Capturing the added value of nurse practitioners: Development of a conceptual framework to guide policy, practice, education, and research

BACKGROUND: The role of nurse practitioners (NPs) is expanding globally, yet their added value remains poorly defined, limiting evidence-based implementation and sustainability. PURPOSE: To propose a conceptual framework of the added value of NPs. METHODS: A five-step process was used: (a) initial concept analysis (n = 16 articles); (b) developing an initial framework; (c) testing the initial framework in a descriptive multiple case study, using both deductive and inductive approaches with thematic analysis; (d) concept analysis of primary health care NPs (n = 37 systematic reviews); and (e) updating and revising the framework. DISCUSSION: The proposed framework identifies how NP activities, professional development, and team dynamics, grounded in a holistic person-centered approach, constitute the essence of their added value. Structures and outcomes are described at different levels. CONCLUSION: This framework, supported by empirical evidence, offers a foundation for evaluating NP roles and guiding practice, research, policy, and education.