{"title":"Nurse practitioners in New Zealand: An integrative review of clinical practice and involvement in policy","authors":"Deborah L. Harris , Eileen McKinlay","doi":"10.1016/j.colegn.2025.08.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Nurse Practitioner roles have escalated internationally with the aim of improving access to healthcare and thereby enhancing health and social outcomes. In Aotearoa New Zealand, Nurse Practitioner registration began in 2001, yet questions remain about their contributions to practice and policy.</div></div><div><h3>Aim</h3><div>To critically appraise peer-reviewed research on nurse practitioners’ contributions to clinical practice and health policy in New Zealand.</div></div><div><h3>Methods</h3><div>This integrative review followed Whittemore and Knafl’s five-stage framework. A search was conducted across six databases between January 2001 and May 2025. Inclusion criteria required studies to report primary research or audits. The Mixed Methods Appraisal Tool assessed methodological quality. Data were extracted, summarised in tabular form, and synthesised narratively across key domains. Twenty-two studies were included: 8 qualitative, 11 quantitative, and 3 mixed methods.</div></div><div><h3>Findings</h3><div>Nurse practitioners deliver expert, culturally safe healthcare across diverse settings. They collaborate interprofessionally to deliver coordinated care, promote health, and provide clinical leadership that improves healthcare access and equity. Studies highlight the nurse practitioner role in supporting underserved communities through models responsive to Māori and Pacific populations. Policy engagement remains weak. Barriers include organisational constraints, limited early-career support, insufficient data on workforce, clinical activity, and patient outcomes, and a misalignment between nurse practitioner values and funding models.</div></div><div><h3>Discussion</h3><div>Strong evidence shows that nurse practitioners improve care across diverse settings. However, their involvement in policy development remains limited. Data gaps and structural barriers continue to constrain their impact. Strengthening practitioner leadership, research capacity, and policy engagement is essential to advance equity and drive health reform.</div></div>","PeriodicalId":55241,"journal":{"name":"Collegian","volume":"32 5","pages":"Pages 328-340"},"PeriodicalIF":1.7000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Collegian","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1322769625000605","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Nurse Practitioner roles have escalated internationally with the aim of improving access to healthcare and thereby enhancing health and social outcomes. In Aotearoa New Zealand, Nurse Practitioner registration began in 2001, yet questions remain about their contributions to practice and policy.
Aim
To critically appraise peer-reviewed research on nurse practitioners’ contributions to clinical practice and health policy in New Zealand.
Methods
This integrative review followed Whittemore and Knafl’s five-stage framework. A search was conducted across six databases between January 2001 and May 2025. Inclusion criteria required studies to report primary research or audits. The Mixed Methods Appraisal Tool assessed methodological quality. Data were extracted, summarised in tabular form, and synthesised narratively across key domains. Twenty-two studies were included: 8 qualitative, 11 quantitative, and 3 mixed methods.
Findings
Nurse practitioners deliver expert, culturally safe healthcare across diverse settings. They collaborate interprofessionally to deliver coordinated care, promote health, and provide clinical leadership that improves healthcare access and equity. Studies highlight the nurse practitioner role in supporting underserved communities through models responsive to Māori and Pacific populations. Policy engagement remains weak. Barriers include organisational constraints, limited early-career support, insufficient data on workforce, clinical activity, and patient outcomes, and a misalignment between nurse practitioner values and funding models.
Discussion
Strong evidence shows that nurse practitioners improve care across diverse settings. However, their involvement in policy development remains limited. Data gaps and structural barriers continue to constrain their impact. Strengthening practitioner leadership, research capacity, and policy engagement is essential to advance equity and drive health reform.
期刊介绍:
Collegian: The Australian Journal of Nursing Practice, Scholarship and Research is the official journal of Australian College of Nursing (ACN).
The journal aims to reflect the broad interests of nurses and the nursing profession, and to challenge nurses on emerging areas of interest. It publishes research articles and scholarly discussion of nursing practice, policy and professional issues.
Papers published in the journal are peer reviewed by a double blind process using reviewers who meet high standards of academic and clinical expertise. Invited papers that contribute to nursing knowledge and debate are published at the discretion of the Editor.
The journal, online only from 2016, is available to members of ACN and also by separate subscription.
ACN believes that each and every nurse in Australia should have the opportunity to grow their career through quality education, and further our profession through representation. ACN is the voice of influence, providing the nursing expertise and experience required when government and key stakeholders are deciding the future of health.