Nurse-Led Models of Care for Patients with Complex Chronic Conditions: A Scoping Review

The burden of complex, chronic conditions in Canadian healthcare is growing, requiring more human and financial resources than ever before. It has become increasingly paramount to look for new ways to more effectively manage complex care to meet the needs of patients and providers. Nurse-led models, including advanced practice models, are uniquely positioned to pioneer innovative care delivery methods for patients with complex chronic needs in Canada. A scoping review was undertaken to determine what is known about nurse-led models of care for patients with complex chronic conditions. Nurse-led models of care include not only nurses independently managing complex care but also nurse practitioners, clinical nurse specialists and other specialist nurses. Using the Arksey and O'Malley framework for scoping reviews, 35 publications were identified in the search. Although the academic literature was surprisingly limited, our results suggest that nurse-led models are feasible opportunities to better coordinate care of patients with complex chronic conditions. Specific aims of nurse-led models of care focused on patients with more than one condition were identified in the review. These findings highlight the need to continue to explore nurse-led models of care as a strategy to facilitate a more coordinated and systematic approach to chronic care delivery.