What do we want to know?
What socioeconomic benefits can be attributed to nursing and midwifery with respect to: mental health nursing, long-term conditions, and role substitution? In order to address this question, we carried out a Systematic Rapid Evidence Assessment (SREA) involving a focused review of systematic reviews with a limited search.
Who wants to know?
Policymakers, research commissioners, practitioners and researchers.
The review was undertaken to inform the work of the Prime Minister's Commission on the Future of Nursing and Midwifery. The Commission covers England only, and considers midwifery and all branches of nursing, in all settings, services and sectors. Its website is available here.
What did we find?
Thirty-two systematic reviews were identified. Most related to care provided by nurses and only two reviews looked solely at the role of midwives. Most of the reviews provided findings relevant to role substitution between nurses, midwives and other health professionals (n=22), or to long-term conditions (n=18). Only five reviews included findings on the role of nurses or midwives in mental health. Review activity on nursing and midwifery provision is recent: only four of the reviews were published before the year 2000, and half were published within the last five years.
The review found examples of the benefits of nursing and midwifery in primary care through home visiting interventions, specialist nursing and general practice based nursing including prevention and treatment. Hospital at home and in-patient care were also addressed in the included studies.
There was evidence of the benefits of nursing and midwifery for a range of outcomes. This was accompanied by no evidence of difference (where statistical tests failed to demonstrate a significant difference between nurse/midwife-delivered interventions and those provided by others) for other outcomes.An important finding of this review was that nursing and midwifery care when compared with other types of care was not shown to produce adverse outcomes. The included reviews rarely provided cost or cost-effectiveness data.
What are the implications?
The review was used to inform the work of the Prime Minister’s Commission on the Future of Nursing and Midwifery which is due to report in March 2010.
How did we get these results?
We searched a number of sources identifying 1741 original records. After screening the title and abstract of these records using our inclusion criteria, 306 full reports were sought and screened for relevance, quality and the presence of appropriate data. Thirty-two systematic reviews were available for inclusion within the review. Screening of full reports, assessment of quality and data extraction conducted separately by two reviewers who then met to compare findings. The findings from reviews with similar topics were grouped and synthesised using a narrative approach. Where possible, these syntheses presented review authors’ pooling of data. Often, authors had presented findings in a narrative form. The individual syntheses for this rapid review often needed to call upon findings from more than one review. As a result, this rapid review’s syntheses are themselves narrative in form.
This summary was prepared by the EPPI-Centre.
This report should be cited as: Caird J, Rees R, Kavanagh J, Sutcliffe K, Oliver K, Dickson K, Woodman J, Barnett-Page E, Thomas J (2010) The socioeconomic value of nursing and midwifery: a rapid systematic review of reviews. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.