{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T12:45:22Z","timestamp":1785674722534,"version":"3.56.0"},"reference-count":87,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Inquiry"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Healthcare systems worldwide face mounting pressure to deliver high\u2010quality care while enhancing efficiency and sustainability. Nurse\u2010led interventions have emerged as promising strategies to optimize care delivery, particularly within value\u2010based health systems. However, a comprehensive understanding of their clinical impact and economic value remains limited. This systematic review conducted following PRISMA guidelines, searched nine international databases to identify and synthesize formally evaluated nurse\u2010led interventions, programs, and strategies. Twenty\u2010eight studies were included, encompassing diverse care settings and patient populations. Most studies reported improvements in clinical outcomes, including reduced hospital readmissions, enhanced quality of life, and improved chronic disease management. Several interventions analyzed effectiveness, particularly those involving advanced nursing roles such as nurse practitioners and case managers. Findings suggest that clinical effectiveness does not necessarily translate into increased professional authority: nurse\u2010led interventions consistently generate value across patient, organizational, and systemic dimensions, yet nursing leadership remains structurally subordinate within healthcare governance. A systematic agenda for rigorous economic evaluation embedded in nursing research programs is urgently needed, alongside structural reforms that redistribute authority\u2014not merely develop competencies\u2014within healthcare organizations.<\/jats:p>","DOI":"10.1111\/nin.70146","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T12:25:27Z","timestamp":1785673527000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy, Effectiveness, and Efficiency of Nurse\u2010Led Interventions: Insights From a Critical Systematic Review"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9026-8434","authenticated-orcid":false,"given":"Aleix","family":"Fontanals\u2010Jimenez","sequence":"first","affiliation":[{"name":"Interuniversity Doctoral Program in Comprehensive Care and Health Services (UJA\u2010UDL\u2010UVIC\u2010Invest\u00e9n ISCIII), Society, Health, Education and Culture Research Group (GESEC), Department of Nursing and Physiotherapy University of Lleida Lleida Spain"},{"name":"Social Determinants and Health Education Research Group (SDHEd) Hospital del Mar Research Institute Barcelona Spain"},{"name":"Healthcare Research Group (GRECS) Institute of Biomedical Research in Lleida (IRBLleida) Lleida Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9233-1776","authenticated-orcid":false,"given":"Marta","family":"Trapero\u2010Bertran","sequence":"additional","affiliation":[{"name":"Healthcare Research Group (GRECS) Institute of Biomedical Research in Lleida (IRBLleida) Lleida Spain"},{"name":"Society, Health, Education and Culture Research Group (GESEC), Department of Economics and Business Universitat de Lleida Lleida Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4778-9769","authenticated-orcid":false,"given":"Esther","family":"Insa\u2010Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Social Determinants and Health Education Research Group (SDHEd) Hospital del Mar Research Institute Barcelona Spain"},{"name":"Hospital del Mar Nursing School (ESIHMar) Universitat Pompeu Fabra\u2010Affiliated Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","DOI":"10.7208\/chicago\/9780226189666.001.0001","volume-title":"The System of Professions: An Essay on the Division of Expert Labor","author":"Abbott A.","year":"1988"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12535"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13537"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.13196"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NNR.0000289501.45284.6e"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15745"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16347"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61122213"},{"issue":"3","key":"e_1_2_14_10_1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.11124\/JBIES-22-00125","article-title":"Revising the JBI Quantitative Critical Appraisal Tools to Improve Their Applicability: An Overview of Methods and the Development Process","volume":"21","author":"Barker T. 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