期刊论文详细信息
BMC Nursing
Recognising the differences in the nurse consultant role across context: a study protocol
Rebecca Mitchell3  Vicki Parker1  Michelle Giles2 
[1] School of Health, University of New England, Armidale, NSW, Australia;Hunter New England Local Health District, James Fletcher Campus, 72 Watt Street Newcastle, Newcastle, NSW 2300, Australia;School of Business and Law, University of Newcastle, Callaghan, NSW 2308, Australia
关键词: Advanced practice nurse;    Role clarity;    Workforce;    Nursing;    Nurse consultant;   
Others  :  1090814
DOI  :  10.1186/1472-6955-13-30
 received in 2014-05-15, accepted in 2014-09-08,  发布年份 2014
PDF
【 摘 要 】

Background

The advanced practice role of the Nurse Consultant is unique in its capacity to provide clinical leadership across a range of contexts. However, the Nurse Consultant role has been plagued with confusion due to lack of clarity over function and appropriateness for purpose within health organisations across contexts. Changing health service delivery models are driving the emergence of new nursing roles, further clouding the waters related to role positioning and purpose. There is an urgent need for evidence of impact and demonstration of how Nurse Consultants contribute to health care outcomes. This study aims to gain a clearer understanding of the Nurse Consultant role and its impact in metropolitan and rural New South Wales (NSW) Australia.

Design

The proposed study employs a sequential mixed method design, underpinned by Realistic Evaluation, to explore how Nurse Consultants contribute to organisational outcomes. The ‘context – mechanism – outcome’ approach of realistic evaluation provides a sound framework to examine the complex, diverse and multifaceted nature of the Nurse Consultant’s role.

Method

Participants will be stakeholders, recruited across a large Local Health District in NSW, comprising rural and metropolitan services. A modified and previously validated survey will be used providing information related to role characteristics, patterns and differences across health context. Focus groups with Nurse Consultant’s explore issues highlighted in the survey data. Focus groups with other clinicians, policy makers and managers will help to achieve understanding of how the role is viewed and enacted across a range of groups and contexts.

Discussion

Lack of role clarity is highlighted extensively in international and Australian studies examining the role of the Nurse Consultant. Previous studies failed to adequately examine the role in the context of integrated and complex health services or to examine the role in detail. Such examination is critical in order to understand the significance of the role and to ascertain how Nurse Consultants can be most effective as members of the health care team. This is the first Australian study to include extensive stakeholder perspectives in order to understand the relational and integrated nature and impact of the role across metropolitan and rural context.

