1
|
Znyk M, Kostrzewski S, Kaleta D. Nurse-led lifestyle counseling in Polish primary care: the effect of current health status and perceived barriers. Front Public Health 2024; 12:1301982. [PMID: 38439750 PMCID: PMC10910074 DOI: 10.3389/fpubh.2024.1301982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Our study included counseling on diet and physical activity, smoking, e-cigarette use, and alcohol consumption. The aim was to examine the correlates of counseling provided by primary care nurses with the health status/health behaviors of nurses and the barriers in the advice provided. Materials and methods In 2022, we conducted a cross-sectional survey among 331 nurses employed in the primary care sector in Lodz. The questionnaire consisted of three sections: characteristics of the patient population receiving treatment and provided with healthy lifestyle counseling by nurses, barriers to the process of assessing, controlling, and guiding patients, and health status/health behaviors of nurses. Results Eighty percent of the nurses in our study provided advice on diet and physical activity to primary care patients. Over 70% of the survey participants performed minimal anti-smoking interventions forsmokers, 67.7% for alcohol drinkers, and 56.8% for e-cigarette users. The correlates of counseling in the field of diet and physical activity turned out to be the knowledge and skills, which enabled nurses to provide advice (OR = 2.57, p < 0.01). The correlates of the conducted minimal anti-smoking interventions in smoking patients were: subjective assessment of overweight and obesity in nurses, knowledge and skills in conducting counseling (OR = 1.92, p < 0.05), and measuring body weight, height and BMI (OR = 2.18, p < 0.01). Among the three most common barriers identified by the nurses in the process of assessing, monitoring, and guiding patients were the opinion that patients are not interested in improving their diet, physical activity, and weight loss (60.7%), lack of time (51.4%), as well as the belief that patients find it too difficult to change their current habits (54.1%). Conclusion The results of our survey indicate that nurses' participation in healthy lifestyle counseling in adult patients is unsatisfactory. Interventions in primary care should be designed considering the specific obstacles nurses may face in leading healthy lifestyles. Further training of nursing staff is required to increase their knowledge on healthy lifestyles.
Collapse
Affiliation(s)
- Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, Lodz, Poland
| | | | | |
Collapse
|
2
|
Davidson AR, Reidlinger DP. A review of the growth and development of Australian practice nursing: Insights for the dietetic workforce. Nutr Diet 2022; 79:497-548. [PMID: 35989542 PMCID: PMC9545586 DOI: 10.1111/1747-0080.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/09/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
Aim The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of dietetics practice in primary care. Methods A scoping review synthesising peer‐reviewed and other literature relevant to the development of Australian practice nurses was conducted. Structured searches using keywords ‘general practice’, ‘nurse’ and ‘Australia’ were conducted in PubMed and Google Scholar in June 2021. Key government websites, Department of Health and Services Australia, were searched to identify grey literature. One reviewer screened the titles and abstracts against inclusion criteria; two reviewers conducted full‐text screening independently. Data on the evolution of practice nursing were extracted based on its interest and transferability to the dietetics workforce. Results A total of 102 results (82 peer‐reviewed and 20 other literature) were included in the review. Key drivers for practice nurse role development in Australia were government funding, practice nurse practice standards, cost–benefit analyses of practice nurses, career and education opportunities, general practitioner and patient perspectives of practice nurses and, individual, community and local needs. Conclusions The practice nurse role has grown and strengthened and there are three key learnings that could be translated to strengthen the dietetics workforce in primary care. (1) Use and expansion of government funding, (2) furthering post‐tertiary education and career opportunities, including dietetic primary care practice standards and (3) targeting underserviced areas such as those that are rural and remote and building positive relationships with other stakeholders including practice nurses, general practitioners, patients and the broader primary care team.
Collapse
Affiliation(s)
- Alexandra R Davidson
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| |
Collapse
|
3
|
Eggleton K, Brough A, Suhren E, McCaskill J. Scope and activities of Māori health provider nurses: an audit of nurse–client encounters. J Prim Health Care 2022; 14:109-115. [PMID: 35771705 DOI: 10.1071/hc22022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The activities and consultations undertaken by Māori health provider nurses are likely broad and operate within a Māori nursing model of care. However, there is little quantitative evidence to document and describe these encounters with clients. The Omaha coding system provides a mechanism in which to quantify nursing encounters through classifying client problems by domain, interventions and specific targets relating to interventions. Aim The aim of this study was to document the types of encounters and interventions undertaken by Māori health provider nurses. Methods An audit was undertaken of patient encounters occurring within a Māori health provider between 1 January 2020 and 31 December 2020. Encounters were randomly selected and problems, activities and interventions coded utilising the Omaha coding system. Simple descriptive statistics were used. Results A total of 5897 nurse-client encounters occurred over the study period. Overall, 61% of the audited nurse-client encounters related to the physiological domain and only 6% of encounters were related to the psychosocial domain. And 29% of nursing interventions involved teaching/guiding/counselling and a further 29% of interventions were case management. Discussion The wide variety of conditions seen and the number of interventions carried out indicate the broad scope of Māori health provider nurses. However, there were likely undocumented problems, which could reflect the medicalisation of the electronic health record. Redesigning electronic health records to apply more of a nursing and Māori health provider lens may facilitate more inclusive ways of documentation.
Collapse
Affiliation(s)
- Kyle Eggleton
- Department of General Practice and Primary Health Care, The University of Auckland, 28 Park Avenue, Grafton, Auckland 1023, New Zealand
| | | | - Evelyn Suhren
- Ki A Ora Ngatiwai, 420 Kamo Road, Whangarei, New Zealand
| | | |
Collapse
|
4
|
Groenendijk-van Woudenbergh GJ, van Hell-Cromwijk MC, van der Veen YJJ, Algra HF, Kroeze W. Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses. Fam Pract 2022; 39:144-149. [PMID: 34482402 DOI: 10.1093/fampra/cmab092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. OBJECTIVE To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. METHODS Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. RESULTS Two main themes were determined: professional characteristics and professional-patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional-patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients' own choices and underuse of existing educational materials. CONCLUSIONS Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.
