Nurse Practitioners In Australia Research Articles

Defining the urology nurse practitioner in Australia and New Zealand: A Delphi study.

Nurse practitioners with roles in specialty environments face challenges including uncertain role expectations and achieve urology expertise with on-the-job training, mentoring, and independent study. This creates a wide variety of preparation and role descriptions. This study employed Delphi methodology to identify essential components of the urology nurse practitioner (NP) role in Australia and New Zealand, representing an inaugural description of the role. This Delphi study was completed in two rounds. Participants were a nonrandom panel of experts with experience as a full-time urology NP. A definition for the urology NP in Australia and New Zealand is proposed: "The urology nurse practitioner uses critical thinking, complex decision-making, clinical reasoning, advanced assessment skills and clinical expertise, offering acute and chronic care to individuals needing urologic health care, including office-based urology procedures as appropriate. This care is provided in an environment of autonomous practice, with a basis of graduate education and relevant specialty clinical experience, and this practice can extend across health care settings and serve as a model to the wider NP profession." Outpatient urology procedures were ranked highly and deemed integral to the Urology NP role. This may reflect the declining number of urologists and efforts to maintain urology access for local populations. Professional roles of the NP were given less weight by participants. The project offers a contemporary definition of the urology NP role that can be offered to educators and other stakeholders as the role continues to evolve in Australia and New Zealand.

Preparing Australian Nurse Practitioners to Meet Health Care Demand

The Australian health care system remains slow in realizing the potential benefit of nurse practitioner (NP) roles. National and international evidence suggests NPs provide an accessible and acceptable way in which health systems can meet the demand for health care delivery, particularly in primary and community settings. One significant barrier to the integration and growth of NP roles in Australia is the highly individualized approach to education that encourages NPs to develop a narrow and specialized skill set. In this report, we discuss whether the current approach to the educational preparation of NPs in Australia adequately addresses existing and emerging health care demand.

The Evolution and Sustainability of the Neonatal Nurse Practitioner in Australia

The Evolution and Sustainability of the Neonatal Nurse Practitioner in Australia

Nurse Practitioners can Influence, Shape and Reform Healthcare

The Australian healthcare system is experiencing “growing pains”. The pains result from increasing pressures on the system as it currently operates. However, these pressures represent opportunities for Nurse Practitioner (NP) roles to become established as a part of the solution. Today, all professional services are developed following the identification of a need and subsequent planning to execute a detailed service model and business plan. Development of these documents is a rite of passage for professionals establishing new enterprises, services or products. Inclusion of NP’s into the healthcare team can only increase the potential of NPs and provide new opportunities for NPs to improve patient services and outcomes. NPs can improve the coordination of healthcare services. NPs in Australia will continue to seek out opportunities to improve the health service delivery to patients, improving patient, community and national health outcomes. NPs must emphasize the well-developed and advanced assessment, diagnostic and analytical skills. Seeking opportunities and taking brave steps forward are skills keenly demonstrated in advanced nursing practice, already established in our health care system. NPs are encouraged to seek opportunities, find and develop innovative models and augment services to be the new norm. Action will demonstrate how NPs can and will influence, shape and reform our healthcare system.

Prescribing by nurse practitioners: Insights from a New Zealand study.

Nurse practitioners (NPs) in New Zealand have been able to prescribe medicines since 2001; however, little is known about their prescribing practice. This study describes the NPs who prescribe community-dispensed medicines, the patients, and identifies the most frequently prescribed medications. A retrospective search of the Ministry of Health pharmaceutical collection was completed from 2013 to 2015. NP registration number, patient age, gender, deprivation index, and the name and date of dispensed medication, including the New Zealand pharmaceutical schedule therapeutic group, were identified. NPs prescribe a broad range of medications across all therapeutic groups with antibacterial and analgesics being the most commonly prescribed medicines. This is comparable to all prescribers in New Zealand and NPs in Australia. The majority of patients lived in the more deprived areas of New Zealand indicating that NPs are working in areas of greater health need. The majority of NPs registered in New Zealand prescribe medicines. Those in primary care prescribe the most medications. NPs prescribe a broad range of medicines across all drug therapeutic groups. The patients seen by NPs often live in the most deprived areas of New Zealand. Understanding prescribing patterns will help to inform curricular development and continuing education programs for NPs.

Collaborative arrangements for Australian nurse practitioners: a policy analysis.

