scholarly journals Theory of the Evolution of Nurse Practitioner Practice

2021 ◽  
Vol 1 (1) ◽  
pp. 23-36
Author(s):  
Roberta Heale

Aim: To determine the nurse practitioner's perception of scope of practice and understanding of changes to practice over time. Background: A great deal of research about nurse practitioners has been conducted related to such things as role clarity, transition, or preparedness to practice and job satisfaction. Conceptual models of nurse practitioner practice have been developed to highlight practice processes, interprofessional relationships and more. However, none of this literature addresses nurse practitioner's perception of scope of practice, the impact of their changing practice experiences and how the understanding of their practice changes over time. Methods: This grounded theory study was undertaken in Ontario, Canada, with interviews of primary health care nurse practitioners which resulted in the Theory of the Evolution of Nurse Practitioner Practice. Conclusion: Within this theory, scope of practice is defined as nurse practitioners working to their maximum potential.  There are both intrinsic and extrinsic elements which render maximum practice potential a fluid and changing state.

2017 ◽  
Vol 76 (5) ◽  
pp. 597-626 ◽  
Author(s):  
Jennifer Perloff ◽  
Sean Clarke ◽  
Catherine M. DesRoches ◽  
Monica O’Reilly-Jacob ◽  
Peter Buerhaus

Context: State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. Method: This study uses six different classifications of state regulations and bivariate and multivariate analyses to compare beneficiaries attributed to primary care nurse practitioners and primary care physicians in 2013 testing two hypotheses: (1) chronic disease management, cancer screening, preventable hospitalizations, and adverse outcomes of care provided by primary care nurse practitioners are better in reduced and restricted practice states compared to states without restrictions and (2) by decreasing access to care, SoP restrictions negatively affect the quality of primary care. Findings: Results show a lack of consistent association between quality of primary care provided by NPs and state SoP restrictions. Conclusion: State regulations restricting NP SoP do not improve the quality of care.


2009 ◽  
Vol 15 (3) ◽  
pp. 232 ◽  
Author(s):  
Kasia Bail ◽  
Paul Arbon ◽  
Marlene Eggert ◽  
Anne Gardner ◽  
Sonia Hogan ◽  
...  

Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.


2020 ◽  
Vol 39 (3) ◽  
pp. 51-73
Author(s):  
Graham J. Reid ◽  
Judith B. Brown ◽  
Stephanie Mowat

Few studies have examined a diversity of professionals’ perspectives in providing children’s mental health (CMH) care, particularly for ongoing-complex problems. Based on interviews with 16 primary healthcare (PHC) providers, care for ongoing-complex CMH problems depended on provider interest and scope of practice. Most providers felt PHC is where ongoing-complex CMH problems should be cared for, where providers can emphasize advocacy, coordination, and ongoing monitoring; few felt able to provide this type of care. A comprehensive approach for incorporating PHC with specialized MH services is needed. Defining a care coordinator would be a clear step toward improving collaboration and care.


Author(s):  
Shaul Stampfer

This chapter investigates the phenomenon of remarriage in nineteenth-century eastern Europe, demonstrating its significance in Jewish marital behaviour. Patterns of remarriage deserve attention for a number of reasons: they influenced fertility levels, affected family structure, played a role in networking, and served as an indicator of the importance of marriage in a given society. Remarriage is highly revealing of group characteristics and behaviour, but remarriage in late nineteenth-century eastern Europe merits attention for an additional reason. Patterns of remarriage and their changes over time significantly diverged among various population groups. Eastern Europe is thus an excellent context for examining the impact of significant variables on remarriage by means of a comparative approach. The chapter then evaluates modes of remarriage among four major religious-national groups: Russian Orthodox, Catholics, Protestants, and Jews. It also considers important differences between Jews and Christians in specific patterns of remarriage.


2005 ◽  
Vol 14 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Leslie A. Hoffman ◽  
Frederick J. Tasota ◽  
Thomas G. Zullo ◽  
Carmella Scharfenberg ◽  
Michael P. Donahoe

• Background Many academic medical centers employ nurse practitioners as substitutes to provide care normally supplied by house staff.• Objective To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.• Methods During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.• Results Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).• Conclusions In a subacute intensive care unit, management by the 2 teams produced equivalent outcomes.


