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Twist IL, Moxham L, Tillott S, Fernandez R. Experiences of nurse practitioners working during the COVID-19 pandemic: A metasynthesis of qualitative studies. J Am Assoc Nurse Pract 2023; 35:347-356. [PMID: 37141430 DOI: 10.1097/jxx.0000000000000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/14/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The impact of the COVID-19 pandemic forced global changes to how nurses practice. Nurse practitioners adjusted their scope, changed how they delivered their service, and worked with limited resources. For some services, patient access was also compromised. OBJECTIVES To synthesize, combine, and present current evidence on the experiences of nurse practitioners working during the COVID-19 pandemic. DATA SOURCES CINAHL, Embase, and MEDLINE electronic databases were used to perform a structured search strategy. CONCLUSION During the COVID-19 pandemic, health care services had to leverage their workforce skills to accelerate COVID-19 identification, treatment, and care. Nurse practitioners rapidly found themselves at the forefront and were concerned about infecting others. They also identified the need for support and were able to adapt to the changing environment. Nurse practitioners also recognized the impact on their well-being. Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning. Understanding how they coped will help with critical preparedness and response actions to other health care crises. IMPLICATIONS FOR PRACTICE Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning because, as we know, the nurse practitioner workforce is one of the most rapidly growing professions in primary health care. Any future work in this space will help inform future nurse practitioner education and also help by informing critical preparedness and response actions to future health care crises, whether global or local or clinical or nonclinical.
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Affiliation(s)
- Ida Laura Twist
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Sarah Tillott
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
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2
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Exploring the perceptions of governance arrangements for nurse practitioners: A pilot study. Collegian 2022. [DOI: 10.1016/j.colegn.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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3
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Ryder M, Jacob E. A translational research framework for nurse practitioners. J Nurs Manag 2021; 30:421-427. [PMID: 34669230 DOI: 10.1111/jonm.13496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/09/2023]
Abstract
AIMS This study aims to explore a proposed translational research continuum for nurse practitioners. BACKGROUND Nurse practitioners are acknowledged as clinical leaders responsible for transforming health care delivery. It is important that nurse practitioners contribute to health care knowledge using scientific processes for the implementation of evidence-based practice and evaluation of outcomes of interventions for their patient groups. EVALUATION This paper provides a review of translational research literature including implementation science to align nurse practitioner activities to a modified translational research framework. KEY ISSUES A translational research framework has the potential to strengthen nursing research in the nurse practitioner role. Adapting an accepted translational research continuum for nurse practitioners places the clinical nursing leaders in an equitable research position with all health care professionals. IMPLICATIONS FOR NURSING MANAGEMENT The translational research continuum provides nursing management with a structure to benchmark nursing research. The continuum applies a modern research framework to support research engagement for the nurse practitioner role.
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Affiliation(s)
- Mary Ryder
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,Nursing Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Elisabeth Jacob
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
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Fox A, Joseph R, Cardiff L, Thoms D, Yates P, Nissen L, Chan RJ. Evidence-informed implementation of nurse prescribing under supervision: An integrative review. J Adv Nurs 2021; 78:301-313. [PMID: 34477229 DOI: 10.1111/jan.14992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/10/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
AIM To explore evidence reporting facilitators and barriers to implementation of nurse prescribing and provide practical recommendations for evidence-informed implementation and adoption of nurse prescribing under a supervision model. BACKGROUND As demand for access to quality health care services increases, health professional roles are expanding to meet population needs. Nurse prescribing has been effective in some countries and is being considered globally to address growing health care demand. Successful implementation of health service models requires careful planning and consideration. No existing reviews have examined implementation factors in the literature. DESIGN Integrative review. DATA SOURCES CINAHL, MEDLINE, PubMed and EMBASE databases were searched from inception to 15 April 2020. REVIEW METHODS This integrative review is guided by Whittemore and Knafl and adheres to PRISMA reporting guidelines. The sustainability of innovation framework was used to synthesize data concerning implementation and sustainability factors (i.e. innovation, organizational, political, workforce and financial) for nurse prescribing. RESULTS A total of 39 articles were reviewed with literature predominantly reporting findings related to non-medical and nurse prescribing under various models. Variable evidence was found to inform nurse prescribing across five implementation and sustainability factors identifying several areas that require in-depth consideration. Very little evidence is available on nurse prescribing under supervision. CONCLUSION Introduction of service reform is often costly. This review highlights gaps in the literature and raises areas for consideration prior to implementation of this new service delivery model. The introduction of nurse prescribing must be planned and informed by available evidence to support effective adoption, practice and patient outcomes. IMPACT There are significant gaps in evidence related to nurse prescribing under a supervision model. Based on the evidence synthesized in this review, this paper provides practical recommendations for health service providers, managers, clinicians, educators and researchers to support implementation and adoption of nurse prescribing.