In Australia in 2010, nurse practitioners (NPs) were granted legislated access to the Medical Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) as providers. These schemes are the federal schemes for third-party reimbursement for health care and medications. As a condition of access to the schemes, it was determined that collaborative arrangements needed to be in place as part of eligibility criteria for NPs. This article is the first published policy analysis of this determination. Published literature and available grey literature (including meeting minutes), and media content, was accessed and analyzed. The policy that was the National Health Collaborative arrangements for Nurse Practitioners Determination to amend the Australian National Health Act 1953 was a success. The policy led to NP access as providers to the MBS and PBS in Australia. Understanding the policy process as it relates to the determination of the need for collaborative arrangements demystifies the process and origins of the policy for NPs in Australia. Understanding the determination means NPs in Australia will not artificially reduce scope of practice based on recommendations from the medical lobby. Clear research direction is provided that may inform the next policy cycle.

Nurse practitioners in Australia: strategic errors and missed opportunities.

Medical Journal of AustraliaVolume 201, Issue 2 p. 85-86 Perspective Nurse practitioners in Australia: strategic errors and missed opportunities Stacy Leidel MSc(Nurs), Corresponding Author Stacy Leidel MSc(Nurs) Lecturer and Nurse Practitioner stacy.leidel@curtin.edu.au School of Nursing and Midwifery, Curtin University, Perth, WA.Correspondence: stacy.leidel@curtin.edu.auSearch for more papers by this author Stacy Leidel MSc(Nurs), Corresponding Author Stacy Leidel MSc(Nurs) Lecturer and Nurse Practitioner stacy.leidel@curtin.edu.au School of Nursing and Midwifery, Curtin University, Perth, WA.Correspondence: stacy.leidel@curtin.edu.auSearch for more papers by this author First published: 21 July 2014 https://doi.org/10.5694/mja14.00125Citations: 10Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume201, Issue2July 2014Pages 85-86 RelatedInformation

Nurse practitioner prescribing practice in Australia: Confidence in aspects of medication management

The findings of the 2010 national survey of nurse practitioner (NP) prescribing in Australia related to confidence in prescribing are reported. A significant correlation between years endorsed as a NP and prescribing confidence was found. NPs in Australia were significantly more confident in the prescribing aspects of commencing a new medication than adjusting or ceasing a medication prescribed by others. These findings are discussed in relation to promotion of the quality use of medicines and identification of potential strategies to promote the ongoing positive evolution of NP practice in Australia.

Changes in professional human care work: the case of Nurse Practitioners in Australia

Changes in professional human care work: the case of Nurse Practitioners in Australia

An exploration of the perceptions of Emergency Physicians and Trainees, towards Emergency Nurse Practitioners in Australia

To explore Emergency Physicians perceptions towards the Emergency Nurse Practitioner role, specifically, examining their support, its perceived benefits, difficulties, impact in the clinical environment and proposed scope of practice. A survey was distributed to all members of the Australasian College of Emergency Medicine via Survey Monkey between August and November 2009. Statistical analysis of the data was performed using the SPSS package. A total of 50.8% (n = 315) responded positively to supporting the Emergency Nurse Practitioner role whilst 20% (n = 124) responded negatively. When comparing those who have worked with Emergency Nurse Practitioners vs those who have not, 59.8% (n = 307) of those who have worked with Emergency Nurse Practitioners were positively identified as supporting the role, compared to 7.5% (n = 8) of those who had not. In those who had not worked with Emergency Nurse Practitioners 53.3% (n = 57) neither agreed nor disagreed in supporting the role. With respect to the benefits and the proposed scope of practice, a response trend of greater significance was found in those who had previously worked with Emergency Nurse Practitioners. Emergency healthcare is evolving in line with increasing demands. Worldwide, the Emergency Nurse Practitioner role has been researched and critiqued at length. This paper provides evidence of Emergency Physicians positive perceptions and recognition of benefits of the Emergency Nurse Practitioner role within Australia. This was especially apparent amongst clinicians that have previously worked alongside them. Despite this, concerns were expressed with regard on-going medical training, medico-legal implications and training of Emergency Nurse Practitioners.

Advanced nursing practice hours as part of endorsement requirements for nurse practitioners in Australia: A definitional conundrum

To define what can be considered to be nursing practice, time that can be calculated as the practice of nursing as well as what is considered to be advanced nursing practice and how all this can be related to the current endorsement process for nurse practitioner (NP) in Australia. Current codes and guidelines cited by the Nurse and Midwifery Board of Australia related to nursing practice and NPs, cited competency standards from the Australian Midwifery Accreditation Council, as well as published material of peak nursing bodies from within Australia as well as internationally were used. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status and nomenclature of advanced practice nursing was considered relevant. The definitional entanglement of what is considered to be nursing practice, the calculation of specific hours and what is advanced nursing practice interferes with endorsement of NPs in Australia, and a clear understanding of what is meant by advanced practice is required to move forward. Dependent on how practice is interpreted by the Nurse and Midwifery Board of Australia directly affects the outcome of the endorsement proceedings for individual NP candidates.

