Types, Frequency, and Depth of Direct Patient Care Experiences of Family Nurse Practitioner Students in the United States

Practice pathways, education, and regulation influencing nurse practitioners' decision to provide primary care: a rapid scoping review

BACKGROUND/OBJECTIVE

Initially established to improve access to healthcare, particularly for primary care, the full potential of the nurse practitioner role is yet to be realised in most countries. Despite this, most countries are working to meet an ageing population's increasing healthcare needs and reduce healthcare costs and access disparities. Achieving these outcomes requires reform at multiple levels, including nurse practitioner practice pathways, education and regulation, and identifying the barriers and facilitators to optimising their primary care role.

METHODS

A rapid scoping review of nurse practitioner practice pathways, education and regulation inclusive of: (1) a systematic search of Medline and CINAHL for peer-reviewed English language articles, including opinion pieces published between January 2015 and February 2022; and (2) a web-based search of nurse practitioner program entry requirements of International Nurse Regulator Collaborative country members with a protected nurse practitioner title and prescribing rights, plus the Netherlands. The individually summarised search data was integrated and synthesised using Popay's narrative approach.

RESULTS

Emerging evidence from the included nurse practitioner courses (n = 86) and articles (n = 79) suggests nurse practitioners working in primary care provide safe, effective care and improve healthcare efficiencies. However, different regulatory and educational models are required if the primary care nurse practitioner is to meet growing demand.

CONCLUSIONS

International variations in entry criteria, curriculum, and regulation shape the global profile of the nurse practitioner primary care workforce and their practice setting. For countries to grow their primary care nurse practitioner workforce to meet unmet needs, different entry requirements, program content and accredited post-registration transitional programs must be urgently considered.

Lack of pediatric mental health clinical experiences among FNP students

BACKGROUND

Mental health disorders accounted for approximately 5% of outpatient child and adolescent visits between 2008 and 2011, and 34.8% of these children were seen by a primary care provider. As primary care providers, family nurse practitioners (FNP) are positioned to address mental health issues across the lifespan; however, they require appropriate training and experience.

AIM

The study examined pediatric mental health assessment clinical experiences in a national survey of FNP students.

METHODS

A secondary analysis was performed on a data set of FNP students (N = 3940). Frequencies and chi-square analyses were performed to examine pediatric mental health assessment clinical experiences.

RESULTS

Nearly 30% (n = 1118) of FNP students reported experiencing two or fewer pediatric mental health assessments during their clinical rotations. More than half (53%) of these students were required to set up their own preceptors and clinical sites.

CONCLUSION

Despite the growing need for mental health care in the U.S, students reported lacking pediatric mental health assessment clinical opportunities. Moreover, students who set up their own clinical sites and preceptors were even less likely to assess pediatric patients' mental health. FNP educators and programs are encouraged to provide students with the support and opportunity for adequate pediatric practice, including mental health assessment.