How is Primary Health Care conceptualised in nursing in Australia? A review of the literature

Abstract

Australia, in common with many other countries, is expanding the role of Primary Health Care (PHC) to manage the growing burden of chronic disease and prevent hospitalisation. Australia's First National Primary Health Care Strategy released in 2010 places general practice at the centre of care delivery, reflecting a constitutional division of labour in which the Commonwealth government's primary means of affecting care delivery in this sector is through rebates for services delivered from the universal healthcare system Medicare. A review of Australian nursing literature was undertaken for 2006–2011. This review explores three issues in relation to these changes: How PHC is conceptualised within Australian nursing literature; who is viewed as providing PHC; and barriers and enablers to the provision of comprehensive PHC. A review of the literature suggests that the terms ‘PHC’ and ‘primary care’ are used interchangeably and that PHC is now commonly associated with services provided by practice nurses. Four structural factors are identified for a shift away from comprehensive PHC, namely fiscal barriers, educational preparation for primary care practice, poor role definition and interprofessional relationships. The paper concludes that while moves towards increasing capacity in general practice have enhanced nursing roles, current policy and the nature of private business funding alongside some medical opposition limit opportunities for Australian nurses working in general practice.

Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment

“…Like Henderson, Coehne, Verrall, Gebbie, and Fuller (), our cohort described a lack of understanding amongst their acute care peers about the career opportunities available in PHC. Similarly, Murray‐Parahi, Digiacomo, Jackson, and Davidson () identified the limited understanding of PHC nursing amongst newly graduated nurses.…”

Primary health care content in Australian undergraduate nursing curricula

“…Forty years after Alma Ata, PHC is reportedly in crisis and the vision unrealised because the focus of health care has been on individual diseases rather than the whole person and community (The Lancet, 2018). Over time, 'primary health care' and 'primary care' terminology have been used interchangeably in the research literature and an overlapping of some PHC services also resulted in a blurring of nursing roles and nomenclature (Keleher, 2001, Keleher et al, 2007Henderson, Koehne, Verrall, Gebbie, & Fuller, 2014;Murray-Parahi, DiGiacomo, Jackson, & Davidson, 2016).…”

Australia’s first transition to professional practice in primary care program for graduate registered nurses: a pilot study

“…International evidence demonstrates that nurses provide cost-effective, high-quality primary health care services to people with chronic and complex conditions [4]. In Australia, data confirms that practice nurses have a central role in the effective management and integration of care for people with chronic and complex health conditions and that these nurses are integral for health service provision [5]. At present, however, there is a considerable nursing shortage in primary care in Australia and it is predicted that this will be up to 110,000 nurses by 2025 [6].…”