Potential scope and impact of a transboundary model of nurse practitioners in aged care
Kasia Bail A G , Paul Arbon B , Marlene Eggert D , Anne Gardner F , Sonia Hogan C , Christine Phillips D , Nicole van Dieman E and Gordon Waddington AA Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia.
B Faculty of Health Sciences, Flinders University, South Australia.
C Patient Safety and Quality Unit, ACT Health, ACT, Australia.
D School of Medicine, Australian National University, Canberra, ACT, Australia.
E Morshead Home, Australia.
F James Cook University and Townsville Health Service District, Qld., Australia.
G Corresponding author. Email: kasia.bail@canberra.edu.au
Australian Journal of Primary Health 15(3) 232-237 https://doi.org/10.1071/PY09009
Published: 9 September 2009
Abstract
Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.
Additional keywords: acute, community, comorbidities, residential, roles, student nurse practitioner.
Acknowledgements
The Aged Care Nurse Practitioner Pilot Project was a jointly funded initiative between the Australian Government (Department of Health and Ageing) and ACT Health to undertake an Aged Care Nurse Practitioner Pilot Project in the ACT. The authors acknowledge the contribution and dedication of the three student nurse practitioners, their clinical support teams, the research team members, the Research Centre for Nursing and Midwifery Practice (The University of Canberra and the Canberra Hospital), and the ACT Nursing and Midwifery Office in the conduct of the project.
Allen D,
Lyne P, Griffiths L
(2002) Studying complex caring interfaces: key issues arising from a study of multi-agency rehabilitative care for people who have suffered a stroke. Journal of Clinical Nursing 11, 297–305.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[Verified 13 August 2009]
Coombs M, Dillon A
(2002) Crossing boundaries, re-defining care: the role of the critical care outreach team. Journal of Clinical Nursing 11, 387–393.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
Danvers L,
Freshwater D,
Cheater F, Wilson A
(2003) Providing a seamless service for children with life-limiting illness: experiences and recommendations of professional staff at the Diana Princess of Wales Children’s Community Service. Journal of Clinical Nursing 12, 351–359.
| PubMed |
Dunnion ME, Kelly B
(2005) From the emergency department to home. Journal of Clinical Nursing 14, 776–785.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
Gardner A, Gardner G
(2005) A trial of nurse practitioner scope of practice. Journal of Advanced Nursing 49(2), 135–145.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
Gardner G,
Carryer J,
Gardner A, Dunn S
(2006) Nurse Practitioner competency standards: findings from collaborative Australian and New Zealand research. International Journal of Nursing Studies 43, 601–610.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
Hibberd PA
(1998) The primary/secondary interface. Cross-boundary teamwork – missing link for seamless care. Journal of Clinical Nursing 7, 274–282.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
CAS |
Jefferies H, Chan K
(2004) Multidisciplinary team working: is it both holistic and effective? International Journal of Gynecological Cancer 14, 210–211.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
CAS |
Masterson A
(2002) Cross-boundary working: a macro-political analysis of the impact on professional roles. Journal of Clinical Nursing 11, 331–339.
| Crossref | GoogleScholarGoogle Scholar | PubMed |