The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.

BackgroundThe disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments.MethodsA cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes.ResultsThe role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care.ConclusionsICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.

National nursing registration in Australia: A way forward for nurse practitioner endorsement

The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia. National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined. The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level. A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs.

Preferences for continuing education through existing electronic access for Australian Nurse Practitioners and its implication in prescribing potential

Little is known about Australian Nurse Practitioners (NPs) perceptions of the importance of continuing education (CE), their preferred methods to undertake CE in relation to prescribing practices or their access to electronic resources at work. Nurse Practitioner access to computerised technology may increase their provision of resources, provide point of care technology, and increase opportunities to participate in CE. This paper aims to explore Australian NP preferences for continuing education and NP access to electronic mediums that may increase CE opportunities. A self-administered online survey was completed by 68 NPs from across Australia. The majority of respondents (93%) viewed CE to be very important and preferred methods of continuing education included receipt of information by email, and interactive online case studies. Respondents working in metropolitan areas had increased access to high speed Internet in comparison to NPs working in rural or remote areas, although this did not reach statistical significance (88% vs. 69%, p = 0.07). Significantly more NPs working in metropolitan areas had access to a Personal Digital Assistant (PDA) than NPs working in rural or remote areas (44% vs. 6%, p = 0.003). This is the first national survey to report preference for CE and access to technology of NPs in Australia. Electronic technology can provide programmed support such as online learning and resources through computers and PDAs to maximise NP prescribing potential.

Progression of the mental health nurse practitioner role in Australia

The guiding principle of health care is to serve the needs of the public. Healthcare services are therefore required to be increasingly flexible and open to new approaches to meet changing demands. They must also adjust and expand as new challenges are presented. Public awareness of mental health issues and the current demands placed on health services for access to affordable and appropriate mental health care have never been so great. The introduction of nurse practitioners (NPs) in Australia is a proud and long-anticipated moment for the discipline of nursing. However, a major challenge for the introduction of NPs in Australia will be to reassure medical colleagues, allied health professionals and the public that NPs are able to deliver high-quality primary care. This paper elaborates on the progress of the mental health NP role in Australia. Attention is centred on the characteristics the mental health NP role, the maintenance of professional competency to practise at an advanced clinical level, and the prospects and potential significance of NPs for mental health nursing practice. The nurse-led clinic, implemented through the process of consultation and systematic evaluation, is identified as an avenue for the extension of mental health NP practice in the delivery of autonomous primary care.

The First Private Practice as a Registration Authority Authorised Nurse Practitioner in Australia

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.

The Emergency Nurse Practitioner in Australia

Nurses are expert as clinicians, educators, researchers and administrators. Yet too often that expertise is not translated into the policy arena. This article discusses opportunities and examples of ways in which expert nurses can use their knowledge, their perspective, their experiences and their skills as communicators to change public policy at all levels of government. Issues in education, practice and research are examined through a nursing lens to explore the political dimensions of advocating for policies that are right for the public and our profession.

Nurse Practitioners: a contract for change and excellence in nursing

The role of the Nurse Practitioner has been in existence in a variety of contexts and within a broad range of the scope of their practice throughout the world for a number of years. Many nurses work at this advanced level of clinical practice without the acknowledgement f the very important and responsible role that they play within the healthcare setting. Although the United States and United Kingdom have recognised the role of the advanced Nurse Practitioner for a number of years, there still exists confusion and disagreement as to their scope of practice. There is uncertainty and anxiety as to where the role boundaries between nursing and medical and allied health professionals begin and end. The role of the Nurse Practitioner in Australia has not been without its problems in the developmental stage of its creation. New South Wales finally achieved recognition of the role this year after a decade of negotiation. This has culminated in the acceptance for the development of 40 Nurse Practitioner positions across the State. The first of these was accepted in the Far West Area Health Service in May 2001. The Far West Area Health Service created a five-year plan, which addresses the development of nurses preparing for authorisation, the creation of Nurse Practitioner positions in the remote communities, the creation of clinical guidelines to support advanced practice and the evaluation process for both the positions and the nurses. The objective of this approach is to ensure effective implementation of these advanced nursing positions in the remote communities of New South Wales. The Nurse Practitioner role needs to respond to the individual, the family and the community, utilising advanced clinical skills and remaining responsive to the changes in health care within a primary health care framework, which is essential for combating the complex health care issues in remote areas (NSW Health 2000).