Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Human Resources for Health
Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | Care | Research

‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services

Authors: Tara N. Officer, Jackie Cumming, Karen McBride-Henry

Published in: Human Resources for Health | Issue 1/2021

Login to get access

Abstract

Background

Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services.

Methods

As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research.

Results

Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion.

Conclusions

This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.
Footnotes
1
An initial theory, developed as part of the original literature review and refined throughout this article, is presented at the conclusion of the ‘Results’ section.
 
Literature
1.
Goodyear-Smith F, Ashton T. New Zealand health system: universalism struggles with persisting inequities. Lancet. 2019;394:432–42.PubMedCrossRef
2.
Ministry of Health. Briefing to the incoming Minister of Health, 2017: The New Zealand health and disability system. Wellington: Ministry of Health; 2017.
3.
Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70:351–79.PubMedCrossRef
4.
Health and Disability System Review. Health and disability system review—interim report. Hauora Manaaki ki Aotearoa Whānui—Pūrongo mō Tēnei Wā. Wellington: Health and Disability System Review; 2019.
5.
Hughes F, Carryer J. Nurse practitioners in New Zealand. Wellington: Ministry of Health; 2002.
6.
Ministry of Health. Regulatory impact statement: overview of required information. In medicines (Designated Prescriber: Pharmacists) regulations: agency disclosure statement. Wellington: Ministry of Health; 2012.
7.
8.
Thomas F. Nurse practitioners going to waste in culture of confusion and mistrust. In New Zealand Doctor; 2017.
9.
10.
Nurse Practitioner Employment and Development Working Party. Funding nurse practitioner training: a discussion paper. Wellington: Ministry of Health; 2006.
11.
Ministry of Health. Social Policy Committee cabinet paper on designated prescribing rights for pharmacist prescribers. Health Report. Wellington: Ministry of Health; 2012.
12.
Bhanbhro S, Drennan V, Grant R, Harris R. Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature. BMC Health Serv Res. 2011;11:330–9.PubMedPubMedCentralCrossRef
13.
Perry C, Thurston M, Killey M, Miller J. The nurse practitioner in primary care: alleviating problems of access? Br J Nurs. 2005;14:255–9.PubMedCrossRef
14.
Famiyeh I, McCarthy L. Pharmacist prescribing: a scoping review about the views and experiences of patients and the public. Res Social Adm Pharm. 2017;13:1–16.PubMedCrossRef
15.
Martin-Misener R, Downe-Wamboldt B, Cain E, Girouard M. Cost effectiveness and outcomes of a nurse practitioner–paramedic–family physician model of care: the Long and Brier Islands study. Prim Health Care Res Dev. 2009;10:14–25.CrossRef
16.
Bissell P, Cooper R, Guillaume L, Anderson C, Avery A, Hutchinson A, James V, Lymn J, Marsden E, Murphy E, et al. An evaluation of supplementary prescribing in nursing and pharmacy. London: Department of Health; 2008.
17.
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.PubMedPubMedCentralCrossRef
18.
19.
Venning P, Durie A, Roland M, Roberts C, Leese B. Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care. BMJ. 2000;320:1048–53.PubMedPubMedCentralCrossRef
20.
Kinnersley P, Anderson E, Parry K, Clement J, Archard L, Turton P, Stainthorpe A, Fraser A, Butler CC, Rogers C. Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting “same day” consultations in primary care. BMJ. 2000;320:1043–8.PubMedPubMedCentralCrossRef
21.
Stanik-Hutt J, Newhouse RP, White KM, Johantgen M, Bass EB, Zangaro G, Wilson R, Fountain L, Steinwachs DM, Heindel L, Weiner JP. The quality and effectiveness of care provided by nurse practitioners. J Nurse Pract. 2013;9:492–500.CrossRef
22.
Tinelli M, Blenkinsopp A, Latter S, Smith A, Chapman SR. Survey of patients’ experiences and perceptions of care provided by nurse and pharmacist independent prescribers in primary care. Health Expect. 2013;18:1241–55.PubMedPubMedCentralCrossRef
23.
Latter S, Blenkinsopp A, Smith A, Chapman S, Tinelli M, Gerard K, Little P, Celino N, Granby T, Nicholls P, Dorer G. Evaluation of nurse and pharmacist independent prescribing. Southampton: University of Southampton Keele University on behalf of Department of Health; 2011.
24.
Hobson RJ, Scott J, Sutton J. Pharmacists and nurses as independent prescribers: Exploring the patient’s perspective. Fam Pract. 2010;27:110–20.PubMedCrossRef
25.
Stewart D, Maclure K, Bond CM, Cunningham S, Diack L, George J, McCaig DJ. Pharmacist prescribing in primary care: the views of patients across Great Britain who had experienced the service. Int J Pharm Pract. 2011;19:328–32.PubMedCrossRef
26.
Mundinger MO, Kane RL, Lenz ER, Totten AM, Tsai W-Y, Cleary PD, Friedewald WT, Siu AL, Shelanski ML. Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial. JAMA. 2000;283:59–68.PubMedCrossRef
27.
Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61:332–51.PubMedCrossRef
28.
