scholarly journals Role Identification: an Impediment to Effective Core Primary Health Care Teamwork?

2021 ◽  
Author(s):  
◽  
Jean Ross
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Team Work ◽  
Role Clarity ◽  
Practice Nurses ◽  
Attitudinal Differences ◽  
Primary Health ◽  
The Future

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>

scholarly journals Role Identification: an Impediment to Effective Core Primary Health Care Teamwork?

2021 ◽  
Author(s):  
◽  
Jean Ross
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Team Work ◽  
Role Clarity ◽  
Practice Nurses ◽  
Attitudinal Differences ◽  
Primary Health ◽  
The Future

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>

scholarly journals Teamwork – general practitioners and practice nurses working together in New Zealand

2012 ◽  
Vol 4 (2) ◽  
pp. 150 ◽  
Author(s):  
Mary Finlayson ◽  
Antony Raymont
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
General Practitioners ◽  
Care Staff ◽  
Care Practice ◽  
Health Care Staff ◽  
Practice Nurses ◽  
Primary Health

INTRODUCTION: Teamwork in primary health care has been encouraged in New Zealand and in the international literature. It may improve work satisfaction for staff, and satisfaction and outcomes for patients. Teamwork may be classified as being multi-, inter- or transdisciplinary and is likely to be influenced by the nature of the work and the organisational context. AIM: To describe and analyse teamwork between general practitioners and practice nurses in New Zealand. METHODS: Data were drawn from a survey of general practices and from interviews with primary health care staff and management. RESULTS: Doctors and nurses in general practice in New Zealand see themselves as a team. Evidence suggests that the nature of the work and the business context most often leads to a multidisciplinary style of teamwork. Some providers have adopted a more intense teamwork approach, often when serving more disadvantaged populations or in caring for those with chronic illnesses. DISCUSSION: Concepts of teamwork differ. This article provides a classification of teams and suggests that most general practice teams are multidisciplinary. It is hoped that this will help personnel to communicate their expectations of a team and encourage progressive team development where it would be of value. KEYWORDS: Teamwork; primary care; practice nurses; general practitioners

scholarly journals What influences practice nurses to participate in post-registration education?

2010 ◽  
Vol 2 (2) ◽  
pp. 142 ◽  
Author(s):  
Anna Richardson ◽  
Jeffrey Gage
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Education Practice ◽  
Practice Nurses ◽  
Primary Health ◽  
Qualitative Thematic Analysis ◽  
The Future ◽  
Changing Roles ◽  
Care Nursing

INTRODUCTION: There is a need for educated primary health nurses to develop their practice, educational and career pathways in response to opportunities emerging from the Primary Health Care Strategy (PHCS). This study aimed to explore the opportunities and constraints encountered by practice nurses when participating in post-registration education. METHODS: This study used exploratory qualitative design, incorporating focus group interviews with 16 practice nurses employed by Pegasus Health, Christchurch. Qualitative thematic analysis used a general inductive approach. FINDINGS: Seven key themes emerged, including motivation to learn, enablers for learning and challenges to accessing education. Practice nurses also described their changing roles with clients and their vision for practice nursing in the future. CONCLUSION: This study considered accessibility of post-registration education for practice nurses and the extent to which they are embracing these opportunities in order to meet their practice needs. The PHCS states that primary health care nursing is crucial to its implementation. Successful expansion of primary health care nursing roles rests on the development of educational qualifications and skills, as well as career frameworks. It is envisaged that, with strong leadership and research skills resulting from professional development, practice nurses will be more able to reduce health inequalities. Study findings indicate that practice nurses are rising to the challenge of expanding their roles and engaging in post-registration education. They are more likely to pursue this if constraints are minimised and support increased. Currently practice nurses make significant contributions to primary health care and have the potential for an even greater contribution in the future. KEYWORDS: Nurses; practice nursing; nursing education, post-registration; New Zealand

scholarly journals The Nursing Presence in General Practice: Revealing Dimensions of Day-to-day Experience of Practice Nurses in New Zealand

2021 ◽  
Author(s):  
◽  
Katrina Fyers
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
Models Of Care ◽  
Complex Nature ◽  
Practice Nurses ◽  
Nursing Leaders ◽  
Primary Health ◽  
General Practices