Collapse
Affiliation(s)
| | | | - Ytje J J van der Veen
- Department of Nursing, Christian University of Applied Sciences (CHE), Ede, The Netherlands
| | - Hylkje F Algra
- Department of Nursing, Christian University of Applied Sciences (CHE), Ede, The Netherlands
| | - Willemieke Kroeze
- Department of Nursing, Christian University of Applied Sciences (CHE), Ede, The Netherlands
| |
Collapse
|
5
|
Halcomb E, Fernandez R, Mursa R, Stephen C, Calma K, Ashley C, McInnes S, Desborough J, James S, Williams A. Mental health, safety and support during COVID-19: A cross-sectional study of primary health care nurses. J Nurs Manag 2021; 30:393-402. [PMID: 34890472 DOI: 10.1111/jonm.13534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/23/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study is to explore primary health care nurses' mental health, concerns and perceived safety and supports during COVID-19. BACKGROUND Respiratory pandemics have negative impacts on nurses' wellbeing. While literature is replete with hospital nurses' experiences, there is less exploration of COVID-19 impacts on primary health care nurses. Given the importance of primary health care nurses in the health system, understanding their experiences is vital. METHODS Three hundred and fifty nine primary health care nurses responded to an online cross-sectional survey. The Depression Anxiety Stress Scales (DASS-21) was used to measure emotional state. Data were analysed using descriptive and inferential statistics. RESULTS DASS-21 scores indicated that 39.6% of participants were experiencing symptoms of depression, anxiety or stress. Of those, 41.8% were experiencing symptoms on one scale, 26.9% were experiencing symptoms on two scales and 31.2% were experiencing symptoms across all three scales. Most participants identified that their feelings were related to COVID-19. CONCLUSIONS COVID-19 is having a significant impact on primary health care nurses' mental health. Nurse managers need to develop strategies to effectively address nurses' concerns and effectively support them to sustain the workforce during and after the pandemic. IMPLICATIONS FOR NURSING MANAGEMENT Findings from this study can inform the design of effective nurse support programmes to reduce mental health impacts and promote staff wellbeing during the pandemic.
Collapse
Affiliation(s)
- Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Institute, Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia
| | - Ruth Mursa
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Institute, Wollongong, New South Wales, Australia
| | - Catherine Stephen
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Institute, Wollongong, New South Wales, Australia
| | - Kaara Calma
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Institute, Wollongong, New South Wales, Australia
| | - Christine Ashley
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Susan McInnes
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jane Desborough
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sharon James
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Department of General Practice, School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Anna Williams
- School of Nursing and Midwifery, Health Sciences and Physiotherapy, University of Notre Dame Australia, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Mukhamedyarova A, Rakhypbekov T, Dauletyarova M, Zhunussova D, Tsigengagel O, Khismetova Z. Measures to Strengthen the Role of Primary Care Nurses During the COVID-19 Pandemic: A Concept Analysis. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
The difficult epidemiological situation of COVID 19 infection in the world and in the country requires drastic measures to strengthen the material, technical and staffing of primary health care (PHC). Under these circumstances, the preparedness of PHC systems in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission infection is crucial. Nurses play a crucial role in this process. This article reviews and summarize latest findings of explore the role of primary care nurses and their support measures in response to COVID-19 and to identify challenges to achieving universal health coverage. The study revealed that there is vast panoply of strategic reforms. There are a number of differences and similarities such as mandatory political commitment and leadership, governance and policy, funding and allocation of resources, and engagement of communities and role of other stakeholders.
Collapse
|
7
|
Nurse educator knowledge, attitude and skills towards using high-fidelity simulation: A study in the vocational education sector. Nurse Educ Pract 2021; 53:103048. [PMID: 33857911 DOI: 10.1016/j.nepr.2021.103048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 02/24/2021] [Accepted: 03/25/2021] [Indexed: 12/27/2022]
Abstract
High-fidelity simulation has become an essential educational approach in nurse education globally. Several studies have explored the experience of undergraduate nursing students and educators with high-fidelity simulation; however, none have explored the experience of students in the vocational educational sector. The aim of the study was to explore nurse educators' knowledge, attitude and skills toward using high-fidelity simulation in the setting of vocational education. An anonymous on-line survey design was conducted at three campuses of a major Australian Technical and Further Education vocational education setting. Forty-eight nurse educators teaching into Diploma of Nursing program for at least six months were invited to participate, 29 participated in the study, a response rate of 60%. Participants expressed lack of knowledge in managing technological issues, simulation facilitation procedures and conducting scenarios. Most participants had positive attitude towards high-fidelity simulation and rated their skills as 'novice'. An urgent need for nurse educator training was identified to enhance knowledge and skills in technical and scenario management of high-fidelity simulation. A program of supportive mentoring by nurse educator mentors experienced in high-fidelity simulation, engaging with existing simulation associations, will enhance and sustain nurse educator knowledge, attitude and skills in a protected environment further, so that they can optimise training they provide to students for safe quality care of patients in the future.
Collapse
|
8
|
Calma KRB, Halcomb E, Williams A, McInnes S. Final-year undergraduate nursing students' perceptions of general practice nursing: A qualitative study. J Clin Nurs 2021; 30:1144-1153. [PMID: 33461242 DOI: 10.1111/jocn.15662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/22/2020] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
AIM To explore final-year nursing students' perceptions of general practice nursing. BACKGROUND The need for general practice nurses has increased due to growing demands for health care in the community. This demand is exacerbated by a shortage in the general practice nursing workforce. Understanding final-year nursing students' perceptions of general practice nursing is important as these may influence career choices. DESIGN Qualitative descriptive study within a mixed methods project. METHODS Telephone interviews were conducted with sixteen final-year nursing students. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Reporting follows the COREQ checklist. RESULTS Perceptions of general practice nursing varied between participants and related to three main themes; ways of working; a broad role to meet diverse health needs; and relationships with patients. General practice nurses were seen to have stable and collaborative working relationships, with their role ranging from supporting general practitioners to being autonomous professionals. The nurse's broad role was associated with diverse presentations and was considered interesting and challenging. Participants perceived that general practice nurses had more time to spend with patients, and this helped establish trust, and facilitated patient-centred care. CONCLUSION Participants' perceptions of general practice nursing varied, with some students recognising the diversity of the role and others perceiving it as limited. These views were often impacted by others experiences rather than personal experience. These variations underscore the need for students to receive greater exposure to general practice nursing. Review of undergraduate curricula to increase focus on preparing nursing students to work in general practice may help shape students' interest to seek employment in this setting. RELEVANCE TO CLINICAL PRACTICE Students perceptions of a clinical setting can influence their career decisions. Understanding these perceptions can inform clinicians and managers and highlight areas that may need to be addressed to promote career opportunities.
Collapse
Affiliation(s)
- Kaara Ray B Calma
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Anna Williams
- School of Nursing, University of Notre Dame, Sydney, NSW, Australia
| | - Susan McInnes
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
9
|
James S, Halcomb E, Desborough J, McInnes S. Barriers and facilitators to lifestyle risk communication by Australian general practice nurses. Aust J Prim Health 2021; 27:30-35. [PMID: 33222756 DOI: 10.1071/py20139] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/16/2020] [Indexed: 11/23/2022]
Abstract
Lifestyle risk factors are antecedents to many chronic conditions and are largely modifiable. Health professional support is often sought to reduce lifestyle risk. The ongoing relationship general practice nurses typically have with patients situates them ideally to provide this support. This paper explores the barriers and facilitators to lifestyle risk communication by registered nurses (RNs) in Australian general practice. Fifteen general practice RNs from south-eastern Australia participated in semistructured interviews. Verbatim transcriptions of the audio-recorded interviews were analysed using thematic analysis. Six themes emerged in terms of perceived barriers and facilitators: educational preparation and confidence; organisational and funding arrangements; lifestyle risk prioritisation; organisational support; autonomous roles; and supporting patients' needs. Although communication about lifestyle risk factors is within the general practice nurses' scope of practice, concerted efforts fostering interdisciplinary collaboration, the prioritisation of time, funding and educational opportunities would better support this role, at the same time optimising chronic disease management and patient outcomes.
