Health Transition Fund Final Report - Projects Listed By Subject Area

performance standards. The sites most likely to be actively engaged in formalizing evaluation/monitoring
procedures were either preparing for accreditation or were required to do so by the funding or regulatory
body.
Organizational/Client Outcomes
The majority of the sites surveyed had not participated in a formal evaluation process either in-house
or by external consultants since employing a registered nurse with extended/expanded role capabilities. Only
three respondents reported that an independent evaluation had been conducted to evaluate the impact of
this type of nursing practice on organizational or client outcomes. In most instances, this was a requirement
imposed by the funding body. Respondents from seven other sites reported that an independent evaluation
was in-progress or about to commence in the near future. As well, there were a number of other sites that
had either completed patient satisfaction surveys or taken steps to do so within the year.
3.2.4 Summary
In summary, registered nurses working in extended/expanded roles are providing a full-range of
primary care services in accordance with relevant authorities in the region and/or province. The geography
of the region was identified as a key factor influencing not only the availability of provider resources but also
the nature of collaborative relations between registered nurses and other providers, the level of preparation
for and competency in performing extended/expanded role functions, and on-site evaluation procedures for
ensuring quality of care and positive organizational/client outcomes. A few of the key issues affecting
effective utilization of registered nurses in extended/expanded roles emerging from the administrative data
include:
< Greater restrictions are placed on nurses’ autonomous performance of primary care
functions when there is a greater concentration of physicians.
< Limited availability of nurses with appropriate extended/expanded role preparation in
remote regions of the country necessitated lowering expectations re education standards
and experiential base.
< Wide-variations existed in requirements for maintaining competency in extended/expanded
role functions.
The Centre for Nursing Studies in collaboration with
The Institute for the Advancement of Public Policy, Inc. 33