What is a primary care advanced practice role in Cornwall?

2020 ◽  
Vol 31 (1) ◽  
pp. 31-36
Author(s):  
Sarah Barea
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Quantitative Study ◽  
Broad Spectrum ◽  
Educational Level ◽  
Current Practice ◽  
Scope Of Practice ◽  
Advanced Practice ◽  
Primary Care Practitioners ◽  
Practice Framework

In this quantitative study, Sarah Barea analyses the current advanced practice roles in primary care in Cornwall Aim: To analyse current primary care advanced practice roles in Cornwall, measured against Health Education England's Multi-Professional Framework for Advanced Clinical Practice. Method: A quantitative questionnaire was sent to all primary care practitioners in the county practicing with an advanced title. Findings: In total, 34 respondents (approximately 60% of those invited) took part. Practitioners have a broad spectrum of experience and education and varied scope of clinical practice. The grading of roles does not compare with educational level, experience or scope of practice. This is consistent with current literature which explores the need to regulate the role. Conclusion: If the Advanced Practice Framework is implemented as planned, then there are gaps in current practice that need to be addressed in order to ensure practitioners have the competencies to provide safe, autonomous practice.

scholarly journals Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Medical Model ◽  
Free Text ◽  
Advanced Practice ◽  
Full Time ◽  
Mixed Methods Evaluation ◽  
Future Direction ◽  
The Right ◽  
Practice Framework

Abstract Background This study aims to understand how the implementation of the advanced clinical practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The advanced clinical practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10. Results The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced clinical practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing advanced clinical practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of advanced clinical practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

scholarly journals Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform (Preprint)

2017 ◽  
Author(s):  
Samina Abidi ◽  
Michael Vallis ◽  
Helena Piccinini-Vallis ◽  
Syed Ali Imran ◽  
Syed Sibte Raza Abidi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Clinical Practice ◽  
Behavior Change ◽  
Self Management ◽  
Change Strategies ◽  
Educational Support ◽  
Behavior Change Interventions ◽  
Patients With Diabetes ◽  
Primary Care Practitioners

BACKGROUND Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. OBJECTIVE The aim of this study was to develop and evaluate a computerized decision support platform called “Diabetes Web-Centric Information and Support Environment” (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines–based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. METHODS A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners’ readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association’s (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients’ progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient’s self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. RESULTS For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool’s screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. CONCLUSIONS This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients’ feedback is now being used to make necessary modification to DWISE.

scholarly journals Perceived Challenges to Routine Uptake of the Ankle Brachial Index within Primary Care Practice

2021 ◽  
Vol 10 (19) ◽  
pp. 4371
Author(s):  
Lily Y. C. Chiu ◽  
Muzammil H. Syed ◽  
Abdelrahman Zamzam ◽  
Ori D. Rotstein ◽  
Rawand Abdin ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Perceived Barriers ◽  
Care Practice ◽  
Greater Toronto Area ◽  
Primary Care Practitioners ◽  
Peripheral Arterial ◽  
Primary Care Practices

(1) Introduction: The ankle-brachial index (ABI) is the most widely used method of diagnosing peripheral arterial disease (PAD). However, the uptake of ABIs has been reported to be low in primary care settings across different various healthcare settings; however, this is yet to be investigated within the Canadian context. (2) Objective: Therefore, we sought to assess the rates of ABI usage as well as perceived barriers among primary care practitioners (PCPs) in Toronto, Canada. (3) Methods: A modified questionnaire was electronically sent to 257 PCPs in the Greater Toronto Area (GTA). Questions pertained to frequency, feasibility, utility, and barriers associated with ABI usage in clinical practice. Responses were collected and tallied. (4) Results: A total of 52 PCPs completed the questionnaire. 79% of PCPs did not routinely perform ABIs within their clinical practice, and 56% deemed ABI usage as unfeasible. Constraints in time and staff personnel, as well as complexity of ABI result interpretation, were cited as the major perceived barriers to ABI usage. The overwhelming majority of PCPs viewed alternative forms of diagnosis, such as a blood test for PAD, as being preferable to ABI, as such an approach would enhance diagnostic simplicity and efficiency. (5) Conclusion: ABI usage rates are poor within primary care practices in Toronto, Canada. Alternative approaches for diagnosing PAD may result in greater adoption rates among PCPs and therefore improve the identification of patients with PAD.

