scholarly journals Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?

2021 ◽  
Vol 7 ◽  
pp. 237796082110534
Author(s):  
Maria Mathews ◽  
Dana Ryan ◽  
Richard Buote ◽  
Sandra Parsons ◽  
Julia Lukewich
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Family Practice ◽  
Newfoundland And Labrador ◽  
Secondary Analysis ◽  
Family Physicians ◽  
Scope Of Practice ◽  
Professional Competencies ◽  
Structured Interviews ◽  
Practice Nurses

Background Family practice nurses are Registered Nurses who work collaboratively in primary care and deliver a range of services. Professional competency statements have been developed to describe the skills and knowledge of family practice nurses as a distinct field. Purpose We conducted a secondary analysis of qualitative interview data to examine how family practice nurse roles/activities relate to recently developed professional competencies. Methods Family physicians and family practice nurses in Newfoundland and Labrador (NL) participated in semi-structured interviews, during which they discussed roles/activities and scope of practice surrounding family practice nursing. For this secondary analysis, we used competency statements to inform thematic coding of the transcribed interviews. Results For the initial study, a total of 8 participants (5 family practice nurses; 3 family physicians) were interviewed from diverse practices. All transcripts from the original study (n = 8) were included in the secondary analysis and analysed across 47 competencies encompassing 6 domains (Professionalism; Clinical Practice; Communication; Collaboration and Partnership; Quality Assurance, Evaluation and Research; Leadership). Roles/activities reported by participants were reflective of the competencies, but with substantial variation in expression. Conclusions Family practice nursing competency statements reflect the actual activities of family practice nurses in NL. The professional competencies can serve as a framework to examine contributions of family practice nurses and identify areas warranting further training. The use of competencies to explore family practice nurses’ roles and activities can assist with optimizing scope of practice.

Monitoring the Dissemination of an Educational Protocol on Pediatric Asthma in Family Practice: A Test of Associations between Dissemination Variables

1999 ◽  
Vol 26 (1) ◽  
pp. 103-120 ◽  
Author(s):  
Ilse Mesters ◽  
Ree M. Meertens
Keyword(s):  
Primary Care ◽  
Diffusion Of Innovation ◽  
Family Practice ◽  
Family Physicians ◽  
Self Management ◽  
Education Programs ◽  
Cross Sectional ◽  
Diffusion Of Innovation Theory ◽  
Perceived Success ◽  
Continued Use

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.

Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

2021 ◽  
Author(s):  
Geertruida J Groenendijk-van Woudenbergh ◽  
Marlies C van Hell-Cromwijk ◽  
Ytje J J van der Veen ◽  
Hylkje F Algra ◽  
Willemieke Kroeze
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Healthy Eating ◽  
Patient Encounter ◽  
Structured Interviews ◽  
Good Communication ◽  
Practice Nurses ◽  
Professional Characteristics ◽  
Primary Care Patients ◽  
Facilitators And Barriers

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.

scholarly journals Off to a good start after a cancer diagnosis: implementation of a time out consultation in primary care before cancer treatment decision

2019 ◽  
Vol 14 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Eveline A. Noteboom ◽  
Niek J. de Wit ◽  
Ingrid J. E. M. van Asseldonk ◽  
Monique C. A. M. Janssen ◽  
Wai Yee Lam-Wong ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Family Physicians ◽  
Treatment Decision ◽  
Added Value ◽  
Structured Interviews ◽  
Time Out ◽  
Almost All ◽  
Care Path

Abstract Purpose Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM. Methods For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists. Results Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively. Conclusion and Implications for Cancer Survivors The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.

scholarly journals A qualitative study exploring the influence of clinic funding on the integration of family practice nurses in Newfoundland and Labrador

Nursing Open ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 1067-1073
Author(s):  
Maria Mathews ◽  
Dana Ryan ◽  
Richard Buote ◽  
Sandra Parsons ◽  
Julia Lukewich
Keyword(s):  
Qualitative Study ◽  
Family Practice ◽  
Newfoundland And Labrador ◽  
Practice Nurses

Passé or a time to pause? A phenomenological study of family physicians’ experiences of physical examination

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696797
Author(s):  
Martina Kelly ◽  
Lisa Freeman
Keyword(s):  
Physical Examination ◽  
Family Practice ◽  
Phenomenological Study ◽  
Essential Element ◽  
Family Physicians ◽  
The Body ◽  
Evidence Based ◽  
Structured Interviews ◽  
Qualitative Phenomenological