Collapse
Affiliation(s)
- Sharon James
- School of Nursing, University of Wollongong, Auckland Street, Bega, NSW 2550, Australia; and Corresponding author.
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, College of Medicine, Biology and the Environment, Australian National University, 63 Eggleston Road, Acton, ACT 2601, Australia
| | - Susan McInnes
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| |
Collapse
|
10
|
Halcomb E, Bird S, Mcinnes S, Ashley C, Huckel K. Exploring job satisfaction and turnover intentions among general practice nurses in an Australian Primary Health Network. J Nurs Manag 2020; 29:943-952. [PMID: 33306862 DOI: 10.1111/jonm.13230] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/25/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022]
Abstract
AIM To explore the job satisfaction and turnover intentions of general practice nurses and examine factors that influence job satisfaction and turnover intention. BACKGROUND Workforce issues such as satisfaction, retention and turnover intention have been explored in acute care. However, increasingly nurses are being employed outside hospitals. General practice is a significantly different work environment to acute care. Understanding workforce issues in community settings is important for employers, managers and policymakers to sustain and grow this workforce to meet consumer demands. METHOD A descriptive survey was conducted within a single Primary Health Network in Australia. RESULTS Having an identified practice nurse leader/manager, feeling that their training and qualifications are used to the full and not feeling isolated, alone or lacking opportunities for mentoring were all significantly correlated with higher job satisfaction. The lowest average satisfaction scores related to pay. 44.9% of participants were unsure whether they would remain working in general practice. The relationship between total job satisfaction and intention to leave was significant. CONCLUSION These findings guide managers in developing strategies to recruit and retain nurses in general practice employment. IMPLICATIONS FOR NURSING MANAGEMENT Managers must consider factors influencing job satisfaction and turnover intention to maximize recruitment and retention of nurses.
Collapse
Affiliation(s)
- Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Sonia Bird
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Susan Mcinnes
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Christine Ashley
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Karen Huckel
- South Western Sydney Primary Health Network, Campbelltown, NSW, Australia
| |
Collapse
|
11
|
Halcomb E, McInnes S, Williams A, Ashley C, James S, Fernandez R, Stephen C, Calma K. The Experiences of Primary Healthcare Nurses During the COVID-19 Pandemic in Australia. J Nurs Scholarsh 2020; 52:553-563. [PMID: 32735758 PMCID: PMC7436753 DOI: 10.1111/jnu.12589] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE The COVID-19 pandemic has presented an international health crisis of a scope not seen in our lifetime. While much attention has been paid to health workers in critical care and acute areas, nurses working outside of hospitals are also significantly affected. This study sought to investigate the experience of nurses working in Australian primary healthcare during the COVID-19 pandemic. In particular, it sought to understand the implications on their employment status, role, and access to personal protective equipment. DESIGN AND METHODS Nurses employed in primary healthcare across Australia were invited to participate in a cross-sectional online survey through social media and professional organizations. The survey tool was composed of demographics, and of questions about the nurses' employment, work role, and access to personal protective equipment. FINDINGS Of the 637 responses received, nearly half (43.7%) reported a decrease in hours and threatened or actual loss of employment. While most respondents felt that they had sufficient knowledge about COVID-19, they expressed concern about work-related risks to themselves and their family. Most respondents described never or only sometimes having sufficient personal protective equipment in their workplace. Just over half of respondents (54.8%) felt well supported by their employer. A third of respondents (34%) perceived that care provided in their workplace was significantly or slightly worse than before the pandemic. CONCLUSIONS This is the first study of primary healthcare nurses' experiences during the COVID-19 pandemic. The study findings highlighted a concerning level of insecurity around primary healthcare nursing employment, as well as issues with the availability of personal protective equipment for these nurses. The perception that the pandemic has resulted in reduced quality of care needs further exploration to ensure that those with chronic conditions are supported to maintain and promote health. CLINICAL RELEVANCE Understanding the implications of COVID-19 on the primary healthcare nursing workforce is vital to ensure staff retention and care quality. Ensuring that the community remains healthy and supported at home is vital to both reduce the burden on the health system and reduce secondary mortality.
Collapse
Affiliation(s)
- Elizabeth Halcomb
- Xi Omicron, Professor of Primary Health Care Nursing, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Susan McInnes
- Xi Omicron, Lecturer, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Anna Williams
- Senior Lecturer/Discipline Lead Primary Health Care and Chronic Illness, School of Nursing, University of Notre Dame, Sydney, NSW, Australia
| | - Christine Ashley
- Project Officer, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Sharon James
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia
| | - Ritin Fernandez
- Professor of Nursing, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, and Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia
| | - Catherine Stephen
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia.,Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| | - Kaara Calma
- Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Bega, NSW, Australia.,Xi Omicron, PhD Candidate/Sessional Tutor, School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
12
|
Chowdhury S, Stephen C, McInnes S, Halcomb E. Nurse-led interventions to manage hypertension in general practice: A systematic review protocol. Collegian 2020. [DOI: 10.1016/j.colegn.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Halcomb E, Bird S. Job Satisfaction and Career Intention of Australian General Practice Nurses: A Cross‐Sectional Survey. J Nurs Scholarsh 2020; 52:270-280. [DOI: 10.1111/jnu.12548] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth Halcomb
- Xi Omicron-at-large, Professor of Primary Health Care Nursing, School of Nursing, Faculty of Science, Medicine & Health University of Wollongong Wollongong NSW Australia
| | - Sonia Bird
- Research Fellow (Applied Statistics), Australian Health Services Research Institute University of Wollongong Innovation Campus Wollongong NSW Australia
| |
Collapse
|
14
|
Sinclair PM, Kable A, Levett-Jones T, Holder C, Oldmeadow CJ. The CKD-DETECT study: An RCT aimed at improving intention to initiate a kidney health check in Australian practice nurses. J Clin Nurs 2019; 28:2745-2759. [PMID: 30970152 DOI: 10.1111/jocn.14882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/09/2019] [Accepted: 03/21/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The burden of Chronic Kidney Disease (CKD) on the Australian health system is growing. Efforts to reverse this trend have not been successful. This paper evaluates the effectiveness of a targeted asynchronous web based e-learning module on general practice nurses' behavioural intentions in relation to opportunistic screening practices for people at risk of CKD. DESIGN Double blinded pre-post interventional randomised control design. METHODS Participants were nurses working in general practice settings in Australia. Participants were randomised to a knowledge based active control or targeted behavioural based intervention which were delivered using asynchronous e-learning modules. The intervention was designed to influence the behavioural constructs of the theory of planned behaviour (TPB): attitude, subjective norm and perceived behavioural control (PBC). RESULTS Of the 420 participants, we analysed the primary and secondary outcomes for 212 (50.47%) who had complete follow up data. There were no significant differences (p 0.424, [d] 0.04) in behavioural intention between the intervention and control groups at follow-up, when controlling for baseline values. However, regression models assessing the relationship between the change in the TPB constructs and behavioural intention at follow-up for all participants, regardless of study arm, demonstrated a significant change in intention to initiate a kidney health check. Although these changes could not be attributed to the effect of the intervention. Attitude (r2 = 0.3525, p 0.0004) and PBC (r2 = 0.3510, p 0.0005) models accounted for approximately 35% of the explained variance in behavioural intentions and social norm (r2 = 0.3297, p 0.0171) accounted for approximately 33% of the variance. When all TPB constructs were included in the model, 37% of the variance in intention was explained. CONCLUSION A targeted behavioural online intervention was no more effective than a knowledge based online program to improve primary health care nurses' intention to initiate a kidney health check in people at risk of chronic kidney disease. RELEVANCE TO CLINICAL PRACTICE Collaborative efforts are required by all staff working in general practice to develop models of care to improve screening practices for chronic kidney disease. Future research should focus on interventions that improve collaboration between health care professionals in the primary care setting and public health campaigns to increase awareness of risks of CKD and the importance of screening in the primary care setting.
