Práticas avançadas de enfermagem no âmbito da atenção primária à saúde: revisão sistemática
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Aug 5, 2025
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Resumo
Objetivo: Sumarizar as evidências existentes acerca das ações de Prática Avançada de Enfermagem no âmbito da Atenção Primária à Saúde à nível mundial. Métodos: Procedeu-se uma revisão sistemática que seguiu a Declaração PRISMA (2020), a partir de um protocolo de revisão cadastrado no PROSPERO sob ID: CRD42022301785, nas bases de dados: ScienceDirect, Scopus, Pubmed, Web of Science, CINAHL e EMBASE, sendo utilizada a seguinte expressão de busca: ((“Advanced Practice Nursing” OR Nursing OR “Nursing specialities”) AND “Primary Health Care” AND “Public Health”). Foram incluídos estudos descritivos publicados no idioma inglês, sem limite temporal, que responderam à questão de pesquisa. Utilizou-se os instrumentos ACROBAT-NRSI e GRADE-CERQual para analisar o risco de viés e a qualidade da evidência, respectivamente. Resultados: Foram identificadas 11.648 publicações, que após a triagem, resultaram em 65 artigos para leitura na íntegra e eleitos 15 manuscritos para síntese qualitativa. Os resultados encontrados demonstraram o desenvolvimento da enfermagem de prática avançada na Atenção Primária à Saúde em diferentes continentes, destacando barreiras e facilitadores em sua implementação. Considerações finais: O estudo possibilita compreender o desenvolvimento da enfermagem de prática avançada em diversos
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Como Citar
CordeiroJ. K. R., NóbregaW. F. S., OliveiraM. E. C. de, Miranda NetoM. V. de, & MartinianoC. S. (2025). Práticas avançadas de enfermagem no âmbito da atenção primária à saúde: revisão sistemática. Revista Eletrônica Acervo Saúde, 25(8), e21024. https://doi.org/10.25248/reas.e21024.2025
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Revisão Bibliográfica
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Referências
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24. MAIJALA V, et al. Primary health care registered nurses’ types in implementation of health promotion practices. Primary Health Care Research & Development, 2016; 17(5).
25. MARTIN-MISENER R, et al. Defining the Role of Primary Health Care Nurse Practitioners in Rural Nova Scotia. Canadian Journal of Nursing Research, 2010; 42(2).
26. MELNYK BM, et al. The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing, 2014; 11(1).
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29. ORGANIZAÇÃO PAN-AMERICANA DE SAÚDE. Organização Mundial de Saúde. Enfermagem na Região das Américas, 2023. Disponível em: https://www.paho.org/pt/topicos/enfermagem/enfermagem-na-regiao-das-americas-2023. Acesso em: 07 de nov. 2023.
30. PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ. 2021; 372(71).
31. PARKER JM, HILL MN. A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China. International Journal of Nursing Sciences, EUA, 2017; 4(2):196–204.
32. PÜSCHEL VAA, et al. Advanced Practice Nursing in Brazil: how are we and what is missing?. Revista Escola de Enfermagem da USP, 2022; 6:e20210455.
33. SHEER B, WONG FKY. The development of advanced nursing practice globally. Journal of Nursing Scholarship, EUA, 2008; 40(3):204-11.
34. SMOLOWITZ J, et al. Role of the registered nurse in primary health care: Meeting health care needs in the 21st century. Nursing Outlook, 2014.
35. STERNE JAC, et al. A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT-NRSI), 2014. Disponível em: http://www.riskofbias.info/. Acesso em: 24 fev. 2023.
36. TOMA TS, et al. GRADE-CERQual: uma abordagem para avaliar a confiança nos resultados de sínteses de evidências qualitativas. São Paulo: Instituto de Saúde, 2019. Disponível em: https://www.arca.fiocruz.br/bitstream/handle/icict/44095/GRADE-CERQual.pdf?sequence=2/. Acesso em: 26 fev. 2023.
37. TAYLOR C, BAILEY V. Nurse prescribing: An essential requirement or an expensive luxury for school nurses?. British Journal of School Nursing, 2017;12(7).
38. TOSO BRGO, et al. Nurses’ performance on primary care in the National Health Service in England. Revista Brasileira de Enfermagem, 2016; 69(1).
39. ZUG KE, et al. Advanced practice nursing in Latin America and the Caribbean: Regulation, education and practice. Revista Latino-Americana de Enfermagem, 2016; 24:e2807.
2. BAGNASCO A, et al. Core competencies for family and community nurses: A European e-Delphi study. Nurse Education in Practice, 2022; 60.
3. BARBOSA ACS, et al. Profile of nursing graduates: competencies and professional insertion. Revista Latino-Americana de Enfermagem, 2019; 27.
4. BRYANT-LUKOSIUS D, et al. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health. Revista Latino-Americana de Enfermagem, 2017; 25:e2826.
5. CASHIN A, et al. Standards for practice for registered nurses in Australia. Collegian, 2017; 24.
6. CASSIANI SHB, SILVA FAM. Expanding the role of nurses in primary health care: the case of Brazil. Revista Latino-Americana de Enfermagem, 2019; 27:e3245.
7. CASSIANI SHB, et al. Competencies for training advanced practice nurses in primary health care. Acta Paulista de Enfermagem, 2018; 31(6).
8. CASSIANI SHB, ZUG KE. Promoting the Advanced Nursing Practice role in Latin America. Revista Brasileira de Enfermagem, 2014; 67(5).
