Optimizing Nursing Roles in Primary Care Settings 1 2 Nelly D. Oelke, PhD, MN, RN, Amanda Wilhelm, MA, 2 2 Karen Jackson, MEd, RN, & Esther Suter, PhD, MSW Background
Aim/Methods
Previous research (Besner, Drummond, Oelke, McKim, & Carter, 2010) identified the following challenges with nurses in primary care settings working to the full extent of their knowledge and skills. • Nursing role had evolved over time • Primary focus was chronic disease management • Psycho-social assessment, education, support, and linkage with other providers were evident at the individual patient level • Lack of a population needs-based approach • Lack of focus on health promotion • Confusion and lack of role clarity between RN and LPN roles • Working to full scope of practice was dependent on relationship (e.g., trust) with other providers • Nursing education did not prepare them to work in the primary care setting
Aim: To facilitate nurses’ capacity to practice to the full extent of their knowledge and skills, including population health and health promotion, in a primary care setting Methods: • An environmental scan of nursing service delivery models in primary care settings across Canada • Interviews with nurses (NPs, RNs, RPNs, LPNs), managers, educators, and regulatory bodies in Alberta to better understand the continuing education needs of nurses in a primary care • A summit with Alberta stakeholders to discuss nursing role optimization in primary care and develop recommendations • Actionable recommendations to optimize nursing roles in primary care settings
Results/Recommendations
1. Increase patient/community engagement in primary care service delivery
6. Implement interprofessional collaborative practice
2. Develop a governance model to support nursing roles and interprofessional shared decision-making at all levels in primary care settings
3. Establish a funding model centred on patient needs, access to care, and support for nursing roles and interprofessional collaborative practice
7. Embed primary care philosophy in all nursing curriculum for entry-topractice and continuing education
8. Establish a standardized education program for nurses working in primary care settings including orientation and mentorship
4. Develop a framework for evaluation and promote ongoing performance measurement for nursing role optimization specifically and primary care service delivery more broadly
5. Define primary care nursing roles, responsibilities, and core competencies within the context of the interprofessional team
9. Enhance opportunities for interprofessional education in entry-topractice nursing programs
10. Facilitate clinical placements in primary care settings
Conclusions These recommendations will support nurses’ ability to practice to the full extent of their knowledge and skills in a primary care setting. Implementing these recommendations can contribute to positive outcomes at the patient, provider, and system levels. 1. 2.
School of Nursing, University of British Columbia, Okanagan Workforce Research and Evaluation, Alberta Health Services
Funding for this project was provided by Alberta Health
For more information, please contact Nelly D. Oelke at nelly.oelke@ubc.ca