There is little known about private practice nursing as an area of advanced practice. As more nurses take the option to develop private practice, the experiences of and influences on nurses currently in private practice might be a useful guide to the pitfalls and difficulties which might be encountered. In addition, an understanding of the experiences of and influences might assist nursing organizations and health services to provide support to nurses who play an integral part in health care delivery in the community. A research study was undertaken utilizing a two-round Delphi Technique to elicit and assess consensus on the reasons for nurses going into business and the experiences they encountered in becoming and being a nurse entrepreneur. The study instrument in round one comprised a questionnaire with statement headings inviting opinions on the influences and experiences of nurses in business. In the second round, levels of agreement were elicited from responders on collated opinions from round one, including statements formed from comments written in round one. The initial questionnaire also included closed questions to obtain a profile of nurses in private practice. Responders were 59 nurses in private practice in round one and 54 nurses in round two. The themes raised could be grouped under headings of influences, advantages/disadvantages, education/experience, skills/knowledge, characteristics and barriers. The level of agreement on the themes was reasonably high. Dissent occurred on issues of increased income, professional image and support structures. This Delphi study has identified key areas of consensus on the experiences of nurses in private practice who have extended their career into the business arena. It has also identified areas in which further work needs to be carried out to understand this work of nurse entrepreneurs.

Executive summaryBackground This report describes the results of a study designed to identify research priorities in nursing arising out of the analysis of 22 systematic review reports published by the Joanna Briggs Institute (JBI) from 1998 to 2002. A feature of the systematic review of evidence is the noticeable lack of high-quality evidence to support a large proportion of nursing interventions and activities. Systematic review topics are selected as areas of concern about practice by nurses comprising the individual and corporate membership of JBI at Professional Advisory Forums and meetings held annually throughout Australia and internationally in conjunction with JBI's collaborating centres. Such selection prioritises nurses' views about what 'matters in their daily practice'. Objective and MethodsThe study comprised a content analysis of the 22 systematic review reports and set out to: • identify any striking gaps in evidence for frequently used practices; • generate research questions to address the gaps; and • suggest research approaches appropriate to the research questions generated. ResultsThe results of the analysis identified in excess of 200 important gaps in the evidence base available for nursing practice in relation to the 22 discrete areas of practice examined. Recommendations included the wide dissemination of this report to promote the results of systematic reviews as an important resource in setting research priorities. Policy makers, the Commonwealth Government, State and Territory Governments, research funding bodies, organisations and individuals involved in decision-making and the funding of research in health care have received little substantive direction in setting priorities for nursing research. This lack of well founded advice is evidenced by the incredibly low level of support for nursing research in Australia and the large number of gaps in evidence for nursing practice. A Averis & A PearsonConclusions Knowledge transfer -of evidence into practice -has the potential to improve health outcomes, but the delivery of 'best practice' care based on sound evidence is dependant upon the generation of evidence to fill systematically identified gaps.

The changing Australian health care system is creating new opportunities for nurses who work directly with clients in private practice settings. This study examines the scope of practice of a cohort of nurses in private practice. In a questionnaire sent to 106 self-employed nurse entrepreneurs, questions were asked pertaining to the participants' scope of practice, their clients, the types of services offered, and their fee structures. Questions about scope of practice were divided into domains of clinical practice, business consultancy, education, and research. Quantitative and qualitative data were collected for a final sample 54 eligible responses. Participants had been in private practice for an average of 7.6 years (range: 1-20) and reported a mean of 21 years of nursing experience (range: 4-42) before entering private practice. Over half held diplomas in specialty areas. Most participants reported clinical practice, consultancy, or education as the primary work domain; research was much less important as a work activity. Nurses reported difficulties with building client base and receiving adequate fees for service, particularly in clinical practice. Increasing awareness within the nursing profession and health sector about various aspects of private practice nursing could improve service quality for their clients.

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