ABSTRACT
Registered nurses' practice in primary care varies and is sometimes sub-optimal. To fill the gap in primary care-specific knowledge, we co-constructed a national educational program to reinforce the nursing workforce. We based our project on the knowledge-to-action approach. Many lessons were learned during the development phase: (1) The experiential knowledge of patient partners and stakeholders allows an education program based on real needs; (2) The development of a national education program requires high-intensity investment from all involved persons; (3) An in-person meeting at the beginning of the project enables robust discussions and optimal co-creation; and (4) In a country where two official languages are spoken, it's essential to create a safe environment and a translation infrastructure that allows everyone to express themselves in the language of their choice. Finally, other initiatives in healthcare education or professional practice improvement could leverage our findings to realize national-scale projects using knowledge creation approaches.
Subject(s)
Primary Health Care , Humans , Multilingualism , Education, Nursing, Continuing , Program Development , AccreditationABSTRACT
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.
Subject(s)
Nurses , Scope of Practice , Humans , Cross-Sectional Studies , Surveys and Questionnaires , Primary Health CareABSTRACT
INTRODUCTION: Universal access to preventative healthcare is essential to children's health. Registered nurses (RN) are well positioned to deliver well-child care within primary care settings; however, RN role implementation varies widely in this sector and the scope of literature that examines the influence of organisational attributes on nursing contributions to well-child care is not well understood. The aim of this scoping review is to identify the scope and characteristics of the literature related to organisational attributes that act as barriers to, or facilitators for RN delivery of well-child care within the context of primary care in high-income countries. METHODS AND ANALYSIS: The Joanna Briggs Institute scoping review methodology will be used to conduct this review. Databases that will be accessed include Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and Embase. Inclusion criteria includes articles with a focus on RNs who deliver well-child care in primary care settings. Literature that meets this inclusion criteria will be included in the study. Covidence software platform will be used to review citations and full-text articles. Titles, abstracts and full-text articles will be reviewed independently by two reviewers. Any disagreements that arise between the reviewers will be resolved through discussion, or with an additional reviewer. Data will be extracted and organised according to the dimensions outlined in the nursing care organisation conceptual framework (NCOF). Principles of the 'best fit' framework synthesis will guide the data analysis approach and the NCOF will act as the framework for data coding and analysis. ETHICS AND DISSEMINATION: This scoping review will undertake a secondary analysis of data already published and does not require ethical approval. Findings will be disseminated via peer-reviewed publications and conference presentations targeting stakeholders involved in nursing practice and the delivery of well-child care. TRIAL REGISTRATION DETAILS: Braithwaite, S., Tranmer, J., Lukewich, J., & Macdonald, D. (2021, March 31). Protocol for a Scoping Review of the Influence of Organisational Attributes on Registered Nurse Contributions to Well-child Care. https://doi.org/10.17605/OSF.IO/UZYX5.
Subject(s)
Child Care , Nurses , Child , Child Health , Delivery of Health Care , Humans , Research Design , Review Literature as TopicABSTRACT
The role of nurse practitioners in primary healthcare has been validated over the years and is now being considered as a key solution in various primary healthcare settings to the provision of comprehensive care. The context in which the role has been established positions nurse practitioners' practice within medical and nursing paradigms. As the healthcare system evolves, nurse practitioners must define their identity to advocate for roles that reflect their professional values. A historical overview highlighting the context in which the NP role expanded will guide a philosophical discussion regarding role identity. After exposing tensions between the nursing and medicine disciplines, Abbots' theory of profession will be utilized to understand the foundations leading to initial research on nurse practitioner integration within the healthcare system. Feminist philosopher bell hooks' discourse on marginality will serve as a platform to reflect on the nurse practitioner identity within the current social context. Foucault's notions of governmentality, parrhesia and care of the self will then guide reflections regarding ways for nurse practitioners to locate themselves as a profession.