Evaluation of the Professional Nurse Advocate’s Role in Quality Improvement to Understand the Impact on Patient Outcomes and Experience: Mixed Methods

Background: The Professional Nurse Advocate (PNA) pro-gramme is delivered through the A-EQUIP model, where qual-ity improvement is integral (NHS England 2023). A national evaluation (2023) highlighted a lack of quantifiable evidence of patient care improvements stemming from PNA-led QI work(Anonymised 2023). This issue is particularly critical in intensive care settings, where complex and high-acuity patient care demands targeted QI initiatives to improve outcomes.
Aim: This study aims to analyse the impact of PNAs on patient outcomes and experience through QI activities.
Method: Using mixed methods, including thematic analysis of PNA interviews, a cross-sectional survey of 105 participants,and case examples, the research was guided by an expert PNA group and Laschinger’s (2001) theoretical framework.
Results: Four key themes emerged from interviews: (1) PNA preparedness and project identification; (2) project implementation and collaboration; (3) monitoring and reporting; and(4) impact on patient outcomes, project reach, and sustain-ability. Facilitators for successful QI work included empower-ment via RCS, multidisciplinary teamwork, and supportive infrastructures. Barriers identified included limited protected time, financial constraints, and insufficient QI training. The survey results showed a median impact rating of ‘High’ on patient care outcomes and ‘Moderate’ on patient experience,with PNAs also acknowledging positive effects on their professional growth.
Implications for Practice: While explicit measures of patient outcomes and experiences were scarce, a strong implicit association suggests that QI work has the potential to enhance patientcare, particularly in critical care environments where timely,targeted improvements can significantly affect outcomes. We recommend establishing robust data collection and reporting frameworks for QI activities. Enhancing dissemination through the A-EQUIP model could improve individual and organisational empowerment, ultimately translating PNA-led QI into tangible benefits for critically ill patients