Collapse
Affiliation(s)
- Peter M Sinclair
- Faculty of Health & Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ashly Kable
- Faculty of Health & Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Carl Holder
- CReDITSS Unit, The Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Christopher J Oldmeadow
- Faculty of Health & Medicine, University of Newcastle, Callaghan, New South Wales, Australia.,CReDITSS Unit, The Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| |
Collapse
|
15
|
McInnes S, Peters K, Bonney A, Halcomb E. The influence of funding models on collaboration in Australian general practice. Aust J Prim Health 2019; 23:31-36. [PMID: 27451984 DOI: 10.1071/py16017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 04/23/2016] [Indexed: 11/23/2022]
Abstract
Despite more nurses working in Australian general practice, there has been limited investigation exploring ways that general practitioners and registered nurses work together to deliver clinical care. However, it has been postulated that the small business structure, common in Australian general practices, might influence collaboration between these two groups of health professionals. This paper presents one theme from a larger qualitative study. Eight general practitioners and fourteen registered nurses working in general practice participated in semistructured face-to-face interviews between February and May 2015. Naturalistic inquiry was adopted to elicit and explore the narrative accounts of participants about working together in general practice. An inductive process of thematic analysis was used to identify, analyse and report patterns and themes. Ancillary costs associated with the employment of registered nurses in general practice and the time registered nurses took to undertake procedural services were a concern for general practitioners. Registered nurses did not always work to their full scope of practice and many felt that their expertise was not appropriately remunerated. Findings suggested that fee for service-funding models can negatively influence collaboration between general practitioners and registered nurses working in general practice.
Collapse
Affiliation(s)
- Susan McInnes
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Andrew Bonney
- School of Medicine, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| |
Collapse
|
16
|
Halcomb EJ, McInnes S, Patterson C, Moxham L. Nurse-delivered interventions for mental health in primary care: a systematic review of randomized controlled trials. Fam Pract 2019; 36:64-71. [PMID: 30364968 DOI: 10.1093/fampra/cmy101] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mental health issues are increasingly prevalent within the community. Many people experiencing mental health issues have established relationships with primary care providers, including general practice nurses (GPNs). With the recent growth of general practice nursing, it is timely to explore the evidence for GPNs to provide mental health interventions for adults with mental illness within their scope of practice. OBJECTIVE To synthesize the evidence about nurse-delivered interventions in primary care for adults with mental illness. METHODS A systematic review of randomized control trials (RCTs) retrieved from the CINAHL, Ovid MEDLINE and EBSCO electronic databases between 1998 and 2017. RESULTS Nine randomized controlled trials were identified, which reported nurse-delivered interventions in primary care for the management of mental health in adults with mental illness. The heterogeneity of interventions and outcomes made comparison of studies difficult. Seven studies demonstrated significant improvement in at least one outcome following the intervention. In some studies, these improvements were sustained well beyond the intervention. Additionally, consumers were satisfied with the interventions and the role of the GPN. CONCLUSION There is currently limited evidence of the impact of nurse-delivered interventions in primary care for adults with mental illness. Given the significant improvements in symptoms and the acceptability of interventions seen in included studies, there is a need for further robust research exploring the role of the GPN both individually and within the multidisciplinary team. Such research will enable stronger conclusions to be drawn about the impact of nurse-delivered interventions in primary care for adults with mental illness.
Collapse
Affiliation(s)
| | - Susan McInnes
- School of Nursing, University of Wollongong, Wollongong, Australia
| | | | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, Australia
| |
Collapse
|
17
|
Daly BM, Arroll B, Honey M, Scragg RKR. Trends in the primary health care nursing workforce providing diabetes care in Auckland, New Zealand: A cross-sectional survey. Prim Care Diabetes 2018; 12:491-500. [PMID: 30145189 DOI: 10.1016/j.pcd.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
AIMS To describe trends from 2006-8 to 2016 in demographic, education and work settings of the primary health care nursing workforce who provide diabetes care in the Auckland region. METHODS A total of 1416 practice, Accident and Medical, district and diabetes specialist nurses were identified who provide community-based care. Of those, 459 were randomly selected and 336 were interviewed in 2016, and were compared with 287 nurses interviewed in 2006-8. RESULTS A 73% response rate was attained in 2016. Compared with nurses in 2006-8, primary health care nurses in 2016 were younger, less experienced, more likely to be Asian, undertook more post-graduate education, worked more in Accident and Medical Clinics and worked in larger practices with ≥4 doctors. However, less worked with a dietitian or received visits from specialist nurses compared with nurses in 2006-8. Significantly more nurses in 2016 had their own room for administrative work and the ability to email patients suggesting greater autonomy. CONCLUSIONS Major demographic, educational and workplace changes have occurred in the Auckland primary health care nursing workforce from 2006-8 to 2016. A significant increase in practice nurses and a large decrease in the number of diabetes specialist nurses were evident, in the Auckland region.