BackgroundOnce the cornerstone of clinical family practice, the role of physical examination is changing. Patients and physicians alike express concern that emphasis on evidence-based medicine and increasing reliance of technology has relegated the role of physical examination in clinical practice.AimTo understand the role of physical examination in contemporary family practice.MethodQualitative phenomenological study, interpreted through the writings of Merleau-Ponty. Semi-structured interviews were conducted with a purposive sample of sixteen family physicians; men, women, recent graduates and experienced physician working in urban, rural and academic practices. Interviews were recorded, transcribed and examined using template analysis, complimented with researcher reflexivity.ResultsStudy participants described physical examination as core to practice, to diagnose, to communicate, and to validate patient and practitioner concerns. Performance of physical examination became routine over time but a disruption to the expected caused physicians to pause. Participants described this as a slowing of time where they became conscious of the body of the patient and their own body, intertwined in a moment. Physicians experienced affective, intellectual, and physical phenomena, which integrated to guide their behaviour, diagnosis, and management of the patient. The role of physical examination was to not only diagnosis as an evidence-based medical expert, but was experienced as a form of embodied, nonverbal communication, which expressed care.ConclusionPhysical examination plays an important role to reassure and communicate trust in the doctor–patient relationship, enacted through the body of the physician. Complimenting diagnosis, the laying on of hands remains an essential element of patient care.

Measuring Scope of Practice Enactment Among Primary Care Registered Nurses

2021 ◽  
pp. 084456212110583
Author(s):  
Suzanne Braithwaite ◽  
Joan Tranmer ◽  
Rosemary Wilson ◽  
Joan Almost ◽  
Deborah Tregunno
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Care Setting ◽  
Primary Care Setting ◽  
Scope Of Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Panel Review

Background Scope of practice enactment is poorly understood in the primary care setting. Purpose The following research objectives were addressed: (1) to revise and adapt the Actual Scope of Practice (ASCOP) questionnaire for use in the primary care setting, and (2) to determine internal consistency, construct validity, and sensitivity of the modified instrument. Methods To address the first objective, a narrative literature review and synthesis and an expert panel review was conducted. To address the second objective, a cross-sectional survey of 178 registered nurses who worked in primary care was conducted. Results The ASCOP, with few modifications, addressed key attributes of nursing scope of practice in the primary care setting. The modified instrument yielded acceptable alpha coefficients ranging from 0.66 to 0.91. Total mean score of 4.8 (SD  =  .67) suggests that registered nurses within interprofessional primary care teams almost always engage in activities reflected in the modified instrument. Conclusions The modified instrument is the first instrument validated to measure nursing scope of practice enactment in the primary care setting. Findings from this study support the use of the modified ASCOP questionnaire as a reliable and valid measure of scope of practice enactment among primary care registered nurses.

scholarly journals Nasal balloon autoinflation for glue ear in primary care: a qualitative interview study

2018 ◽  
Vol 69 (678) ◽  
pp. e24-e32
Author(s):  
Jane Vennik ◽  
Ian Williamson ◽  
Caroline Eyles ◽  
Hazel Everitt ◽  
Michael Moore
Keyword(s):  
Primary Care ◽  
Low Cost ◽  
Daily Routine ◽  
Structured Interviews ◽  
Early Management ◽  
Practice Nurses ◽  
Holistic Treatment ◽  
Qualitative Interview Study ◽  
Cost Treatment ◽  
Glue Ear

BackgroundNasal balloon autoinflation is an effective, non-surgical treatment for symptomatic children with glue ear, although uptake is variable and evidence about acceptability and feasibility is limited.AimTo explore parent and healthcare professional views and experiences of nasal balloon autoinflation for children with glue ear in primary care.Design and settingQualitative study using semi-structured interviews with a maximum-variety sample of parents, GPs, and practice nurses. The study took place between February 2013 and September 2014.MethodSemi-structured face-to-face and telephone interviews were audiorecorded, transcribed verbatim, and analysed using inductive thematic analysis.ResultsIn all, 14 parents, 31 GPs, and 19 nurses were included in the study. Parents described the nasal balloon as a natural, holistic treatment that was both acceptable and appealing to children. GPs and nurses perceived the method to be a low-cost, low-risk strategy, applicable to the primary care setting. Good instruction and demonstration ensured children mastered the technique and engaged with the treatment, but uncertainties were raised about training provision and potential impact on the GP consultation. Making nasal balloon autoinflation part of a child’s daily routine enhances compliance, but difficulties can arise if children are unwell or refuse to cooperate.ConclusionNasal balloon autoinflation is an acceptable, low-cost treatment option for children with glue ear in primary care. Provision of educational materials and demonstration of the method are likely to promote uptake and compliance. Wider use of the nasal balloon has the potential to enhance early management, and may help to fill the management gap arising from forthcoming changes to care pathways.

