Nurses in expanded roles to strengthen community-based health promotion and chronic care: policy implications from an international perspective; A commentary

Abstract

Chronic conditions and health inequalities are increasing worldwide. Against this backdrop, several countries, including Israel, have expanded the roles of nurses as one measure to strengthen the primary care workforce. In Israel, community nurses work in expanded roles with increased responsibilities for patients with chronic conditions. They also work increasingly in the field of health promotion and disease prevention. Common barriers to role change in Israel are mirrored by other countries. Barriers include legal and financial restrictions, resistance by professional associations, inflexible labor markets and lack of resources. Policies should be revisited and aligned across education, financing and labor markets, to enable nurses to practice in the expanded roles. Financial incentives can accelerate the uptake of new, expanded roles so that all patients including vulnerable population groups, benefit from equitable and patient-centered service delivery in the communities.

Community nurses and chronic disease in Israel: Professional dominance as a social justice issue

“…Yet, there is also a real opportunity for countries to learn from each other's programs and initiatives. An examination of community nurses' roles in other Western countries found a great number of shared commonalities with Israel in nursing roles, albeit with some important differences, consistent with the observations of others (Maier, Budde, & Buchan, 2018). We will primarily compare Israel with the United States [U.S.] and the United Kingdom [U.K.], countries selected because their health systems share similarities with Israel (e.g., a growing focus on community health initiatives and increasingly diverse populations) yet are also different in important ways (e.g., extent of health insurance and socialized medicine).…”

Health Promotion Capacity Among Chinese Healthcare Professionals and Its Influence on Preventive Health Service Practices

“…This finding is contrary to previous studies in other countries. [38][39][40] This might be for two reasons. First, the number of nurses in China is markedly insufficient; they experience a large amount of pressure from daily clinical nursing work and…”

Selbstständige Ausübung von Heilkunde durch Pflegekräfte

“…In vielen Ländern ist die Implementierung des neuen Skill Mix, also die Mischung aus Gesundheitsberufen sowie die Mischung ihrer Fähigkeiten und Rollen, bereits weit fortgeschritten (Freund et al 2015;Maier et al 2018a;Maier et al 2018b); dies zeigt sich unter anderem daran, dass Pflegende teilweise die erste Anlaufstelle für Patientinnen und Patienten (mit speziellen Erkrankungen) sind (Grant et al 2017;Maier und Aiken 2016), selbstständig behandeln und überweisen dürfen (Maier und Aiken 2016) oder beispielsweise als Doctor of Nursing Practice noch weiterreichende Kompetenzen erwerben (Walker und Polancich 2015). Deutschland kann hier von den Erfahrungen anderer europäischer Länder wie den Niederlanden, Großbritannien, Irland und Finnland bei der Entwicklung entsprechender Versorgungsmodelle sehr profitieren.…”