【 授权许可】

   
2014 Giles et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]AIHW (Australian Institute of Health and Welfare): Australia’s Health 2012. Canberra: AIHW; 2012. [Australia’s Health series no 13. Cat. no. Aus 156]
  • [2]HWA (Health Workforce Australia): Health Workforce Australia Annual Report 2012-13. Adelaide: Health Workforce Australia; 2013.
  • [3]IMF: The challenges of health care reforn in advanced and emerging economies. In The economics of public health care reform in advanced and emerging economies. Edited by Gupta S, Clements B, Coady D. Washington, D.C; 2012.
  • [4]Lowe G, Plummer V, O’Brien AP, Boyd L: Time to clarify the value of advanced practice nursing roles in health care. J Adv Nurs 2012, 68(3):677-685.
  • [5]Duffield C, Gardner G, Chang AM, Catling-Paull C: Advanced nursing practice: a global perspective. Collegian 2009, 16(2):55-62.
  • [6]Pulcini J, Jelic M, Gul R, Loke A: An international survey on advanced practice nursing education. Pract Regulat J Nurs Scholar 2010, 42(1):31-39.
  • [7]Lloyd Jones M: Role development and effective practice in specialist and advanced practice roles in acute hospital settings: systematic review and meta-synthesis. J Adv Nurs 2005, 49(2):191-209.
  • [8]Gardner G, Chang A, Duffield C: Making nursing work: breaking through the role confusion of advanced practice nursing. J Adv Nurs 2007, 57(4):382-391.
  • [9]Chang A, Gardner G, Duffield C, Ramus M: A Delphi study to validate an advanced practice nursing tool. J Adv Nurs 2010, 66(10):2320-2330.
  • [10]Hutchinson M, East L, Stasa HDJ: Deriving COnsensus on the characteristics of advanced practice nursing: meta-summary of more than 2 decades of research. Nurs Res 2014, 62(3):116-128.
  • [11]Jokiniemi K, Pietila A, Kylma J, Haatainen K: Advanced nursing roles: a systematic review. Nurs Health Sci 2012, 14:421-431.
  • [12]Dowling M, Beauchesne M, Farrelly F, Murphy K: Advanced practice nursing: a concept analysis. Int J Nurs Pract 2013, 19:131-140.
  • [13]Por J: A critical engagement with the concept of advancing nursing practice. J Nurs Manag 2008, 16:84-90.
  • [14]Manley K: A conceptual framework for advanced practice: an action research project operationalizing an advanced practitioner/consultant nurse role. J Clin Nurs 1997, 6(3):179-190.
  • [15]Higgins A: The developing role of the consultant nurse. Nurs Manag 2003, 10(1):22-28.
  • [16]Duffield C, Diers D, O’Brien-Pallas L, Aisbett C, Roche M, King M, Aisbett K: Nursing staff, nursing workload, the work environment and patient outcomes. Appl Nurs Res 2011, 24:244-255.
  • [17]NSW Department of Health: Clinical Nurse Consultant - Higher Grades - Public Hospital Nurses' (State) Award. In Policy Directive. Sydney: NSW Government; 2005.
  • [18]Guest D, Redfern S, Wilson-Barnett J, Dewe P, Peccei R, Rosenthal P, Evans A, Young C, Montgomery J, Oakley P: A Preliminary Evaluation of the Establishment of Nurse, Midwife and Health Visitor Consultants: A Report to the Department of Health. London: Kings College London; 2001.
  • [19]Guest DE, Peccei R, Rosenthal CJ, Redfern S, Wilson-Barnett J, Dewe P, Coster S, Evans A, Sudbury A: An Evaluation of the Impact of Nurse, Midwife and Health Visitor Consultants. London: King’s College; 2004.
  • [20]DoH UK: Making a Difference. Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care. London: The Stationary Office; 1999.
  • [21]Baldwin R, Duffield C, Fry M, Roche M, Stasa H, Solman A: The role and function of clinical nurse consultants, an Australian advanced practice role: a descriptive exploratory cohort study. Int J Nurs Stud 2013, 50(3):326-334.
  • [22]Karnick P: Clarifying advanced practice nursing. Nurs Sci Q 2011, 24(3):215.
  • [23]Thoun DS: Specialty and advanced practice nursing: discerning the differences. Nurs Sci Q 2011, 24(3):216-222.
  • [24]Chiarella M, Harford E, Lau C: Report on the evaluation of Nurse/Midwife Practitioner and Clinical Nurse/Midwife Consultant Roles. In Volume November. Edited by Health N. North Ryde: Better Health Centre Publications Warehouse; 2007.
  • [25]Drennan V, Goodman C: Sustaining innovation in the health care workforce: a case study of community nurse consultant posts in England. BMC Health Serv Res 2011, 11:200. BioMed Central Full Text
  • [26]DiCenso A, Bryant-Lukosius D: Clinical Nurse Specialists and Nurse Practitioners in Canada:A Decision Support Synthesis. Ontario: Canadian Health Services Research Foundation (CHSRF); 2010.
  • [27]Fry M, Duffield C, Baldwin R, Roche M, Stasa H, Solman A: Development of a tool to describe the role of the clinical nurse consultant in Australia. J Clin Nurs 2013, 22(11–12):1531-1538.
  • [28]Fairley D, Closs S: Evaluation of a nurse consultant’s clinical activities and the search for patient outcomes in critical care. J Clin Nurs 2006, 15:1106-1114.
  • [29]Gerrish K, Nolan M, Kirshbaum M, McDonnell A, Tod A, Guillaume L: The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses. J Adv Nurs 2011, 67(9):2004-2014.