scholarly journals Physician Wages in States with Expanded APRN Scope of Practice

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Patricia Pittman ◽  
Benjamin Williams
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Advanced Practice Nursing ◽  
Scope Of Practice ◽  
Control Group ◽  
Advanced Practice ◽  
Economic Interests ◽  
Access To Primary Care ◽  
Reducing Costs ◽  
Bureau Of Labor Statistics

In recent years, states have looked to reforms in advanced practice nursing scope of practice (SOP) barriers as a potential means to increase access to primary care while reducing costs. Currently, 16 states and the District of Columbia permit advanced practice registered nurses to practice independently of physicians, allowing them to perform functions such as diagnosing and prescribing under their own authority within the primary care setting. Given the resistance of many physician associations to these reforms, we asked whether the economic interests of primary care physicians might be affected by reforms. Using the Bureau of Labor Statistics data on earnings, we compared primary care physicians' earnings in states that have instituted SOP reforms to those that maintain these practice barriers. We also compared surgeons' earnings as a control group. Lastly, we compared the rate of growth in the earnings of primary care physicians and surgeons over the last ten years. This preliminary analysis revealed no evidence of differences in earnings across the two groups of states.

scholarly journals Workforce Experience of the Implementation of An Advanced Clinical Practice Framework in England: A Mixed Methods Evaluation

2020 ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Medical Model ◽  
Advanced Practice ◽  
Full Time ◽  
Mixed Methods Evaluation ◽  
Job Title ◽  
Future Direction ◽  
The Right ◽  
Practice Framework

Abstract Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey freetext were analysed using thematic analysis using NVivo 10. Results: The questionnaire received over 500 respondents (a response rate ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ACP was the right job title. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employers training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework, that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

scholarly journals Perspectives and Management of Atypical Asthma in Chinese Specialists and Primary Care Practitioners—A Nationwide Questionnaire Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Huaqiong Huang ◽  
Wen Hua ◽  
Ruchong Chen ◽  
Yue Hu ◽  
Songmin Ying ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Inhaled Corticosteroids ◽  
Good Control ◽  
Cough Variant Asthma ◽  
Flow Monitoring ◽  
Provocation Tests ◽  
Beta Agonists ◽  
Primary Care Practitioners ◽  
Long Acting

Background and objective: To evaluate the awareness/knowledge and clinical practice for the treatment of atypical asthma among respiratory specialists and primary care practitioners (PCPs) in China.Methods: A total number of 1,997 physicians participated in the survey via WeChat. The questionnaire included six main items: physician demographic characteristics, awareness, diagnosis, medical prescription, assessment/education, and proposal.Results: Cough variant asthma (CVA) was recognized by 97.51% of physicians (1,166 respiratory specialists and 799 PCPs), followed by chest tightness variant asthma (CTVA, 83.72%) and occult asthma (73.54%). Specialists were more likely to follow diagnostic recommendations than PCPs (P < 0.01); however, 34.15% of physicians reported the utility of bronchodilation tests, airway provocation tests, and peak expiratory flow monitoring. A total of 91.70% and 92.01% of physicians prescribed inhaled corticosteroids (ICS) or ICS plus long-acting beta-agonists (LABA) for CVA and CTVA, respectively. Physicians prescribed an ICS or ICS/LABA for 4 (2–8) or 8 (4–12) weeks for CVA and 4 (2–8) or 5 (4–12) weeks for CTVA, and the prescription durations were significantly shorter for PCPs than for specialists (P < 0.01). Further, 52.42% and 35.78% reported good control of CVA and CTVA, respectively, with significantly lower control rates for PCPs than for specialists (P < 0.01). Additionally, specialists exhibited better assessment and educational habits than PCPs.Conclusion: While atypical asthma was identified by most specialists and PCPs, there remains a gap between management in real clinical practice and guideline recommendations, especially for PCPs. Further training of PCPs and clinical studies of atypical asthma are required to improve practice.

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