Clients' understanding of the role of nurse practitioners

Nurse practitioners (NPs) have an emerging role in the Australian health care system. However, there remains a dearth of data about public understanding of the NP role. The aim of this study was to evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales were invited to recruit five consecutive clients to complete the self-administered survey. Thirty-two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two-thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP-related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (P = 0.005), and where applicable would to prefer to see an NP rather than a doctor (P = 0.022). Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction, more awareness of the scope of the NP role is required. What is known about the topic?The role of nurse practitioners (NPs) in Australian health care is diverse and evolving. There is a dearth of research focusing on NPs, particularly looking at the client perception of their role. What does this paper add?This study investigates the client’s perception of the role of nurse practitioners and levels of confidence and satisfaction through the use of a self-administered questionnaire. What are the implications for practitioners?The results suggest that clients have a moderate awareness of the nurse practitioner role. Despite this, clients appear to have high levels of confidence and satisfaction after consultations with nurse practitioners. These results suggest that greater community awareness of the role may help maximise their positive contribution to health care in Australia.

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Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

10.32920/14639799 ◽

2021 ◽

Author(s):

Jenny Ploeg ◽

Sharon Kaasalainen ◽

Carrie McAiney ◽

Ruth Martin-Misener ◽

Faith Donald ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Nurse Practitioners ◽

Long Term Care ◽

Family Members ◽

Term Care ◽

Qualitative Descriptive

Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience

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Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

10.32920/14639799.v1 ◽

2021 ◽

Author(s):

Jenny Ploeg ◽

Sharon Kaasalainen ◽

Carrie McAiney ◽

Ruth Martin-Misener ◽

Faith Donald ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Nurse Practitioners ◽

Long Term Care ◽

Family Members ◽

Term Care ◽

Qualitative Descriptive

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A atuação do enfermeiro auditor na qualidade da assistência à saúde: revisão bibliográfica integrativa

Revista de Administração em Saúde ◽

10.23973/ras.83.293 ◽

2021 ◽

Vol 21 (83) ◽

Author(s):

Gabriela Marchiori do Carmo Azzolin

Keyword(s):

Health Care ◽

Quality Of Care ◽

Quality Of Health Care ◽

Nursing Process ◽

Inclusion Criteria ◽

Great Relevance ◽

Role Of Nursing ◽

Selection Of

Objetivo: descrever a atuação do enfermeiro auditor na qualidade da assistência a saúde. Método: trata-se de uma revisão integrativa de artigos publicados no período de 2015 a 2020. A pesquisa e seleção dos artigos foi realizada nas bases de dados: BEDENF, LILACS e MEDLINE, por meio dos descritores “Enfermagem”, “Auditoria de enfermagem” , “Registros de enfermagem” e “ Qualidade da assistência à saúde”. Os critérios de inclusão foram artigos online gratuitos, com textos completos, publicados de 2015 a 2020, nos idiomas português e inglês. Resultados: foram selecionados 11 artigos, por cumprirem os critérios estabelecidos no estudo. Na análise dos resultados foi possível evidenciar a importância significativa da qualidade dos registros no processo de enfermagem. Conclusão: a atuação da enfermagem na auditoria tem ganhado notoriedade nos últimos anos, por ser de grande relevância para a qualidade da assistência prestada e abranger muito mais que a gestão de custos.Palavras-chave: Enfermagem; Auditoria de enfermagem; Registros de enfermagem; Qualidade da assistência à saúde. The auditor's nurse's performance in the quality of health care: integrative bibliographic review ABSTRACTObjective: to describe the role of the nurse auditor in the quality of health care. Method: this is an integrative review of articles published from 2015 to 2020. The research and selection of articles was carried out in the databases: BEDENF, LILACS and MEDLINE, using the descriptors “Nursing”, “Nursing audit "," Nursing records "and" Quality of health care ". The inclusion criteria were free online articles, with full texts, published from 2015 to 2020, in Portuguese and English. Result: 11 articles were selected, as they meet the criteria established in the study. In the analysis of the results, it was possible to highlight the significant importance of the quality of the records in the nursing process. Conclusio: the role of nursing in the audit has gained notoriety in recent years, as it is of great relevance to the quality of care provided and covers much more than cost management.Keywords: Nursing; Nursing audit; Nursing records; Quality of health care.

