ABSTRACT
Background
The effectiveness of advanced practice nurses, such as nurse practitioners (NP), has
been demonstrated across several measures of health status and family satisfaction,
for older adults in residential aged care settings. There is limited evidence, however,
about how best to develop NP from the existing workforce in this setting.
Aim
To describe the structures and processes that both enabled and were barriers to the
development of the nurse practitioner role.
Methods
Qualitative descriptive methods, involving semistructured interviews and focus groups,
were employed to explore participant perspectives of the structures and processes
involved in developing a nurse practitioner candidate (NPC) (student). Study participants
included older adult residents, visiting General Practitioners (GPs), the NPC and
facility staff, including nurses and personal care assistants. Content analysis of
data categorised as structural and processes enablers and barriers was undertaken.
Findings
Nine residents and 25 staff participated in individual interviews or focus groups.
Physical structures required for appropriate functioning of the NP role included integrated
practice management software, however, social structures such acceptance by existing
staff and visiting GPs were initially a barrier but improved over time. Efficient
collaboration, enhanced assessment and surveillance of older adults, and improved
communication were identified as the key processes enabling the development of the
nurse practitioner role from candidate to endorsed nurse practitioner.
Discussion and conclusion
The development of a NPC onsite in a residential aged care setting improved communication
with GPs and local hospital emergency staff and supported facility staff through capacity
building and providing access to primary care onsite. These improvements could stimulate
policymakers to access the potential of their existing registered nursing staff, interested
in becoming NP to improve primary care for older populations while undertaking their
education and beyond.
Keywords
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Article info
Publication history
Published online: February 27, 2023
Accepted:
December 28,
2022
Received in revised form:
December 6,
2022
Received:
April 14,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Australian College of Nursing Ltd. Published by Elsevier Ltd.
