Expansion of the nurse practitioner (NP) role worldwide indicates a need to understand how the role functions in interprofessional healthcare teams. Through the adoption of a mixed methods approach that gathered on-site tracking and observation, self-recorded logs of consultations and focus group interviews of team members and NPs, we describe the extent of role activity and the nature of interprofessional practices of 46 NPs and their team members in nine hospital sites across the province of Ontario, Canada. Findings outline the nature of the NP role activities, which largely focused on providing clinical care, with the support of their team, to a range of patients across the study settings. We discuss how 'embedding' the NP in this way appears to contribute to utilization of expertise of all professions as well as enabling team members to promote evidence-based practices. We argue that the use of NPs augments interprofessional role utilization through their desire to consult with a range of professionals and the capacity to perform holistic care for patients that is not limited to traditional nursing boundaries.
The PCC measure demonstrated acceptable psychometric properties. The low variance in responses, which is anticipated for instruments assessing fidelity of intervention implementation, accounts for the low reliability coefficients. Additional testing of the measure's psychometric properties in different groups of healthcare providers is warranted. The measure can be used to monitor healthcare providers' implementation of PCC in their usual practice.
There is a need to understand nurse practitioner (NP) interprofessional practice within hospital teams to inform effective role integration and evolution. To begin this understanding a supplementary analysis of 30 hospital team member focus groups was carried out using constructivist grounded theory methodology. This conceptual rendering of the team members' shared perspective of NP actions provides insight into the meaning and importance of the NP role. Participants emphasized three hospital-based (HB) NP practice foci as the meaning of role value; easing others' workload, holding patient care together and evolving practice. Trust emerged as a pre-requisite condition for HB NP role efficacy. A team member perspective framework of HB NP practice is presented as the first stage in developing a model of HB NP interprofessional practice within hospitals. The framework provides multiple perspectives to the meaning and value of the HB NP role beyond basic role description. The framework may be used by healthcare professionals, operational leaders, academia and HB NPs to enhance role respect and understanding.
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