Academic Journal
Changing nursing practice within primary health care innovations: the case of advanced access model
| العنوان: | Changing nursing practice within primary health care innovations: the case of advanced access model |
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| المؤلفون: | Abou Malham, Sabina, Breton, Mylaine, Touati, Nassera, Maillet, Lara, Duhoux, Arnaud, Gaboury, Isabelle |
| المساهمون: | Réseau de recherche portant sur les interventions en sciences infirmières du Québec, Canadian Institutes of Health Research |
| المصدر: | BMC Nursing ; volume 19, issue 1 ; ISSN 1472-6955 |
| بيانات النشر: | Springer Science and Business Media LLC |
| سنة النشر: | 2020 |
| الوصف: | Background The advanced access (AA) model has attracted much interest across Canada and worldwide as a means of ensuring timely access to health care. While nurses contribute significantly to improving access in primary healthcare, little is known about the practice changes involved in this innovative model. This study explores the experience of nurse practitioners and registered nurses with implementation of the AA model, and identifies factors that facilitate or impede change. Methods We used a longitudinal qualitative approach, nested within a multiple case study conducted in four university family medicine groups in Quebec that were early adopters of AA. We conducted semi-structured interviews with two types of purposively selected nurses: nurse practitioners (NPs) ( n = 6) and registered nurses (RNs) ( n = 5). Each nurse was interviewed twice over a 14-month period. One NP was replaced by another during the second interviews. Data were analyzed using thematic analysis based on two principles of AA and the Niezen & Mathijssen Network Model (2014). Results Over time, RNs were not able to review the appointment system according to the AA philosophy. Half of NPs managed to operate according to AA. Regarding collaborative practice, RNs were still struggling to participate in team-based care. NPs were providing independent and collaborative patient care in both consultative and joint practice, and were assuming leadership in managing patients with acute and chronic diseases. Thematic analysis revealed influential factors at the institutional, organizational, professional, individual and patient level, which acted mainly as facilitators for NPs and barriers for RNs. These factors were: 1) policy and legislation ; 2) organizational policy support ( leadership and strategies to support nurses’ practice change); facility and employment arrangements ( supply and availability of human resources); Inter-professional collegiality; 3) professional boundaries; 4) knowledge and capabilities; and 5) patient ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1186/s12912-020-00504-z |
| DOI: | 10.1186/s12912-020-00504-z.pdf |
| DOI: | 10.1186/s12912-020-00504-z/fulltext.html |
| الاتاحة: | http://dx.doi.org/10.1186/s12912-020-00504-z http://link.springer.com/content/pdf/10.1186/s12912-020-00504-z.pdf http://link.springer.com/article/10.1186/s12912-020-00504-z/fulltext.html |
| Rights: | http://creativecommons.org/licenses/by/4.0/ ; http://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.E75746A5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12912-020-00504-z |
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