Biomedical subjects

D Irvine

Publications and source records attributed to D Irvine.

60 records · Page 4Linked to original sources

PubMedDate not supplied

Implementation of the primary care nurse practitioner role in Ontario.

The purpose of this descriptive study was to examine the implementation of the nurse practitioner role in primary care settings. Nurse practitioners who were certified by the College of Nurses of Ontario as Extended Class were surveyed. The questionnaire inquired about the nurse practitioners' professional characteristics, employment settings, scope of practice, practice pattern, and satisfaction with their role. The majority of the 166 respondents working as nurse practitioners were Baccalaureate prepared; has been in the role for a relatively short period of time; were employed in community health centers; and were able to practice to their full potential, within the expanded scope of practice. They saw patients who are primarily healthy or presenting with acute minor illness, and provided care with an emphasis on wellness. They were satisfied with their role. Directions for future research are presented.

Adult↗

PubMedDate not supplied

Organizational factors influencing nurse practitioners' role implementation in acute care settings.

The purpose of this study was to explore the influence of organizational factors on the Acute Care Nurse Practitioner (ACNP) role implementation. A descriptive correlational design, incorporating quantitative and qualitative methods for data collection was used. The sample of convenience consisted of 57 ACNPs assigned to various medical and surgical programs within acute care hospitals. Ten ACNPs participated in the unstructured qualitative interviews. In addition to the interviews, data pertinent to various organizational factors, including role formalization, receptivity of the role by others, perceived autonomy, role strain, and additional factors that may interfere with role implementation, were collected through a self-report structured questionnaire. A four-diary day was completed to gather data on role implementation. Descriptive and correlational statistics were used to analyze the quantitative data. The qualitative data were content analyzed. The ACNPs engaged most frequently in activities reflective of the clinical practice component of the role and less frequently in the non-clinical components (i.e., education, administration, and research). Results of the quantitative and qualitative analyses indicated that lack of formal clear job description, conflicting demands and expectations, lack of receptivity of the role by others, lack of autonomy, and increased workload were negatively correlated with the ACNP role implementation. The ACNP role implementation varies across practice settings. This variability should be accounted for when examining outcomes of ACNP care.

Acute Disease↗

PubMedDate not supplied

Update on revalidation.

Explore the source record for details and available documents.

Delivery of Health Care↗

PubMedDate not supplied

Measuring nursing workload: understanding the variability.

The authors present a new multifactorial intensity and complexity of care model and meta-paradigm that is designed to examine costs, nursing work, and the variability in resource use across patients and environments. Relationships were observed among four key variables which included patient-nursing condition, medical condition, caregiver characteristics and the environment. Patient-nursing complexity and medical complexity are commonly measured by nursing diagnosis and DRG or Canadian case mix groupings (CMG) respectively. The complexities associated with the work environment had been the least previously studied factors. Environmental complexity factors include both supply and demand dimensions: scheduling and coordination of procedures, multiple and long procedures, and characteristics and composition of the caregiver team.

Adolescent↗

PubMedDate not supplied

Linking outcomes to nurses' roles in health care.

As the health care industry refines quality assurance and quality improvement standards, the accountability of individual care providers is intensifying. Care providers work within a system of interdependent roles and functions and collaborate to attain the common goal of quality care. A conceptual model was developed which relates the achievement of specific outcomes to nurses' independent, dependent, and interdependent roles and functions. Empirical literature was used to identify outcomes associated with nurses' role functions. Outcomes associated with nurses' independent role functions included the prevention of complications, clinical outcomes, knowledge of diseases and treatments, satisfaction, and cost outcomes. Outcomes associated with nurses' dependent role included adverse incidents which caused problems or prolonged hospital stays. Outcomes associated with nurses' interdependent role included interdisciplinary team functioning.

Humans↗

PubMedDate not supplied

Finding value in nursing care: a framework for quality improvement and clinical evaluation.

Fiscal constraints have heightened attention to health care costs and patient outcomes as measures of health care system effectiveness. Determining which patient and costs outcomes nurses may be held accountable for requires differentiating the impact of dependent, independent and interdependent nursing activities. A nursing role effectiveness model that includes a number of structural variables is offered to help track quality improvement and research activities. Some of the nurse-sensitive patient outcomes that have been identified include: freedom from complications, clinical outcomes, functional health outcomes, knowledge outcomes, perceived health benefit (or satisfaction), and costs outcomes. This model can be used to evaluate the effectiveness of current as well as evolving nurse roles, processes, and structural changes.

Humans↗