Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada.
J Adv Nurs. 2013 Jan;69(1):205-17. doi: 10.1111/j.1365-2648.2012.06046.x. Epub 2012 May 27.
This article describes a new conceptual framework for acute care nurse practitioner role enactment, boundary work and perceptions of team effectiveness.
Acute care nurse practitioners contribute positively to patient care by enacting an expanded scope of practise. Researchers have found both positive and negative reactions to the introduction of acute care nurse practitioners in healthcare teams. The process of role enactment, shifting role boundaries, and perceptions of team effectiveness has been studied disparately. A framework linking team structures and processes to desirable outcomes is needed.
Literature was obtained by searching CINAHL, PsycInfo, MedLine, PubMed, British Nursing Index, Cochrane Library, JSTOR Archive, Web of Science, and Google Scholar from 1985-2010. A descriptive multiple-case study was completed from March 2009-May 2009.
A new conceptual framework describing how role enactment and boundary work affect perceptions of team effectiveness was developed by combining theoretical and empirical sources. The framework proposes proximal indicators used by team members to assess their team's performance.
The framework identifies the inter-related dimensions and concepts that different stakeholders need to consider when introducing nurse practitioners in healthcare teams. Further study is needed to identify team-level outcomes that reflect the contributions of all providers to quality patient care, and explore the patients' and families' perceptions of team effectiveness following the introduction of acute care nurse practitioners.
The new framework can guide decision-making and research related to the structures, processes, and outcomes of nurse practitioner roles in healthcare teams.
本文描述了一个新的概念框架，用于阐述急症护理执业护士的角色表现、边界工作以及对团队有效性的看法。
急症护理执业护士通过实施扩大的实践范围，为患者护理做出了积极贡献。研究人员发现，在医疗保健团队中引入急症护理执业护士既有积极的反应，也有消极的反应。角色表现、角色边界的转变以及对团队有效性的看法的过程已经分别进行了研究。需要一个将团队结构和流程与理想结果联系起来的框架。
通过在 1985 年至 2010 年间搜索 CINAHL、PsycInfo、MedLine、PubMed、英国护理索引、 Cochrane 图书馆、JSTOR 档案、Web of Science 和 Google Scholar，获取了文献。2009 年 3 月至 5 月完成了一项描述性多案例研究。
通过结合理论和实证来源，开发了一个新的概念框架，描述了角色表现和边界工作如何影响对团队有效性的看法。该框架提出了团队成员用来评估团队绩效的近端指标。
该框架确定了不同利益相关者在向医疗保健团队引入执业护士时需要考虑的相互关联的维度和概念。需要进一步研究以确定反映所有提供者对高质量患者护理贡献的团队水平结果，并探讨在引入急症护理执业护士后患者和家庭对团队有效性的看法。
新框架可以指导与医疗保健团队中执业护士角色的结构、流程和结果相关的决策和研究。
