Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Clients’ understanding of the role of nurse practitioners

Jane Allnutt A , Nissa Allnutt A , Rose McMaster A , Jane O’Connell A , Sandy Middleton A F , Sharon Hillege B , Phillip R. Della C , Glenn E. Gardner D and Anne Gardner E

A School of Nursing (NSW and ACT), Australian Catholic University, PO Box 958, North Sydney, NSW 2059, Australia.

B School of Nursing & Midwifery College of Health and Science, The University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia.

C School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.

D School of Nursing, Queensland University of Technology and Royal Brisbane and Women’s Hospital, GPO Box 2434, Brisbane, QLD 4001, Australia.

E School of Nursing, Midwifery and Nutrition, James Cook University, PO Box 670, Townsville, QLD 4814, Australia.

F Corresponding author. Email: sandy.middleton@acu.edu.au

Australian Health Review 34(1) 59-65 http://dx.doi.org/10.1071/AH09688
Submitted: 5 September 2008  Accepted: 2 March 2009   Published: 25 March 2010

Abstract

Nurse practitioners (NPs) have an emerging role in the Australian health care system. However, there remains a dearth of data about public understanding of the NP role. The aim of this study was to evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales were invited to recruit five consecutive clients to complete the self-administered survey.

Thirty-two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two-thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP-related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (P = 0.005), and where applicable would to prefer to see an NP rather than a doctor (P = 0.022). Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction, more awareness of the scope of the NP role is required.

What is known about the topic? The role of nurse practitioners (NPs) in Australian health care is diverse and evolving. There is a dearth of research focusing on NPs, particularly looking at the client perception of their role.

What does this paper add? This study investigates the client’s perception of the role of nurse practitioners and levels of confidence and satisfaction through the use of a self-administered questionnaire.

What are the implications for practitioners? The results suggest that clients have a moderate awareness of the nurse practitioner role. Despite this, clients appear to have high levels of confidence and satisfaction after consultations with nurse practitioners. These results suggest that greater community awareness of the role may help maximise their positive contribution to health care in Australia.


References

[1]  Amendment N . (Nurse Practitioners) Act 1998 No 102 (NSW). Available at http://www.legislation.nsw.gov.au/sessionalview/sessional/TITLE/Nurses%20Amendment%20(Nurse%20Practitioners)%20Act%201998%20No%20102.pdf [verified June 2008].

[2]  Australian Nursing and Midwifery Council. National competency standards for the nurse practitioner. 1st edn. Canberra: ANMC, 2006. Available at http://www.anmc.org.au/publications#principles [verified October 2006].

[3]  Gardner G 2004 Issues in nurse practitioner developments in Australia. Can Forum 28 3 132 4

[4]  van Offenbeek MAG Knip M 2004 The organizational and performance effects of nurse practitioner roles. J Adv Nurs 47 672 81
doi:10.1111/j.1365-2648.2004.03156.x Pubmed Abstract

[5]  Henneman EA 1995 Nurse-physician collaboration: a poststructuralist view. J Adv Nurs 22 359 63 doi:10.1046/j.1365-2648.1995.22020359.x Pubmed Abstract

[6]  Wilson K Coulon L Hillege S Swan W 2005 Nurse practitioners’ experiences of working collaboratively with general practitioners and allied health professionals in NSW Australia. Aust J Adv Nurs 23 22 7 Pubmed Abstract

[7]  Driscoll A Worrall-Carter L O’Reilly J Stewart S 2005 A historical review of the nurse practitioner role in Australia. Clin Excell Nurse Pract 9 3 141 52

[8]  Gardner A Gardner G 2005 A trial of nurse practitioner scope of practice. J Adv Nurs 49 135 45
doi:10.1111/j.1365-2648.2004.03273.x Pubmed Abstract

[9]  Donald FC McCurdy C 2002 Review: nurse practitioner primary care improves patient satisfaction and quality of care with no difference in health outcomes. Evid Based Nurs 5 121 doi:10.1136/ebn.5.4.121 Pubmed Abstract

[10]  Horrocks S Anderson E Salisbury C 2002 Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ 324 819 23 doi:10.1136/bmj.324.7341.819 Pubmed Abstract

[11]  Laurent M Reeves D Hermens R Braspenning J Grol R Sibbald B 2004 Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev 4 CD001271 doi:10.1002/14651858.CD001271.pub2

[12]  Litaker D Mion LC Planavsky L Kippes C Mehta N Frolkis J 2003 Physician–nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients’ perception of care. J Interprof Care 17 223 37 doi:10.1080/1356182031000122852 Pubmed Abstract

[13]  Lauder W Sharkey S Reel S 2003 The development of family health nurses and family nurse practitioners in remote and rural Australia. Aust Fam Physician 32 750 2 Pubmed Abstract

[14]  Lindeke L Jukkala A Tanner M 2005 Perceived barriers to nurse practitioner practice in rural settings. J Rural Health 21 178 81 doi:10.1111/j.1748-0361.2005.tb00079.x Pubmed Abstract

[15]  Middleton S Allnutt J Griffiths R McMaster R O’Connell J Hillege S 2007 Identifying measures for evaluating new models of nursing care: a survey of NSW nurse practitioners. Int J Nurs Pract 13 331 40 doi:10.1111/j.1440-172X.2007.00647.x Pubmed Abstract

[16]  Department of Primary Industries and Energy and Department of Human Services and Health. Rural, remote and metropolitan areas classification 1991 census edition. Canberra: AGPS, 1994.

[17]  Bryant R Graham MC 2002 Advanced practice nurses: a study of client satisfaction. J Am Acad Nurse Pract 14 88 92 doi:10.1111/j.1745-7599.2002.tb00096.x Pubmed Abstract

[18]  Wilson J Bunnell T 2007 A review of the merits of the nurse practitioner role. Nurs Stand 21 35 40 Pubmed Abstract

[19]  Britt H , Miller GC , Charles J , Henderson J , Bayram C , Harrison C , Valenti L , Fahridin S , Pan Y , O’Halloran J. General practice activity in Australia, 2007–08. General Practice Series no. 22. Canberra: Australian Institute for Health and Welfare, 2008. (AIHW cat. no. GEP 22)



Export Citation