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The acute care nurse practitioner role in Canada.

https://arctichealth.org/en/permalink/ahliterature135437
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Publication Type
Article
Date
Dec-2010
Author
Kelley Kilpatrick
Patricia Harbman
Nancy Carter
Ruth Martin-Misener
Denise Bryant-Lukosius
Faith Donald
Sharon Kaasalainen
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Department of Nursing, Université du Québec en Outaouais, CHSRF/CIHR Program in Advanced Practice Nursing, St-Jérôme, QC.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Acute Disease
Advanced Practice Nursing - education - organization & administration - standards
Canada
Clinical Competence
Curriculum
Delivery of Health Care - organization & administration
Educational Measurement
Educational Status
Focus Groups
Health Policy
Humans
Nurse Practitioners - education - organization & administration - standards
Nurse's Role
Quebec
Abstract
The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.
PubMed ID
21478690 View in PubMed
Less detail

Advanced practice nursing in Canada: overview of a decision support synthesis.

https://arctichealth.org/en/permalink/ahliterature135441
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Ruth Martin-Misener
Denise Bryant-Lukosius
Ivy Bourgeault
Kelley Kilpatrick
Faith Donald
Sharon Kaasalainen
Patricia Harbman
Nancy Carter
Sandra Kioke
Julia Abelson
R James McKinlay
Dianna Pasic
Brandi Wasyluk
Julie Vohra
Renee Charbonneau-Smith
Author Affiliation
Ontario Training Centre in Health Services & Policy Research, Nursing and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - classification - methods - organization & administration
Canada
Decision Support Systems, Clinical - classification - organization & administration
Focus Groups
Health Care Surveys
Health Policy
Humans
Leadership
Nurse Clinicians - classification - organization & administration
Nurse Practitioners - classification - organization & administration
Periodicals as Topic - statistics & numerical data
Publishing - statistics & numerical data
Abstract
The objective of this decision support synthesis was to identify and review published and grey literature and to conduct stakeholder interviews to (1) describe the distinguishing characteristics of clinical nurse specialist (CNS) and nurse practitioner (NP) role definitions and competencies relevant to Canadian contexts, (2) identify the key barriers and facilitators for the effective development and utilization of CNS and NP roles and (3) inform the development of evidence-based recommendations for the individual, organizational and system supports required to better integrate CNS and NP roles into the Canadian healthcare system and advance the delivery of nursing and patient care services in Canada. Four types of advanced practice nurses (APNs) were the focus: CNSs, primary healthcare nurse practitioners (PHCNPs), acute care nurse practitioners (ACNPs) and a blended CNS/NP role. We worked with a multidisciplinary, multijurisdictional advisory board that helped identify documents and key informant interviewees, develop interview questions and formulate implications from our findings. We included 468 published and unpublished English- and French-language papers in a scoping review of the literature. We conducted interviews in English and French with 62 Canadian and international key informants (APNs, healthcare administrators, policy makers, nursing regulators, educators, physicians and other team members). We conducted four focus groups with a total of 19 APNs, educators, administrators and policy makers. A multidisciplinary roundtable convened by the Canadian Health Services Research Foundation formulated evidence-informed policy and practice recommendations based on the synthesis findings. This paper forms the foundation for this special issue, which contains 10 papers summarizing different dimensions of our synthesis. Here, we summarize the synthesis methods and the recommendations formulated at the roundtable.
PubMed ID
21478685 View in PubMed
Less detail

Clinical nurse specialists and nurse practitioners: title confusion and lack of role clarity.

https://arctichealth.org/en/permalink/ahliterature135434
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Publication Type
Article
Date
Dec-2010
Author
Faith Donald
Denise Bryant-Lukosius
Ruth Martin-Misener
Sharon Kaasalainen
Kelley Kilpatrick
Nancy Carter
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Affiliate Faculty, Daphne Cockwell School of Nursing, Ryerson University, CHSRF/CIHR Program in Advanced Practice Nursing, Toronto, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - organization & administration
Attitude of Health Personnel
Awareness
Canada
Curriculum
Focus Groups
Health Policy
Humans
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Nurse's Role
Social Perception
Abstract
Title confusion and lack of role clarity pose barriers to the integration of advanced practice nursing roles (i.e., clinical nurse specialist [CNS] and nurse practitioner [NP]). Lack of awareness and understanding about NP and CNS roles among the healthcare team and the public contributes to ambiguous role expectations, confusion about NP and CNS scopes of practice and turf protection. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis commissioned by the Canadian Health Services Research Foundation and the Office of Nursing Policy in Health Canada. The goal of this synthesis was to develop a better understanding of advanced practice nursing roles and the factors that influence their effective development and integration in the Canadian healthcare system. Specific recommendations from interview participants and the literature to enhance title and role clarity included the use of consistent titles for NP and CNS roles; the creation of a vision statement to articulate the role of CNSs and NPs across settings; the use of a systematic planning process to guide role development and implementation; the development of a communication strategy to educate healthcare professionals, the public and employers about the roles; attention to inter-professional team dynamics when introducing these new roles; and addressing inter-professionalism in all health professional education program curricula.
PubMed ID
21478694 View in PubMed
Less detail

