Elsevier

International Journal of Nursing Studies

Barriers and facilitators to the implementation of the avant-garde nurse practitioner role in primary intendance settings: A scoping review

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Open access

Abstract

Groundwork

Workload and workforce issues in principal care are key drivers for the growing international trend to expand nursing roles. Advanced nurse practitioners are increasingly existence appointed to take on activities and roles traditionally carried out by doctors. Successful implementation of any new function within multidisciplinary teams is complex and fourth dimension-consuming, therefore it is important to sympathise the factors that may hinder or support implementation of the advanced nurse practitioner role in principal intendance settings.

Objectives

To identify, assess and synthesise the barriers and facilitators that bear on implementation of advanced practitioner roles in main care settings.

Methods

A scoping review conducted using the Arksey and O'Malley (2005) framework and reported in accord with PRISMA-ScR. Eight databases (Cochrane Library, Health Business Elite, Kings Fund Library, HMIC, Medline, CINAHL, SCOPUS and Web of Science) were searched to identify studies published in English between 2002 and 2017. Report selection and methodological cess were conducted past ii contained reviewers. A pre-piloted extraction class was used to excerpt the post-obit data: study characteristics, context, participants and information describing the advanced nurse practitioner part. Deductive coding for barriers and facilitators was undertaken using a modified Yorkshire Contributory Framework. We used anterior coding for barriers or facilitators that could non be classified using pre-defined codes. Disagreements were addressed through word. Descriptive data was tabulated within evidence tables, and fundamental findings for barriers and facilitators were brought together within a narrative synthesis based on the volume of bear witness.

Findings

Systematic searching identified 5976 potential records, 2852 abstracts were screened, and 122 full texts were retrieved. L-iv studies (reported across 76 publications) met the selection criteria. Half of the studies (n = 27) were conducted in North America (n = 27), and 25/54 employed a qualitative blueprint. The advanced nurse practitioner role was diverse, working across the lifespan and with different patient groups. However, there was lilliputian agreement about the level of autonomy, or what constituted everyday activities. Squad factors were the well-nigh frequently reported barrier and facilitator. Individual factors, lines of responsibility and 'other' factors (i.e., funding), were also oftentimes reported barriers. Facilitators included individual factors, supervision and leadership and 'other' factors (i.e., funding, planning for role integration).

Conclusion

Building collaborative relationships with other healthcare professionals and negotiating the function are critical to the success of the implementation of the avant-garde nurse practitioner role. Team consensus about the role and how it integrates into the wider squad is too essential.

Keywords

Avant-garde Practice Nursing

Barriers

Facilitators

Implementation

Primary care

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