Abstract
BackgroundThe role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area.MethodsA number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints.ResultsFour enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers.ConclusionsThe influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider’s role will be fundamental to comprehensive service delivery in the future.
Highlights
The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005
The four enablers are: general practitioner (GP) being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork
The process of enacting each of these enablers is conditional on all members of the general practice team being in a position to identify their own professional development needs as well as gaps in service delivery related to their particular practice
Summary
The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. While previous studies have examined the role of PNs as Pap smear [cervical screening] providers [1,2,3,4] findings are limited to identifying barriers to implementing the role, while recommending further research in the area. Findings from this study are largely framed in terms of enablers for change in the context of general practice, and include the influence of workplace culture, educational opportunities and communication strategies on the implementation of a new model of nurse led care Strategies employed by both the participants and their colleagues to overcome previously identified barriers to changing models of practice nursing to include cervical screening and well women’s health care services were identified and further recommendations made based on these findings. All practice nurses taking Pap smears and other preventive checks should have undertaken an accredited training course
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