | Low-moderate | |
Halcomb | • Depression symptoms: small to moderate improvements in 5 out of 8 studies • Functional outcomes: small and inconsistent significant improvements in 3 out of 4 studies | N/A | |
Huntley | • Length of stay: MD = − 1.28 days; 95% CI − 2.04 to − 0.52 p = 0.001; heterogeneity I2 = 63% • Hospital readmission: Rate ratio = 0.74; 95% CI 0.60 to 0.9 p = 0.008; heterogeneity I2 = 69% | Low (5) High or unknown (5) | |
Latour | • Hospital days: small and inconsistent improvements | Low (6) Moderate-high (4) | |
Oeseburg | None. | Low (2) Moderate (4) High (2) | |
Taylor | None. | Moderate-high (3) High (6) | |
Self-management support | Baker | • Anxiety: significant improvement in 3 out of 5 studies – no effect size reported in primary studies • Self-efficacy: significant improvements in 6 out of 10 studies – no effect size reported in primary studies • Physician visits: significant differences reported in 3 out of 5 studies – no effect size reported in primary studies | Moderate |
Caro-Bautista | • HbA1c : Programmes in which nurses participated in the intervention vs. programmes without nurses participating Short-term: MD − 0.32% 95% CI: −0.57% to − 0.07% versus. −0.25%; 95% CI: −0.60–0.11% Mid-term: MD − 0.38%; 95% CI: −0.74% to − 0.02% versus. −0.20%; 95% CI: −0.54–0.13% | Moderate-high | |
Gorina | • Systolic and diastolic blood pressure: moderate significant improvements in 8 out of 12 studies • Changes in physical activity practice: moderate significant improvements in 2 out of 2 studies • Total cholesterol, high-density cholesterol, low-density cholesterol, and triglyceride: small significant improvements in 5 out of 8 studies • Change in nutritional habits: small improvement in 1 single study | Low (1) Uncertain (14) High (5) | |
Massimi | • HbA1c: MD -0.15, 95% CI -0.32 to 0.01, heterogeneity I2 = 28%, p = 0.21 • SBP: MD -3.04, 95% CI -5.01 to -1.06, heterogeneity I2 = 55%, p = 0.02 • DBP: MD -1.42, 95% CI -2.36 to -0.49, heterogeneity I2 = 34%, p = 0.14 | Low (9) Moderate (9) High (2) | |
Rice | • Readmission: small significant improvements in 3 out of 3 studies – no effect size reported • Hospitalization: small significant improvements in 2 out of 3 studies – no effect size reported | N/A | |
Vermeire | • HbA1c: minimal effects in 2 out of 2 studies MD -0.10, 95% CI -0.12 to -0.08, p < 0.00001; heterogeneity: 0.0% | Low (3) Moderate (13) High (5) | |
Yu-Mei Chen | • SBP: MD -2.22, 95%CI -3.59 to -0.49, heterogeneity: I2 = 0%, p = 0.55 |  N/A | |
Prescribing | Tabesh | None. | Moderate |
| Â | Wang | None. | Low (8) High (9) |
Nurse-led care | Clark | Community monitoring: • SBP: MD -4.8 mmHg, 95% CI − 7.0 to − 2.7, heterogeneity: I²=0%, p = 0.51 • DBP: MD − 3.5, 95% CI − 4.5 to − 2.5, heterogeneity: I²=0%, p = 0.54 Nursing follow-up: • SBP: MD -3.48, 95% CI -5.88 to -1.08, heterogeneity: I² = 36%, p = 0.16 • DBP:MD -1.92, 95% CI -3.39 to -0.45, heterogeneity: I²= 43%, p = 0.12 | Moderate |
|  | Crowe | • HbA1c: small to moderate significant improvements in 9 out of 15 studies • Blood pressure: small significant improvements in 5 out of 7 studies • Patient satisfaction: improvements in 2 out of 2 studies – no effect size reported | Low-moderate |
| Â | Deschodt | None. | Considerable |
|  | Dhar | • Pain: small improvements in 4 out of 4 studies – no effect size reported • Wound size: moderate improvements in 2 out for 3 studies – no effect size reported • Economic outcomes: small improvement in 1 study | Moderate-low |
|  | Han | • Self-care: moderate significant improvement in 9 out of 9 studies • Quality of life: moderate significant improvement in 2 out of 2 studies • Healthcare outcomes: moderate significant improvement in 11 out of 11 studies • Healthcare use of services: moderate significant improvements in 8 out of 8 studies | Moderate |
|  | Osakwe | • ED visits: moderate significant improvement in 2 out of 3 studies • Quality of life: moderate significant improvement in 1 single study | Low (1) Uncertain (2) High (4) |
|  | Parker | • SBP: MD -4.40, 95%CI -7.06 to -1.74, heterogeneity: I2 = 59%, p = 0.06 • DBP: MD -2.96 95%CI -4.97 to -0.96, heterogeneity: I2 = 78% p = 0.004 | Acceptable |
|  | Schadewaldt | • Quality of life: small and inconsistent improvements in 4 out of 4 studies | N/A |
|  | Wong | • Health related quality of life – disease specific: MD -2.60, 95% CI -4.81 to -0.39, heterogeneity: I²= 0% p = 0.77 • General quality of life: small and inconsistent improvements in 2 out of 3 studies | Moderate-high |
Continuity | Facchinetti | • Readmission rate at one month: RR 0.84, 95% CI 0.71 to 0.99, heterogeneity I2 = 3% p = 0.41 • Readmission rates at 1–3 months: RR 0.74, 95% 0.65 to 0.84, heterogeneity I2 = 7% p = 0.38 • Readmission rates at 6 to 12 months: RR 0.84, 95% CI 0.74 to 0.95, heterogeneity: I2 = 51% p = 0.02 | Low-moderate |