Understanding the practice patterns of nephrology nurse practitioners in Australia.
advanced practice nursing
nephrology
nurse practitioner
renal
Journal
Journal of renal care
ISSN: 1755-6686
Titre abrégé: J Ren Care
Pays: United States
ID NLM: 101392167
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
17
09
2022
received:
29
05
2022
accepted:
19
09
2022
medline:
22
11
2023
pubmed:
10
10
2022
entrez:
9
10
2022
Statut:
ppublish
Résumé
Nurse practitioners (NP) have an expanded scope of practice beyond that of a registered nurse. In kidney care, nephrology NP can manage patients at various points along the chronic kidney disease (CKD) trajectory. To profile the characteristics, service patterns, and domains of practice of nephrology NP in Australia. A cross-sectional online secure survey. Nephrology NP (NP students) who were members of the Renal Society of Australasia and working in Australia (n = 73). Data collected were demographic and practice characteristics, and domains of practice (using the modified Strong Model of Advanced Practice). The survey also sought qualitative perspectives of the enablers and barriers to sustainability nurse practitioner healthcare delivery services. Nephrology NP (n = 45) primarily worked in adult services, managing those receiving haemodialysis, peritoneal dialysis, or patients with earlier grades of CKD. Providing direct comprehensive care was the dominant domain of advanced practice although administrative activities took up considerable time each week. Support from nurse leaders and medical colleagues was identified as key enablers for sustainability of these services whereas succession planning, and workload were the main barriers. This study found a highly qualified, experienced but older nephrology nurse practitioner workforce who provide an additional model of health service delivery which can meet the growing CKD burden. Internationally, this level of nurse provides an opportunity for a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce.
Sections du résumé
BACKGROUND
BACKGROUND
Nurse practitioners (NP) have an expanded scope of practice beyond that of a registered nurse. In kidney care, nephrology NP can manage patients at various points along the chronic kidney disease (CKD) trajectory.
OBJECTIVES
OBJECTIVE
To profile the characteristics, service patterns, and domains of practice of nephrology NP in Australia.
DESIGN
METHODS
A cross-sectional online secure survey.
PARTICIPANTS
METHODS
Nephrology NP (NP students) who were members of the Renal Society of Australasia and working in Australia (n = 73).
MEASUREMENTS
METHODS
Data collected were demographic and practice characteristics, and domains of practice (using the modified Strong Model of Advanced Practice). The survey also sought qualitative perspectives of the enablers and barriers to sustainability nurse practitioner healthcare delivery services.
RESULTS
RESULTS
Nephrology NP (n = 45) primarily worked in adult services, managing those receiving haemodialysis, peritoneal dialysis, or patients with earlier grades of CKD. Providing direct comprehensive care was the dominant domain of advanced practice although administrative activities took up considerable time each week. Support from nurse leaders and medical colleagues was identified as key enablers for sustainability of these services whereas succession planning, and workload were the main barriers.
CONCLUSIONS
CONCLUSIONS
This study found a highly qualified, experienced but older nephrology nurse practitioner workforce who provide an additional model of health service delivery which can meet the growing CKD burden. Internationally, this level of nurse provides an opportunity for a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce.
Types de publication
Journal Article
Langues
eng
Pagination
278-287Informations de copyright
© 2022 The Authors. Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.
Références
Ackerman, M.H., Norsen, L., Martin, B., Wiedrich, J. & Kizman, H.J. (1996) Development of a model of advanced practice. American Journal of Critical Care, 5(1), 68-73. https://doi.org/10.4037/ajcc1996.5.1.68
Australian Institute of Health and Welfare [AIHW]. (2020) Chronic kidney disease. https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease
Barrett, E., Salem, L., Wilson, S., O'Neill, C., Davis, K. & Bagnulo, S. (2015) Chronic kidney disease in an aboriginal population: a nurse practitioner-led approach to management. Australian Journal of Rural Health, 23(6), 318-321. https://doi.org/10.1111/ajr.12230
Bonner, A., Douglas, B., Brown, L., Harvie, B., Lucas, A. & Tomlins, M. (2021) Nephrology specific clinical performance indicators for NP education in Australia, 2nd edition. Australia: Griffith University.
Bonner, A., Havas, K., Stone, C., Abel, J., Barnes, M., Tam, V. et al. (2020) A multimorbidity nurse practitioner-led clinic: evaluation of health outcomes. Collegian, 27(4), 430-436. https://doi.org/10.1016/j.colegn.2019.11.010
Bonner, A., Havas, K., Tam, V., Stone, C., Abel, J., Barnes, M. et al. (2019) An integrated chronic disease nurse practitioner clinic: service model description and patient profile. Collegian, 26(2), 227-234. https://doi.org/10.1016/j.colegn.2018.07.009
Coleman, S., Havas, K., Ehrsam, S., Stone, C., Taylor, B., Graham, A. et al. (2017) Patient satisfaction with nurse-led chronic kidney disease clinics: a multicentre evaluation. Journal of Renal Care, 43(1), 11-20. https://doi.org/10.1111/jorc.12189
Currie, J., Chiarella, M. & Buckley, T. (2016) Workforce characteristics of privately practicing nurse practitioners in Australia: results from a national survey. Journal of the American Association Nurse Practitioners, 28(10), 546-553. https://doi.org/10.1002/2327-6924.12370
Davis, J. & Zuber, K. (2021) The changing landscape of nephrology physician assistants and nurse practitioners. Journal of the American Association of Nurse Practitioners, 33(1), 51-56. https://doi.org/10.1097/JXX.0000000000000490
Davis, J.S. & Zuber, K. (2010) The role of advanced nurse practitioners in nephrology? Dialysis & Transplantation 38(12), 488-491. https://doi.org/10.1002/dat.20400
Donabedian, A. (2003) An introduction to quality assurance in health care. New York: Oxford University Press.