Factors enabling advanced practice nursing role integration in Canada.

https://arctichealth.org/en/permalink/ahliterature135433
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Denise Bryant-Lukosius
Ruth Martin-Misener
Faith Donald
Julia Abelson
Ivy Bourgeault
Kelley Kilpatrick
Nancy Carter
Sharon Kaasalainen
Patricia Harbman
Author Affiliation
CHSRF/CIHR in Advanced Practice Nursing, Ontario Training Centre in Health Services & Policy Research, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - manpower - organization & administration
Awareness
Canada
Curriculum
Decision Support Systems, Clinical
Delivery of Health Care - manpower - organization & administration
Education, Nursing, Continuing
Focus Groups
Great Britain
Health Care Surveys
Health Policy
Humans
Interprofessional Relations
Leadership
Nurse Clinicians - organization & administration - supply & distribution
Nurse Practitioners - organization & administration - supply & distribution
Personnel Turnover
Primary Health Care - organization & administration
United States
Abstract
Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper.
PubMed ID
21478695 View in PubMed
Less detail

A historical overview of the development of advanced practice nursing roles in Canada.

https://arctichealth.org/en/permalink/ahliterature135440
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Publication Type
Article
Date
Dec-2010
Author
Sharon Kaasalainen
Ruth Martin-Misener
Kelley Kilpatrick
Patricia Harbman
Denise Bryant-Lukosius
Faith Donald
Nancy Carter
Alba DiCenso
Author Affiliation
Affiliate Faculty, School of Nursing, McMaster University, Career Scientist, Ontario Ministry of Health and Long-Term Care, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - history - manpower - methods
Canada
Delivery of Health Care - history - organization & administration
Health Policy - history - trends
Health services needs and demand
History of Nursing
History, 20th Century
Humans
Nurse Clinicians
Nurse's Role - history
Qualitative Research
Abstract
Advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide. To understand the development and current status of advanced practice nursing within a Canadian context, it is important to explore its historical roots and influences. The purpose of this paper is to provide a historical overview of the major influences on the development of advanced practice nursing roles that exist in Canada today, those roles being the nurse practitioner and the clinical nurse specialist. Using a scoping review and qualitative interviews, data were summarized according to three distinct time periods related to the development of advanced practice nursing. They are the early beginnings; the first formal wave, between the mid 1960s and mid 1980s; and the second wave, beginning in the late 1980s and continuing to the present. This paper highlights how advanced practice nursing roles have evolved over the years to meet emerging needs within the Canadian healthcare system. A number of influential factors have both facilitated and hindered the development of the roles, despite strong evidence to support their effectiveness. Given the progress over the past few decades, the future of advanced practice nursing within the Canadian healthcare system is promising.
PubMed ID
21478686 View in PubMed
Less detail

The primary healthcare nurse practitioner role in Canada.

https://arctichealth.org/en/permalink/ahliterature135438
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:88-113
Publication Type
Article
Date
Dec-2010
Author
Faith Donald
Ruth Martin-Misener
Denise Bryant-Lukosius
Kelley Kilpatrick
Sharon Kaasalainen
Nancy Carter
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Affiliate Faculty, Daphne Cockwell School of Nursing, Ryerson University, CHSRF/CIHR Program in Advanced Practice Nursing, Toronto, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:88-113
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Canada
Clinical Competence
Educational Measurement
Educational Status
Focus Groups
Government Regulation
Health Care Surveys
Health Policy
Humans
Nurse Clinicians - legislation & jurisprudence - organization & administration
Nurse Practitioners - legislation & jurisprudence - organization & administration
Nurse's Role
Primary Health Care - legislation & jurisprudence - organization & administration
Abstract
Primary healthcare nurse practitioners (PHCNPs), also known as family or all-ages nurse practitioners, are the fastest growing advanced practice nursing role in Canada. All 10 provinces and three territories now have legislation that authorizes their role. Their introduction is linked to countrywide health reform efforts to improve the accessibility and quality of primary healthcare.
PubMed ID
21478689 View in PubMed
Less detail