<p>This study makes visible and gives value to the day-to-day experience of practice nurses who work in New Zealand general practices. Nursing leaders internationally and locally have highlighted the importance of the Primary Health Care nurse to improving health outcomes, addressing inequalities and implementing new models of care. As one of the largest groups of Primary Health Care nurses, practice nurses have a significant part to play. There is however, no consensus and limited research related to the day-to-day experience of practice nurses. Therefore, the nature, extent, and contribution of nursing in general practice may be overlooked or misunderstood. Furthermore as an autonomous self-regulating profession, nursing has a responsibility to the public to provide understanding of nursing in the present and in the future, particularly when this relates to the care of families and the structure of health systems. Located within the qualitative research paradigm and utilising a narrative inquiry methodology, this study applies a 'supportive voice' to highlight the experience of five practice nurses, and in the process makes visible the dimensions of nursing work in New Zealand general practices. The five constructed narratives particularly draw attention to the complex nature of nursing work that practice nurses engage in daily, the importance of nurse-patient relationships and continuity of care and the significance of autonomous and specialty aspects of nursing practice. Ultimately, the value of the practice nurse in the day-to-day operation of general practice is brought to the fore.</p>

scholarly journals Primary health care and general practice nurses: What is the nexus?

2005 ◽  
Vol 11 (1) ◽  
pp. 47 ◽  
Author(s):  
Elizabeth Patterson ◽  
Kay Price ◽  
Desley Hegney
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
General Practitioners ◽  
Preventive Health Care ◽  
Social Needs ◽  
Initial Assessment ◽  
Practice Nurses ◽  
Primary Health ◽  
Therapeutic Procedures

This paper presents the findings from three separate qualitative studies that sought to explore the current and potential role of nurses employed in general medical practices in Australia. General practitioners', practice nurses' and consumers' views and perceptions were gathered from individual and group interviews. The data indicate that practice nurses (PNs) are involved in first level or primary care of individuals and engage in some form of preventive health care. Some PNs have a family/community focus in addition to their focus of care on individuals. Engagement in health promotion was found to be opportunistic rather than planned, and focussed on interventions to free individuals from medically defined diseases - the aim being compliance with therapeutic procedures and advice. The broader concept of health promotion, as documented in the Ottawa Charter for Health Promotion, was not pronounced in the PNs' reported practice. Consumers do not articulate confidence in PNs acting autonomously as primary health care practitioners but rather as complementary to general practitioners (GPs), undertaking initial assessment for triage purposes and providing ongoing management, education and support under the GPs' delegation. They would also like them to be family-oriented and holistic in their practice; supporting emotional and social needs in the context of their family lives.

Costs and Remuneration for Cervical Screening in General Practice in the West of Scotland

1996 ◽  
Vol 1 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Susan Myles ◽  
Sally Wyke ◽  
Tracy Ibbotson ◽  
Sally Macintyre ◽  
Jim McEwen ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Cervical Screening ◽  
Sensitivity Analyses ◽  
The West ◽  
Skill Mix ◽  
Primary Health ◽  
Deprived Areas

Objectives: To investigate associations between costs and remuneration for cervical screening in general practice in relation to skill mix, features of practice structure and deprivation levels in the local area; and, to identify efficient policies for organising cervical screening in general practice. Method: Questionnaire survey and interview study in 87 general practices in Greater Glasgow Health Board an area in the west of Scotland which covers a socio-economically varied population. The main outcome measures were remuneration to cost ratios (RCRs) for cervical screening and their natural logarithms (logRCRs). Results: Both the costs of cervical screening and RCRs varied widely between the 87 practices taking part. RCRs ranged from 0.29 to 14.67 (mean 2.64, median 2.18, interquartile range 1.15–2.98). Twenty-one per cent (18) of practices earned less than they spent on the organisation of screening, whilst 9% (8) of practices had RCRs of more than 5:1. RCRs were significantly lower if medical staff were involved in either taking smears or dealing with results. RCRs did not vary by social deprivation score, despite uptake being lower in practices in more deprived areas. This was explained by nurses working in practices in deprived areas being more likely to take smears than nurses working in more affluent areas. Sensitivity analyses were undertaken, altering key time and cost assumptions. As a result, the absolute values of the RCRs changed, although the overall pattern of association did not, with the exception of doctor involvement in processing results which was no longer significant when average general practitioners’ income was substituted for locum rates. Conclusions: Practices in deprived areas may be responding to greater pressure of work by making optimal use of skill mix within the primary health care team. A more graduated incentive payment scheme may more fairly reward practices in deprived areas which are less likely to achieve 80% uptake due to relatively intractable features of practice structure. Assuming that practice nurses provide an equivalent quality of service to that provided by general practitioners, results suggest that doctor-nurse substitution would be cost-effective for general practice based cervical screening. Resource savings (principally doctor's time) could be redeployed to other areas of primary health care.