Collapse
Affiliation(s)
- Barbara M Daly
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Bruce Arroll
- School of Population Health, University of Auckland , New Zealand
| | - Michelle Honey
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | | |
Collapse
|
18
|
Poitras ME, Chouinard MC, Fortin M, Girard A, Crossman S, Gallagher F. Nursing activities for patients with chronic disease in family medicine groups: A multiple-case study. Nurs Inq 2018; 25:e12250. [DOI: 10.1111/nin.12250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 04/27/2018] [Accepted: 05/13/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Marie-Eve Poitras
- Département des Sciences de la Santé; Université du Québec à Chicoutimi; Chicoutimi Québec Canada
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean; Saguenay Québec Canada
| | - Maud-Christine Chouinard
- Département des Sciences de la Santé; Université du Québec à Chicoutimi; Chicoutimi Québec Canada
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean; Saguenay Québec Canada
| | - Martin Fortin
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean; Saguenay Québec Canada
- Faculté de Médecine et des Sciences de la Santé; Université de Sherbrooke; Sherbrooke Québec Canada
| | - Ariane Girard
- Faculté de Médecine et des Sciences de la Santé; Université de Sherbrooke; Sherbrooke Québec Canada
| | | | - Frances Gallagher
- Faculté de Médecine et des Sciences de la Santé; Université de Sherbrooke; Sherbrooke Québec Canada
| |
Collapse
|
19
|
Drennan VM. More care out of hospital? A qualitative exploration of the factors influencing the development of the district nursing workforce in England. J Health Serv Res Policy 2018; 24:11-18. [PMID: 29754532 PMCID: PMC6304681 DOI: 10.1177/1355819618769082] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Many countries seek to improve care for people with chronic conditions and
increase delivery of care outside of hospitals, including in the home.
Despite these policy objectives in the United Kingdom, the home visiting
nursing service workforce, known as district nursing, is declining. This
study aimed to investigate the factors influencing the development of
district nursing workforces in a metropolitan area of England. Methods A qualitative study in a metropolitan area of three million residents in
diverse socio-economic communities using semi-structured interviews with a
purposive sample of senior nurses in provider and commissioning
organizations. Thematic analysis was framed by theories of workforce
development. Findings: All participants reported that the context for the
district nursing service was one of major reorganizations in the face of
wider National Health Service changes and financial pressures. The analysis
identified five themes that can be seen to impact the ways in which the
district nursing workforce was developed. These were: the challenge of
recruitment and retention, a changing case-mix of patients and the
requirement for different clinical skills, the growth of specialist home
visiting nursing services and its impact on generalist nursing, the capacity
of the district nursing service to meet growing demand, and the influence of
the short-term service commissioning process on the need for long-term
workforce development. Conclusion There is an apparent paradox between health policies which promote more care
within and closer to home and the reported decline in district nursing
services. Using the lens of workforce development theory, an explanatory
framework was offered with factors such as the nature of the nursing labour
market, human resource practices, career advancement opportunities as well
as the contractual context and the economic environment.
Collapse
Affiliation(s)
- Vari M Drennan
- Professor of Health Care & Policy Research, Centre for Health & Social Care Research, Faculty of Health, Social Care & Education, Kingston University and St George's University of London, UK
| |
Collapse
|
20
|
Thomas TH, Bloomfield JG, Gordon CJ, Aggar C. Australia’s first Transition to Professional Practice in Primary Care Program: Qualitative findings from a mixed-method evaluation. Collegian 2018. [DOI: 10.1016/j.colegn.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
21
|
Ashley C, Peters K, Brown A, Halcomb E. Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment. J Nurs Manag 2018; 26:663-670. [DOI: 10.1111/jonm.12597] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Christine Ashley
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
| | - Kath Peters
- School of Nursing & Midwifery; Western Sydney University; Penrith NSW Australia
| | - Angela Brown
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
| | - Elizabeth Halcomb
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
| |
Collapse
|
22
|
|
23
|
Heywood T, Laurence C. An overview of the general practice nurse workforce in Australia, 2012–15. Aust J Prim Health 2018; 24:227-232. [DOI: 10.1071/py17048] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 01/02/2018] [Indexed: 11/23/2022]
Abstract
Several surveys of the general practice nurse (GPN) workforce have been undertaken in Australia over the last decade, but they have limitations, which mean that the workforce is not well-understood. The aim of this study is to describe the profile of the GPN workforce using the dataset available through the Australia Health Practitioner Registration Agency and to explore how it differs from the non-GPN nursing workforce, and if this workforce is changing over time. Data from labour force surveys conducted from 2012 to 2015 were used. Variables examined were age group, gender, remoteness area, hours worked, nurse type (enrolled (EN) or registered (RN)), years in the workforce and also intended years of work before exiting the workforce. When compared with the broader nursing workforce, a greater proportion of GPNs in 2015 were older (60 v. 51%), worked part-time (65 v. 48%) and worked in regional areas (35 v. 26%). Additionally, the characteristics of GPNs has changed between 2012 and 2015, with an increased proportion of younger nurses, more registered nurses and fewer working in remote areas. To ensure a sustainable workforce, particularly in rural and remote areas, strategies to recruit and retain this workforce will be needed.
Collapse
|
24
|
|
25
|
Desborough J, Phillips C, Mills J, Korda R, Bagheri N, Banfield M. Developing a positive patient experience with nurses in general practice: An integrated model of patient satisfaction and enablement. J Adv Nurs 2017; 74:564-578. [DOI: 10.1111/jan.13461] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy; Research School of Population Health; Australian National University; Canberra, ACT Australia
| | - Christine Phillips
- Australian National University Medical School; Australian National University; Canberra ACT Australia
| | - Jane Mills
- College of Health; Massey University; Palmerston North New Zealand
| | - Rosemary Korda
- National Centre for Epidemiology and Population Health; Research School of Population Health; Australian National University; Canberra ACT Australia
| | - Nasser Bagheri
- Department of Health Services Research and Policy; Research School of Population Health; Australian National University; Canberra, ACT Australia
| | - Michelle Banfield
- National Institute for Mental Health Research; Research School of Population Health; Australian National University; Canberra ACT Australia
| |
Collapse
|
26
|
Ashley C, Halcomb E, Peters K, Brown A. Exploring why nurses transition from acute care to primary health care employment. Appl Nurs Res 2017; 38:83-87. [PMID: 29241525 DOI: 10.1016/j.apnr.2017.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/06/2017] [Accepted: 09/03/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Christine Ashley
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave Wollongong, NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave Wollongong, NSW 2522, Australia.
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Angela Brown
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave Wollongong, NSW 2522, Australia.
| |
Collapse
|
27
|
McInnes S, Peters K, Bonney A, Halcomb E. Understanding collaboration in general practice: a qualitative study. Fam Pract 2017; 34:621-626. [PMID: 28334812 DOI: 10.1093/fampra/cmx010] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An increased incidence of chronic and complex conditions in the community is placing pressure on human resources in general practice. Improving collaboration between GPs and registered nurses may help alleviate workforce stressors and enhance health outcomes. OBJECTIVE To explore the facilitators and challenges of collaboration between GPs and registered nurses in Australian general practice. METHODS Eight GPs and 14 registered nurses from general practices in New South Wales, Australia, participated in semi-structured face-to-face interviews. Recordings were transcribed verbatim and underwent thematic analysis. RESULTS The overarching theme 'Understanding collaboration in general practice' comprises four sub-themes, namely (i) interpreting collaboration in general practice, (ii) modes of communication, (iii) facilitators of collaboration and (iv) collaboration in practice. CONCLUSION Our findings suggest that regular, formal avenues of communication, professional development and non-hierarchical environments facilitated collaboration between nurses and GPs. Implementing strategies to promote these features has the potential to improve inter-professional collaboration and quality of care within primary care.
