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

ABSTRACT

AIM: This study explores the contributions of family practice nurses in primary care across Newfoundland and Labrador funded by fee-for-service and alternate payment plans to examine the influence of funding arrangements on nursing roles/activities. DESIGN: A qualitative descriptive design was employed. METHODS: Semi-structured telephone interviews were conducted between March-July 2018 with physicians and Registered Nurses working in primary care settings in Newfoundland and Labrador. Interviews were transcribed verbatim, and a content analysis approach was used to identify recurring themes. RESULTS: Clinic funding was instrumental in the integration of family practice nurses into primary care settings and influenced roles/activities. In fee-for-service practices, nurses work with physicians and focus on one-on-one patient care in office-based settings, whereas nurses in alternate payment plans practices work more independently, in a wider range of settings and with emphasis on both individual and group-based encounters. Compared with alternate payment plans practices, fee-for-service practices tend to be more restrictive due to physician billing requirements.