(DOCX 29 kb). This study aimed to explore the experiences and perceptions of NPs and their colleagues about barriers to and enablers of extended scope of practice and consider the relevance of the findings to other health professions. They have an interest and previous research experience in collaborative team-based care and interprofessional boundary-work. Australia's Health Workforce Research Report. (1994). Nursing Practice Meets Theory, Debra J. Morton. Role clarity was of considerable importance, along with embedded professional hierarchies and traditional role expectations influencing interactions with individual colleagues. Schedule of questions used for primary and secondary informant interviews. Operationalizing a Theoretical Framework to Improve Patient Perception of Care, Debra J. Morton. 2016. https://doi.org/10.1136/bmjopen-2016-011901. https://doi.org/10.1016/j.healthpol.2014.04.016. Recognition of specific competencies shared across professions requires disentangling competencies from professional repertoires and acknowledgement of individuals’ abilities to competently perform tasks to meet specific patient needs [53]. One NP explained that she encountered significant resistance from nursing colleagues and would have resigned if not for the support from medical colleagues. 1 and Table 2). Some studies broke down barriers and enablers into different levels similar to the structure used in this study, such as the healthcare system, organisational, team and individual practitioner levels [41] or the policy, workplace and personal levels [45]. Since the American Association of Colleges of Nursing’s (AACN’s) Position Statement on Defining Scholarship for the Discipline of Nursing was published in 1999, academic nursing leaders have been continually evaluating nursing education programs to ensure that they are preparing the next generation of nurses to meet the healthcare needs of … Because in many parts of the world there is an enduring geographic maldistribution of health workforce, there is a persistent need to explore workforce planning and alternative models of care in rural communities [69]. From a retention perspective, the findings echo those of previous studies [65], that leadership and supervisor–practitioner relationships are central to positive experiences, influencing intentions to stay, be it in the rural community generally [66] or specifically in an extended scope of practice role. Broadening the scope of nursing practice. It often stemmed from issues of role clarity and relationships as new roles evolved. However, the capacity of NPs to provide definitive care across the entire care continuum is limited by lack of access to the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) [13, 16]. Cashin A, Theophilos T, Green R. The internationally present perpetual policy themes inhibiting development of the nurse practitioner role in the primary care context: an Australian–USA comparison. Hum Resour Health. J Am Acad Nurse Pract. However, the sustainability of the NP model has been questioned, with criticism that NPs have not made a marked difference to gaps in rural health services [18]. It has been argued that significant productivity gains, including better access to care in rural and remote areas, would eventuate from changing practice and funding models [21, 23]. Productivity Commission. For communities to benefit from extended scope of practice models of health service delivery, energy needs to be directed towards addressing legislative and regulatory barriers. Aust Health Rev. Lowe G, Plummer V, Boyd L. Nurse practitioner roles in Australian healthcare settings. BMJ open. Glaser BG. Organ Stud. (NP11). (NP7), When the senior medical officer for the district … is on-board with saying that the nurse practitioners should be doing it, it gets listened to by a lot of people. Collegian. Corbin JM, Strauss AL. For one NP working in a remote Aboriginal community it was difficult to organise annual leave coverage, there was little respite and, at times, exposure to personal risk. Such anomalies and complexities contribute to an overly complicated practice environment, as evidenced elsewhere [13] and observed by study informants. (NP8). | NPs’ and colleagues’ quotations are numbered, with the latter indicated by the letter ‘C’ after the number. McMurray R. The struggle to professionalize: an ethnographic account of the occupational position of advanced nurse practitioners. 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