Collapse
Affiliation(s)
- Susan McInnes
- School of Nursing, University of Wollongong, Wollongong, Australia
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Andrew Bonney
- School of Medicine, University of Wollongong, Wollongong, Australia
| | | |
Collapse
|
28
|
Ashley C, Halcomb E, Brown A, Peters K. Experiences of registered nurses transitioning from employment in acute care to primary health care-quantitative findings from a mixed-methods study. J Clin Nurs 2017; 27:355-362. [PMID: 28618208 DOI: 10.1111/jocn.13930] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the experiences of registered nurses who transition from acute to primary health care (PHC) employment. BACKGROUND Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses. DESIGN A sequential mixed-methods study comprising a survey, and semi-structured interviews. This study reports on survey findings relating to the transition experience. METHODS Convenience and snowballing techniques were used to recruit 111 registered nurses who had transitioned from Australian acute settings to PHC employment within the last 5 years. An online survey gathered data relating to personal and professional demographics, type of PHC setting and transition experiences. RESULTS Most respondents (n = 90, 81.1%) reported receiving some orientation, although the length and content varied considerably. Those working in metropolitan locations were more likely to report concerns associated with their orientation, with respondents from rural or remote locations more likely to have access to a preceptor than city/metropolitan respondents. Just under half of respondents found prioritising workload (n = 47; 42.7%) or organisational knowledge (n = 45; 40.9%) difficult or very difficult, and 47.7% (n = 53) felt isolated or unsupported. 49.5% (n = 55) reported being overwhelmed with the new role either sometimes or regularly. Barriers to transitioning successfully included limited employer support to attend professional development activities. CONCLUSIONS Availability of specific support measures may assist in the transition process. Findings from our study should be considered by employers when recruiting nurses new to PHC, and when designing orientation and ongoing education programmes. RELEVANCE TO CLINICAL PRACTICE This study highlights the challenges faced by nurses who transition from acute care into PHC employment. Understanding the barriers and facilitators to successful transitions enhances the process for future recruitment and retention of PHC nurses. This evidence can inform managers, educators and policymakers in developing support programmes for nurses moving into PHC.
Collapse
Affiliation(s)
- Christine Ashley
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Angela Brown
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Kath Peters
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| |
Collapse
|
29
|
McInnes S, Peters K, Bonney A, Halcomb E. A qualitative study of collaboration in general practice: understanding the general practice nurse's role. J Clin Nurs 2017; 26:1960-1968. [DOI: 10.1111/jocn.13598] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Susan McInnes
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| | - Kath Peters
- School of Nursing & Midwifery; Western Sydney University; Campbelltown NSW Australia
| | - Andrew Bonney
- School of Medicine; University of Wollongong; Wollongong NSW Australia
| | - Elizabeth Halcomb
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| |
Collapse
|
30
|
Lovett D, Rasmussen B, Holden C, Livingston PM. Are nurses meeting the needs of men in primary care? Aust J Prim Health 2017; 23:319-322. [DOI: 10.1071/py16106] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 05/24/2017] [Indexed: 11/23/2022]
Abstract
Meeting men’s health needs by improving healthcare service access is a key objective of comprehensive primary health care. The aims of this qualitative study were to explore the perception of nurses in men’s health services and to describe men’s expectation of the nurse. The comparative component identifies the barriers and facilitators to improved access to health services. A purposive sample of 19 nurses and 20 men was recruited from metropolitan and regional settings in the state of Victoria, Australia, and each participant was interviewed individually or as part of three focus groups. The main findings were: nurses and men were unclear on the role of the nurse in men’s health; and health promotion provided by nurses was predominantly opportunistic. Both participant groups indicated barriers to healthcare access related to: the culture and environment in general practice; limitation of Australia’s Medicare healthcare financing system; out-of-pocket costs, waiting time and lack of extended hours; and men not wanting to be perceived as complainers. Facilitators related to: positive inter-professional relations; effective communication; personal qualities; and level of preparedness of nurse education. The findings demonstrate a need for the role to be better understood by both men and nurses in order to develop alternative approaches to meeting men’s healthcare needs.
Collapse
|
31
|
Lane R, Halcomb E, McKenna L, Zwar N, Naccarella L, Davies GP, Russell G. Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations. AUST HEALTH REV 2017; 41:127-132. [DOI: 10.1071/ah15239] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 02/29/2016] [Indexed: 11/23/2022]
Abstract
Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses’ skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally. What does this paper add? This study delineates organisational support roles for PHCOs in strengthening nurses’ roles and career development in Australian general practice. What are the implications for practitioners? Effective implementation of appropriate responsibilities by PHCOs can assist development of the primary care nursing workforce.
Collapse
|
32
|
Desborough J, Bagheri N, Banfield M, Mills J, Phillips C, Korda R. The impact of general practice nursing care on patient satisfaction and enablement in Australia: A mixed methods study. Int J Nurs Stud 2016; 64:108-119. [PMID: 27768985 DOI: 10.1016/j.ijnurstu.2016.10.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/05/2016] [Accepted: 10/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The numbers of nurses in general practice in Australia tripled between 2004 and 2012. However, evidence on whether nursing care in general practice improves patient outcomes is scarce. Although patient satisfaction and enablement have been examined extensively as outcomes of general practitioner care, there is little research into these outcomes from nursing care in general practice. The aim of this study was to examine the relationships between specific general practice characteristics and nurse consultation characteristics, and patient satisfaction and enablement METHODS: A mixed methods study examined a cross-section of patients from 21 general practices in the Australian Capital Territory. The Patient Enablement and Satisfaction Survey was distributed to 1665 patients who received nursing care between September 2013 and March 2014. Grounded theory methods were used to analyse interviews with staff and patients from these same practices. An integrated analysis of data from both components was conducted using multilevel mixed effect models. RESULTS Data from 678 completed patient surveys (response rate=42%) and 48 interviews with 16 nurses, 23 patients and 9 practice managers were analysed. Patients who had longer nurse consultations were more satisfied (OR=2.50, 95% CI: 1.43-4.35) and more enabled (OR=2.55, 95% CI: 1.45-4.50) than those who had shorter consultations. Patients who had continuity of care with the same general practice nurse were more satisfied (OR=2.31, 95% CI: 1.33-4.00) than those who consulted with a nurse they had never met before. Patients who attended practices where nurses worked with broad scopes of practice and high levels of autonomy were more satisfied (OR=1.76, 95% CI: 1.09-2.82) and more enabled (OR=2.56, 95% CI: 1.40-4.68) than patients who attended practices where nurses worked with narrow scopes of practice and low levels of autonomy. Patients who received nursing care for the management of chronic conditions (OR=2.64, 95% CI: 1.32-5.30) were more enabled than those receiving preventive health care. CONCLUSIONS This study provides the first evidence of the importance of continuity of general practice nurse care, adequate time in general practice nurse consultations, and broad scopes of nursing practice and autonomy for patient satisfaction and enablement. The findings of this study provide evidence of the true value of enhanced nursing roles in general practice. They demonstrate that when the vision for improved coordination and multidisciplinary primary health care, including expanded roles of nurses, is implemented, high quality patient outcomes can be achieved.
