DAMPAK PERAN PERAWAT PRAKTIK MAHIR/ADVANCED PRACTICE NURSES DALAM PELAYANAN KESEHATAN PRIMER: A SCOPING REVIEW

Abstract

Tujuan Penelitian: menganalisis dampak peran perawat praktik mahir (advance practice nurse/APN) dalam pelayanan kesehatan primer terhadap mutu, efisiensi, dan akses layanan. Metode: Scoping review ini mengikuti pedoman PRISMA-ScR dengan pertanyaan PCC (population, concept, context). Pencarian literatur dilakukan secara sistematis di PubMed, Proquest, dan Science Direct dengan kriteria inklusi; artikel berbahasa Inggris, terbit pada tahun 2020 hingga Mei 2025, open access dengan subjek komunitas/masyarakat, membahas dampak perawat praktik mahir (APN) di layanan kesehatan primer. Jenis penelitian kualitatif maupun kuantitatif (RCT, quasi-eksperimen, deskriptif). Artikel disaring dengan Mendeley, dinilai menggunakan The Joanna Briggs Institute (JBI) appraisal tools, dianalisis secara deskriptif dan tematik, lalu data dikelompokkan berdasarkan dampak APN terhadap mutu, efisiensi, dan akses layanan. Hasil: Dari 8 artikel terpilih, ditemukan dampak peran APN dalam layanan primer ialah adanya peningkatan efektivitas waktu pelayanan, kualitas perawatan, kepuasan pasien, dan efisiensi biaya. Meskipun waktu klasifikasi DRAFT triase meningkat, hal ini berdampak positif terhadap ketepatan dan keselamatan pasien. Diskusi: Perawat praktik mahir (APN) berperan penting dalam meningkatkan mutu, efisiensi, dan akses layanan kesehatan primer melalui pengelolaan penyakit secara mandiri dan kolaboratif serta melalui pendekatan holistik. APN juga meningkatkan kepuasan pasien, efektivitas waktu pelayanan, serta pengelolaan terapi yang efektif. Simpulan: Temuan ini mendukung bahwa APN dapat meningkatkan kualitas layanan primer sehingga memperkuat sistem kesehatan primer. Untuk itu, diperlukan regulasi, pelatihan, dan integritas dalam tim kesehatan primer secara holistik dan berkelanjutan sehingga peran APN dapat lebih optimal.

Kata Kunci: peran, perawat praktik mahir, pelayanan primer

The Impact of Advanced Practice Nurses in Primary Health Care Services: A Scoping Review ABSTRACT

Objective: This study aimed to analyze the impact of the role of Advanced Practice Nurses (APNs) in primary health care services on quality of care, efficiency, and access to health services. Methods: This scoping review followed the PRISMA-ScR guidelines and used the PCC framework (Population, Concept, Context). A systematic literature search was conducted in PubMed, ProQuest, and ScienceDirect. The inclusion criteria were English-language articles published between 2020 and May 2025, open-access publications, studies involving community populations, and articles examining the impact of Advanced Practice Nurses in primary health care settings. Both qualitative and quantitative studies were included, such as randomized controlled trials (RCTs), quasi-experimental studies, and descriptive studies. Articles were screened using Mendeley and critically appraised using the Joanna Briggs Institute (JBI) appraisal tools. The data were analyzed using descriptive and thematic approaches, and the findings were categorized based on the impact of APNs on quality, efficiency, and access to health services. Results: Eight articles met the inclusion criteria. The findings indicate that the involvement of APNs in primary health care services contributes to improved service time effectiveness, higher quality of care, increased patient satisfaction, and greater cost efficiency. Although the triage classification process required more time, it resulted in improved accuracy and enhanced patient safety. Discussion: Advanced Practice Nurses play a significant role in improving the quality, efficiency, and accessibility of primary health care services through both independent and collaborative disease management, as well as through a holistic approach to patient care. Their involvement also contributes to higher patient satisfaction, more effective service delivery, and improved therapeutic management. Conclusion: The findings support the role of Advanced Practice Nurses in enhancing the quality of primary health care services and strengthening primary health care systems. Therefore, appropriate regulations, professional training, and strong integration within primary health care teams are necessary to optimize the role of APNs in a sustainable and holistic manner.

Keywords: role, advanced practice nurses, primary health care services