  • [30]Gerrish K, McDonnell A, Kennedy F: The development of a framework for evaluating the impact of nurse consultant roles in the UK. J Adv Nurs 2013, 69(10):2295-2308.
  • [31]Franks H, Howarth M: Being an effective nurse consultant in the english national health service: what does it take? A study of consultants specializing in safeguarding. J Nurs Manag 2012, 20:847-857.
  • [32]Dean E: Indistinct nurse consultant role is disappearing from view. Nurs Stand 2011, 25(38):1.
  • [33]McSherry R, Mudd D, Campbell S: Evaluating the percieved role of the nurse consultant through the lived experience of healthcare professionals. J Clin Nurs 2007, 16:2066-2080.
  • [34]Woodward V, Webb C, Prowse M: Nurse consultants: Their characteristics and achievements. J Clin Nurs 2005, 14:845-854.
  • [35]Kennedy F, McDonnell A, Gerrish K, Howarth A, Pollard C, Redman J: Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review. J Adv Nurs 2012, 68(4):721-742.
  • [36]Coster S, Redfern S, Wilson-Barnett J, Evans A, Peccei R, Guest D: Impact of the role of nurse, midwife and health visitor consultant. J Adv Nurs 2006, 55:352-363.
  • [37]Begley C, Murphy K, Higgins A, Elliott N, Lalor J, Sheerin F, Coyne I, Comiskey C, Normand C, Casey C, Dowling M, Devane D, Cooney A, Farrelly F, Brennan M, Meskell P, MacNeela P: Evaluation of Clinical Nurse and Midwife Specialist and Advanced Nurse and Midwife Practitioner Roles in Ireland (SCAPE) Final Report. Dublin: National Council for the Professional Development of Nursing and Midwifery in Ireland; 2010.
  • [38]Newhouse R, Stanik-Hutt J, White K, Johantgen M, Bass E, Zangaro G, Wilson R, Fountain L, Steinwachs D, Heindel L, Weiner JP: Advanced practice nurse outcomes 1990–2008: a systematic review. Nurs Econ 2011, 29(5):230-250.
  • [39]Bloomer MJ, Cross WM: An exploration of the role and scope of the clinical nurse consultant (CNC) in a metropolitan health service. Collegian 2010, 18(2):61-69.
  • [40]O’Baugh J, Wilkes L, Vaughan K, O’Donohue R: The role and scope of the clinical nurse consultant in Wentworth area health service, New South Wales, Australia. J Nurs Manag 2007, 15:12-21.
  • [41]AIHW (Australian Institute of Health and Welfare): Health in Rural and Remote Australia. Canberra: Australian Government; 2004.
  • [42]Wakerman J: Rural and remote public health in Australia: building on our strengths. Aust J Rural Health 2008, 16:52-55.
  • [43]Paliadelis P, Parmenter G, Parker V, Giles M, Higgins I: The challenges confronting clinicians in rural acute care settings: a participatory research project. Rural Remote Health 2012, 12(2):1-12.
  • [44]Lea J, Paliadelis P, Sanderson HPT: The lure of the bush: do rural placements influence student nurses to seek employment in rural settings? Collegian 2008, 15:77-82.
  • [45]Cao Q, Maruping L, Takeuchi R: Disentangling the effects of CEO turnover and succession on organizational capabilities: a social network perspective. Org Sci 2006, 17(5):563-567.
  • [46]Ventatesh V, Brown S, Bala H: Bridging the qualitative – quantitative divide: guidelines for conducting mixed method research in information systems. MIS Quarterly 2012, 37(1):21-54.
  • [47]Tashakkori A, Teddlie C: Handbook of Mixed Methods in Social and Behavioural Research. Thousand Oaks: Sage; 2003.
  • [48]Morse J, Niehaus L: Mixed method Design: Principles and Procedures. California: Left Coast Press; 2009.
  • [49]Foss C, Ellenfsen B: The value of combining qualitative and quantitative approaches in nursing research by means of method triangulation. J Adv Nurs 2002, 40(2):242-248.
  • [50]Pawson R, Tilley N: Realistic Evaluation. London: London Sage Publications; 1997.
  • [51]Berwick DM: The science of improvement. JAMA: J Am Med Assoc 2008, 299(10):1182-1184.
  • [52]Rycroft-Malone J, Fontenla M, Bick D, Seers K: A realistic evaluation: the case of protocol-based care. Implement Sci 2010, 38(5):1-14.
  • [53]Pawson R, Greenhalgh T, Harvey G, Walshe K: Realist Synthesis: An introduction. Manchester: ESRC Research Methods Programme; 2004.
  • [54]Bryant-Lukosius D, DiCenso A, Browne G, Pinelli J: Advanced practice nursing roles: development, implementation and evaluation. J Adv Nurs 2004, 48(5):519-529.
  • [55]Bryant-Lukosius D, DiCenso A: A framework for the introduction and evaluation of advanced practice nursing roles. J Adv Nurs 2004, 48(5):530-540.
  • [56]Woodward VA, Webb C, Prowse M: Nurse consultants: organizational influences on role achievement. J Clin Nurs 2006, 15:272-280.
  • [57]Fuller J, Edwards J, Martinez L, Edwards B, Reid K: Collaboration and local networks for rural and remote primary mental healthcare in South Australia. Health Social Care Community 2004, 12(1):75-84.
  • [58]Hair J, Sarstedt M, Pieper T, Ringle C: The Use of partial least squares structural equation modeling in strategic management research: a review of past practices and recommendations for future applications. Long Range Plan 2012, 45(5–6):320-340.
  • [59]Mays N, Pope C: Rigour and qualitative research. BMJ 1995, 311:109-112.
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