Clients’ understanding of the role of nurse practitioners
Jane Allnutt A , Nissa Allnutt A , Rose McMaster A , Jane O’Connell A , Sandy Middleton A F , Sharon Hillege B , Phillip R. Della C , Glenn E. Gardner D and Anne Gardner EA School of Nursing (NSW and ACT), Australian Catholic University, PO Box 958, North Sydney, NSW 2059, Australia.
B School of Nursing & Midwifery College of Health and Science, The University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia.
C School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
D School of Nursing, Queensland University of Technology and Royal Brisbane and Women’s Hospital, GPO Box 2434, Brisbane, QLD 4001, Australia.
E School of Nursing, Midwifery and Nutrition, James Cook University, PO Box 670, Townsville, QLD 4814, Australia.
F Corresponding author. Email: sandy.middleton@acu.edu.au
Australian Health Review 34(1) 59-65 https://doi.org/10.1071/AH09688
Submitted: 5 September 2008 Accepted: 2 March 2009 Published: 25 March 2010
Abstract
Nurse practitioners (NPs) have an emerging role in the Australian health care system. However, there remains a dearth of data about public understanding of the NP role. The aim of this study was to evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales were invited to recruit five consecutive clients to complete the self-administered survey.
Thirty-two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two-thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP-related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (P = 0.005), and where applicable would to prefer to see an NP rather than a doctor (P = 0.022). Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction, more awareness of the scope of the NP role is required.
What is known about the topic? The role of nurse practitioners (NPs) in Australian health care is diverse and evolving. There is a dearth of research focusing on NPs, particularly looking at the client perception of their role.
What does this paper add? This study investigates the client’s perception of the role of nurse practitioners and levels of confidence and satisfaction through the use of a self-administered questionnaire.
What are the implications for practitioners? The results suggest that clients have a moderate awareness of the nurse practitioner role. Despite this, clients appear to have high levels of confidence and satisfaction after consultations with nurse practitioners. These results suggest that greater community awareness of the role may help maximise their positive contribution to health care in Australia.
[1]
[2]
[3] Gardner G. Issues in nurse practitioner developments in Australia. Can Forum 2004; 28(3): 132–4.
[4] van Offenbeek MAG, Knip M. The organizational and performance effects of nurse practitioner roles. J Adv Nurs 2004; 47 672–81.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[5] Henneman EA. Nurse-physician collaboration: a poststructuralist view. J Adv Nurs 1995; 22 359–63.
| Crossref | GoogleScholarGoogle Scholar | PubMed | CAS |
[6] Wilson K, Coulon L, Hillege S, Swan W. Nurse practitioners’ experiences of working collaboratively with general practitioners and allied health professionals in NSW Australia. Aust J Adv Nurs 2005; 23 22–7.
| PubMed |
[7] Driscoll A, Worrall-Carter L, O’Reilly J, Stewart S. A historical review of the nurse practitioner role in Australia. Clin Excell Nurse Pract 2005; 9(3): 141–52.
[8] Gardner A, Gardner G. A trial of nurse practitioner scope of practice. J Adv Nurs 2005; 49 135–45.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Donald FC, McCurdy C. Review: nurse practitioner primary care improves patient satisfaction and quality of care with no difference in health outcomes. Evid Based Nurs 2002; 5 121.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[10] Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ 2002; 324 819–23.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[11] Laurent M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev 2004; 4 CD001271.
| Crossref | GoogleScholarGoogle Scholar |
[12] Litaker D, Mion LC, Planavsky L, Kippes C, Mehta N, Frolkis J. Physician–nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients’ perception of care. J Interprof Care 2003; 17 223–37.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Lauder W, Sharkey S, Reel S. The development of family health nurses and family nurse practitioners in remote and rural Australia. Aust Fam Physician 2003; 32 750–2.
| PubMed |
[14] Lindeke L, Jukkala A, Tanner M. Perceived barriers to nurse practitioner practice in rural settings. J Rural Health 2005; 21 178–81.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[15] Middleton S, Allnutt J, Griffiths R, McMaster R, O’Connell J, Hillege S. Identifying measures for evaluating new models of nursing care: a survey of NSW nurse practitioners. Int J Nurs Pract 2007; 13 331–40.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[16]
[17] Bryant R, Graham MC. Advanced practice nurses: a study of client satisfaction. J Am Acad Nurse Pract 2002; 14 88–92.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[18] Wilson J, Bunnell T. A review of the merits of the nurse practitioner role. Nurs Stand 2007; 21 35–40.
| PubMed |
[19]