1994 ◽  
Vol 5 (3) ◽  
pp. 404-407
Author(s):  
Lynn A. Kelso ◽  
Lori M. Massaro

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.


1996 ◽  
Vol 16 (2) ◽  
pp. 120-127 ◽  
Author(s):  
V Keough ◽  
J Jennrich ◽  
K Holm ◽  
W Marshall

The students and faculty enrolled in the first TNP class have set a standard for future TNPs: a rigorous course of education with advanced practice and scholarship within an advanced practice collaborative model. Because of the increasingly number of trauma victims and the highly specialized care they require, nurses must come forward and provide quality care. The TNPs and their faculty must promote further recognition of the TNP role, become leaders in the field of acute care, and continue to develop and maintain collaborative relationship with physicians in support of advanced practice nursing in many areas of tertiary care. The first three graduates of the trauma/critical care practitioner class are now employed in advanced practice roles and are applying their education within trauma/critical care settings. Two of the students are trauma nurse practitioners in a community hospital, and one is a critical care nurse practitioner in a university hospital. Currently, there is an acute care nurse practitioner certification examination that is appropriate for nurses in the field of trauma/critical care. Co-sponsored by the AACN Certification Corporation and the American Nurses Credentialing Center, this examination is offered twice a year, in June and October. AACN is active in supporting and promoting the TNP role and, in conjunction with the American Nurses Association, has developed new standards of care and scope of practice to include this expanded role for the advanced practice nurse. The future for this exciting and demanding role looks bright for the advanced practice nurse interested in the care of the acutely ill patient. The time is right for this collaboration between nurses and physicians.


2013 ◽  
Vol 37 (5) ◽  
pp. 594 ◽  
Author(s):  
Shannon Clark ◽  
Rhian Parker ◽  
Brenton Prosser ◽  
Rachel Davey

Aim To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. Results This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners’ care in aged care settings. Conclusions If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required. What is known about the topic? Australia, like many industrialised countries, faces unprecedented challenges in the provision of health services to an ageing population. Attempts to respond to these challenges have resulted in changing models of healthcare and shifting professional boundaries, including the development of advance practice roles for nurses. One such role is that of the nurse practitioner. There is international evidence that nurse practitioners provide high-quality healthcare. Despite being established in the United States for nearly 50 years, nurse practitioners are a relatively recent addition to the Australian health workforce. What does this paper add? This paper positions a current Australian evaluation of nurse practitioners in aged care against the background of the development of the role of nurse practitioners internationally, evidence for the effectiveness of the role, and evidence for nurse practitioners in aged care. Recent legislative changes in Australia now mean that private nurse practitioner roles can be fully implemented and hence evaluated. In the face of the increasing demands of an ageing population, the paper highlights limitations in current Australian evidence for nurse practitioners in aged care and identifies the importance of a national evaluation to begin to address these limitations. What are the implications for practitioners? The success of future healthcare planning and policy depends on implementing effective initiatives to address the needs of older Australians. Mapping the terrain of contemporary evidence for nurse practitioners highlights the need for more research into nurse practitioner roles and their effectiveness across Australia. Understanding the boundaries and limitations to current evidence is relevant for all involved with health service planning and delivery.


2013 ◽  
Vol 16 (10) ◽  
pp. 1277-1284 ◽  
Author(s):  
Petr Dostál ◽  
Jana Müllerová ◽  
Petr Pyšek ◽  
Jan Pergl ◽  
Tereza Klinerová

2006 ◽  
Vol 12 (3) ◽  
pp. 20 ◽  
Author(s):  
Andrew Cashin

The first private practice conducted, owned by and advertised as an authorised nurse practitioner practice in Australia was established in February 2004. A mental health nurse practitioner established the practice in a medical centre to provide counselling and mental health services for individuals, couples and families. This paper discusses the first 18 months of operation and considers the experience in the context of the small amount of published data, internationally, related to nurse owned and run private practices in general, and nurse practitioner practices. The practical steps of setting up, reimbursement and meeting challenges, in particular, are discussed. Diary entries and copies of emails were used as data through which the experience was tracked. The conclusion was reached that private practice as a nurse practitioner is possible. Scope of practice and financial remuneration are limited by the current third party reimbursement arrangements under Medicare and the lack of provision of PBS provider numbers to nurse practitioners.


Sign in / Sign up

Export Citation Format

Share Document