Revision and evaluation of an ‘advanced’ nursing role in an Australian emergency department

Hodge, Alister; Perry, Lin; Daly, Barbara; Hagness, Carmel; Tracy, Deborah H.

doi:10.1016/j.aenj.2011.02.004

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…The dynamic nature of SOP was not only limited to a profession's external practice boundaries, but also reflected temporal changes in the understanding and application of its' internal SOP continuum 184 . A number of authors described the phenomena whereby an individual's adoption of a task considered to be novel for the profession, whilst initially constituting an extended practice, will eventually transition to usual practice as the task is routinely undertaken by more practitioners of the profession 37,59,73,77,185,186 . It was suggested that as a task temporally transitions, professional consensus as to the status of the task may not always be possible at any given timepoint, 6 reflecting the complex and simultaneous interplay of change of scope between professions and change of scope within a profession, as described by Freidson cited in Bourgeault and Grignon 179…”

Section: Resultsmentioning

confidence: 99%

“…The term was equally described as an increase or advancement consistent with the current scope of the profession but traditionally the remit of other professions, 31,40,45,[60][61][62][63][64][65][66][67][68] or with regards to aspects of performance measurement, specialisation or expert status. 27,42,[46][47][48][49][50][51][52][53][54][55]65,69,70 This discourse was particularly evident within the nursing literature, 40,[71][72][73][74][75][76][77][78] with debate as to the differences between advanced practice role titles (including the protected title of Nurse Practitioner), advanced nursing practice as a description of the characteristics and levels of highly developed nursing practice, and advanced SOP inferring application of knowledge and skills within full professional scope.…”

Section: Definitions Of Sop For Medical and Health Professionsmentioning

confidence: 99%

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How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

Downie

Walsh

Kirk-Brown

et al. 2023

Health Planning & Management

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BackgroundThe term scope of practice (SOP) refers to the limits of a health professional's knowledge, skills and experience and reflects all tasks and activities they undertake within the context of their professional role. Inconsistency in definitions of SOP contributes to uncertainty and confusion regarding professional practice boundaries and potentially impacts societal access to safe, effective and efficient healthcare options. The aim of this paper is to understand the conceptual diversity that may exist in terminology used to describe medical, nursing/midwifery and allied health SOP within an Australian practice context exemplar.MethodsA systematic review for scoping and content analysis of SOP definitions and concepts, involving inductive thematic analysis and synthesis of published and grey literature.ResultsThe initial search strategy yielded 11,863 hits, of which 379 were suitable for inclusion. Data coding identified various SOP terms and definitions and the emergence of six, conceptual elements underpinning the theoretical construct. These were subsequently proposed as a preliminary conceptual model (‘Solar’) to explain how the six conceptual elements may be applied across various professions, clinical settings and jurisdictions to better understand and address current and evolving SOP issues.ConclusionThe findings of this study highlight limited consistency in SOP definitions and terminology within a single jurisdiction, and the conceptual complexity of the underlying theoretical construct. Further research is required to build on the proposed ‘Solar’ conceptual model and create a universal SOP definition across jurisdictions, to enhance understanding of the importance of SOP to workforce policy, clinical governance, service models and patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Definitions Of Sop For Medical and Health Professionsmentioning

confidence: 99%

How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

Downie

Walsh

Kirk-Brown

et al. 2023

Health Planning & Management

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“…The broadening of the ED nursing role has occurred globally, as reported by Neades (1997), Hoskins (2011), Hodge, Perry, Daly, Hagness, and Tracy (2011), and Niezen and Mathijssen (2014). What differs across contexts is how socio-cultural and political factors constructed the extended nursing role…”

Section: Shifting Boundariesmentioning

confidence: 99%

Expanding knowledge and roles for authority and practice boundaries of Emergency Department nurses: a grounded theory study

