Changes, challenges and choices for the primary health care workforce: looking to the future

Abstract

Workforce issues and questions of professional roles and boundaries, in the context of the "greying" community nursing workforce, demand solutions if patient/client demand is to be met over the next two decades.

Physicians' view of primary care-based case management for patients with heart failure: a qualitative study

“…At the individual practice level, the principles of both substitution and delegation imply that non-physician health professionals with appropriate training can take over specific tasks while maintaining or improving patient outcomes [8, 30, 31]. The German Federal Medical Association is opposed to nurse–doctor substitution and favours delegation under the ‘therapeutic responsibility’ of doctors [32].…”

The retention of health human resources in primary healthcare centers in Lebanon: a national survey

“…Literature over the past two decades has examined the escalating PHC HHR crisis, elaborating on the centrality of recruitment and retention of PHC HHR for building balanced, effective and sustainable primary care services [9,13-15]. Moreover, the role of HHR has been acknowledged to be even more important in community-based care, which tends to use less advanced equipment and is more dependent on competent personnel [5].…”

Is an expanded nurse role economically viable?

“…Nurses are now working in different ways and at higher levels of practice, which allows them to adapt their roles and take on new responsibilities (Shirley & Walsh 2000). Examples of such extended roles include practice nurses and community health nurses who provide treatment for minor illness and chronic disease management, two areas already well established in primary care settings (Jenkins‐Clarke & Carr‐Hill 2001). As health care professionals focus more on health promotion and disease prevention, nurse practitioners are also defining their niche in this environment (Mundinger et al.…”