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Affiliation(s)
- Amanda Fox
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ria Joseph
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lynda Cardiff
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Debra Thoms
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Patsy Yates
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lisa Nissen
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Raymond Javan Chan
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
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Clinician experience, perceptions, and acceptance of paediatric complex care nurse practitioner roles. Collegian 2021. [DOI: 10.1016/j.colegn.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Williamson F, Grant K, Warren J, Handy M. Trauma Tertiary Survey: Trauma Service Medical Officers and Trauma Nurses Detect Similar Rates of Missed Injuries. J Trauma Nurs 2021; 28:166-172. [PMID: 33949352 DOI: 10.1097/jtn.0000000000000578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Trauma tertiary surveys (TTSs) can improve patient outcomes by identifying missed injuries following initial trauma reception and resuscitation. Most TTSs are conducted by medical officers despite the multidisciplinary team approach of modern trauma care. OBJECTIVE The study aim was to assess the accuracy of detecting missed injuries when the TTS was performed by specialist trauma nursing staff, rather than trauma service medical officers (TSMOs). METHODS A prospective, convenience sample of adult trauma patients admitted to a tertiary trauma center and attended by the trauma service between October 2015 and August 2018 was obtained. For this sample, a TTS was completed by both the TSMO and the trauma nurse (TN). The number of radiological investigations ordered and missed injuries identified were compared between the two clinicians. Additional injuries were graded using the Clavien-Dindo system. RESULTS The study sample consisted of 165 patients with a dual TTS, for which at least one team member requested 35 additional radiological investigations. There was fair agreement (κ = 0.36) between the TN and the TSMO in requesting additional radiological investigations. Ten missed injuries were identified by TN-initiated review (n = 24), and 4 missed injuries were identified by TSMO-initiated review (n = 21). Injuries identified following TTSs ranged in severity grading from 0 to 3. CONCLUSIONS Performance of the TN on the TTS in the identification of missed injuries is similar to that of the TSMO. Trauma nurses use an appropriate and rationalized approach to ordering additional radiological investigations and contribute a valuable addition to trauma patient care.