Trisyani

Windsor

2019

International Journal of Qualitative Studies on Health and Well

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Purpose: While emergency department nurses in Indonesia are critical to quality care, the role lacks recognition and standard practices and regulation of scope of practice are absent. This research explored the role of nurses in Indonesian EDs. Method: The conceptual lens applied in the research was grounded theory. The main data source was 51 semi-structured interviews with 43 ED nurses, three directors of nursing, three nurse leaders and two nurse educators. Data were also generated through observations and memos. Results: Two key categories were constructed; shifting work boundaries and lack of authority. Shifting work boundaries was symbolic of a lack of professional authority and legitimized knowledge. Lack of authority reflected the dimension of professional autonomy through the nexus of power and knowledge. The interrelationship of these two concepts constructed a core category, securing legitimate power, which underpinned the positioning of nursing in Indonesia. Conclusions: The interconnection between political gains, tertiary knowledge, professional regulation and implementation of gender-sensitive policies was critical to the development of the ED role, the positioning of nursing within the health care system and improvement in quality of care.

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“…Reports from Australia, Canada, England, Ireland, Scotland, and the United States (USA) detailed more widespread but far from universal employment of NMPs in EDs/UTCs [15][16][17][18][19][20]. While there were accounts reporting on the facilitators and challenges in single organisation introduction of an or more than one NMP into an ED/UTCs [21][22][23][24][25][26], there have been none that investigated explanations for the variation in the extent of employment of NMPs in EDs/UTCs from across a health system. The National Health Service in England has had a national policy of support for NMPs in ED/UTCs and offered an opportunity to investigate across a health system.…”

Section: Introductionmentioning

confidence: 99%

Non-medical practitioners in the staffing of emergency departments and urgent treatment centres in England: a mixed qualitative methods study of policy implementation

Drennan,

Halter,

Taylor

et al. 2023

BMC Health Serv Res

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Background Patient demand, internationally, on emergency departments and urgent care treatment centres has grown. Shortages of staff, particularly of emergency medicine doctors, have compounded problems. Some countries are pursuing solutions of including non-medical practitioners e.g., nurse practitioners and physician associates/assistants in their emergency department workforces. This study investigated at the macro and meso level of the health system in England: what the rationale was and the factors influencing the current and future employment, or otherwise, of non-medical practitioners in emergency departments and urgent treatment centres. Methods Mixed qualitative methods in the interpretative tradition were employed. We undertook, in 2021–2022, a documentary analysis of national, regional and subregional policy (2017–2021), followed by semi-structured interviews of a purposive sample (n = 18) of stakeholders from national, regional and subregional levels. The data were thematically analysed and then synthesised. Results There was general national policy support for increasing the presence of non-medical practitioners as part of the solution to shortages of emergency medicine doctors. However, evidence of policy support dissipated at regional and subregional levels. There were no published numbers for non-medical practitioners in emergency departments, but stakeholders suggested they were relatively small in number, unevenly distributed and faced uncertain growth. While the experience of the COVID-19 pandemic and its aftermath were said to have made senior decision makers more receptive to workforce innovation, many factors contributed to the uncertain growth. These factors included: limited evidence on the relative advantage of including non-medical practitioners; variation in the models of service being pursued to address patient demand on emergency departments and the place of non-medical practitioners within them; the lack of a national workforce plan with clear directives; and the variation in training for non-medical practitioner roles, combined with the lack of regulation of that level of practice. Conclusions We identified many features of a system ready to introduce non-medical practitioners in emergency departments and urgent treatment centres but there were uncertainties and the potential for conflict with other professional groups. One area of uncertainty was evidence of relative advantage in including non-medical practitioners in staffing. This requires urgent attention to inform decision making for short- and long-term workforce planning. Further investigation is required to consider whether these findings are generalisable to other specialties, and to similar health systems in other countries.

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Revision and evaluation of an ‘advanced’ nursing role in an Australian emergency department

Cited by 9 publications

References 10 publications

How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

Expanding knowledge and roles for authority and practice boundaries of Emergency Department nurses: a grounded theory study

Non-medical practitioners in the staffing of emergency departments and urgent treatment centres in England: a mixed qualitative methods study of policy implementation

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