Cultura

The Evolution Of Nursing Practice In Modern Healthcare: Expanding Clinical Scope, Professional Autonomy, And Interdisciplinary Integration

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Shouq Faya Moghram Asiri, Mona Hamad AlSalman, Mohammed Ahmed Albakri, Mohammad Muhsen Hussein Almalki, Hatem Awadallah Ali Almalki
Bayan Salem Ibrahem, Abdulaziz Abdullah Almousa, Abdullah Ali Mutni Alharbi, Fatimah Eid M Alrehaili, Najwa Eid M Alrehaili

Abstract

The nursing profession has undergone profound transformation over recent decades, evolving from a predominantly task-oriented and supportive role into a highly autonomous, knowledge-driven, and integral component of modern healthcare systems. This review aims to synthesize contemporary evidence on the evolution of nursing practice, with particular emphasis on the expansion of clinical scope, the growth of professional autonomy, and the increasing integration of nurses within interdisciplinary healthcare teams. Using a comprehensive review of peer-reviewed literature published between 2015 and 2025, this article examines key drivers of nursing evolution, including healthcare system complexity, demographic and epidemiological transitions, technological innovation, and policy and educational reforms. The findings highlight significant advancements in advanced nursing practice, nurse-led models of care, independent clinical decision-making, and interprofessional collaboration across diverse healthcare settings. Evidence consistently demonstrates that the evolving role of nurses contributes to improved patient outcomes, enhanced care continuity, increased system efficiency, and strengthened workforce resilience. Despite these advances, challenges remain related to regulatory variability, role clarity, and organizational readiness. This review underscores the strategic importance of supporting nursing evolution to achieve sustainable, high-quality, and patient-centered healthcare systems.

Keywords : Nursing evolution; Nursing practice development; Professional autonomy; Advanced nursing roles; Interdisciplinary healthcare; Health systems transformation.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty