Nurse practitioner competency standards: Findings from collaborative Australian and New Zealand research
ABSTRACT The title, Nurse Practitioner, is protected in most jurisdictions in Australia and New Zealand and the number of nurse practitioners is increasing in health services in both countries. Despite this expansion of the role, there is scant national or international research to inform development of nurse practitioner competency standards.
The aim of this study was to research nurse practitioner practice to inform development of generic standards that could be applied for the education, authorisation and practice of nurse practitioners in both countries.
The research used a multi-methods approach to capture a range of data sources including research of policies and curricula, and interviews with clinicians. Data were collected from relevant sources in Australia and New Zealand.
The research was conducted in New Zealand and the five states and territories in Australia where, at the time of the research, the title of nurse practitioner was legally protected.
The research was conducted with a purposeful sample of nurse practitioners from diverse clinical settings in both countries. Interviews and material data were collected from a range of sources and data were analysed within and across these data modalities.
Findings included identification of three generic standards for nurse practitioner practice: namely, Dynamic Practice, Professional Efficacy and Clinical Leadership. Each of these standards has a number of practice competencies, each of these competencies with its own performance indicators.
Generic standards for nurse practitioner practice will support a standardised approach and mutual recognition of nurse practitioner authorisation across the two countries. Additionally, these research outcomes can more generally inform education providers, authorising bodies and clinicians on the standards of practice for the nurse practitioner whilst also contributing to the current international debate on nurse practitioner standards and scope of practice.
Full-textDOI: · Available from: Jenny Carryer, Aug 28, 2015
- SourceAvailable from: Christine Duffield
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- "In 2004, the (then) Australian Nursing Council and the Nursing Council of New Zealand collaborated to fund research to describe the core role and develop standards for recognition, education, and practice of nurse practitioners in Australia and New Zealand (Australian Nursing & Midwifery Council 2006). The outcomes of this research were as follows: description of the core role, generic competency standards, education standards, and standards for authorization of nurse practitioners in the two countries (Gardner et al. 2006a,b, Carryer et al. 2007). In 2006, the Australian Nursing and Midwifery Council adopted these standards nationally. "
ABSTRACT: AIMS: To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles. BACKGROUND: There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles. DESIGN: A statewide survey. METHODS: Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains. RESULTS: There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall. CONCLUSION: Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service.Journal of Advanced Nursing 11/2012; 69(9). DOI:10.1111/jan.12054 · 1.69 Impact Factor
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- "This has been driven by the rapid increase in the number of new advanced practice roles introduced (Bryant-Lukosius & DiCenso 2004, Bryant-Lukosius et al. 2004, Ruel & Motyka 2009), as well as research findings from countries such as the UK, USA, Canada and Australia demonstrating that advanced practice roles enhance service delivery and improve patient outcomes (Heaney & Paxton 1997, Sakr et al. 1999, 2003, Hutchinson 2000, Szafran & Bell 2000, Salisbury et al. 2002, Salisbury & Munro 2003, Snooks & Nicholl 2007). There is a general agreement that APN practice entails use of specialised knowledge and expert skills to undertake autonomous patient-focused practice (Hanson & Hamric 2003, Bryant-Lukosius et al. 2004, Gardner et al. 2006, Currie et al. 2007, Pulcini & Raisa 2010). However, considerable confusion exists within the international nursing profession about the terminology used to describe advanced practice nursing roles and their scope of practice (Bryant-Lukosius et al. 2004, Gardner et al. 2007, Duffield et al. 2009, Chang et al. 2010). "
ABSTRACT: Aims and objectives. To develop a tool for defining and measuring the role characteristics and responsibilities of an advanced practice nursing role in Australia. Background. Internationally, there is considerable confusion about the precise role responsibilities of advanced practice nursing positions. In Australia, the clinical nurse consultant is an advanced practice role with five nominated domains of practice. However, there are no tools for measuring the performance of clinical nurse consultants against the listed domains. Design and methods. Participants were 56 clinical nurse consultants at a tertiary public hospital. The existing literature, an online survey, and position descriptions were used to generate the a priori themes for the initial template. Semi-structured interviews were conducted (in 2010) to test the template characteristics. The template underwent multiple iterations in its development. Results. A 50-item tool was devised, which consisted of five domains with a ten-point hierarchical scale within each domain. In preliminary testing, the revised template was found to provide greater clarity regarding roles and grades than the original position descriptions. Conclusions. Further testing and refinement of the modified rating scale is needed, but it offers the possibility of a new tool that can be used by health service managers to determine the grade of a clinical nurse consultant position and for evaluating role performance. Relevance to clinical practice. This preliminary study suggests that the tool provides a useful means of measuring advanced nursing practice and responsibilities across different domains and levels of appointment. The tool may be able to be adapted for use with other advanced practice nursing roles both within Australia and internationally.Journal of Clinical Nursing 09/2012; 22(11-12). DOI:10.1111/j.1365-2702.2012.04264.x · 1.26 Impact Factor
- "There is now increasing interest in health service research in investigating the workforce and work activity of nurse practitioners, and there is an emerging body of work reporting these studies (Rosenfeld et al. 2003, Hurlock- Chorostecki et al. 2008, van Soeren et al. 2009, Wallerstedt et al. 2009). This may well be related to the move in several countries towards standardization and regulation of the nurse practitioner role (Furlong & Smith 2005, Gardner et al. 2006, van Soeren et al. 2009, Stanley 2009). Furlong and Smith (2005), for example, caution that a policy framework and standards for education are necessary to fully realize the potential of the nurse practitioner role for improving healthcare delivery. "
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ABSTRACT: This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks. A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.0% and service-related activities made up 31.9%. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.Journal of Advanced Nursing 07/2010; 66(10):2160-9. DOI:10.1111/j.1365-2648.2010.05379.x · 1.69 Impact Factor