scholarly journals Nurse practitioner consultations in primary health care: patient, carer, and nurse practitioner qualitative interpretations of communication processes

2018 ◽  
Vol 20 ◽  
Author(s):  
Julian Barratt ◽  
Nicola Thomas
Keyword(s):  
Social Interactions ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Care Patient ◽  
Computer Assisted ◽  
Structured Interviews ◽  
Policy Makers ◽  
Mixed Methods Case Study ◽  
Communication Processes ◽  
Practitioner Role

AbstractAimTo advance understanding of the discrete nature of the communication processes and social interactions occurring in nurse practitioner consultations.BackgroundPreceding qualitative investigations of nurse practitioner consultations have, when conducting interviews with participants, often exclusively sampled either nurse practitioners or patients. Furthermore, previous qualitative studies of the nature of nurse practitioner consultations have not typically also sampled carers attending with patients for nurse practitioner consultations. Accordingly this study was developed, in part, to address this exclusivity of sampling in qualitative research of nurse practitioner consultations by developing an inclusive sample of patient, carer and nurse practitioner participants of nurse practitioner consultations, so as to conjointly develop an understanding of the multiple perceptions of those participants of communication processes occurring in nurse practitioner consultations.MethodsQualitative component of a larger mixed methods case study of communication processes and social interactions in nurse practitioner consultations, utilising individual semi-structured interviews with the patient (n = 9), carer (n = 2) and nurse practitioner (n = 3) participants of video-recorded consultations derived from a nurse practitioner-led general practice clinic. Interview transcripts were initially analysed via an emergent thematic analysis, followed up by computer-assisted qualitative data analysis with NVivo 9.FindingsThe participants’ perceptions of nurse practitioner consultation communication processes and social interactions were represented through six themes: Consulting style of nurse practitioners; Nurse practitioner – GP comparisons; Lifeworld content or lifeworld style; Nurse practitioner role ambiguity; Creating the impression of time and Expectations for safety netting. The findings identify a need for policy makers to address a perceived ambiguity of the nature of the nurse practitioner role amongst patients and carers. The benefits of nurse practitioners using personable, everyday lifeworld styles of communication for optimising interactions, sharing clinical reasoning and conveying a sense of having time for patients and carers in consultations are also identified.

Implementation of the Acute Care Nurse Practitioner Role

1994 ◽  
Vol 5 (3) ◽  
pp. 404-407
Author(s):  
Lynn A. Kelso ◽  
Lori M. Massaro
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Center ◽  
Care Nurse ◽  
University Of Pittsburgh ◽  
Acute Care Nurse Practitioner ◽  
The University ◽  
Pittsburgh Medical ◽  
Practitioner Role

In this article, the experiences of two new acute care nurse practitioners working at the University of Pittsburgh Medical Center arc described. Included are the experiences they encountered in initiating the role and some of the responsibilities they assumed.

scholarly journals Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement

2018 ◽  
Vol 20 ◽  
Author(s):  
Julian Barratt ◽  
Nicola Thomas
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Convenience Sample ◽  
Primary Health ◽  
Communication Processes ◽  
Consultation Time

AbstractBackgroundResearch has not yet fully investigated links to consultation duration, patient expectations, satisfaction, and enablement in nurse practitioner consultations. This study was developed to address some of these research gaps in nurse practitioner consultations, particularly with a focus on expectations, satisfaction, and enablement.AimTo explore the influence of pre-consultation expectations, and consultation time length durations on patient satisfaction and enablement in nurse practitioner consultations in primary health care.DesignSurvey component of a larger convergent parallel mixed methods case study designed to conjointly investigate the communication processes, social interactions, and measured outcomes of nurse practitioner consultations. The survey element of the case study focusses on investigating patients’ pre-consultation expectations and post-consultation patient satisfaction and enablement.MethodsA questionnaire measuring pre-consultation expectations, and post-consultation satisfaction and enablement, completed by a convenience sample of 71 adults consulting with nurse practitioners at a general practice clinic. Initial fieldwork took place in September 2011 to November 2012, with subsequent follow-up fieldwork in October 2016.ResultsRespondents were highly satisfied with their consultations and expressed significantly higher levels of enablement than have been seen in previous studies of enablement with other types of clinicians (P=0.003). A significant, small to moderate, positive correlation of 0.427 (P=0.005) between general satisfaction and enablement was noted. No significant correlation was seen between consultation time lengths and satisfaction or enablement.ConclusionHigher levels of patient enablement and satisfaction are not necessarily determined by the time lengths of consultations, and how consultations are conducted may be more important than their time lengths for optimising patient satisfaction and enablement.

