Browsing by Author "Adams S"

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    Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers
    (CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2021-09) Mustafa M; Adams S; Bareham C; Carryer J
    INTRODUCTION: Establishing the nurse practitioner (NP) workforce in New Zealand is a viable solution to health and workforce challenges in primary health care. General practices have been slow to implement NP services. Managers of general practices are central to the employment and development of NP roles. AIM: To explore the perspectives of managers on employing NPs in general practice. METHODS: An electronic survey was used to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively. RESULTS: In total, 143 managers participated in the survey (response rate 39.7%); 54 (37.8%) worked in practices employing at least one NP. Of respondents, 88.9% (nā€‰=ā€‰127) agreed or strongly agreed that NPs could enhance continuity of care (89/143, 62.2%), improved access to services and medications (89/143, 62.2%) and filled a gap that added value to health care (97/143, 67.8%). Practices employing NPs had statistically significant higher levels of agreement about the advantages of NPs than practices not employing NPs. Challenges and enablers to employing NPs were themed under organisational environment, NP scope of practice and role, and NP workforce development. DISCUSSION: This exploratory study revealed that there is little knowledge about the NP workforce in surveyed general practices. Ongoing work is required to improve knowledge for employing general practices, including dissemination of information about NP education and training, scope and models of care, and ability to generate business income.
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    Integrating nurse practitioners into primary healthcare to advance health equity through a social justice lens: An integrative review
    (John Wiley and Sons Ltd, 2024-02-06) Adams S; Komene E; Wensley C; Davis J; Carryer J
    AIM: To develop a framework to guide the successful integration of nurse practitioners (NPs) into practice settings and, working from a social justice lens, deliver comprehensive primary healthcare which advances health equity. DESIGN: Integrative review. METHODS: The integrative review was informed by the Whittemore and Knafl's framework and followed the Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. Quality was assessed using the Johns Hopkins Research Evidence Appraisal Tool. Findings were extracted and thematically analysed using NVivo. A social justice lens informed all phases. DATA SOURCES: Databases, including CINAHL, PubMed, Scopus and Web of Science, were searched for peer-reviewed literature published in English between 2005 and April 2022. RESULTS: Twenty-eight articles were included. Six themes were identified at the individual (micro), local health provider (meso), and national systems and structures (macro) levels of the health sector: (1) autonomy and agency; (2) awareness and visibility; (3) shared vision; (4) leadership; (5) funding and infrastructure; and (6) intentional support and self-care. The evidence-based framework is explicitly focused on the components required to successfully integrate NPs into primary healthcare to advance health equity. CONCLUSION: Integrating NPs into primary healthcare is complex and requires a multilevel approach at macro, meso and micro levels. NPs offer the potential to transform primary healthcare delivery to meet the health needs of local communities. Health workforce and integration policies and strategies are essential if the contribution of NPs is to be realized. The proposed framework offers an opportunity for further research to inform NP integration. IMPACT STATEMENT: \ - Nurse practitioners (NPs) offer the potential to transform primary healthcare services to meet local community health needs and advance health equity. - Globally, there is a lack of guidance and health policy to support the integration of the NP workforce. - The developed framework provides guidance to successfully integrate NPs to deliver comprehensive primary healthcare grounded in social justice. - Integrating NPs into PHC is complex and requires a multilevel approach at macro, meso and micro levels. - The framework offers an opportunity for further research to inform NP integration, education and policy. SUMMARY STATEMENT: - What problem did the study address: The challenges of integrating nurse practitioners (NPs) into primary healthcare (PHC) are internationally recognized. Attempts to establish NP roles in New Zealand have been ad hoc with limited research, evidence-informed frameworks or policy to guide integration initiatives. Our review builds on existing international literature to understand how NPs are successfully integrated into PHC to advance health equity and provide a guiding framework. - What were the main findings: Six themes were identified across individual (micro), local health provider (meso) and national systems and structures (macro) levels as fundamental to NP integration: autonomy and agency; awareness and visibility of the NP and their role; a shared vision for the direction of primary healthcare utilizing NP scope of practice; leadership in all spaces; necessary funding and infrastructure; and intentional support and self-care. - Where and on whom will the research have an impact: Given extant health workforce challenges together with persisting health inequities, NPs provide a solution to delivering comprehensive primary healthcare from a social justice lens to promote healthcare access and health equity. The proposed evidence-informed framework provides guidance for successful integration across the health sector, training providers, as well as the NP profession, and is a platform for future research. REPORTING METHOD: This integrative review adhered to the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.