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Affiliation(s)
- Frances Williamson
- Trauma Service (Mss Williamson and Grant and Mr Handy) and Jamieson Trauma Institute (Mss Williamson and Warren and Mr Handy), Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia; and Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia (Ms Williamson)
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Gardner A, Helms C, Gardner G, Coyer F, Gosby H. Development of nurse practitioner metaspecialty clinical practice standards: A national sequential mixed methods study. J Adv Nurs 2021; 77:1453-1464. [PMID: 33617021 PMCID: PMC7898871 DOI: 10.1111/jan.14690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/10/2020] [Accepted: 11/05/2020] [Indexed: 11/27/2022]
Abstract
AIM To achieve profession-wide consensus on clinical practice standards for six broad Australian nurse practitioner specialty areas (termed metaspecialties). DESIGN Sequential mixed methods with initial interpretive study (Interpretive Phase) followed by modified three-round Delphi study (Survey Phase). METHODS Participants from all Australian jurisdictions were recruited. Main eligibility criterion was current endorsement as a nurse practitioner for 12 or more months. Interpretive Phase comprised in-depth interviews of purposeful sample of nurse practitioners to identify clinical care activities and practice processes. Six sets of draft clinical practice standards relevant to six previously identified metaspecialties were developed. Outcome informed Round 1 of Survey Phase (six nested web-based Delphi surveys), with draft standards reviewed profession-wide. Responses comprised scoring using Likert scales to calculate content validity indexes for individual standards with qualitative responses supporting decision-making. For Rounds 2 and 3, participants rated relevancy of original or revised standards after consideration of individual and group feedback. The study was conducted 2014-2017. RESULTS Interpretive Phase: Analysis of interview data with 16 nurse practitioners provided 75 draft standards. Survey Phase: 221 nurse practitioners completed Round 1 (20% of then eligible Australian nurse practitioners). Weighted respondent retention was 92%. Seventy-three standards were validated, with final content validity indices of 92-100%. Scale-level indices were 98%, strongly validating metaspecialty taxonomy. CONCLUSION A research-derived, professionally endorsed suite of nurse practitioner clinical practice standards was developed. This provides a broad clinical learning structure with metaspecialties guiding nurse practitioner student clinical education. IMPACT The clinical practice standards and metaspecialty taxonomy strengthen nurse practitioner clinical education and professional development nationally and internationally. These novel study methods and findings are applicable to advanced specialty roles in other health professions.
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Affiliation(s)
- Anne Gardner
- Queensland University of Technology (QUT)BrisbaneQldAustralia
| | | | - Glenn Gardner
- Queensland University of Technology (QUT)BrisbaneQldAustralia
- Edith Cowan UniversityPerthWAAustralia
| | - Fiona Coyer
- School of Nursing, and Intensive Care Services (ICS)Queensland University of Technology (QUT)Royal Brisbane and Women's HospitalBrisbaneQldAustralia
- Institute for Skin Integrity and Infection PreventionUniversity of HuddersfieldHuddersfieldUK
| | - Helen Gosby
- The Sydney Children’s Hospital NetworkSydneyNSWAustralia
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Lowe G, Tori K, Jennings N, Schiftan D, Driscoll A. Nurse practitioner work patterns: A cross-sectional study. Nurs Open 2021; 8:966-974. [PMID: 33434388 PMCID: PMC7877128 DOI: 10.1002/nop2.705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/16/2020] [Accepted: 10/28/2020] [Indexed: 11/18/2022] Open
Abstract
AIM The aim was to determine how nurse practitioner (NP) roles are translated into clinical practice across Victoria, Australia. This paper reports details about NP work patterns and scopes of practice across multiple clinical settings and geographic locations. DESIGN A quantitative survey design was used. A data abstraction tool, based on previous work, was adapted for this study. METHODS All NPs in one state of Australia were eligible to participate in the study and invited to complete an online survey about their NP practice. A previously developed data collection tool, capturing practice patterns of NPs, was adapted for online use in REDCAP. The data were exported, and descriptive statistics were analysed using SPSS. RESULTS Participants were mostly female, with males accounting for 25%. Findings indicate several NPs working in outpatient settings, community settings and forensic care. Patterns of practice-prescribing and ordering diagnostics-are associated with clinical context and model of care of the NP work.
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Affiliation(s)
- Grainne Lowe
- School of Nursing & MidwiferyCentre for Quality and Patient Safety ResearchDeakin UniversityBurwoodVic.Australia
| | | | | | - Dan Schiftan
- Department of Health and Human ServicesMelbourneVic.Australia
| | - Andrea Driscoll
- School of Nursing & MidwiferyCentre for Quality and Patient Safety ResearchDeakin UniversityBurwoodVic.Australia
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Dwyer T, Craswell A, Browne M. Predictive factors of the general public's willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey. HUMAN RESOURCES FOR HEALTH 2021; 19:21. [PMID: 33596928 DOI: 10.1186/s12960-021-00562-711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/01/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers 'willingness' to be seen by NPs warrants further investigation. METHODS Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. RESULTS While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. CONCLUSION Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.