scholarly journals Using the PEPPA Framework to Develop and Implement a Nurse Practitioner Role Within Canada’s National Ballet School

2021 ◽  
Vol 1 (1) ◽  
pp. 10-22
Author(s):  
Erin Ziegler ◽  
Sophia Kim ◽  
Rachel J. Bar
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Advanced Practice Nursing ◽  
Health And Wellness ◽  
Physical And Mental Health ◽  
Wellness Program ◽  
Nursing Role ◽  
Dance Training ◽  
Timely Access ◽  
Practitioner Role

Aim: To outline the successful development and implementation of a nurse practitioner role within a professional ballet school. Background: Nurse practitioners are well integrated into primary and acute care in Ontario, yet the role within schools and private athletic institutions is not well documented. Canada’s National Ballet School is a professional ballet school with a combination of day students and those living in residences. Students complete both dance training and academics at the School. The physical and mental health of students was identified as a key priority by the school, leading to the development of an integrated health and wellness program. To facilitate more timely access to healthcare and provide an opportunity for collaboration and consultation within the school, a plan to implement a nurse practitioner role into the school was developed. Methods: In order to develop and implement the role of the nurse practitioner within the institution, the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (PEPPA) framework was used. The first seven steps of the PEPPA framework were applied in this project. Findings: The PEPPA framework allowed for us to identify key barriers and facilitators for the role implementation and successfully implement the nurse practitioner role. While the initial plan was for a slower implementation, the COVID-19 pandemic highlighted the need for a nurse practitioner in the institution more urgently. Conclusion: The PEPPA framework provided us with an organized process for developing and implementing the nurse practitioner role at Canada’s National Ballet School.

scholarly journals ‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tara N. Officer ◽  
Jackie Cumming ◽  
Karen McBride-Henry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Consumer Satisfaction ◽  
Care Delivery ◽  
Realist Evaluation ◽  
Structured Interviews ◽  
Primary Health ◽  
Advanced Practitioner

Abstract Background Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services. Methods As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research. Results Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion. Conclusions This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.

scholarly journals A mixed methods study of the work patterns of full-time nurse practitioners in Canadian nursing homes

2021 ◽  
Author(s):  
R. Martin-Misener ◽  
F. Donald ◽  
Abigail Wickson-Griffiths ◽  
Noori Akhtar-Danesh ◽  
J. Ploeg ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Case Studies ◽  
Nurse Practitioners ◽  
National Survey ◽  
Nurse Practitioner ◽  
Family Care ◽  
Full Time ◽  
Work Patterns ◽  
Practitioner Role

The aim of this study was to explore the integration of the nurse practitioner role in Canadian nursing homes to enable its full potential to be realised for resident and family care. The objective was to determine nurse practitioners' patterns of work activities. Nurse practitioners were introduced in Canadian nursing homes a decade ago on a pilot basis. In recent years, government and nursing home sector interest in the role has grown along with the need for data to inform planning efforts. The study used a sequential mixed methods design using a national survey followed by case studies. A national survey of nurse practitioners included demographic items and the EverCare Nurse Practitioner Role and Activity Scale. Following the survey, case studies were conducted in four nursing homes. Data were collected using individual and focus group interviews, document reviews and field notes. Twenty-three of a target population of 26 nurse practitioners responded to the survey, two-thirds of whom provided services in nursing homes with one site and the remainder in nursing homes with as many as four sites. On average, nurse practitioners performed activities in communicator, clinician, care manager/coordinator and coach/educator subscales at least three to four times per week and activities in the collaborator subscale once a week. Of the 43 activities, nurse practitioners performed daily, most were in the clinician and communicator subscales. Case study interviews involved 150 participants. Findings complemented those of the survey and identified additional leadership activities. Nurse practitioners undertake a range of primary health care and advanced practice activities which they adapt to meet the unique needs of nursing homes. Knowledge of work patterns enables nursing homes to implement the full range of nurse practitioner roles and activities to enhance resident and family care.