scholarly journals The Nursing Presence in General Practice: Revealing Dimensions of Day-to-day Experience of Practice Nurses in New Zealand

2021 ◽  
Author(s):  
◽  
Katrina Fyers
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
Models Of Care ◽  
Complex Nature ◽  
Practice Nurses ◽  
Nursing Leaders ◽  
Primary Health ◽  
General Practices

<p>This study makes visible and gives value to the day-to-day experience of practice nurses who work in New Zealand general practices. Nursing leaders internationally and locally have highlighted the importance of the Primary Health Care nurse to improving health outcomes, addressing inequalities and implementing new models of care. As one of the largest groups of Primary Health Care nurses, practice nurses have a significant part to play. There is however, no consensus and limited research related to the day-to-day experience of practice nurses. Therefore, the nature, extent, and contribution of nursing in general practice may be overlooked or misunderstood. Furthermore as an autonomous self-regulating profession, nursing has a responsibility to the public to provide understanding of nursing in the present and in the future, particularly when this relates to the care of families and the structure of health systems. Located within the qualitative research paradigm and utilising a narrative inquiry methodology, this study applies a 'supportive voice' to highlight the experience of five practice nurses, and in the process makes visible the dimensions of nursing work in New Zealand general practices. The five constructed narratives particularly draw attention to the complex nature of nursing work that practice nurses engage in daily, the importance of nurse-patient relationships and continuity of care and the significance of autonomous and specialty aspects of nursing practice. Ultimately, the value of the practice nurse in the day-to-day operation of general practice is brought to the fore.</p>

Welcome to The Lucky Country: the Royal Australian College of General Practitioners deters overseas-trained academic general practitioners

2020 ◽  
Vol 44 (5) ◽  
pp. 782
Author(s):  
Katharine A. Wallis
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Full Time ◽  
Teaching And Research ◽  
Minimum Requirement ◽  
Primary Health ◽  
Royal Australian College ◽  
Practice Activity

In assessing overseas-trained general practitioners (GPs) applying for specialist recognition in Australia, the Royal Australian College of General Practitioners (RACGP) sets a minimum requirement of 2 days per week ‘undertaking general practice activities’ over the 3 years prior to application. The RACGP does not consider academic practice (i.e. relevant teaching and research) to be a ‘general practice activity’, thereby blocking overseas-trained full-time academic GPs from specialist recognition in Australia. The actions of the RACGP have implications for access to quality primary health care in Australia.

Chronic Condition Self-Management: A primary health care change management problem

2005 ◽  
Vol 11 (2) ◽  
pp. 70
Author(s):  
Susan Lambert
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Chronic Condition ◽  
Care Service ◽  
Health Care Service ◽  
Primary Health Care Service ◽  
Self Management ◽  
Primary Health

Australian general practitioners are recognising the need to implement some form of chronic condition management program to better service and cope with the ever-increasing number of patients presenting with chronic conditions. Chronic Condition Self-Management (CCSM) is one such program. In this paper it is argued that the basis of CCSM is a multi-disciplinary, care-team approach, and that implementation of such an approach represents a paradigm shift in primary health care service delivery. This equates to a significant innovation in primary health care service that, in economic terms, aims to increase primary health care outputs. Although general practitioners are at the centre of the change they cannot implement the change without the participation and collaboration of the other stakeholders. These stakeholders include other health service providers, the Divisions of General Practice, the Department of Health and Ageing, and the patient. This paper presents a general practice business model to illustrate the relationships between stakeholders in the primary health care sector and to identify the impact of CCSM on these relationships. The organisational and business issues that need to be addressed to promote the uptake of CCSM are also identified.

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