Nurse Practitioner Integration: Insights Into the Next Generation of Policy and Research

Document Type : Viewpoint

Authors

1 Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA

2 Department of Health Policy and Management, Guilford Glazer Faculty of Business & Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel

3 Israel Implementation Science and Policy Engagement Centre, Ben-Gurion University of the Negev, Be’er Sheva, Israel

4 Center for Healthcare Delivery Research and Innovations, School of Nursing, Columbia University, New York City, NY, USA

5 Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York City, NY, USA

6 Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

Keywords


Introduction

Introduction of the nurse practitioner (NP) role is becoming an increasingly prevalent response around the world to address growing healthcare service and provider shortages (Box 1). Aside from positive patient outcomes associated with NPs,2 their holistic care is well-suited to meet population needs.2 Realizing these outcomes, nevertheless, cannot be achieved by introducing the NP role alone; it relies on successfully integrating NPs into all levels of the health system. ...(Read more...)

  1. International Council of Nurses (ICN). Guidelines on Advanced Practice Nursing. Geneva, Switzerland: ICN; 2020.
  2. Maier CB, Aiken LH, Busse R. Nurses in Advanced Roles in Primary Care: Policy Levers for Implementation. Paris, France: OECD Publishing; 2017. doi:1787/a8756593-en
  3. Porat-Dahlerbruch J, Poghosyan L, Blumenthal N, Ratz S, Ellen ME. Nurse practitioner integration: conceptual development to enhance application in policy and research. J Am Assoc Nurse Pract. 2022;34(10):1106-1115. doi:1097/jxx.0000000000000761
  4. Andrews CS, Steller JV, Friedman AK. Development of collaborative family nurse practitioner education using physician preceptors: a focused critical ethnographic study. Nurse Educ Today. 2021;107:105110. doi:1016/j.nedt.2021.105110
  5. Kodi SM, Sharma SK. Realities, scope, challenges, and facilitators for implementation of nurse practitioner's role in India: a review. Int J Nurs Sci. 2021;8(2):237-242. doi:1016/j.ijnss.2021.03.003
  6. Bryant-Lukosius D, Dicenso A, Browne G, Pinelli J. Advanced practice nursing roles: development, implementation and evaluation. J Adv Nurs. 2004;48(5):519-529. doi:1111/j.1365-2648.2004.03234.x
  7. National Academies of Sciences, Engineering, and Medicine. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. National Academies of Sciences, Engineering, and Medicine; 2021. doi:17226/25982
  8. Curnew DR, Lukewich J. Nursing within primary care settings in Atlantic Canada: a scoping review. Sage Open. 2018;8(2):2158244018774379. doi:1177/2158244018774379
  9. Carthon MB, Brom H, Nikpour J, Todd B, Aiken L, Poghosyan L. Supportive practice environments are associated with higher quality ratings among nurse practitioners working in underserved areas. J Nurs Regul. 2022;13(1):5-12. doi:1016/s2155-8256(22)00028-x
  10. Henni SH, Kirkevold M, Antypas K, Foss C. The integration of new nurse practitioners into care of older adults: a survey study. J Clin Nurs. 2019;28(15-16):2911-2923. doi:1111/jocn.14889
  11. Torrens C, Campbell P, Hoskins G, et al. Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: a scoping review. Int J Nurs Stud. 2020;104:103443. doi:1016/j.ijnurstu.2019.103443
  12. Faraz A. Facilitators and barriers to the novice nurse practitioner workforce transition in primary care. J Am Assoc Nurse Pract. 2019;31(6):364-370. doi:1097/jxx.0000000000000158
  13. Poghosyan L, Ghaffari A, Liu J, McHugh MD. Organizational support for nurse practitioners in primary care and workforce outcomes. Nurs Res. 2020;69(4):280-288. doi:1097/nnr.0000000000000425
  14. Carryer J, Adams S. Nurse practitioners as a solution to transformative and sustainable health services in primary health care: a qualitative exploratory study. Collegian. 2017;24(6):525-531. doi:1016/j.colegn.2016.12.001
  15. Kilpatrick K, Tchouaket É, Jabbour M, Hains S. A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities. BMC Nurs. 2020;19:6. doi:1186/s12912-019-0395-2
  16. Poghosyan L, Norful AA, Liu J, Friedberg MW. Nurse practitioner practice environments in primary care and quality of care for chronic diseases. Med Care. 2018;56(9):791-797. doi:1097/mlr.0000000000000961
  17. Bryant-Lukosius D, DiCenso A. A framework for the introduction and evaluation of advanced practice nursing roles. J Adv Nurs. 2004;48(5):530-540. doi:1111/j.1365-2648.2004.03235.x
  18. Sangster-Gormley E, Griffith J, Schreiber R, Borycki E. Using a mixed-methods design to examine nurse practitioner integration in British Columbia. Nurse Res. 2015;22(6):16-21. doi:7748/nr.22.6.16.e1343
  19. Poghosyan L, Carthon JMB. The untapped potential of the nurse practitioner workforce in reducing health disparities. Policy Polit Nurs Pract. 2017;18(2):84-94. doi:1177/1527154417721189
  20. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10:53. doi:1186/s13012-015-0242-0