The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada.

https://arctichealth.org/en/permalink/ahliterature135435
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:167-85
Publication Type
Article
Date
Dec-2010
Author
Nancy Carter
Ruth Martin-Misener
Kelley Kilpatrick
Sharon Kaasalainen
Faith Donald
Denise Bryant-Lukosius
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Junior Faculty, CHSRF/CIHR Program in Advanced Practice Nursing, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:167-85
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - organization & administration
Awareness
Canada
Delivery of Health Care - organization & administration
Focus Groups
Health Policy
Health Resources
Humans
Mentors
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Nurse's Role
Social Identification
Abstract
Supportive nursing leadership is important for the successful introduction and implementation of advanced practice nursing roles in Canadian healthcare settings. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe and explore organizational leadership in planning and implementing advanced practice nursing roles. Leadership strategies that optimize successful role integration include initiating systematic planning to develop the roles based on patient and community needs, engaging stakeholders, using established Canadian role implementation toolkits, ensuring utilization of all dimensions of the role, communicating clear messages to increase awareness about the roles in the organization, creating networks and facilitating mentorship for those in the role, and negotiating role expectations with physicians and other members of the healthcare team. Leaders face challenges in creating and securing sustainable funding for the roles and providing adequate infrastructure support.
Notes
Comment In: Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:186-821478693
PubMed ID
21478692 View in PubMed
Less detail

Utilization of nurse practitioners to increase patient access to primary healthcare in Canada--thinking outside the box.

https://arctichealth.org/en/permalink/ahliterature135432
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:239-59
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Ivy Bourgeault
Julia Abelson
Ruth Martin-Misener
Sharon Kaasalainen
Nancy Carter
Patricia Harbman
Faith Donald
Denise Bryant-Lukosius
Kelley Kilpatrick
Author Affiliation
CHSRF/CIHR in Advanced Practice Nursing, Director, Ontario Training Centre in Health Services & Policy Research, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:239-59
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Canada
Continuity of Patient Care
Decision Support Techniques
Delivery of Health Care - organization & administration
Focus Groups
Health Policy - trends
Health Services Accessibility - statistics & numerical data - trends
Health services needs and demand
Humans
Models, organizational
Nurse Practitioners - statistics & numerical data - utilization
Nurse's Role
Primary Health Care - organization & administration - statistics & numerical data - utilization
Qualitative Research
Abstract
In the past decade, all Canadian provinces and territories have launched various team-based primary healthcare initiatives designed to improve access and continuity of care. Nurse practitioners (NPs) are increasingly becoming integral members of primary healthcare teams across the country. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis about advanced practice nursing in Canada. We describe and analyze two novel approaches to NP integration designed to address the gap in patient access to primary healthcare: (1) the integration of NPs in traditional fee-for-service practices in British Columbia, and (2) the creation of NP-led clinics in Ontario. Although fee-for-service remuneration has been a barrier to collaborative practice, the integration of government-salaried NPs into fee-for-service practices in British Columbia has enabled the creation of inter-professional teams, and based on early evaluation findings, has increased patient access to care and patient and provider satisfaction. NP-led clinics are designed to provide inter-professional care in communities with high numbers of patients who do not have a regular primary healthcare provider. Given the shortage of physicians in communities where these clinics are being introduced, the ratio of physicians to NPs is lower than in other primary healthcare delivery models, and physicians function in more of a consulting role. Initial evaluation of the first of 26 NP-led clinics indicates increased access to care and high levels of patient and provider satisfaction. Implementing a creative mosaic of collaborative primary healthcare models that are responsive to patient needs challenges traditional assumptions about professional roles and responsibilities. To address this challenge, we endorse a recommendation that governments establish a mechanism to bring together both physician and non-physician primary healthcare providers to advise on primary healthcare policy development and implementation.
PubMed ID
21478696 View in PubMed
Less detail

8 records – page 1 of 1.