Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement

Barratt, Julian; Thomas, Nicola

doi:10.1017/s1463423618000415

Cited by 18 publications

(16 citation statements)

References 49 publications

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“…In this study, the CNPs highlighted the luxury of time as one of the cornerstones for the possibilities to provide functional care. The unhurriedness has been noticed as a signi cant enabler for the quality of the client-centered home care services (35,43). Our results are consistent with this and signi ed the possibility of the CNP to settle down and spend more time to nd more contributing solution for the patient's care needs.…”

Section: Discussionsupporting

confidence: 87%

Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

Rasku

Kaunonen

Thyer

et al. 2020

Preprint

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Background Primary care, the principal function of the healthcare system, needs efforts from the local primary healthcare teams. Community Paramedicine has managed to reduce the use of Emergency Medical Services (EMS) for non-emergent calls. For the paramedic to move from traditional emergency call outs to non-emergency care means new demands. There is a paucity of paramedics’ experiences and perceptions of their novel roles as community paramedics. This study aimed to explore the community nurse-paramedics experiences of their new sphere of practice. Methods A descriptive ethnographic research was conducted collecting data through participant observation (total 317 hours) and semi-structured interviews (N = 24) in three Hospital Districts where the community nurse-paramedics (CNP) have worked at least one year. Both data were combined, organized, and analyzed with inductive content analysis. Results From the inductive content analysis, five themes emerged: the CNP's new way of thinking, the broad group of patients, the demanding way to provide care, the diversity of multi-agency collaboration and management challenges. The CNP needs an appropriate attitude for the care and the broader way of thinking than before, taking care of the patient but also about the family members. The CNPs pointed out as enablers for the way of providing care as challenges for the management of the CNP model. The diversity of multiagency collaboration team can be sensitive while offering new possibilities. Conclusion The CNP's deep involvement in patients' and families' care needs and the challenges of CNPs’ skills and competences. Their professional attitudes and eagerness to develop and maintain the multi-agency collaboration can offer preventive and long-term caring solutions from which the citizens and allied health, safety, and social care providers benefit locally and globally.

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Section: Discussionsupporting

confidence: 87%

Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

Rasku

Kaunonen

Thyer

et al. 2020

Preprint

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“…This study indicates that the Australian public have limited awareness of the NP role with only half of the sample having heard of an NP, a finding consistent in contemporary literature [ 22 , 48 ]. This is not surprising given the general publics’ limited understanding of the different categories nurses or levels within nursing groups [ 26 , 49 ], the relatively low number of NPs (approximately 0.5% of the nursing workforce [ 14 , 55 ]) and the fact that the majority of NPs in Australia are predominantly employed in the public sector [ 1 ]. International cross-country comparisons suggest that public exposure to the NP role will also be influenced by the fact that there are only 4.4 NPs per 100,000 population compared with 395 physicians per 100,00 population [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite these espoused correlations between extended consultation times and reported patient satisfaction, we found that spending more time during consultations was not a contributing factor to willingness to be see an NP. A recent study found that NPs do not have lengthy consultation times, rather they convey a sense that they are spending more time during consultations [ 55 ]. Indeed, no correlation was found between the length of NP consultations and post-consultation consumer satisfaction or enablement [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of the general public’s willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey

2021

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Background Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers ‘willingness’ to be seen by NPs warrants further investigation. Methods Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. Results While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. Conclusion Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.

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“…The convergent parallel mixed methods case study (Creswell, 2014) was intended to concomitantly scrutinise the communication processes, social interactions and measured outcomes of nurse practitioner consultations using three parallel strands of inquiry: video recordings of nurse practitioner consultations; a validated questionnaire measuring patient expectations, patient satisfaction and patient enablement and also semi-structured individual interviews with selected patient, carer and nurse practitioner participants of the video-recorded consultations. The detailed results of the video recorded and questionnaire components of the study are presented elsewhere in Primary Health Research & Development (Barratt and Thomas, 2018a, 2018b); this paper focuses on reporting the qualitative dimension of the mixed methods case study.…”

Section: Study Design Aim and Research Questionsmentioning

confidence: 99%

Nurse practitioner consultations in primary health care: patient, carer, and nurse practitioner qualitative interpretations of communication processes

Barratt

Thomas

2018

Prim Health Care Res Dev

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AimTo advance understanding of the discrete nature of the communication processes and social interactions occurring in nurse practitioner consultations.BackgroundPreceding qualitative investigations of nurse practitioner consultations have, when conducting interviews with participants, often exclusively sampled either nurse practitioners or patients. Furthermore, previous qualitative studies of the nature of nurse practitioner consultations have not typically also sampled carers attending with patients for nurse practitioner consultations. Accordingly this study was developed, in part, to address this exclusivity of sampling in qualitative research of nurse practitioner consultations by developing an inclusive sample of patient, carer and nurse practitioner participants of nurse practitioner consultations, so as to conjointly develop an understanding of the multiple perceptions of those participants of communication processes occurring in nurse practitioner consultations.MethodsQualitative component of a larger mixed methods case study of communication processes and social interactions in nurse practitioner consultations, utilising individual semi-structured interviews with the patient (n = 9), carer (n = 2) and nurse practitioner (n = 3) participants of video-recorded consultations derived from a nurse practitioner-led general practice clinic. Interview transcripts were initially analysed via an emergent thematic analysis, followed up by computer-assisted qualitative data analysis with NVivo 9.FindingsThe participants’ perceptions of nurse practitioner consultation communication processes and social interactions were represented through six themes: Consulting style of nurse practitioners; Nurse practitioner – GP comparisons; Lifeworld content or lifeworld style; Nurse practitioner role ambiguity; Creating the impression of time and Expectations for safety netting. The findings identify a need for policy makers to address a perceived ambiguity of the nature of the nurse practitioner role amongst patients and carers. The benefits of nurse practitioners using personable, everyday lifeworld styles of communication for optimising interactions, sharing clinical reasoning and conveying a sense of having time for patients and carers in consultations are also identified.

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Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement

Abstract: Higher levels of patient enablement and satisfaction are not necessarily determined by the time lengths of consultations, and how consultations are conducted may be more important than their time lengths for optimising patient satisfaction and enablement.

Cited by 18 publications

References 49 publications

Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

Predictive factors of the general public’s willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey

Nurse practitioner consultations in primary health care: patient, carer, and nurse practitioner qualitative interpretations of communication processes

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