An investigation of the international literature on nurse practitioner private practice models

Currie, Jane; Chiarella, Mary; Buckley, Thomas

doi:10.1111/inr.12060

Cited by 21 publications

(40 citation statements)

References 51 publications

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“…The survey questions were informed by current literature and focused on the following aspects of PPNP practice: workforce characteristics, 2 collaborative arrangements, access to MBS and PBS and practice activities. 12 Participants responded to 13 questions related to collaborative arrangements, nine focused on eliciting quantitative responses and four focused on eliciting qualitative responses (Table 1). To confirm the clarity of the survey, a pilot study was conducted (n = 6) and several minor amendments were made to the survey questions before administration of the national survey.…”

Section: Designmentioning

confidence: 99%

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Currie

Chiarella

Buckley

2017

Aust. Health Review

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Objective. Since the introduction of legislative changes in 2010, services provided by privately practising nurse practitioners (PPNPs) in Australia have been eligible for subsidisation through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). To provide eligible services, PPNPs must collaborate formally with a medical practitioner or an entity that employs medical practitioners. This paper provides data from a national survey on these collaborative arrangements in Australia. The aim of the study was to evaluate the impact of PPNP services on patient access to care in Australia.Methods. PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed using thematic analysis. Seventy-three surveys were completed.Results. Ninety-three per cent of participants reported having a collaborative arrangement in place. Frequency of communication ranged from daily (27%) to never (1%). Participants reported that collaborative arrangements facilitate learning, patient care and offer support to PPNPs. However, for some PPNPs, organising a formal collaborative arrangement is demanding because it is dependent on the availability and willingness of medical practitioners and the open interpretation of the arrangement. Only 19% of participants believed that collaborative arrangements should be a prerequisite for PPNPs to access the MBS and PBS.Conclusion. Although there are benefits to collaborative arrangements, there is also concern from PPNPs that mandating such arrangements through legislation presents a barrier to establishing PPNP services and potentially reduces patient access to care. Collaboration with medical practitioners is intrinsic to nursing practice. Thus, legislating for collaborative arrangements is unnecessary, because it makes the normal abnormal.What is known about the topic? To access the MBS and PBS, PPNPs are required by law to have a collaborative arrangement with a medical practitioner or entity that employs medical practitioners. To date, the effects of these collaborative arrangements on PPNP services in Australia have not been known. What does the paper add? This paper provides unique data from a national survey on collaborative arrangements between PPNPs and medical practitioners in Australia. What are the implications for practitioners? Although there are benefits to collaborative arrangements, there is also concern that mandating such arrangements presents a barrier to establishing PPNP services and potentially reduces patient access to care.

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Section: Designmentioning

confidence: 99%

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Currie

Chiarella

Buckley

2017

Aust. Health Review

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“…PPNP services are relatively new to Australia, but there is also only a small volume of literature on the topic internationally (Currie, Chiarella, & Buckley, 2013). In 2010, legislative amendments (Health Legislation Amendment (Midwives and Nurse Practitioners) Act 2010(Cth)) allowed NP services to be subsidised through the Medicare Benefits Schedule (MBS).…”

Section: What Is Known Of Ppnp Services In Australiamentioning

confidence: 99%

“…However, prior to this legislation NPs were not prevented from working privately, but their patients were unable to seek reimbursement through the MBS. Since the introduction of the MBS subsidies for NPs, a number of PPNP services have been initiated in Australia (Currie et al, 2013). Examples include: NPs integrating with pharmacies in a primary health care and health promotion role (McMillan & Emmerton, 2013); community mental health roles (Cashin, 2007;Raeburn et al, 2015); and NPs working in GP surgeries (Helms, Crookes & Bailey, 2015).…”

Section: What Is Known Of Ppnp Services In Australiamentioning

confidence: 99%

“…Examples include: NPs integrating with pharmacies in a primary health care and health promotion role (McMillan & Emmerton, 2013); community mental health roles (Cashin, 2007;Raeburn et al, 2015); and NPs working in GP surgeries (Helms, Crookes & Bailey, 2015). These private practice roles have an emphasis on primary health care.Existing literature highlights issues impacting upon the sustainability of PPNPs, including limited access to MBS items (Elmer &Stirling, 2013); the level of NP reimbursement (Helms et al, 2015;Currie et al, 2013); and the complexity of the requirements for collaborative arrangements (Harvey, 2011).…”

Section: What Is Known Of Ppnp Services In Australiamentioning

confidence: 99%

“…In the case of PPNPs, the authors attended conference presentations on the topic of PPNPs and held informal discussions with relevant stakeholders and advisors. In addition, an integrative review of the international literature on PPNP services was undertaken in which themes were extracted from the literature (Currie et al, 2013 …”

Section: Theory Buildingmentioning

confidence: 99%

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Preparing a Realist Evaluation to Investigate the Impact of Privately Practising Nurse Practitioners on Patient Access to Care in Australia

Currie¹,

Chiarella²,

Buckley³

2015

IJN

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Background: Evaluation of privately practising nurse practitioner (PPNP) services in Australia is an important issue, because the sustainability of viable health services requires that they are underpinned by sound research. As part of ongoing work in relation to the evaluation of PPNP services, the authors plan to use realist evaluation (RE) to explore, not only whether PPNP services increase patient's access to care, but also the means by which they achieve (or do not achieve) this outcome. RE is a complex methodology and its application requires careful preparation. Objective: To present the application of the RE methodology to an evaluation of PPNP services of health care in Australia. Method: This paper explores the philosophical underpinnings of RE and articulates the steps taken in preparing to apply RE to an evaluation of PPNP services in Australia. Discussion: RE is a complex methodology to understand and apply. There is an absence of documented detail in terms of how to apply RE to ensure that the evaluation is truly 'realist'. Yet making the choice to apply RE to evaluations of PPNP services in Australia and overseas holds many advantages, primarily because of RE's emphasis upon the context in which health care is delivered and how and why the context relates to the outcomes produced. This paper will contribute to the emerging dialogue on how to apply RE to evaluations of health care and will assist those considering using RE.

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Workforce characteristics of privately practicing nurse practitioners in Australia

Currie

Chiarella

Buckley

2016

Journal of the American Association of Nurse Practitioners

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Purpose Australian private practice nurse practitioner (PPNP) services have grown since legislative changes in 2010 enabled eligible nurse practitioners (NPs) to access reimbursement for care delivered through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). This article provides data from a national survey on the workforce characteristics of PPNPs in Australia. Method PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. There were 73 completed surveys. Conclusions One of the intentions of expanding access to MBS and PBS for patients treated by NPs was to increase patients’ access to health care through greater flexibility in the healthcare workforce. The results of this survey confirm that the workforce characteristics of PPNPs provide a potentially untapped resource to meet current primary healthcare demand. Implications for practice The findings of this study allow us to understand the characteristics of PPNP services, which are significant for workforce planning. The focus of PPNP practice is toward primary health care with PPNPs working predominantly in general practice settings. The largest age group of PPNPs is over 50 years and means a proportion will be retiring in the next 15 years.

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An investigation of the international literature on nurse practitioner private practice models

Cited by 21 publications

References 51 publications

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Preparing a Realist Evaluation to Investigate the Impact of Privately Practising Nurse Practitioners on Patient Access to Care in Australia

Workforce characteristics of privately practicing nurse practitioners in Australia

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