Metrics used by nurse practitioners to evaluate the impact of their role: A scoping review

Background: The link between the care provided by nurse practitioners and its impact on patient outcomes is not clear. Aim: To identify what metrics are currently being used by nurse practitioners to evaluate their practice. Design: Scoping review guided by Joanna Briggs Institute methodology. Methods: The population, concept, and context framework was used to guide keyword and index terms used. Metrics used to evaluate nurse practitioner practice and methods used in quantitative and qualitative studies, published in English between 2017 and 2023, were included. A content analysis was performed to identify metrics common to all nurse practitioners. Data sources: Medline, CINAHL, Embase, and the Joanna Briggs Institute Evidence-Based Practice Database were searched in July 2024. Grey literature was identified by searching Open Dissertations and Google Scholar. Results: Of the 2742 articles identified, 83 met the aim of this review. Most publications originated from the United States (n=46). No studies indicated consumer involvement in study design. Data analysis of the 294 metrics identified 17 themes. All themes were aligned to Donabedian's categories of structure (n=2), process (n=9), and outcome (n=6). Conclusions: Nurse practitioners are evaluating their specialty practice using a variety of metrics via quality assurance and observational design where the comparator is medicine. A lack of consumer involvement in practice evaluation was noted in this review. Metrics, co-designed with consumers, that measure nurse practitioner practice regardless of specialty is lacking throughout the literature and is desperately needed. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Nursing Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).