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Affiliation(s)
- Trudy Dwyer
- CQUniversity Australia, Building 18 Rockhampton Campus, Bruce Highway, Rockhampton, Q 4702, Australia.
| | - Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Q 4556, Australia
| | - Matthew Browne
- CQUniversity Australia, University Drive, Building 8/G.47, Branyan Australia, Bundaberg, Qld, 4670, Australia
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Dwyer T, Craswell A, Browne M. Predictive factors of the general public's willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey. HUMAN RESOURCES FOR HEALTH 2021; 19:21. [PMID: 33596928 PMCID: PMC7890991 DOI: 10.1186/s12960-021-00562-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers 'willingness' to be seen by NPs warrants further investigation. METHODS Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. RESULTS While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. CONCLUSION Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.
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Affiliation(s)
- Trudy Dwyer
- CQUniversity Australia, Building 18 Rockhampton Campus, Bruce Highway, Rockhampton, Q 4702, Australia.
| | - Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Q 4556, Australia
| | - Matthew Browne
- CQUniversity Australia, University Drive, Building 8/G.47, Branyan Australia, Bundaberg, Qld, 4670, Australia
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Ryder M, Jacob E, Hendricks J. A survey identifying leadership and research activities among Nurse Practitioners. Contemp Nurse 2020; 56:441-454. [PMID: 33048006 DOI: 10.1080/10376178.2020.1835508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Nurse Practitioners are identified as the ideal conduit to transform healthcare delivery internationally. Healthcare transformation requires the application of leadership and research skills. Current literature has limited information on NPs as leaders or researchers in the nursing profession.Objectives: Determine if Nurse Practitioners identify themselves as leaders in nursing. Identify the leadership and research activities and influencing characteristics of Nurse Practitioners in Ireland and Australia. Establish similarities in leadership and research activities between Nurse Practitioners in Ireland and Australia. To identify if there is a relationship between leadership and research activities.Design: A quantitative electronic survey.Methods: A survey instrument was developed by combining two previously validated instruments. Nurse Practitioners in Ireland or Australia that had practiced within the last five years, and members of the respective professional association were included. Descriptive statistics were used to describe the findings and explore relationships in the data.Results: 14% (n = 96) of Nurse Practitioners responded to the survey. Nurse Practitioners in Ireland and Australia identified themselves as leaders of the nursing profession. Nurse Practitioners work practices, leadership and research activities are similar in Ireland and Australia. The majority (n = 55, 57%), of participants reported being research active. There was an association between perceived leadership and research activities among participants.Conclusion: Nurse Practitioners in both Ireland and Australia identify themselves as leaders of the nursing profession. There is no difference in reported work practices, leadership or research activities of Nurse Practitioners in both Ireland and Australia. There is an association between perceived leadership and research activity.Impact Statement: Nurse Practitioners in Ireland and Australia percieved themselves as leaders in nursing and this perception increases with research activity.