Collapse
Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Australia.
| | - Nasser Bagheri
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Australia
| | - Michelle Banfield
- National Institute for Mental Health Research, Research School of Population Health, Australian National University, Australia
| | - Jane Mills
- Nursing, School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Christine Phillips
- Social Foundations of Medicine, Australian National University Medical School, Australia
| | - Rosemary Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australia
| |
Collapse
|
33
|
Murray-Parahi P, Edgar V, Descallar J, Comino E, Johnson M. ENsCOPE: Scoping the Practice of Enrolled Nurses in an Australian Community Health Setting. Int Nurs Rev 2016; 64:59-68. [PMID: 27652574 DOI: 10.1111/inr.12305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION A continuing shift of healthcare delivery from hospital to the community has increased the acuity and complexity of care provided in the home. Global financial crises and nursing shortages have prompted policies supporting two tiers of nursing and expansion of the licensed practical nurse, second level or enrolled nurse role and evoked debate surrounding roles traditionally undertaken by registered nurses. Community nursing offers unique challenges for enrolled nurses wanting to enact their full scope of practice. AIM To compare and describe registered and enrolled nurse opinions of their current and potential enrolled nurse scope of practice in the community health setting. METHODS A cross-sectional survey of 136 nurses (115 registered and 21 enrolled nurses) was undertaken within a large community nursing team in Australia. Participants reported their opinions of enrolled nurse scope of practice based on 27 core community nursing skills. RESULTS Although substantial agreement was evident, there were statistically significant differences between registered nurse and enrolled nurse opinions in core skill areas; 'Patient Education' and 'Clinical Observation'. Registered nurses identified some specialized skills-catheter and gastrostomy care-that could be undertaken by enrolled nurses with further education. CONCLUSION We confirm that registered nurses do agree with extending the skills of enrolled nurses. Education approaches that build shared confidence in enrolled nurse advanced skills are recommended. IMPLICATIONS FOR NURSING AND HEALTH POLICY The future supply of nurses is at risk. There are limited resources and increasing demand for quality health care where people live and work. While there may be opportunities internationally to improve productivity through advanced nursing roles, these policies should prioritize efficiency by firstly promoting the full enactment of nursing skills in these settings.
Collapse
Affiliation(s)
- P Murray-Parahi
- Centre of Cardiovascular and Chronic Care, Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, NSW, Australia.,Caroline Chisholm Centre, Liverpool Hospital, Liverpool, NSW, Australia.,Primary & Community Health Nursing, SWSLHD, Liverpool, NSW, Australia
| | - V Edgar
- Primary & Community Health Nursing, SWSLHD, Liverpool, NSW, Australia
| | - J Descallar
- The Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Clinical School UNSW, Sydney, NSW, Australia
| | - E Comino
- The Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Centre for Health Equity Training Research and Evaluation (CHETRE), UNSW Centre for Primary Health Care and Equity, A Unit of Population Health, South Western Sydney and Sydney Local Health Districts, NSW Health, Sydney, NSW, Australia
| | - M Johnson
- The Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.,Centre for Applied Nursing Research, South Western Sydney Local Health District & University of Western Sydney, Liverpool, NSW, Australia (Affiliated with the Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia)
| |
Collapse
|
34
|
Smith S, Sim J, Halcomb E. Australian general practice nurse's knowledge, attitudes and practices regarding influenza vaccination: a cross-sectional survey. J Clin Nurs 2016; 25:2502-10. [DOI: 10.1111/jocn.13287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Sarah Smith
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| | - Jenny Sim
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| | - Elizabeth Halcomb
- School of Nursing; University of Wollongong; Wollongong NSW Australia
| |
Collapse
|
35
|
Davidson PM. Cardiovascular Nursing: The Future is Bright. Heart Lung Circ 2016; 25:757-8. [PMID: 27256907 DOI: 10.1016/j.hlc.2016.05.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Patricia Mary Davidson
- Johns Hopkins University, School of Nursing, Baltimore, MD, USA; University of Technology, Sydney, NSW, Australia.
| |
Collapse
|
36
|
Poitras ME, Chouinard MC, Fortin M, Gallagher F. How to report professional practice in nursing? A scoping review. BMC Nurs 2016; 15:31. [PMID: 27231437 PMCID: PMC4880971 DOI: 10.1186/s12912-016-0154-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 05/17/2016] [Indexed: 11/22/2022] Open
Abstract
Background Nursing professional practice in different contexts of care has been widely described in evidence-based literature. Currently, there is no consensus on a common structure for these descriptions. Understanding and comparing similar practices is made difficult by the varying nature of descriptions provided in scientific literature. Purpose of the study: 1) to report research methods found in the scientific literature that were used to describe the practice of different health professionals; 2) to report on the main concepts used to describe the practice of these health professionals; 3) to propose a structure for the description of the practice in nursing. Methods A scoping review following a five-stage approach: 1) identifying the research question; 2) identifying relevant studies; 3) selecting studies; 4) charting data; 5) reporting results. The Medline, CINAHL, psychARTICLES, psyCRITIQUES, psycEXTRA, Psychology and Behavioral Science Collection and psycINFO databases were searched. Each study was analyzed and extracted data were classified by categories and structures used to describe the health professional practices. Results Forty-nine studies were included. In these studies, quantitative, qualitative or mixed methods were used to describe professional practice in different health disciplines. Three major concepts were reported most frequently in describing professional practice: roles, domains and activities. The concepts varied greatly among authors. We found that to define roles or to characterize a professional practice, activities must be described and organized on the basis of different domains. Conclusions A promising structure for describing nursing professional practice is proposed by the authors of this review. The structure facilitates the accurate description of all domains and activities performed by nurses in different contexts of practice, and will contribute to the development of knowledge about nursing practice in different contexts based on shared concepts. Electronic supplementary material The online version of this article (doi:10.1186/s12912-016-0154-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Marie-Eve Poitras
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
| | | | - Martin Fortin
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada ; Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Chicoutimi, 305, Saint-Vallier, Chicoutimi, G7H 5H6 Québec Canada
| | - Frances Gallagher
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
| |
Collapse
|
37
|
Parker S, Fuller J. Are nurses well placed as care co-ordinators in primary care and what is needed to develop their role: a rapid review? HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:113-122. [PMID: 25676344 DOI: 10.1111/hsc.12194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 06/04/2023]
Abstract
Care co-ordination is reported to be an effective component of chronic disease (CD) management within primary care. While nurses often perform this role, it has not been reported if they or other disciplines are best placed to take on this role, and whether the discipline of the co-ordinator has any impact on clinical and health service outcomes. We conducted a rapid review of previous systematic reviews from 2006 to 2013 to answer these questions with a view to informing improvements in care co-ordination programmes. Eighteen systematic reviews from countries with developed health systems comparable to Australia were included. All but one included complex interventions and 12 of the 18 involved a range of multidisciplinary co-ordination strategies. This multi-strategy and multidisciplinarity made it difficult to isolate which were the most effective strategies and disciplines. Nurses required specific training for these roles, but performed co-ordination more often than any other discipline. There was, however, no evidence that discipline had a direct impact on clinical or service outcomes, although specific expertise gained through training and workforce organisational support for the co-ordinator was required. Hence, skill mix is an important consideration when employing care co-ordination, and a sustained consistent approach to workforce change is required if nurses are to be enabled to perform effective care co-ordination in CD management in primary care.
