Health Transition Fund Final Report - Projects Listed By Subject Area

collected from nursing associations and ministries of health was subjected to an in-depth analysis to identify
commonalities and differences.
The persons contacted at the provincial/territorial ministries of health and nursing associations were
also asked to identify primary health care settings where registered nurses perform primary care functions,
work under similar and different practice models, and have variant education preparation requirements.
Interviews were subsequently completed with representatives from 44 provincial/ territorial sites. The
findings suggested that there were significant differences among the approaches used to deliver
extended/expanded nursing services. Although there were a number of possible explanations for these
disparate conditions, one significant factor influencing the enactment of nursing roles in each jurisdiction was
the environmental context (i.e., legislative, regulatory, employing organization, nurse/physician relationships,
etc.). Thus, the decision was made to select sites from two provinces with legislation and regulations, and
one with medical directives and/or protocol agreements in place. The final selection of sites was made
following consultation with representatives on the Advisory Committee on Health Human Resources
Working Group on Nursing and Unregulated Workers.
Data collection at the sites selected for participation in this study was initiated following approval
of the Research Protocol by relevant site personnel (see SD2). Data collection consisted of interviews with
registered nurses working in extended/expanded roles and physicians working with these nurses, surveys
of patients/clients accessing the resources at the centre/clinic, and participant observation sessions with the
registered nurses during patient/client appointments. The nurses and physicians were identified through
consultation with management personnel at each site. The contact person(s) approached nurses and
physicians to briefly explain the study and provide them with a summary sheet of the project (see SD2,
Appendix A), and ascertain their willingness to be contacted by a member of the research team. Those
who indicated an initial willingness to participate were subsequently contacted, the study explained more
fully and any questions/concerns addressed at this time.
Data collection at the sites occurred over a four-week period. In Ontario and Saskatchewan, the
data were collected by two Masters prepared faculty teaching in the Primary Health Care Nurse
Practitioner Program at the Centre for Nursing Studies, the Health Care Corporation of St. John’s. In
The Centre for Nursing Studies in collaboration with
The Institute for the Advancement of Public Policy, Inc. 11