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Affiliation(s)
- Mary Ryder
- School of Nursing, Midwifery & Health Systems, University College Dublin, Room B318, Belfield, Dublin, Ireland.,Nurse Education & Practice Development, St. Vincent's University Hospital, Dublin, Ireland.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Elisabeth Jacob
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Joyce Hendricks
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
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Abu-Qamar MZ, Vafeas C, Ewens B, Ghosh M, Sundin D. Postgraduate nurse education and the implications for nurse and patient outcomes: A systematic review. NURSE EDUCATION TODAY 2020; 92:104489. [PMID: 32653811 DOI: 10.1016/j.nedt.2020.104489] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/02/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To synthesise the current evidence of the implications of postgraduate nursing qualifications on patient and nurse outcomes. DESIGN A systematic review. DATA SOURCES Primary research findings. REVIEW METHODS A systematic search following PRISMA guidelines and the Joanna Briggs Institute's framework was conducted. A structured and comprehensive search of three electronic databases CINAHL, MEDLINE, PsychINFO, search engine Google Scholar, and a manual-search of reference lists was undertaken. The search was limited to articles in English between 2000 and 2019. The combined search yielded 3710 records. Search records were exported to EndNote X8 and duplicates were removed. Inclusion eligibility was assessed by title, abstract and full text. All team members were involved in selecting the studies and assessing methodical quality. Discrepancies were resolved through rigorous discussion between the reviewers. Twenty studies (quantitative and qualitative) were finally selected as suitable for inclusion in the review. A qualitative descriptive synthesis was undertaken to summarise and report the findings. RESULTS This systematic review has shown that the empirical evidence to date does not support nurses' perceptions of the implications of postgraduate education. The findings from this review fell into three major themes: perceived implications of postgraduate study, clinical outcomes and patient satisfaction. Nurses perceived that postgraduate qualifications had improved their knowledge and skills and thus clinical practice, patient outcomes and health services. This perception has not been borne out by measurable outcomes as yet. The literature also suggests that postgraduate education should improve career opportunities and progression for nurses. This is not supported by the nurses' perceptions in the research available to date. It should be noted that these findings predominantly came from qualitative data. A few studies did report descriptive statistical analysis: demographics, knowledge levels, qualifications etc. None conducted any inferential statistical analysis. CONCLUSION Although the literature suggests that postgraduate nursing qualifications improve outcomes for patients, the level of evidence is weak. Exploration methods are suggested to move beyond examining nurses' perceptions, to empirical measures of the value of postgraduate education on nurse and patient outcomes.
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Affiliation(s)
- Ma'en Zaid Abu-Qamar
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia; Department of Adult Health Nursing, Faculty of Nursing, Mu'tah University, Mu'tah, Jordan.
| | - Caroline Vafeas
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Beverley Ewens
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Manonita Ghosh
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Deborah Sundin
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
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Currie J, Carter MA, Lutze M, Edwards L. Preparing Australian Nurse Practitioners to Meet Health Care Demand. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2020.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Medway P, Sweet L, Müller A. Barriers and enablers for midwives to use the Nursing and Midwifery Board of Australia's Endorsement for scheduled medicines for midwives. Women Birth 2020; 34:e57-e66. [PMID: 32591243 DOI: 10.1016/j.wombi.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2010, the Nursing and Midwifery Board of Australia introduced a new registration standard: Endorsement for scheduled medicines for midwives. The endorsement enables midwives to provide women with Medicare-rebatable care, prescribe relevant medications, and order relevant Medicare-rebatable diagnostics. Translating endorsement education into clinical midwifery practice has been slow, indicating the presence of barriers affecting midwives' ability to use this standard, despite it increasing their scope for service provision. AIM To discover the mechanisms affecting midwives' ability to work to full scope of practice after completing a programme of study leading to endorsement. METHODS An observational (non-experimental) design was used. Midwives who had completed an education programme leading to endorsement were invited to complete a survey. Descriptive statistics were used to analyse the quantitative questions and content analysis was conducted on the qualitative data. FINDINGS Results indicated that barriers - such as the limitations of Medicare provisions for endorsed midwives and a general lack of support for the role - restrict endorsed midwives' ability to provide quality maternity services. Having some form of support for the role may act as an enabler, in addition to midwives having personal determination and confidence in their ability to use the endorsement. Recommendations to strengthen the endorsed midwife's role include facilitating endorsement use in the public sector, relaxing Medicare Benefit Schedule and Pharmaceutical Benefit Scheme restrictions, raising awareness of the role and scope, and improving midwives' pre-endorsement preparation. CONCLUSION This study highlights the need for an all-of-system approach to support and develop the endorsed midwife's role.
