Practice nursing: A systematic literature review of facilitators and barriers in three countries

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Background: Practice Nurses (PN) play an increasing role in chronic disease management, however, this role is poorly defined.

Question: How do Practice Nurses in New Zealand, Canada and the United Kingdom manage chronic disease? 

Aim: This systematic review aims to identify the barriers and facilitators for practice nurses in New Zealand (NZ), Canada and the United Kingdom (UK) when caring for patients with a chronic disease. To determine how Practice Nurses in three high income countries manage chronic disease. 

Methods: We searched Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, (CINAHL), and MEDLINE in February 2021. The initial search yielded 495 articles. Four hundred and sixty-four articles were excluded because they did not address the research question or included the community nurse or nurse practitioner. Nine articles with a total sample size of 1050 PN participants met the inclusion criteria. 

Findings: Six main themes were identified that outline the barriers and facilitators to the role of the practice nurse when managing chronic disease: financial incentives, funding, power differences between the nurse and patient and the nurse and doctor, time, education, and role ambiguity. 

Discussion: Policy initiatives across the three countries were replicated with similar barriers and facilitators to the PN role.

Conclusion: Working within a context driven by incentive funding and competing demands can be prohibitive to the effective management of chronic disease by the PN.

Original languageEnglish
Pages (from-to)254-263
Number of pages10
Issue number2
Early online date27 Sept 2022
Publication statusPublished - Apr 2023


  • Chronic disease
  • General practice
  • Management
  • Nurse
  • Policy
  • Primary health care


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