Nurses’ Engagement in Healthcare Policy Development: An Umbrella Review

IF 3.7 3区医学 Q1 NURSING

International Nursing Review Pub Date : 2025-09-29 DOI:10.1111/inr.70109

Lindsay Smith, Karyn J. Roberts, Barbara Giambra, Michele Polfuss, Cynthia Danford, Debbie Sheppard-Lemoine, Theresa Ryan Schultz, Natalie Winter, Adam Mulcaster, Intima Alrimawi, Junko Honda, Petra Brysiewicz, Susan Carr, Suzanne Feetham

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引用次数: 0

Abstract

Background and Introduction

Healthcare policy establishes guidelines for delivering safe and effective healthcare, achieving and improving health-related outcomes, and mitigating public health risks. Nurses are uniquely positioned to lead healthcare policy development; however, evidence of nurses’ engagement in policymaking is limited. This umbrella review aims to examine and summarize nurses’ involvement in healthcare policy development aimed at transforming health.

Methods

Following the Joanna Briggs Institute umbrella review methodology, a systematic search was conducted across seven databases for peer-reviewed literature. Quality and risk of bias were assessed using the ROBIS tool. Data were analyzed using qualitative content analysis and meta-synthesis. This review is registered in PROSPERO (ID: CRD42023458475).

Results

The search yielded 591 records, which were evaluated using PRISMA guidelines. Articles (N = 7) were included if they were written in English, Japanese, or Arabic, reported a literature review study, and participants were registered or licensed nurses. Four master themes were identified: (1) diminished support and preconceived expectations of nurses’ roles in policy development contributed to individual, organizational, and system-level barriers; (2) hierarchical marginalization of nurses’ voices, interprofessional and gender dynamics, and limited leadership roles of nurses impact meaningful participation; (3) nurses’ internal perceptions, knowledge, and beliefs regarding power, role expectations, and interest, limit involvement in policy development; and (4) the development of skills and understanding of policy through education, training, modeling, and mentorship is foundational for informed and authentic engagement.

Conclusions

None of the included reviews identified nurses’ engagement in healthcare policy development. Lack of engagement was due to multilevel barriers, hierarchical marginalization, and limited skills.

Implications for Nursing and Healthcare Policy

Nurses are the voice of patient, family, and community health and well-being. This responsibility requires our engagement in healthcare policy development at all levels. Including nurses in healthcare policy development is crucial in creating healthcare that is fit for purpose and in the sustainability of the nursing workforce.

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护士在医疗保健政策制定中的参与：概括性回顾。

背景和介绍：医疗保健政策为提供安全和有效的医疗保健、实现和改善与健康相关的结果以及减轻公共卫生风险建立了指导方针。护士在领导医疗政策制定方面具有独特的地位；然而，护士参与政策制定的证据有限。本综述旨在检查和总结护士参与旨在改变健康的医疗保健政策制定。方法：遵循乔安娜布里格斯研究所（Joanna Briggs Institute）的伞形综述方法，对七个数据库进行了系统的检索，以获取同行评议的文献。使用ROBIS工具评估偏倚的质量和风险。数据分析采用定性内容分析和综合分析。本综述已在PROSPERO注册（ID: CRD42023458475）。结果：检索得到591条记录，使用PRISMA指南对其进行评估。文章（N = 7）如果用英语、日语或阿拉伯语撰写，报告文献回顾研究，并且参与者是注册或持牌护士，则纳入。确定了四个主要主题：(1)对护士在政策制定中的作用的支持减少和先入为主的期望导致了个人，组织和系统层面的障碍；(2)护士声音的等级边缘化、跨专业和性别动态以及护士有限的领导角色影响了有意义的参与；(3)护士对权力、角色期望和兴趣的内在认知、知识和信念限制了对政策制定的参与；(4)通过教育、培训、建模和指导发展技能和对政策的理解是知情和真实参与的基础。结论：纳入的综述均未发现护士参与医疗保健政策制定。缺乏参与是由于多层障碍、等级边缘化和有限的技能。对护理和保健政策的影响：护士是病人、家庭和社区健康和福祉的代言人。这一责任要求我们参与各级医疗保健政策的制定。将护士纳入医疗保健政策的制定对于创造符合目的的医疗保健和护理人员的可持续性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Nursing Review 医学-护理

CiteScore

7.90

自引率

7.30%

发文量

审稿时长

6-12 weeks

期刊介绍： International Nursing Review is a key resource for nurses world-wide. Articles are encouraged that reflect the ICN"s five key values: flexibility, inclusiveness, partnership, achievement and visionary leadership. Authors are encouraged to identify the relevance of local issues for the global community and to describe their work and to document their experience.