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Nurse-led models of service delivery for skin cancer detection: a systematic review.

Authors: Kattach, L., Singleton, H., Ersser, S., Holley, D., Pearson, I. and Shadeed, A.

Journal: Journal of Advanced Nursing

Publisher: Wiley-Blackwell

eISSN: 1365-2648

ISSN: 0309-2402

Abstract:

Aim: This systematic review aims to consolidate evidence on nurse-led models for skin cancer detection, focusing on their roles in assessment, treatment, and education. It compares their effectiveness to physician-led care and highlights any 'value-added' benefits.

Design: Systematic review methodology with narrative synthesis.

Data sources: MEDLINE Complete, PubMed, Embase, CINAHL Complete, ScienceDirect, Scopus, BNI, LILACS, PsycINFO, Trip Medical Database, ERIC, EThOS, CDSR, WoS, Google Scholar, ClinicalTrials.gov, ICTRP, CENTRAL, and the website 'Getting It Right First Time'.

Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. Studies from January 1992 to September 2024 were assessed using Joanna Briggs Institute Critical Appraisal Checklists. The search included peer-reviewed and grey literature, but no grey literature met the inclusion criteria.

Results: Of the 6,680 records screened, six studies met the inclusion criteria, involving 3,325 patients across England, New Zealand, and the United States. These studies focused on nurse-led models of care for skin cancer, assessing outcomes such as diagnostic accuracy, treatment effectiveness, patient adherence, cost savings, waiting times, access to care, and patient satisfaction. While none directly compared nurse-led to dermatologist-led models, one study demonstrated comparable diagnostic accuracy between nurses and ophthalmologists. Nurse-led models were shown to effectively substitute for or complement physician-led care, with only one study authored by a nurse consultant. Service users favoured community-based, nurse-led care for its accessibility, convenience, and cost-effectiveness, with health education noted as an added benefit in one study.

Conclusion: The review suggests nurse-led models have the potential to offer high diagnostic accuracy, effective treatment, and skin self-examination education, though role clarity remains a challenge. Nurses play a key role in supporting dermatologists with high referral demands.

Impact: This paper highlights the potential of nurse-led models in skin cancer care, demonstrating nurses' diagnostic accuracy and role in identifying unsuspected lesions. It emphasises the need to standardise these models as scalable frameworks to support dermatologists in managing high referral demands and ensuring consistent international care standards, with further research required to assess their efficiency and cost-effectiveness.

Patient Contribution: A patient representative with melanoma contributed to the study protocol.

https://eprints.bournemouth.ac.uk/40776/

Source: Manual

Nurse-led models of service delivery for skin cancer detection: a systematic review.

Authors: Kattach, L., Singleton, H., Ersser, S.J., Holley, D., Pearson, I. and Shadeed, A.

Journal: Journal of Advanced Nursing

Publisher: Wiley-Blackwell

ISSN: 0309-2402

Abstract:

Aim: This systematic review aims to consolidate evidence on nurse-led models for skin cancer detection, focusing on their roles in assessment, treatment, and education. It compares their effectiveness to physician-led care and highlights any 'value-added' benefits. Design: Systematic review methodology with narrative synthesis.

Data sources: MEDLINE Complete, PubMed, Embase, CINAHL Complete, ScienceDirect, Scopus, BNI, LILACS, PsycINFO, Trip Medical Database, ERIC, EThOS, CDSR, WoS, Google Scholar, ClinicalTrials.gov, ICTRP, CENTRAL, and the website 'Getting It Right First Time'. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. Studies from January 1992 to September 2024 were assessed using Joanna Briggs Institute Critical Appraisal Checklists. The search included peer-reviewed and grey literature, but no grey literature met the inclusion criteria.

Results: Of the 6,680 records screened, six studies met the inclusion criteria, involving 3,325 patients across England, New Zealand, and the United States. These studies focused on nurse-led models of care for skin cancer, assessing outcomes such as diagnostic accuracy, treatment effectiveness, patient adherence, cost savings, waiting times, access to care, and patient satisfaction. While none directly compared nurse-led to dermatologist-led models, one study demonstrated comparable diagnostic accuracy between nurses and ophthalmologists. Nurse-led models were shown to effectively substitute for or complement physician-led care, with only one study authored by a nurse consultant. Service users favoured community-based, nurse-led care for its accessibility, convenience, and cost-effectiveness, with health education noted as an added benefit in one study.

Conclusion: The review suggests nurse-led models have the potential to offer high diagnostic accuracy, effective treatment, and skin self-examination education, though role clarity remains a challenge. Nurses play a key role in supporting dermatologists with high referral demands.

Impact: This paper highlights the potential of nurse-led models in skin cancer care, demonstrating nurses' diagnostic accuracy and role in identifying unsuspected lesions. It emphasises the need to standardise these models as scalable frameworks to support dermatologists in managing high referral demands and ensuring consistent international care standards, with further research required to assess their efficiency and cost-effectiveness.

Patient Contribution: A patient representative with melanoma contributed to the study protocol.

https://eprints.bournemouth.ac.uk/40776/

Source: BURO EPrints