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Pediatric Recertification and Quality of Care: The Role of the American Board of Pediatrics in Improving Children’s Health Care

The Journal of Pediatrics ◽

10.1016/j.jpeds.2007.08.015 ◽

2007 ◽

Vol 151 (5) ◽

pp. S17-S20 ◽

Cited By ~ 4

Author(s):

Paul V. Miles

Keyword(s):

Health Care ◽

Quality Of Care ◽

Children's Health ◽

Children’S Health ◽

Children’S Health Care

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Assessing the Quality of Care at Primary Health Care Level in Two Pilot Regions of Albania

Frontiers in Public Health ◽

10.3389/fpubh.2021.747689 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jasmina Saric ◽

Sabine Kiefer ◽

Altina Peshkatari ◽

Kaspar Wyss

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Quality Of Care ◽

Primary Health Care ◽

Health System ◽

Clinical Observation ◽

Urban Setting ◽

Health System Strengthening ◽

Primary Health

The quality of care (QoC) of primary health care (PHC) services in Albania faces challenges on multiple levels including governance, access, infrastructure and health care workers. In addition, there is a lack of trust in the latter. The Health for All Project (HAP) funded by the Swiss Agency for Development and Cooperation therefore aimed at enhancing the population's health by improving PHC services and implementing health promotion activities following a multi-strategic health system strengthening approach. The objective of this article is to compare QoC before and after the 4 years of project implementation. A cross-sectional study was implemented at 38 PHC facilities in urban and rural locations in the Diber and Fier regions of Albania in 2015 and in 2018. A survey measured the infrastructure of the different facilities, provider–patient interactions through clinical observation and patient satisfaction. During clinical observations, special attention was given to diabetes and hypertensive patients. Infrastructure scores improved from base- to endline with significant changes seen on national level and for rural facilities (p < 0.01). Facility infrastructure and overall cleanliness, hygiene and basic/essential medical equipment and supplies improved at endline, while for public accountability/transparency and guidelines and materials no significant change was observed. The overall clinical observation score increased at endline overall, in both areas and in rural and urban setting. However, infection prevention and control procedures and diabetes treatment still experienced relatively low levels of performance at endline. Patient satisfaction on PHC services is generally high and higher yet at endline. The changes observed in the 38 PHC facilities in two regions in Albania between 2015 and 2018 were overall positive with improvements seen at all three levels assessed, e.g., infrastructure, service provision and patient satisfaction. However, to gain overall improvements in the QoC and move toward a more efficient and sustainable health system requires continuous investments in infrastructure alongside interventions at the provider and user level.

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An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis

Journal of Chiropractic Education ◽

10.7899/jce-19-22 ◽

2020 ◽

Vol 34 (1) ◽

pp. 15-30 ◽

Cited By ~ 4

Author(s):

Bart N. Green ◽

Claire D. Johnson ◽

Richard Brown ◽

Charmaine Korporaal ◽

Doug Lawson ◽

...

Keyword(s):

Quality Of Care ◽

Qualitative Analysis ◽

Response Rate ◽

Minimum Standard ◽

Ethical Practices ◽

Electronic Survey ◽

Written Comments ◽

The Cost

Objective: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs. Methods: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes. Results: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies. Conclusion: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

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Patient safety, ethics and whistleblowing: a nursing response to the events at the Campbelltown and Camden Hospitals

Australian Health Review ◽

10.1071/ah040013 ◽

2004 ◽

Vol 28 (1) ◽

pp. 13 ◽

Cited By ~ 16

Author(s):

Megan-Jane Johnstone

Keyword(s):