Jebara T, Cunningham S, MacLure K, Awaisu A, Pallivalapila A, Stewart D. Stakeholders’ views and experiences of pharmacist prescribing: a systematic review. Br J Clin Pharmacol. 2018;84:1883–905.PubMedPubMedCentralCrossRef
29.
Pawson R, Tilley N. Realistic evaluation. London: SAGE Publications Ltd; 1997.
30.
Pawson R. Evidence-based policy: a realist perspective. London: SAGE Publications; 2006.CrossRef
31.
32.
33.
Officer TN. Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience. Wellington: Victoria University of Wellington; 2018.
34.
Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist synthesis: an introduction. Research methods: an ESRC research programme. Manchester: University of Manchester; 2004.
35.
Manzano A. The craft of interviewing in realist evaluation. Evaluation. 2016;22:342–60.CrossRef
36.
Marchal B, van Belle S, van Olmen J, Hoerée T, Kegels G. Is realist evaluation keeping its promise? A review of published empirical studies in the field of health systems research. Evaluation. 2012;18:192–212.CrossRef
37.
Pawson R. The science of evaluation: a realist manifesto. London: SAGE Publications Ltd; 2013.CrossRef
38.
Byng R, Norman I, Redfern S. Using realistic evaluation to evaluate a practice-level intervention to improve primary healthcare for patients with long-term mental illness. Evaluation. 2005;11:69–93.CrossRef
39.
Wand T. Implementation and pilot evaluation of an emergency department based mental health nurse practitioner outpatient service. Sydney: University of Sydney, Sydney Nursing School; 2011.
40.
Prosser B, Clark S, Davey R, Parker R. Developing a public health policy-research nexus: An evaluation of nurse practitioner models in aged care. Eval Program Plann. 2013;40:55–63.PubMedCrossRef
41.
42.
43.
McCann LM, Haughey SL, Parsons C, Lloyd F, Crealey G, Gormley GJ, Hughes CM. A patient perspective of pharmacist prescribing: ‘Crossing the specialisms-crossing the illnesses.’ Health Expect. 2015;18:58–68.PubMedCrossRef
44.
McMillan SS, Kendall E, Sav A, King MA, Whitty JA, Kelly F, Wheeler AJ. Patient-centered approaches to health care: a systematic review of randomized controlled trials. Med Care Res Rev. 2013;70:567–96.PubMedCrossRef
45.
Sibbald B, Shen J, McBride A. Changing the skill-mix of the health care workforce. J Health Serv Res Policy. 2004;9:28–38.PubMedCrossRef
46.
Officer TN, Cumming J, McBride-Henry K. Successfully developing advanced practitioner roles: policy and practice mechanisms. J Health Organ Manag. 2019;33:63–77.PubMedCrossRef
47.
Bate P, Robert G. Experience-based design: from redesigning the system around the patient to co-designing services with the patient. Qual Saf Health Care. 2006;15:307–10.PubMedPubMedCentralCrossRef
48.
McCarron TL, Moffat K, Wilkinson G, Zelinsky S, Boyd JM, White D, Hassay D, Lorenzetti DL, Marlett NJ, Noseworthy T. Understanding patient engagement in health system decision-making: a co-designed scoping review. Syst Rev. 2019;8:97.PubMedPubMedCentralCrossRef
49.
Carryer J, Adams S. Nurse practitioners as a solution to transformative and sustainable health services in primary health care: a qualitative exploratory study. Collegian. 2017;24:525–31.CrossRef
50.
51.
52.
Satia J, Chauhan K. What is quality? Quality of care frameworks. In: Satia J, Chauhan K, editors. Improving quality of care in family planning: a research and advocacy agenda for india. Singapore: Springer Singapore; 2018. p. 13–31.CrossRef
53.
Adams S, Carryer J. Establishing the nurse practitioner workforce in rural New Zealand: barriers and facilitators. J Prim Health Care. 2019;11:152–8.PubMedCrossRef
54.
Wilkinson J, Carryer J, Budge C. Impact of postgraduate education on advanced practice nurse activity – a national survey. Int Nurs Rev. 2018;65:417–24.PubMedCrossRef
55.
Lawton J, Rankin D, Elliott J. Is consulting patients about their health service preferences a useful exercise? Qual Health Res. 2013;23:876–86.PubMedCrossRef
56.
57.
Mukumbang FC, Marchal B, Van Belle S, van Wyk B. Using the realist interview approach to maintain theoretical awareness in realist studies. Qual Res. 2020;20:485–515.CrossRef
Metadata
Title
‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services
Authors
Tara N. Officer
Jackie Cumming
Karen McBride-Henry
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00587-y

Other articles of this Issue 1/2021

Human Resources for Health 1/2021 Go to the issue

Research

Retention of knowledge and clinical competence among Ugandan mid-level health providers 1 year after intensive clinical mentorship in TB and HIV management

Research

Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study

Research

Task-sharing to support paediatric and child health service delivery in low- and middle-income countries: current practice and a scoping review of emerging opportunities

Review

Participation of women in the health workforce in the fragile and conflict-affected countries: a scoping review

Research

A practical measure of health facility efficiency: an innovation in the application of routine health information to determine health worker productivity in Ethiopia

Research

Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: inter-professional training and task-sharing considerations