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Affiliation(s)
- Paula Medway
- College of Nursing and Health Sciences, Flinders University, Australia; Department for Health and Wellbeing, Government of South Australia, Australia.
| | - Linda Sweet
- School of Nursing & Midwifery, Deakin University and Western Health Partnership, Australia; College of Nursing and Health Sciences, Flinders University, Australia
| | - Amanda Müller
- College of Nursing and Health Sciences, Flinders University, Australia
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Thomas S, O'Loughlin K, Clarke J. Sonographers' communication in obstetrics: Challenges to their professional role and practice in Australia. Australas J Ultrasound Med 2020; 23:129-139. [PMID: 34760592 PMCID: PMC8411765 DOI: 10.1002/ajum.12184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION/PURPOSE Despite the clinical importance of patient-centred care in the sonographer/patient interaction in obstetric ultrasound, there has been very little current research in Australia on sonographer and sonologist communication practices in the event of an adverse finding. This study sought the views, experiences and practices of Australian sonographers, particularly in relation to adverse findings, with consideration of the implications for their professional role and practice. METHODS Qualified and trainee sonographers who perform obstetric ultrasound were invited to complete a survey through the Australasian Sonographers Association. Using qualitative methodology, the authors developed themes on a range of issues related to sonographer and sonologist communication practices and roles from responses to three open-ended questions within the survey. RESULT Analysis of 249 responses revealed three distinct 'Communicator types'. 'Open Communicators' confidently practice open and direct communication; 'Limited Communicators' perceived barriers preventing them from openly communicating; 'Variable Communicators' indicated various challenging 'grey areas' which created inconsistent communication practices. Variables, such as the complexity of an adverse finding and a reporting sonologist's role, attitude and level of control they exercised over sonographer communication, all influenced respondents' communication practices. Respondents believed professional bodies should agree on a standardised policy regarding sonographers' roles. DISCUSSION This paper highlights the complexity of the sonographer/patient interaction and outlines the difficulty in providing true patient-centred care in obstetric ultrasound. CONCLUSION The need for a collaborative, patient-focussed policy, which defines and recognises the role of the sonographer in the event of obstetric adverse findings, will improve the current model of care.
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Affiliation(s)
- Samantha Thomas
- Faculty of Health SciencesUniversity of SydneyCumberland CampusLidcombeNew South Wales1825Australia
| | - Kate O'Loughlin
- Faculty of Health Sciences, Ageing, Work and Health Research UnitUniversity of SydneyCumberland CampusLidcombeNew South Wales1825Australia
| | - Jillian Clarke
- Faculty of Health SciencesMedical Radiation SciencesUniversity of SydneyCumberland CampusLidcombeNew South Wales1825Australia
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Clifford S, Lutze M, Maw M, Jennings N. Establishing value from contemporary Nurse Practitioners’ perceptions of the role: A preliminary study into purpose, support and priorities. Collegian 2020. [DOI: 10.1016/j.colegn.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Barriers and enablers for midwives using endorsement for scheduled medicines: A literature review. Women Birth 2020; 33:3-14. [DOI: 10.1016/j.wombi.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/11/2018] [Accepted: 11/16/2018] [Indexed: 11/22/2022]
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Lazarou M, Fitzgerald L, Warner M, Downing S, Williams OD, Gilks CF, Russell D, Dean JA. Australian interdisciplinary healthcare providers' perspectives on the effects of broader pre-exposure prophylaxis (PrEP) access on uptake and service delivery: a qualitative study. Sex Health 2020; 17:485-492. [PMID: 33292927 DOI: 10.1071/sh20156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022]
Abstract
Background The addition of pre-exposure prophylaxis (PrEP) for HIV prevention to the Australian Government-subsidised Pharmaceutical Benefits Scheme (PBS) enables any doctor or nurse practitioner to prescribe it and has increased accessibility options. However, understanding of Australian healthcare providers' (HCP) knowledge and preparedness to prescribe PrEP remains limited. METHODS Semistructured interviews, conducted before PBS listing (October 2016-April 2017), explored PrEP knowledge and prescription experiences of 51 multidisciplinary HCPs involved with the Queensland Pre-Exposure Prophylaxis Demonstration study. RESULTS Thematic analysis revealed that participants viewed PrEP as a necessary HIV prevention option, but there was concern about confusing prevention messages and potential risk compensation. Clinical capacity, stigma, cultural norms, rural access and PrEP-associated costs were identified as barriers to access and uptake. Some of these barriers may be addressed by the PBS listing; nonetheless, there was strong specialist concern about the preparedness of general practitioners without sexual health experience to prescribe PrEP. Participants identified a need to educate all HCPs, implement multidisciplinary supply models and provide timely access to PrEP for vulnerable populations and those ineligible for Medicare (Australia's universal healthcare insurance system). CONCLUSIONS Although PrEP listing on the PBS addressed structural barriers to access, this study highlights the role of nurses and other interdisciplinary healthcare workers in the provision of PrEP in addressing the sociocultural barriers that still affect the access of certain populations to HIV prevention measures. These findings will inform further professional training as PrEP is more widely accessed and requested outside specialist sexual health services. Future work is needed to ensure that the primary healthcare workforce is prepared to provide competent and safe access to PrEP across diverse locations and population groups.