Collapse
Affiliation(s)
- Sharon Parker
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Jeffrey Fuller
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
- Centre of Research Excellence in Primary Health Care Microsystems, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
38
|
Trust and decision-making: How nurses in Australian general practice negotiate role limitations. Collegian 2015; 22:225-32. [PMID: 26281411 DOI: 10.1016/j.colegn.2015.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To explore the importance of role recognition and relationships between the opportunities for decision-making, social support, and skill development, in a sample of nurses working in general practice in New South Wales, Australia. BACKGROUND Understanding how nurses make decisions about patients and their care in general practice will benefit organisations and public policy. This understanding is important as the role changes and opportunities for further role development emerge. DESIGN A sequential mixed methods design was used. Study 1 utilised the internationally validated Job Content Questionnaire to collect data about decision making, social support, skill development, and identity derived from the role. In 2008 a purposive sample of nurses working in general practice (n = 160) completed and submitted an online Job Content Questionnaire. Study 2 used a set of open-ended questions informed by Study 1 to guide semi-structured interviews. In 2010 fifteen interviews were undertaken with nurses in general practice. Demographic characteristics of both samples were compared, and the findings of both studies were integrated. RESULTS The integration of findings of Study 1 and 2 suggests that nurses defined their expertise as being able to identify patient need and communicate this to the general practitioner, the ability to do so led to the development of trusting relationships. Trusting relationships led to greater support from the general practitioner and this support allowed the nurse greater freedom to make decisions about patient care. CONCLUSIONS Nurses gained influence in clinical decision-making by building trusting relationships with patients and medical colleagues. They actively collaborated in and made decisions about patient care. These results suggest that there is a need to consider how nursing can more effectively contribute to care in general practice settings.
Collapse
|
39
|
A case study exploring employment factors affecting general practice nurse role development. Prim Health Care Res Dev 2015; 17:87-97. [DOI: 10.1017/s1463423615000304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AimThe aim of this study was to explore the factors affecting role development in practice nursing in the United Kingdom.BackgroundGeneral practice is currently central to National Health Service reform, producing favourable conditions for the practice nurse role to be further strengthened and developed. However, the literature has continued to describe evidence that practice nurses are a disempowered, isolated group with many constraints reducing their ability to respond to opportunities to develop their role. The rationale for conducting the study was therefore to provide a greater understanding about the constraining factors and their influence on practice nurses wishing to develop their role.MethodThe method used to conduct the research followed a case approach, as the subject being investigated was complex with multiple inter-related factors and the approach was exploratory. The cases comprised six UK general practices and the participants within each case were a practice nurse, a GP and a practice manager.FindingsA combination of factors was found to contribute to the way the practice nurse role evolves. These are education, practice culture, practice nurse personal characteristics and empowerment. Empowerment holds the key to maximising the conditions favourable to practice nurse role evolution. This is not, however, a ‘single’ factor; it represents the combined synergistic effects of practice culture and practice nurse personal characteristics on creating an empowering environment. The inter-relationship between these was captured in a framework and given the title ‘empowering employment principles’.ConclusionThe ‘empowering employment principles’ illustrate the features most conducive to role evolution, thus providing a tool for practice nurses and their employers to enhance opportunities for nurses to develop their role.
Collapse
|
40
|
Bloomfield JG, Gordon CJ, Williams AM, Aggar C. Nursing students’ intentions to enter primary health care as a career option: Findings from a national survey. Collegian 2015; 22:161-7. [DOI: 10.1016/j.colegn.2015.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
41
|
Gordon CJ, Aggar C, Williams AM, Walker L, Willcock SM, Bloomfield J. A transition program to primary health care for new graduate nurses: a strategy towards building a sustainable primary health care nurse workforce? BMC Nurs 2014; 13:34. [PMID: 25550684 PMCID: PMC4279900 DOI: 10.1186/s12912-014-0034-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/03/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This debate discusses the potential merits of a New Graduate Nurse Transition to Primary Health Care Program as an untested but potential nursing workforce development and sustainability strategy. Increasingly in Australia, health policy is focusing on the role of general practice and multidisciplinary teams in meeting the service needs of ageing populations in the community. Primary health care nurses who work in general practice are integral members of the multidisciplinary team - but this workforce is ageing and predicted to face increasing shortages in the future. At the same time, Australia is currently experiencing a surplus of and a corresponding lack of employment opportunities for new graduate nurses. This situation is likely to compound workforce shortages in the future. A national nursing workforce plan that addresses supply and demand issues of primary health care nurses is required. Innovative solutions are required to support and retain the current primary health care nursing workforce, whilst building a skilled and sustainable workforce for the future. DISCUSSION This debate article discusses the primary health care nursing workforce dilemma currently facing policy makers in Australia and presents an argument for the potential value of a New Graduate Transition to Primary Health Care Program as a workforce development and sustainability strategy. An exploration of factors that may contribute or hinder transition program for new graduates in primary health care implementation is considered. SUMMARY A graduate transition program to primary health care may play an important role in addressing primary health care workforce shortages in the future. There are, however, a number of factors that need to be simultaneously addressed if a skilled and sustainable workforce for the future is to be realised. The development of a transition program to primary health care should be based on a number of core principles and be subjected to both a summative and cost-effectiveness evaluation involving all key stakeholders.
Collapse
Affiliation(s)
| | - Christina Aggar
- />Sydney Nursing School, University of Sydney, Sydney, NSW 2006 Australia
| | - Anna M Williams
- />Sydney Nursing School, University of Sydney, Sydney, NSW 2006 Australia
| | - Lynne Walker
- />Australian Primary Health Care Nurses Association (APNA), Melbourne, Victoria 3205 Australia
| | - Simon M Willcock
- />Central Clinical School, University of Sydney, Sydney, NSW 2006 Australia
| | | |
Collapse
|