Gardner Glenn, Chang Anne, Duffield Christine
Clinical Nursing Queensland University of Technology and Royal Brisbane and Women's Hospital, Brisbane, Australia.
J Adv Nurs. 2007 Feb;57(4):382-91. doi: 10.1111/j.1365-2648.2007.04114.x.
This paper reports a study to develop a research-informed model of the service parameters and an analysis framework for advanced practice nursing roles.
Changing patterns of health care are forcing service planners to examine new service delivery models. Apparent is the call for nursing service that incorporates expanded levels of autonomy, skill and decision-making. A number of nursing roles conform to this description under the generic title of advanced practice nurse. However, there is confusion in the health service community internationally about nomenclature, role and scope for advanced practice nursing roles. An emerging priority in response to recent developments in the nurse practitioner role is to establish service parameters for advanced practice nursing and to differentiate operationally between advanced practice and practitioner nursing roles.
We conducted an interpretive, qualitative examination of the practice of a random sample of nine advanced practice nurses working in three acute care hospitals in south east Queensland, Australia in 2006. Data collection involved individual in-depth interviews, which were deductively analysed and tested against published advanced practice nursing models.
The data most comprehensively supported the Strong Model of Advanced Practice as representing the practice experiences of the research participants. This model supports definition of the service parameters and the design of an operational framework for implementation and evaluation of advanced practice nursing roles.
The findings differentiate advanced practice nurse and nurse practitioner roles, and offer an operational framework to identify, establish and evaluate advanced and extended nursing positions. Subject to further validation, this outcome can provide operational information for implementing innovative nursing roles appropriate to consumer needs and specific health service models.
本文报告一项研究，旨在开发一个基于研究的高级实践护理服务参数模型以及一个分析框架。
医疗保健模式的变化促使服务规划者审视新的服务提供模式。对具有更高自主性、技能和决策水平的护理服务的需求显而易见。一些护理角色在高级实践护士这一统称下符合这一描述。然而，国际卫生服务界在高级实践护理角色的命名、职责和范围方面存在困惑。应对执业护士角色近期发展的一个新重点是确定高级实践护理的服务参数，并在操作上区分高级实践护理和执业护士角色。
2006年，我们对澳大利亚昆士兰州东南部三家急症医院的九名随机抽取的高级实践护士的实践进行了诠释性定性研究。数据收集包括个人深度访谈，对访谈结果进行演绎分析，并对照已发表的高级实践护理模型进行检验。
数据最全面地支持了高级实践的强大模型，该模型代表了研究参与者的实践经验。该模型支持服务参数的定义以及高级实践护理角色实施和评估操作框架的设计。
研究结果区分了高级实践护士和执业护士角色，并提供了一个操作框架，用于识别、确立和评估高级及扩展护理职位。经过进一步验证，这一结果可为实施符合消费者需求和特定卫生服务模式的创新护理角色提供操作信息。
