Nursing's contribution to general practice: general practitioners' and practice nurses' views

Patterson, Elizabeth; Mar, C. Del; Najman, Jake M.

doi:10.1016/s1322-7696(08)60607-1

Cited by 13 publications

(27 citation statements)

References 10 publications

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“…Similar to the findings of many other studies about the role of PNs in primary health care in Australia, PNs played a supportive rather than instrumental role, but have demonstrated the potential to make a far greater contribution if given the opportunity. 4,6,8,14,[18][19][20] Although initially not recognised or included as key stakeholders in the coordinated care model, the importance of PNs gradually became apparent in the evaluation, highlighting the need to interview PNs. The interview data confirmed the willingness of PNs to contribute to the process of care coordination.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…1991;LeSueur & Barnard 1993;Anastasiou, 1993;Keyzer, Hall, Mahnken & Keyzer, 1996;Bonawit & Watson 1996;Patterson, Del Mar & Najman, 1999a, 1999bCondon, Willis & Litt, 2000), there is still debate in nursing and medical circles about what the focus of the role should be. For example, Lauder, Sharkey and Reel (2003) suggest that nurses and GPs in rural and remote areas should be interchangeable and that the focus should be on the competency of the person delivering care rather than the right of one discipline (medicine) to perform a particular role.…”

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confidence: 99%

Primary health care and general practice nurses: What is the nexus?

Patterson¹,

Price²,

Hegney³

2005

Aust. J. Prim. Health

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This paper presents the findings from three separate qualitative studies that sought to explore the current and potential role of nurses employed in general medical practices in Australia. General practitioners', practice nurses' and consumers' views and perceptions were gathered from individual and group interviews. The data indicate that practice nurses (PNs) are involved in first level or primary care of individuals and engage in some form of preventive health care. Some PNs have a family/community focus in addition to their focus of care on individuals. Engagement in health promotion was found to be opportunistic rather than planned and focussed on interventions to free individuals from medically defined diseases, the aim being compliance with therapeutic procedures and advice. The broader concept of health promotion, as documented in the Ottawa Charter for Health Promotion was not pronounced in the PNs' reported practice. Consumers do not articulate confidence in PNs acting autonomously as primary health care practitioners but rather as complementary to general practitioners (GPs), undertaking initial assessment for triage purposes and providing ongoing management, education and support under the GPs' delegation. They would also like them to be family oriented and holistic in their practice; supporting emotional and social needs in the context of their family lives.

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“…The authors found that generally consumers had a lack of awareness of the actual or potential scope of nursing in general practice. However, those consumers with a greater exposure to practice nurses, (such as carers and persons with a chronic illness) were able to envisage roles for nurses that extended beyond the traditional role identified in previous Australian studies (Patterson et al, 1999a;Patterson et al, 1999b). …”

Section: Introductionmentioning

confidence: 87%

“…Over the last few years the Australian Government has sought to identify initiatives that would produce a more sustainable and responsive health workforce, while maintaining a commitment to high quality and safe health outcomes (Productivity Commission, 2005) Advancing the nurse's role in general practice is one strategy that has been Various studies have investigated practice nurses' perceptions of their role. In the main, studies suggest that practice nurses perceive their role as being assistive and therefore practise accordingly (Bonawit & Watson, 1996;Dunt, Temple-Smith, & Johnson, 1991;Keyzer, Hall, Mahnken, & Keyzer, 1996;Patterson, Del Mar, & Najman, 1999a;Patterson, Del Mar, & Najman, 1999b). All of these studies suggested that the main functions of a practice nurse are delegated by the doctor and usually involve undertaking prescribed assessment and therapeutic activities (Dunt et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

“…However, many believe that the traditional role of the practice nurse must change. Indeed a study throughout Australia funded by the Department Factors identified as limiting the development of the practice nurse role include a lack of funding to employ them and to provide for continuing education opportunities, 'gate keeping' of special interest groups, and general practitioners' reluctance to relinquish any 'medical work' to nurses (Condon, Willis, & Litt, 2000;Le Sueur & Barnard, 1993;Patterson et al, 1999a;Patterson et al, 1999b). Although it is recognised that they are working in different health systems, one of the most striking differences between two countries where practice nurses are commonly employed was the attitude of the medical profession -relatively hostile to the extended or advanced practice role of nurses in the USA, and supportive in the UK (Buchan & Calman,2005).…”

Section: Introductionmentioning

confidence: 99%

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Consumers' Level of Comfort with an Advanced Practice Role for Registered Nurses in General Practice: A Queensland, Australia, Study

Hegney¹,

Eley

Buikstra³

et al. 2006

Aust. J. Prim. Health

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with nurses performing what may be considered traditional roles of the practice nurse. They were less comfortable with the more extended roles that are seen more as the traditional role of the general practitioner. However for no procedure were consumers uncomfortable in nurses performing that task. There were no differences in responses due to consumers' age, sex or previous contact with practice nurses.These results may be used to expand the role of practice nurses to complement the services provided by general practitioners.

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Nursing's contribution to general practice: general practitioners' and practice nurses' views

Cited by 13 publications

References 10 publications

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

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

Primary health care and general practice nurses: What is the nexus?

Consumers' Level of Comfort with an Advanced Practice Role for Registered Nurses in General Practice: A Queensland, Australia, Study

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