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Published in: Human Resources for Health 1/2019

Open Access 01-12-2019 | Care | Research

Implementation of an older person’s nurse practitioner in rural aged care in Victoria, Australia: a qualitative study

Authors: Kaye Ervin, Carol Reid, Anna Moran, Cynthia Opie, Helen Haines

Published in: Human Resources for Health | Issue 1/2019

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Abstract

Background

There are staff shortages nation-wide in residential aged care, which is only predicted to grow as the population ages in Australia. The aged care staff shortage is compounded in rural and remote areas where the health service workforce overall experiences difficulties in recruitment and retention. There is evidence that nurse practitioners fill important service gaps in aged care and rural health care but also evidence that barriers exist in introducing this extended practice role.

Methods

In 2018, 58 medical and direct care staff participated in interviews and focus groups about the implementation of an older person’s nurse practitioner (OPNP) in aged care. All 58 interviewees had previously or currently worked in an aged care setting where the OPNP delivered services.
The interviews were analysed using May’s implementation theory framework to better understand staff perceptions of barriers and enablers when an OPNP was introduced to the workplace.

Results

The major perceived barrier to capacity of implementing the OPNP was a lack of material resources, namely funding of the role given the OPNP’s limited ability to self-fund through access to the Medicare Benefits Schedule (MBS). Staff perceived that benefits included timely access to care for residents, hospital avoidance and improved resident health outcomes.

Conclusion

Despite staff perceptions of more timely access to care for residents and improved outcomes, widespread implementation of the OPNP role may be hampered by a poor understanding of the role of an OPNP and the legislative requirement for a collaborative arrangement with a medical practitioner as well as limited access to the MBS.
This study was not a registered trial.
Footnotes
1
Medicare is Australia’s government health care system. Employed people pay a Medicare levy as part of their income tax to fund the system for all Australians requiring medical treatment. Government-funded medical services are listed on the MBS. The government authorises which practitioners can claim the government funding for providing services. Most services provided by a medical practitioner are funded wholly or partly by Medicare. Nurses and allied health practitioners have restricted access to the MBS for providing services.
 
Literature
2.
go back to reference Roche T, Gardner G, Jack L. The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study. BMC Health Serv Res. 2017;17(445). https://doi.org/10.1186/s12913-017-2395-9. Roche T, Gardner G, Jack L. The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study. BMC Health Serv Res. 2017;17(445). https://​doi.​org/​10.​1186/​s12913-017-2395-9.
3.
4.
go back to reference Commonwealth of Australia. A matter of care Australia’s aged care workforce strategy, aged care workforce strategy taskforce; 2018. Commonwealth of Australia. A matter of care Australia’s aged care workforce strategy, aged care workforce strategy taskforce; 2018.
6.
go back to reference Wilson K, Cameron P, Jennings N. Emergency nurse practitioners: an underestimated addition to the emergency care team. Emerg Med Australas. 2008;20(6):453–5.PubMed Wilson K, Cameron P, Jennings N. Emergency nurse practitioners: an underestimated addition to the emergency care team. Emerg Med Australas. 2008;20(6):453–5.PubMed
7.
go back to reference Nursing and Midwifery Board of Australia. Registrant data. Reporting period: 1 July – 30 September 2018; 2018. [cited 2019 Jan 2]. Available from: http:www.ahpra.com.au Nursing and Midwifery Board of Australia. Registrant data. Reporting period: 1 July – 30 September 2018; 2018. [cited 2019 Jan 2]. Available from: http:www.​ahpra.​com.​au
9.
go back to reference Schadewaldt V, McInnes E, Hiller J, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods. BMC Fam Pr. 2016;17:99. https://doi.org/10.1186/s12875-016-0503-2. Schadewaldt V, McInnes E, Hiller J, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods. BMC Fam Pr. 2016;17:99. https://​doi.​org/​10.​1186/​s12875-016-0503-2.
11.
go back to reference Saldana J. The coding manual for qualitative researchers. Thousand Oaks: SAGE Publications Ltd.; 2016. Saldana J. The coding manual for qualitative researchers. Thousand Oaks: SAGE Publications Ltd.; 2016.
12.
go back to reference Hodder I. The interpretation of documents and material culture. Thousand Oaks: Sage; 1994. p. 155. Hodder I. The interpretation of documents and material culture. Thousand Oaks: Sage; 1994. p. 155.
13.
go back to reference Peters D, Tran N, Adam T. Implementation research in health: a practical guide: Alliance Heal Policy Syst Res. World Heal; 2013. Peters D, Tran N, Adam T. Implementation research in health: a practical guide: Alliance Heal Policy Syst Res. World Heal; 2013.
15.
go back to reference Schadewaldt V, McInnes E, Hiller J, Gardner A. Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care: an integrative review. BMC Fam Pr. 2013;14(132):1–11. Schadewaldt V, McInnes E, Hiller J, Gardner A. Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care: an integrative review. BMC Fam Pr. 2013;14(132):1–11.
16.
go back to reference Willis E. Introduction: taking stock of medical dominance. Heal Sociol Rev. 2006;15(5):421–31.CrossRef Willis E. Introduction: taking stock of medical dominance. Heal Sociol Rev. 2006;15(5):421–31.CrossRef
20.
go back to reference Schadewaldt V, McInnes E, Hiller J, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods. BMC Fam Pract. 2016;17(99). https://doi.org/10.1186/s12875-016-0503-2. Schadewaldt V, McInnes E, Hiller J, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods. BMC Fam Pract. 2016;17(99). https://​doi.​org/​10.​1186/​s12875-016-0503-2.
21.
go back to reference McInnes E. Review of processes for the implementation of the role of nurse practitioners in South Australia. Report for SA Health; 2008. McInnes E. Review of processes for the implementation of the role of nurse practitioners in South Australia. Report for SA Health; 2008.
22.
23.
go back to reference Nursing and Midwifery Board of Australia. Nurse practitioner standards of practice: ANMB; 2014. p. 1–5. Nursing and Midwifery Board of Australia. Nurse practitioner standards of practice: ANMB; 2014. p. 1–5.
24.
go back to reference Medical Board of Australia. Good medical practice. A code of conduct for doctors in AustraliaMBA; 2014. p. 1–25. Medical Board of Australia. Good medical practice. A code of conduct for doctors in AustraliaMBA; 2014. p. 1–25.
25.
go back to reference Arbon P, Bail K, Eggert M, Gardner A, Hogan S, Phillips C, et al. Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital Territory. J Clin Nurs. 2009;18. Arbon P, Bail K, Eggert M, Gardner A, Hogan S, Phillips C, et al. Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital Territory. J Clin Nurs. 2009;18.
26.
27.
go back to reference Parker R, Forrest L, McCracken J, McRae I, Cox D. What primary health-care services are Australian consumers willing to accept from nurse practitioners? A national survey. Health Expect. 2014;17(5):733–40.CrossRef Parker R, Forrest L, McCracken J, McRae I, Cox D. What primary health-care services are Australian consumers willing to accept from nurse practitioners? A national survey. Health Expect. 2014;17(5):733–40.CrossRef
Metadata
Title
Implementation of an older person’s nurse practitioner in rural aged care in Victoria, Australia: a qualitative study
Authors
Kaye Ervin
Carol Reid
Anna Moran
Cynthia Opie
Helen Haines
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
Human Resources for Health / Issue 1/2019
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-019-0415-z

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