Evolution of practice nursing in Australia

Halcomb, Elizabeth; Patterson, Elizabeth; Davidson, Patricia M.

doi:10.1111/j.1365-2648.2006.03908.x

Cited by 31 publications

(45 citation statements)

References 28 publications

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“…However, care must be taken here to differentiate between the extension of the practice nurse role within a model of collaborative care and the development of the protocol driven, autonomous role of the nurse practitioner. 49 In an increasingly litigious society, practice nurses and GPs are entitled to be concerned about their legal responsibilities. 50 The paucity of clear job descriptions, lack of nursing competencies (at the time of the investigation) and various requirements of state/territory regulatory bodies leave both practice nurses and GPs vulnerable.…”

Section: Legal Implicationsmentioning

confidence: 99%

“…51 It is likely that nursing education undertaken in the hospital setting does not sufficiently prepare nurses to work in advanced practice roles and promotes dependent rather than independent and collaborative practice. 49 The final aspect identified related to individual practice nurse remuneration and funding of service delivery. Currently, practice nurses generally receive lower remuneration than their acute care colleagues, as many are not covered under an industrial Award and wages are negotiated between the individual nurse and their employer.…”

Section: Belief That the Current Role Is Appropriatementioning

confidence: 99%

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Cardiovascular disease management: time to advance the practice nurse role?

Halcomb¹,

Davidson²,

Griffiths³

et al. 2008

Aust. Health Review

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Objective: More than two-thirds of health expenditure is attributable to chronic conditions, of which a significant proportion are related to cardiovascular disease. This paper identifies and explores the factors cited by practice nurses as impacting on the development of their role in cardiovascular disease management.Methods: Sequential mixed methods design combining postal survey (n = 284) and telephone interviews (n = 10) with general practice nurses.

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Section: Legal Implicationsmentioning

confidence: 99%

Section: Belief That the Current Role Is Appropriatementioning

confidence: 99%

Cardiovascular disease management: time to advance the practice nurse role?

Halcomb¹,

Davidson²,

Griffiths³

et al. 2008

Aust. Health Review

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“…12 However, some recent studies have indicated that while there are some PNs working in more advanced roles to achieve these aims, this is still not typical practice. [13][14][15][16] In fact, Watts et al 14 noted that general practice nursing "seems to represent the last frontier of the nursing profession . .…”

Section: Australian Practice Nursesmentioning

confidence: 99%

The role of practice nurses in coordinated care of people with chronic and complex conditions

Patterson¹,

Muenchberger²,

Kendall³

2007

Aust. Health Review

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General practice in Australia must cope with growing numbers of individuals with chronic and complex needs. The Australian Government has recognised the need to reform the primary health care sector to address this issue, with recent initiatives, such as coordinated care. The overall goal of coordinated care at a national level is to facilitate integrated care for people with chronic and complex conditions, by enhancing collaborative partnerships among general practitioners, primary health care providers, community service providers and clients. Interestingly, practice nurses (PNs) have not been identified as key stakeholders in the coordinated care service delivery model in Australia. In contrast, an expanded role for PNs has been in place in the United Kingdom and New Zealand for some time. This paper is based on focus group discussions with Australian PNs who have had a range of experiences in coordinated care models. The study identifies an important role for PNs, suggesting trial of a variety of models of coordinated care that include PNs in chronic disease man- THE MANAGEMENT of chronic and complex conditions is a major issue for health systems in the developed world today. The Australian health care system has responded to this problem by introducing a number of initiatives; one of which has been coordinated health care. The overall goal of coordinated care is to facilitate integrated care for people with chronic and complex conditions, by enhancing collaborative partnerships among general practitioners (GPs) and non-medical primary and community services providers. Coordinated care is also based on the development of disease management approaches and evidence-based protocols for multidisciplinary care that maximise the likelihood of effective care within existing resources and enhance the coordination of care across acute and primary care sectors. Key stakeholders of coordinated care include: GPs, who act as care coordinators; community and domiciliary nurses from both public and private sectors, whose role is service coordination; service providers from public, private and institutional health care settings; and the target populations (elderly people with chronic conditions).

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“…However, there is a lack of understanding between GPs and practice nurses relating to clearly defined roles which can contribute to confusion and challenges in the general practice setting (Phillips et al, 2008). Expansion of the PN role can sometimes be challenged by the small business nature of Australian general practice mixed with the GPs' attitudes and perceptions towards the hierarchal roles between doctors and nurses (Halcomb, Patterson, & Davidson, 2006;Phillips et al, 2007;Phillips, et al, 2008). Some barriers to utilising PNs that have been identified in the literature include a lack of training, poor GP understanding of nursing roles, liability concerns, billing structure within the practice, lack of professional nursing standards, PN employment costs, part time or casual employment and lack of space (Gibson & Heartfield, 2005;Halcomb, Davidson, Griffiths, & Daly, 2008;Phillips, et al, 2008).…”

Section: Introductionmentioning

confidence: 99%