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Affiliation(s)
- Mattea Lazarou
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Lisa Fitzgerald
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Melissa Warner
- Blood Borne Virus and Sexually Transmissible Infection Unit, Communicable Disease Branch, Queensland Health, Butterfield Street, Herston, Qld 4006, Australia
| | - Sandra Downing
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Douglas, Qld 4811, Australia
| | - Owain D Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Darren Russell
- Cairns Sexual Health Service, Cairns and Hinterland Hospital and Health Service, 381 Sheridan Street, Cairns North, Qld 4870, Australia; and College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, Qld 4811, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia; and Corresponding author.
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Gardner G, Gardner A, Middleton S, Considine J, Fitzgerald G, Christofis L, Doubrovsky A, Adams M, O'Connell J. Mapping workforce configuration and operational models in Australian emergency departments: a national survey. AUST HEALTH REV 2019; 42:340-347. [PMID: 28514641 DOI: 10.1071/ah16231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/14/2017] [Indexed: 11/23/2022]
Abstract
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs. Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study. Telephone interviews were conducted with nursing or medical department managers to collect data related to hospital characteristics, ED workforce and training and ED service and operational models. Results Surveys were completed in 87% of the population sample (n=135). Metropolitan EDs were significantly more likely to retain higher full-time equivalents (FTEs) in several medical (staff specialist, registrar, resident and intern) and nursing (nurse practitioner (NP), nurse educator, nurse unit manager and registered nurse) positions. NPs were employed by 52% of Australian EDs overall, but this ranged from 40% to 75% depending on jurisdiction. The most commonly used operational models were FastTrack teams (72% of EDs), short-stay/observational unit (59%) and patient liaison models for aged care (84%) and mental health (61%). EDs that employed NPs were significantly more likely to use FastTrack (P=0.002). Allied health services most frequently available within these EDs were radiology (60%), social work (69%), physiotherapy (70%) and pharmacy (65%). Conclusions The present study has established a baseline measure of the staffing configuration and organisational characteristics of Australian EDs. What is known about the topic? EDs are overcrowded due, in part, to the combined effect of increased service demand and access block. Innovative service and workforce models have been implemented by health departments aiming to improve service and performance. National uptake of these service and workforce innovations is unknown. What does this paper add? The present study is the most comprehensive to date profiling Australian EDs covering hospital characteristics, workforce configuration, operational models and NP service patterns and practice. What are the implications for practitioners? Information from the present study will assist health service planners to evaluate workforce and service reform models, and to monitor trends in emergency service development.
