Advanced paramedics and nurses can deliver safe and effective pre-hospital and in-hospital emergency care: An integrative review.

AIM To explore and present an overview of scope of practice among registered nurses and paramedics with an advanced level of education in pre-hospital and in-hospital emergency care. DESIGN An integrative literature review. METHOD Studies published between 2006 and 2018 were retrieved by searching the databases CINAHL, PubMed, Scopus and Web of Science. Studies were selected by three independent researchers, and data were synthesized using thematic analysis. RESULTS The 25 studies identified focused on in-hospital (n = 15) and pre-hospital emergency care (n = 10) and included 13 professional titles originated from seven countries. The thematic analysis disclosed four themes; "Versatile care," "Safe care based on precision and accuracy," "Autonomous performance within boundaries" and "Beneficial towards patients and society." Advanced paramedics' and advanced nurses' services are characterized as safe, of high quality and of public benefit. Their services are being used in everyday practice as well as directed to certain categories of patients.