9. CASSIANI SHB, et al. Regulação da Prática de Enfermagem na Região das Américas: Relatório final do Fórum de Regulação da Prática de Enfermagem na Região das Américas 15 e 16 de março de 2023. Enfermagem em Foco, 2023; 14(1):e-202301ESP1.
10. CARNEY, M. Regulation of advanced nurse practice: its existence and regulatory dimensions from an international perspective. Journal of Nursing Management, 2016; 24(1):105-14.
11. CARNWELL R, DALY WM. Advanced nursing practitioners in primary care settings: an exploration of the developing roles. Journal of Clinical Nursing, 2003; 12.
12. CARRYER J, ADAMS S. Nurse practitioners as a solution to transformative and sustainable health services in primary health care: A qualitative exploratory study. Collegian. 2016.
13. CHRISTMALS CD, ARMSTRONG SJ. The essence, opportunities and threats to Advanced Practice Nursing in Sub-Saharan Africa: a scoping review. Heliyon, 2019; 5(10):e02531.
14. CORDEIRO JKR, et al. Advanced Practice Nursing in primary health care: a systematic review protocol. Online Brazilian Journal of Nursing, 2024; 23(1).
15. DELAMAIRE M, LAFORTUNE G. A Description and Evaluation of Experiences in 12 Developed Countries. OECD Health Working Papers, 2010; 54:e5kmbrcfms5g7-em.
16. FERINGA MM, et al. Registered nurses’ knowledge, attitude and practice regarding their scope of practice in Botswana. Health SA Gesondheid, 2020; 25.
17. GALVÃO MCB, RICARTE ILM. Revisão sistemática da literatura: conceituação, produção e publicação. Logeion, Rio de Janeiro, 2020; 6(1).
18. GUZMAN A, et al. Nurse Practitioner Role Implementation in Ontario Public Health Units. Canadian Journal of Public Health, 2010; 101(4).
19. INTERNATIONAL COUNCIL OF NURSES. Definition and Characteristics of the Role, 2022. Disponível em: https://international.aanp.org/Practice/APNRoles/. Acesso em: 25 nov. 2022.
20. JEAN E, et al. Context and implementation of advanced nursing practice in two countries; an exploratory qualitative comparative study. Nursing Outlook, 2019; 67(4).
21. JOSI R, BIANCHI M. Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles. BMJ Open, 2019; 9:e033929.
22. LANDIS JR, KOCH GG. The Measurement of Observer Agreement for Categorical Data. Biometrics, 1977; 33(1).
23. LI Y, et al. Perceptions and Expectations of Advanced Geriatric Nursing Role Development in Primary Health Care: A Qualitative Study Exploring Staff’s Perspectives. Journal of Multidisciplinary Healthcare, 2021;14.
24. MAIJALA V, et al. Primary health care registered nurses’ types in implementation of health promotion practices. Primary Health Care Research & Development, 2016; 17(5).
25. MARTIN-MISENER R, et al. Defining the Role of Primary Health Care Nurse Practitioners in Rural Nova Scotia. Canadian Journal of Nursing Research, 2010; 42(2).
26. MELNYK BM, et al. The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing, 2014; 11(1).
27. MORGAN RL, et al. Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environment International, 2018; 121(1).
28. ORGANIZAÇÃO PAN-AMERICANA DA SAÚDE. Expanding the Roles of Nurses in Primary Health Care, 2018. Disponível em: https://iris.paho.org/handle/10665.2/34960/. Acesso em: 24 jan. 2023.
29. ORGANIZAÇÃO PAN-AMERICANA DE SAÚDE. Organização Mundial de Saúde. Enfermagem na Região das Américas, 2023. Disponível em: https://www.paho.org/pt/topicos/enfermagem/enfermagem-na-regiao-das-americas-2023. Acesso em: 07 de nov. 2023.
30. PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ. 2021; 372(71).
31. PARKER JM, HILL MN. A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China. International Journal of Nursing Sciences, EUA, 2017; 4(2):196–204.
32. PÜSCHEL VAA, et al. Advanced Practice Nursing in Brazil: how are we and what is missing?. Revista Escola de Enfermagem da USP, 2022; 6:e20210455.
33. SHEER B, WONG FKY. The development of advanced nursing practice globally. Journal of Nursing Scholarship, EUA, 2008; 40(3):204-11.
34. SMOLOWITZ J, et al. Role of the registered nurse in primary health care: Meeting health care needs in the 21st century. Nursing Outlook, 2014.
35. STERNE JAC, et al. A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT-NRSI), 2014. Disponível em: http://www.riskofbias.info/. Acesso em: 24 fev. 2023.
36. TOMA TS, et al. GRADE-CERQual: uma abordagem para avaliar a confiança nos resultados de sínteses de evidências qualitativas. São Paulo: Instituto de Saúde, 2019. Disponível em: https://www.arca.fiocruz.br/bitstream/handle/icict/44095/GRADE-CERQual.pdf?sequence=2/. Acesso em: 26 fev. 2023.
37. TAYLOR C, BAILEY V. Nurse prescribing: An essential requirement or an expensive luxury for school nurses?. British Journal of School Nursing, 2017;12(7).
38. TOSO BRGO, et al. Nurses’ performance on primary care in the National Health Service in England. Revista Brasileira de Enfermagem, 2016; 69(1).
39. ZUG KE, et al. Advanced practice nursing in Latin America and the Caribbean: Regulation, education and practice. Revista Latino-Americana de Enfermagem, 2016; 24:e2807.