Understanding factors affecting the integration of geriatric nurse practitioners into health systems.
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
01 Dec 2023
01 Dec 2023
Historique:
received:
04
05
2023
accepted:
14
07
2023
medline:
5
12
2023
pubmed:
23
8
2023
entrez:
23
8
2023
Statut:
epublish
Résumé
Geriatric nurse practitioners (NPs) are introduced into health systems to alleviate provider shortages and improve care for older adults. To achieve these goals, geriatric NPs must be integrated into the health system such that they can efficaciously practice. Internationally, little is known about factors affecting the integration of NPs. Such evidence would improve policymaking and the impact of geriatric NPs on care. In Israel, geriatric NPs were recently introduced. Their ongoing integration is an exemplar for other countries. To identify factors affecting the integration of geriatric NPs in Israel and discuss application of these factors in international policy and research. The Consolidated Framework for Implementation Research guided this qualitative descriptive study. A semistructured interview guide was used to collect data from four professional groups (geriatric NPs, physicians, administrators, and policymakers), which, together, provide a system-level perspective. Factors were identified using deductive content analysis and designated as facilitators, barriers, neutral, or mixed effects. There were 58 participants across the four professional groups. Twenty-eight factors were identified, including patient needs and leadership engagement (facilitators), available information (barrier), culture (mixed), and evidence strength (neutral). Perspectives on several factors differed by the professional group's role in integrating NPs (e.g., costs ). The barriers highlight lacking interprofessional support from a priori policymaking and communication breakdowns. Policies should reflect priorities of administrators, clinicians, and policymakers. These factors may inform policymaking in other countries but would be most effective if based on country-specific research. This implementation science approach may inform future studies.
Sections du résumé
BACKGROUND
BACKGROUND
Geriatric nurse practitioners (NPs) are introduced into health systems to alleviate provider shortages and improve care for older adults. To achieve these goals, geriatric NPs must be integrated into the health system such that they can efficaciously practice. Internationally, little is known about factors affecting the integration of NPs. Such evidence would improve policymaking and the impact of geriatric NPs on care. In Israel, geriatric NPs were recently introduced. Their ongoing integration is an exemplar for other countries.
PURPOSE
OBJECTIVE
To identify factors affecting the integration of geriatric NPs in Israel and discuss application of these factors in international policy and research.
METHODOLOGY
METHODS
The Consolidated Framework for Implementation Research guided this qualitative descriptive study. A semistructured interview guide was used to collect data from four professional groups (geriatric NPs, physicians, administrators, and policymakers), which, together, provide a system-level perspective. Factors were identified using deductive content analysis and designated as facilitators, barriers, neutral, or mixed effects.
RESULTS
RESULTS
There were 58 participants across the four professional groups. Twenty-eight factors were identified, including patient needs and leadership engagement (facilitators), available information (barrier), culture (mixed), and evidence strength (neutral). Perspectives on several factors differed by the professional group's role in integrating NPs (e.g., costs ).
CONCLUSIONS
CONCLUSIONS
The barriers highlight lacking interprofessional support from a priori policymaking and communication breakdowns. Policies should reflect priorities of administrators, clinicians, and policymakers.
IMPLICATIONS
CONCLUSIONS
These factors may inform policymaking in other countries but would be most effective if based on country-specific research. This implementation science approach may inform future studies.
Identifiants
pubmed: 37610786
doi: 10.1097/JXX.0000000000000937
pii: 01741002-990000000-00152
doi:
Types de publication
Journal Article
Langues
eng
Pagination
813-825Subventions
Organisme : U.S.-Israel Fulbright Commission
ID : 11541-IS
Informations de copyright
Copyright © 2023 American Association of Nurse Practitioners.
Déclaration de conflit d'intérêts
Competing interests: The authors report no conflicts of interest.
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