Health Transition Fund Final Report - Projects Listed By Subject Area

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Figure 1 - Project Logic Model Components Policy Framework Legislation/ Regulation Organizational Structure Activities Survey Nursing Association Survey Health Ministries Survey Administrators Interview Nurses, Physicians & Clients Observe Nurses in Practice Target Groups ACHHR HTF F/P/T Governments Nursing Regulatory Bodies Health Boards/ Authorities Short Term Outcomes Long Term Outcomes Enhance understanding of facilitators and barriers to effective nursing practice in primary health care settings. Raise awareness of facilitators and barriers to effective nursing practice in primary health care settings. Increase access to effective nursing practice in primary health care settings. The Centre for Nursing Studies in collaboration with The Institute for the Advancement of Public Policy, Inc. 9
2.3 Population and Sample (see SD1 – Profile of Extended/Expanded Nursing Roles in Primary Health Care Settings) During the initial stages of the current project, all relevant provincial/territorial legislation and regulations were reviewed and a cross-country survey of key informants undertaken to document existing information on nursing practice models. Data were gathered from consultants employed by the nursing associations concerning the regulation of, as well as the policy and standards for, extended/expanded nursing practice in their respective jurisdictions. Representatives of provincial/territorial ministries of health were also contacted to augment and/or clarify information received from the nursing associations. Summaries of the information compiled for each jurisdiction were subsequently forwarded to the relevant ministries of health and provincial/territorial nursing associations for review and confirmation. All summaries were confirmed and/or updated in July and August 2000. The final component of this phase of data collection involved a survey of administrative personnel in different provincial agencies/organizations that employ registered nurses to work in extended/expanded practice roles. During the second phase of data collection, an in-depth study was conducted at select sites in primary health care settings in the provinces of Newfoundland, Ontario and Saskatchewan. The population of interest consisted of physicians working in primary care settings, and registered nurses working in extended/expanded roles with physicians in these settings. A third target population was patients/clients receiving care from registered nurses performing these roles at the study sites. 2.4 Procedure The consulting team collected background information to describe the context for extended/expanded nursing practice. The first step in this process involved a review of relevant legislation across Canada, and initiating contact with Legislative Counsel offices or solicitors on staff with ministries of health. Nursing regulatory bodies within each jurisdiction were also contacted to obtain information on the interpretation and application of provisions relevant for extended/expanded nursing practice in primary care settings. The information on policy directions and planning for extended/expanded nursing practice The Centre for Nursing Studies in collaboration with The Institute for the Advancement of Public Policy, Inc. 10
Page 1 and 2: Le texte suivant provient d’un or
Page 3 and 4: Executive Summary Table of Contents
Page 5 and 6: Executive Summary In March, 1999 th
Page 7 and 8: nursing role varies within and acro
Page 9 and 10: There were commonalities and differ
Page 11 and 12: Recommendation 2 It is recommended
Page 13 and 14: Project Team This research project
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Page 17 and 18: skill transfer, etc.) have been sat
Page 19 and 20: SD4 Dissemination plan. 1.2 Rationa
Page 21 and 22: influence role performance and job
Page 23 and 24: to balance institutional care with
Page 25: 2.2 Determination of Terms and Defi
Page 29 and 30: Newfoundland, data collection was c
Page 31 and 32: 2.7 Overview of Restrictions and Li
Page 33 and 34: Manitoba has enacted similar legisl
Page 35 and 36: Table 1 - Titles for Registered Nur
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Page 39 and 40: One significant concern raised in t
Page 41 and 42: 3.1.4 Summary The extension of auth
Page 43 and 44: autonomous nature of extended/expan
Page 45 and 46: managed, nurses were expected to wo
Page 47 and 48: Expected core competencies for regi
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Page 51 and 52: Limited support mechanisms in place
Page 53 and 54: Development of an Experiential Base
Page 55 and 56: working in urban areas. Regardless
Page 57 and 58: The fact that patients continued to
Page 59 and 60: oles was reflected in increased uti
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Page 63 and 64: 84% of patient visits lasted less t
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Page 67 and 68: minimum standards for entry into th
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Page 73 and 74: Appendix A - Sources Regulatory Con
Page 75 and 76: Hicks, C. & Hennessy, D. (1998). A
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Beddome, G., Clarke, H. F., and Why
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generalist. Educational Innovations
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Stanhope, M. K. (1995). Primary hea
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Scotia. (1997). Guidelines for regi
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Pitblado, J. R. & Pong, R. W. (1999
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Supporting Document 1 (SD1) Profile
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Profile of the Extended/Expanded Nu
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Supporting Document 2 Evaluation of
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There is an increasing trend in the
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and in some cases superior to, trad
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5 The current study will address th
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7 Instruments The interviews/observ
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9 Ethical Considerations Participan
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11 increase NP status and value. Th
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13 Brief Overview of Research Study
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15 INSTITUTE FOR THE ADVANCEMENT OF
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17 Signature Page Title of Project:
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Duration of participant’s involve
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Appendix C: Interview Schedules 21
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23 8. How has this role changed the
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25 8. How has this role changed the
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27 Patient/Client Survey Part I: Ce
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29 Part II: Satisfaction We are int
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31 CODE #_______ OBSERVATION TIME__
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33 CODE #_______ OBSERVATION TIME__
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Appendix F: Letter of Support 35
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Table of Contents 1. Physicians’
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Physicians’ Perceptions of Extend
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attributed to either inadequacies o
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Many of the physician participants
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Illustrative Quotes 1. “I definit
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area of concern voiced by physician
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1.2.1.2 Implications for physicians
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14. In the outpost community the nu
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2. “In many cases, it’s the oth
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3. “People are just happy to have
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4. “There was a great need to hav
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findings are summarized according t
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3. “It is just one of the things
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Nurses’ Perceptions of Extended/E
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2.1 Practical Knowing Self-confiden
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Illustrative Quotes 1. “As time g
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participants felt that additional k
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practice, balancing collaborative a
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16. “The people that are working
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nearby. . . . I like being able to
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9. “I certainly don’t want to g
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8. “I think that the people reali
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2.4 Barriers to and Facilitators of
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8. “The physicians have been very
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nursing role was strongly influence
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2.4.2.2 Policy Implications Partici
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14. “There is definitely a space
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54 II. Patients’ Perceptions of N
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56 there are other possible factors
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eing completed in less than 15 minu
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60 for relevant history, diagnostic
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62 The NP ordered relevant diagnost
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64 The third case captures how the
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Appendix G - 1: Patient Survey Inst
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Use the following scale to rate the
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Thank you for taking the time to fi
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73 CODE #_______OBSERVATION TIME___
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75 CODE #_______OBSERVATION TIME___
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Dissemination Final Report The Natu
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Conferences < Ontario Association o
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