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Affiliation(s)
- Glenn Gardner
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
| | - Anne Gardner
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, PO Box 256, Dickson, ACT 2602, Australia. Email
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Level 5, DeLacey Building, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia. Email
| | - Julie Considine
- School of Nursing and Midwifery, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia. Email
| | - Gerard Fitzgerald
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email
| | - Luke Christofis
- Emergency Department, Lyell McEwin Hospital, Oldham Rd, Elizabeth Vale, SA 5112, Australia. Email
| | - Anna Doubrovsky
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
| | - Margaret Adams
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
| | - Jane O'Connell
- School of Nursing, University of Technology Broadway, 15 Broadway, Ultimo, Sydney, NSW 2007, Australia. Email
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Effectiveness of nurse-initiated X-ray for emergency department patients with distal limb injuries: a systematic review. Eur J Emerg Med 2019; 26:314-322. [DOI: 10.1097/mej.0000000000000604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Craswell A, Dwyer T. Reasons for choosing or refusing care from a nurse practitioner: Results from a national population-based survey. J Adv Nurs 2019; 75:3668-3676. [PMID: 31441094 DOI: 10.1111/jan.14176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/12/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023]
Abstract
AIM To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services. DESIGN This cross-sectional, population-based survey study used computer assisted telephone interviewing to elicit public opinions on the topic. METHODS Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open-ended responses. RESULTS Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life-threatening condition. CONCLUSION Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role. IMPACT This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners. Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.
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Affiliation(s)
- Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Trudy Dwyer
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Qld, Australia
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Ryder M, Jacob E, Hendricks J. An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective. J Clin Nurs 2019; 28:2644-2658. [DOI: 10.1111/jocn.14853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/05/2019] [Accepted: 03/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Mary Ryder
- Edith Cowan University Joondalup Western Australia Australia
- University College Dublin Dublin Ireland
- St. Vincent’s University Hospital Dublin Ireland
| | - Elisabeth Jacob
- Edith Cowan University Joondalup Western Australia Australia
| | - Joyce Hendricks
- Edith Cowan University Joondalup Western Australia Australia
- Central Queensland University Brisbane Queensland Australia
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Smith T, McNeil K, Mitchell R, Boyle B, Ries N. A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nurs 2019; 18:14. [PMID: 30976197 PMCID: PMC6444450 DOI: 10.1186/s12912-019-0337-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Shortages of skills needed to deliver optimal health care in rural and remote locations raises questions about using extended scopes of practice or advanced practice models in a range of health professions. The nurse practitioner (NP) model was introduced to address health service gaps; however, its sustainability has been questioned, while other extended scope of practice roles have not progressed in Australia. This study aimed to explore the experiences and perceptions of NPs and their colleagues about barriers to and enablers of extended scope of practice and consider the relevance of the findings to other health professions. METHODS Semi-structured, in-depth interviews were conducted with primary, nurse practitioner informants, who were also invited to nominate up to two colleagues, as secondary informants. Data analysis was guided by a multi-level, socio-institutional lens of macro-, meso- and micro-perspectives. RESULTS Fifteen primary informants and five colleagues were interviewed from various rural and remote locations. There was a fairly even distribution of informants across primary, aged, chronic and emergency or critical care roles. Key barriers and enablers at each level of analysis were identified. At the macro-level were legal, regulatory, and economic barriers and enablers, as well as job availability. The meso-level concerned local health service and community factors, such as attitudes and support from managers and patients. The micro-level relates to day-to-day practice. Role clarity was of considerable importance, along with embedded professional hierarchies and traditional role expectations influencing interactions with individual colleagues. Given a lack of understanding of NP scope of practice, NPs often had to expend effort promoting and advocating for their roles. CONCLUSIONS For communities to benefit from extended scope of practice models of health service delivery, energy needs to be directed towards addressing legislative and regulatory barriers. To be successful, extended scope of practice roles must be promoted with managers and decision-makers, who may have limited understanding of the clinical importance. Support is also important from other members of the interprofessional health care team.
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Affiliation(s)
- Tony Smith
- Department of Rural Health, The University of Newcastle, 69A High Street, Taree, NSW 2430 Australia
| | - Karen McNeil
- Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Rebecca Mitchell
- Faculty of Business and Law, University of Newcastle, Callaghan, Australia
| | - Brendan Boyle
- Faculty of Business and Law, University of Newcastle, Callaghan, Australia
| | - Nola Ries
- Faculty of Law, University of Technology Sydney, Ultimo, Australia
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Lowe G, Plummer V, Boyd L. Perceptions of NP Roles in Australia: Nurse Practitioners, Managers, and Policy Advisors. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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