Health Care ◽

At Risk ◽

Patient Safety ◽

Quality Of Care ◽

Code Of Ethics ◽

Codes Of Ethics ◽

Lessons Learned ◽

Professional Conduct ◽

Australian Health

IN NOVEMBER 2002, in what stands as one of the most significant whistle blowing cases in the history of the Australian health care system, four nurses went public with concerns they had about the management of clinical incidents and patient safety at two hospitals in Sydney, New South Wales. The handling of this case and its aftermath raises important moral questions concerning the nature of whistleblowing in health care domains and the possible implications for the patient safety and quality of care movement in Australia. This paper presents an overview of the case, the moral risks associated with whistleblowing, and some lessons learned. The International Council of Nurses (2000) Code of Ethics stipulates that nurses have a stringent responsibility to 'take appropriate action to safeguard individuals when their care is endangered by a co-worker or any other person'. Other local and international nursing codes of ethics and standards of professional conduct likewise obligate nurses to take appropriate action to safeguard individuals when placed at risk by the incompetent, unethical or illegal acts of others ? including the system. Despite these coded moral prescriptions for responsible and accountable professional conduct, taking appropriate action when others are placed at risk (including making reports to appropriate authorities) is never an easy task nor is it free of risk for nurses. As has been amply demonstrated in the literature, taking a moral stance to protect patient safety and quality of care can be extremely hazardous to nurses (Johnstone 1994, 2002, 2004; Ahern & McDonald 2002). In situations where nurses report their concerns to an appropriate authority but nothing is done to either investigate or validate their claims, nurses are faced with the ethical dilemma and 'choice' of whether to: do nothing ('put up and shut up'); leave their current place of employment (and possibly even the profession); or take the matter further ('blow the whistle') by reporting their concerns to an external authority that they perceive as having the power to do something about their concerns. It is rare for nurses to 'blow the whistle' in the public domain. When they do, it is usually because they perceive that something is terribly wrong and, as a matter of conscience, they cannot just look on as morally passive bystanders. For those nurses who do take a stand, the costs to them personally and professionally are almost always devastating, with no guarantees that the situation on which they have taken a public stance will be improved. Nurses who blow the whistle often end up with their careers and lives in tatters (see case studies in Johnstone 1994 & 2004).

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Attitude and Perception of Physicians and Nurses Toward the Role of Clinical Pharmacists in Riyadh, Saudi Arabia: A Qualitative Study

SAGE Open Nursing ◽

10.1177/2377960819889769 ◽

2019 ◽

Vol 5 ◽

pp. 237796081988976

Author(s):

Nada Alsuhebany ◽

Lama Alfehaid ◽

Hind Almodaimegh ◽

Abdulkareem Albekairy ◽

Shmeylan Alharbi

Keyword(s):

Health Care ◽

Quality Of Care ◽

Focus Group ◽

Health Care Providers ◽

Care Providers ◽

Focus Group Discussions ◽

Group Discussions ◽

Clinical Pharmacists

Clinical pharmacists are responsible for guiding pharmacotherapy and ensuring medication safety along with other health-care providers. This study highlighted barriers that physicians and nurses encounter when interacting with clinical pharmacists. Twenty-seven physicians and nurses were randomly invited to participate in focus-group discussions. Five focus-group discussions were recorded and then transcribed, and the transcripts were reviewed and coded. Three major themes were identified, which were the role of clinical pharmacists, interprofessional communication, and competency. The greatest challenge reported in this study was lack of consistent understanding of the role of clinical pharmacists which to some extent caused communication deficiencies and affected the level of involvement with multidisciplinary teams. Despite that, majority of the participants perceived pharmacists as beneficial in optimizing pharmacotherapy and improving quality of care. Clinical pharmacy services are perceived positively in impacting quality of care as expressed by majority of the study participants. However, there is a lack of common understanding of the role of clinical pharmacists by other health-care providers.

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Retail Health Clinics: How the Next Innovation in Market-Driven Health Care is Testing State and Federal Law

American Journal of Law & Medicine ◽

10.1177/009885880903500106 ◽

2009 ◽

Vol 35 (1) ◽

pp. 205-231 ◽

Cited By ~ 5

Author(s):

Kaj Rozga

Keyword(s):

Health Care ◽

Quality Of Care ◽

Nurse Practitioners ◽

Conflicts Of Interest ◽

Grocery Stores ◽

Basic Health ◽

Health Clinics ◽

Basic Health Care ◽

Retail Health Clinics

The emergence of in-store retail health clinics (RHCs) has sparked a debate that pits quality of care concerns against the advantages of consumer choice in the marketplace for health care. RHCs appear in pharmacies, grocery stores, and big-box retailers like Wal-Mart, offering basic health care services on a walk-in basis that are administered primarily by nurse practitioners (NPs). Proponents of these clinics hail their pro-market effects: convenience and cost-savings associated with consumer-driven health care; lower prices from increased competition between providers; and increased access to basic health care. Critics of RHCs raise concerns that quality of care is hindered by the lack of physician oversight, disruption of the “medical home,” and the conflicts of interest arising from prescribing drugs at pharmacy-housed clinics.

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