scholarly journals Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

2019 ◽  
Vol 51 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Mingliang Dai ◽  
Richard C. Ingham ◽  
Lars E. Peterson
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Nurse Practitioners ◽  
Family Physicians ◽  
Physician Assistants ◽  
Scope Of Practice ◽  
Certification Examination ◽  
Panel Size ◽  
Practice Characteristics ◽  
Number Of Patients

Background and Objectives: Little is known about how the presence of nurse practitioners (NPs) and physician assistants (PAs) in a practice impacts family physicians’ (FPs’) scope of practice. This study sought to examine variations in FPs’ practice associated with NPs and PAs. Methods: We obtained data from American Board of Family Medicine practice demographic questionnaires completed by FPs who registered for the Family Medicine Certification Examination during 2013-2016. Scope of practice score was calculated for each FP, ranging from 0-30 with higher numbers equating to broader scope of practice. FPs self-reported patient panel size. Primary care teams were classified into NP only, PA only, both NP and PA, or no NP or PA. We estimated variation in scope and panel size with different team configurations in regression models. Results: Of 27,836 FPs, nearly 70% had NPs or PAs in their practice but less than half (42.5%) estimated a panel size. Accounting for physician and practice characteristics, the presence of NPs and/or PAs was associated with significant increases in panel sizes (by 410 with PA only, 259 with NP only and 245 with both; all P<0.05) and in scope score (by 0.53 with PA only, 0.10 with NP only and 0.51 with both; all P<0.05). Conclusions: We found evidence that team-based care involving NPs and PAs was associated with higher practice capacity of FPs. Working with PAs seemed to allow FPs to see a greater number of patients and provide more services than working with NPs. Delineation of primary care team roles, responsibilities and boundaries may explain these findings.

scholarly journals Patient and practitioner views on cancer risk discussions in primary care: a qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0108
Author(s):  
David N Blane ◽  
Sara MacDonald ◽  
Catherine A O'Donnell
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Cancer Risk ◽  
Lifestyle Modification ◽  
Structured Interviews ◽  
It Use ◽  
Practice Nurses ◽  
Primary Care Practitioners ◽  
The Uk

BackgroundIt is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the last five years if people had healthier lifestyles, with the principle modifiable risk factors being smoking, obesity, alcohol consumption and inactivity. There is growing interest in the use of cancer risk information in general practice to encourage lifestyle modification.AimTo explore the views and experiences of patients and practitioners in relation to cancer prevention and cancer risk discussions in general practice.Design & settingQualitative study among patient and practitioners in general practices in Glasgow, UK.MethodSemi-structured interviews were conducted with nine practitioners (5 GPs and four practice nurses, recruited purposively from practices based on list size and deprivation status) and 13 patients (aged 30–60, with two or more specified co-morbidities).ResultsCurrently, cancer risk discussions focus on smoking and cancer, with links between alcohol/obesity and cancer rarely made. There was support for the use of the personalised cancer risk tool as an additional resource in primary care. Practitioners felt practice nurses were best placed to use it. Use in planned appointments (eg, chronic disease reviews) was preferred over opportunistic use. Concerns were expressed, however, about generating anxiety, time constraints, and widening inequalities.ConclusionsHealth behaviour change is complex and the provision of information alone is unlikely to have significant effects. Personalised risk tools may have a role, but important concerns about their use – particularly in areas of socio-economic disadvantage – remain.

scholarly journals Perceived limitations of telemedicine from a phenomenological perspective

2020 ◽  
Author(s):  
Michael Knop ◽  
Marius Mueller ◽  
Henrik Freude ◽  
Caroline Ressing ◽  
Bjoern Niehaves
Keyword(s):  
Primary Care ◽  
Communication Technology ◽  
Primary Care Physicians ◽  
Secondary Analysis ◽  
Future Research ◽  
Structured Interviews ◽  
Technological Transformation ◽  
Holistic View ◽  
Phenomenological Perspective ◽  
Information And Communication

In the course of healthcare digitization, the roles of therapists and patients are likely to change. To shape a theoretical based process of technological transformation, a phenomenological perspective on Information and Communication Technology (ICT) is introduced. Therefore, this paper illustrates the benefit of a holistic view on patients and therapists to describe and explain phenomena concerning Human Technology Interaction (HTI). The differentiation between a measurable objective body and a habitual subjective body helps to evaluate and anticipate constituting factors of accepting telemedicine systems. Taking into account findings from a secondary analysis of semi-structured interviews we conducted with primary care physicians, we develop a phenomenological framework for HTI in healthcare. Our aim is to structure future research concerning design implications for ICT and the implementation of telemedicine systems in clinical and primary care.

Sign in / Sign up

Export Citation Format

Share Document