Douglas, C., Schmalkuche, D., Nizette, D., Yates, P. & Bonner, A. (2018) Nurse-led services in Queensland: a scoping study. Collegian, 25(4), 363-370. https://doi.org/10.1016/j.colegn.2017.10.011
Dwyer, T., Craswell, A. & Browne, M. (2021) 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. Human resources for health, 19(1), 21. https://doi.org/10.1186/s12960-021-00562-7
Fong, J., Buckley, T., Cashin, L. & Pont, L. (2017) Nurse practitioner prescribing in Australia: a comprehensive literature review. Australian Critical Care, 30(5), 252-259.
Gardner, A., Helms, C., Gardner, G., Coyer, F. & Gosby, H. (2021) Development of nurse practitioner metaspecialty clinical practice standards: a national sequential mixed methods study. Journal of Advanced Nursing, 77(3), 1453-1464. https://doi.org/10.1111/jan.14690
Gardner, G., Chang, A.M., Duffield, C. & Doubrovsky, A. (2013) Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified Strong Model of advanced practice. Journal of Advanced Nursing, 69(9), 1931-1942. https://doi.org/10.1111/jan.12054
Gardner, G., Duffield, C., Doubrovsky, A. & Adams, M. (2016) Identifying advanced practice: a national survey of a nursing workforce. International Journal of Nursing Studies, 55, 60-70. https://doi.org/10.1016/j.ijnurstu.2015.12.001
Heale, R. & Buckley, R. (2015) An international perspective of advanced practice nursing regulation. Nursing Regulation, 62(3), 421-429. https://doi.org/10.1111/inr.12193
Heale, R., James, S., Wenghofer, E. & Garceau, M.L. (2018) Nurse practitioner's perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients. Primary Health Care Research & Development, 19(6), 553-560. https://doi.org/10.1017/S1463423617000913
IBM Corp. (2020) IBM SPSS statistics for windows, version 27.0, Armonk, IBM Corp.
International Council of Nurses [ICN]. (2020) Guidelines on advanced practice nursing. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf
Levin, A., Stevens, P.E., Bilous, R.W., Coresh, J., De Francisco, A.L. M., De Jong, P.E. et al. (2013) Kidney disease: improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements, 3(1), 1-150. https://doi.org/10.1038/kisup.2012.73
Lindgren, B.M., Lundman, B. & Graneheim, U.H. (2020) Abstraction and interpretation during the qualitative content analysis process. International Journal of Nursing Studies, 108, 103632.https://doi.org/10.1016/j.ijnurstu.2020.103632
McCrory, G., Patton, D., Moore, Z., O'Connor, T. & Nugent, L. (2018) The impact of advanced nurse practitioners on patient outcomes in chronic kidney disease: a systematic review. Journal of renal care, 44(4), 197-209. https://doi.org/10.1111/jorc.12245
Nandwana, S.B., Walls, D.G., Ibraheem, O., Murphy, F., Tridandapani, S. & Cox, K. (2016) Beyond complications: comparison of procedural differences and diagnostic success between nurse practitioners and radiologists performing image-guided renal biopsies. Journal of the American Association of Nursing Practitioners, 28(10), 554-558. https://doi.org/10.1002/2327-6924.12376
Nursing & Midwifery Board of Australia [NMBA]. (2020) Advanced nursing practice and specialty areas within nursing. NMBA.
Nursing & Midwifery Board of Australia [NMBA]. (2021) 2020/21 annual summary. https://www.nursingmidwiferyboard.gov.au/News/Annual-report.aspx
O'Connell, J., Gardner, G. & Coyer, F. (2014) Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing. Journal of Advanced Nursing, 70(12), 2728-2735. https://doi.org/10.1111/jan.12475
Peeters, M.J., van Zuilen, A.D., van den Brand, J.A., Bots, M.L., van Buren, M., Ten Dam, M.A. et al. (2014) Nurse practitioner care improves renal outcome in patients with CKD. Journal of American Society of Nephrology, 25, 390-398.
Raftery, C., Sassenberg, A. & Bamford-Wade, A. (2021) Business acumen for nursing leaders: optional or essential in today's health system? A discussion paper. Collegian, 28(6), 610-615. https://doi.org/10.1016/j.colegn.2021.08.001
Scanlon, A., Cashin, A., Bryce, J., Kelly, J.G. & Buckely, T. (2016) The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), 129-142. https://doi.org/10.1016/j.colegn.2014.09.009
Smith, T., McNeil, K., Mitchell, R., Boyle, B. & Ries, N. (2019) A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nursing, 18(1), 14. https://doi.org/10.1186/s12912-019-0337-z
Wierdsma, J., Vervoort, S.C.J.M., van Zuilen, A.D., Berkhout, N.C. & Gundlach, P.J. (2016) Evaluation of the role of nurse practitioners in MASTERPLAN. Journal of renal care, 42(1), 23-33. https://doi.org/10.1111/jorc.12128