Glenn Gardner1, Christine Duffield2, Anna Doubrovsky3, Margaret Adams4. 1. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia; Institute for Health & Biomedical Innovation, Brisbane, Queensland, Australia. Electronic address: ge.gardner@qut.edu.au. 2. Centre for Health Services Management, New South Wales, Australia; University of Technology Sydney, New South Wales, Australia. 3. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia. 4. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia; Institute for Health & Biomedical Innovation, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: The size and flexibility of the nursing workforce has positioned nursing as central to the goals of health service improvement. Nursing's response to meeting these goals has resulted in proliferation of advanced practice nursing with a confusing array of practice profiles, titles and roles. Whilst numerous models and definitions of advanced practice nursing have been developed there is scant published research of significant scope that supports these models. Consequently there is an ongoing call in the literature for clarity and stability in nomenclature, and confusion in the health industry on how to optimise the utility of advanced practice nursing. OBJECTIVES: To identify and delineate advanced practice from other levels of nursing practice through examination of a national nursing workforce. DESIGN: A cross-sectional electronic survey of nurses using the validated Advanced Practice Role Delineation tool based on the Strong Model of Advanced Practice. PARTICIPANTS: Study participants were registered nurses employed in a clinical service environment across all states and territories of Australia. METHODS: A sample of 5662 registered nurses participated in the study. Domain means for each participant were calculated then means for nursing position titles were calculated. Position titles were grouped by delineation and were compared with one-way analysis of variance on domain means. The alpha for all tests was set at 0.05. Significant effects were examined with Scheffe post hoc comparisons to control for Type 1 error. RESULTS: The survey tool was able to identify position titles where nurses were practicing at an advanced level and to delineate this cohort from other levels of nursing practice, including nurse practitioner. The results show that nurses who practice at an advanced level are characterised by high mean scores across all Domains of the Strong Model of Advanced Practice. The mean scores of advanced practice nurses were significantly different from nurse practitioners in the Direct Care Domain and significantly different from other levels of nurse across all domains. CONCLUSIONS: The study results show that the nurse practitioner, advanced practice nurse and foundation level registered nurse have different patterns of practice and the Advanced Practice Role Delineation tool has the capacity to clearly delineate and define advanced practice nursing. These findings make a significant contribution to the international debate and show that the profession can now identify what is and what is not advanced practice in nursing.
BACKGROUND: The size and flexibility of the nursing workforce has positioned nursing as central to the goals of health service improvement. Nursing's response to meeting these goals has resulted in proliferation of advanced practice nursing with a confusing array of practice profiles, titles and roles. Whilst numerous models and definitions of advanced practice nursing have been developed there is scant published research of significant scope that supports these models. Consequently there is an ongoing call in the literature for clarity and stability in nomenclature, and confusion in the health industry on how to optimise the utility of advanced practice nursing. OBJECTIVES: To identify and delineate advanced practice from other levels of nursing practice through examination of a national nursing workforce. DESIGN: A cross-sectional electronic survey of nurses using the validated Advanced Practice Role Delineation tool based on the Strong Model of Advanced Practice. PARTICIPANTS: Study participants were registered nurses employed in a clinical service environment across all states and territories of Australia. METHODS: A sample of 5662 registered nurses participated in the study. Domain means for each participant were calculated then means for nursing position titles were calculated. Position titles were grouped by delineation and were compared with one-way analysis of variance on domain means. The alpha for all tests was set at 0.05. Significant effects were examined with Scheffe post hoc comparisons to control for Type 1 error. RESULTS: The survey tool was able to identify position titles where nurses were practicing at an advanced level and to delineate this cohort from other levels of nursing practice, including nurse practitioner. The results show that nurses who practice at an advanced level are characterised by high mean scores across all Domains of the Strong Model of Advanced Practice. The mean scores of advanced practice nurses were significantly different from nurse practitioners in the Direct Care Domain and significantly different from other levels of nurse across all domains. CONCLUSIONS: The study results show that the nurse practitioner, advanced practice nurse and foundation level registered nurse have different patterns of practice and the Advanced Practice Role Delineation tool has the capacity to clearly delineate and define advanced practice nursing. These findings make a significant contribution to the international debate and show that the profession can now identify what is and what is not advanced practice in nursing.
Authors: Karen A Theobald; Fiona Maree Coyer; Amanda Jane Henderson; Robyn Fox; Bernadette F Thomson; Alexandra L McCarthy Journal: BMC Nurs Date: 2021-03-12
Authors: Isabel Amélia Costa Mendes; Carla Aparecida Arena Ventura; Manoel Carlos Neri da Silva; Valeria Lerch Lunardi; Ítalo Rodolfo Silva; Sara Soares Dos Santos Journal: Rev Lat Am Enfermagem Date: 2020-11-06