How nurse practitioners implement their roles

2012 ◽  
Vol 36 (1) ◽  
pp. 22 ◽  
Author(s):  
Jane L. Desborough
Keyword(s):  
Clinical Practice ◽  
Focus Group ◽  
Focus Group Discussion ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Group Discussion ◽  
Successful Implementation ◽  
Central Process ◽  
Policy Makers

Objective. This is a report of a qualitative health research study examining how nurse practitioners construct and implement their roles. Methods. In-depth interviews and a focus group discussion were conducted to obtain narrative data from nurse practitioners from a variety of clinical backgrounds. Data were analysed utilising the principles of grounded theory. Subjects. Seven nurse practitioners participated in face-to-face interviews and six participated in a focus group discussion. Results. The central process of ‘developing legitimacy and credibility’ is achieved through the processes of: ‘developing Clinical Practice Guidelines’, ‘collaborating with the multidisciplinary team’, ‘communicating’, and ‘transitioning to practice’. Conclusion. Policy makers and those responsible for operationalising nurse practitioner roles need to support the central process of developing legitimacy and credibility vital for successful implementation. First, this involves enabling a supportive and informed process of Clinical Practice Guideline development. Second, key inter-disciplinary relationships need to be identified to facilitate collaboration and sources of mentorship for nurse practitioners. Finally, an identified period of transition will facilitate identification, development and implementation of the above processes. What is known about the topic? The contemporary role of the nurse practitioner was introduced to provide a flexible, innovative, integrated care strategy, providing increased continuity of nursing care at an advanced practice level. Implementation of the role of the nurse practitioner can be challenging and is influenced by several identified barriers and facilitators. What does this paper add? This paper adds an understanding of workplace relationships and processes, which are integral to the construction and implementation of nurse practitioner roles. The interplay of these processes and relationships support the central process of ‘developing legitimacy and credibility’. What are the implications for practitioners? This paper provides a clear guide for policy makers and those responsible for operationalising nurse practitioner roles in regard to the requirements underpinning successful role development and implementation.

scholarly journals ‘She Taught Me’: Factors Consumers Find Important in Nurse Practitioner and Pharmacist Prescriber Services

2020 ◽  
Author(s):  
Tara Officer ◽  
Jackie Cumming ◽  
Karen McBride-Henry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Consumer Satisfaction ◽  
Care Delivery ◽  
Realist Evaluation ◽  
Structured Interviews ◽  
Primary Health ◽  
Advanced Practitioner

Abstract Background: Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services.Methods: As part of a larger realist evaluation, 21 consumers of advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context-mechanism-outcome configurations tested and refined throughout the research.Results: Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners are more accessible, engage at the consumer’s ‘level’, and operate with passion.Conclusions: This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.

scholarly journals Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes

2018 ◽  
Vol 20 ◽  
Author(s):  
Julian Barratt ◽  
Nicola Thomas
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Social Interactions ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Interaction Analysis ◽  
Interaction Styles ◽  
Primary Health ◽  
Patient Enablement ◽  
Consultation Time

AbstractObjectiveTo determine the discrete nature of social interactions occurring in nurse practitioner consultations and investigate the relationship between consultation social interaction styles (biomedical and patient-centred) and the outcomes of patient satisfaction, patient enablement, and consultation time lengths.MethodsA case study-based observational interaction analysis of verbal social interactions, arising from 30 primary health care nurse practitioner consultations, linked with questionnaire measures of patient satisfaction and enablement.ResultsA significant majority of observed social interactions used patient-centred communication styles (P=0.005), with neither nurse practitioners nor patients or carers being significantly more verbally dominant. Nurse practitioners guided the sequence of consultation interaction sequences, but patients actively participated through interactions such as asking questions. Usage of either patient-centred or biomedical interaction styles were not significantly associated with increased levels of patient satisfaction or patient enablement. The median consultation time length of 10.1 min (quartiles 8.2, 13.7) was not significantly extended by high levels of patient-centred interactions being used in the observed consultations.ConclusionHigh usage levels of patient-centred interaction styles are not necessarily contingent upon having longer consultation times available, and clinicians can encourage patients to use participatory interactions, whilst still then retaining overall guidance of the phased sequences of consultations, and not concurrently extending consultation time lengths. This study adds to the body of nurse practitioner consultation communication research by providing a more detailed understanding of the nature of social interactions occurring in nurse practitioner consultations, linked to the outcomes of patient satisfaction and enablement.

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