Introduction: advanced practice nurses are a growing number of professionals within the healthcare workforce worldwide, working within different clinical settings, among them emergency departments. Emergency departments are globally reporting an increasing number of visits, and additionally, emergency care is becoming more complex due to demographic changes and multimorbidity. Extended waiting times and overcrowding in emergency departments are global challenges negatively affecting quality of care. 

Aim: to provide a current overview of how advanced practice nurses in emergency departments impact these challenges by comparing the quality of care they provide to that of physicians, specifically focusing on the quality-of-care measures timeliness and safety.

Method: a systematic literature review was conducted. Searches were carried out in the databases CINAHL, PubMed and Embase. Articles meeting inclusion criteria underwent quality appraisal according to GRADE. The articles were summarized thematically, grouped along patient outcomes.

Results: 21 studies were included. When advanced practice nurses were compared to physicians, they demonstrated equal or improved performance on timeliness and safe care.

Conclusion: advanced practice nurses can safely provide quality patient care for lower acuity patients in emergency departments and reduce wait times and length of stay. Their impact on higher acuity patients shows promise but warrants further research.