Begley Cecily, Murphy Kathy, Higgins Agnes, Cooney Adeline
School of Nursing and Midwifery, Trinity College Dublin, Dublin.
J Nurs Manag. 2014 May;22(4):410-22. doi: 10.1111/jonm.12018. Epub 2012 Dec 1.
To ascertain and explore the views held by key healthcare policy-makers on the impact of clinical specialist and advanced practice nursing and midwifery roles.
Specialist and advanced practice roles are common world-wide and were introduced in Ireland in 2000. After experiencing these roles for a decade, the views of healthcare policy-makers were sought as part of a national evaluation.
A qualitative, descriptive design was used. Following ethical approval, 12 policy-makers were interviewed in 2010, using a six-part interview schedule.
Policy-makers believed that specialist and advanced practice roles resulted in better continuity of care, improved patient/client outcomes and a more holistic approach. These clinicians were also said to be leading guideline development, new initiatives in care, education of staff, audit and policy development. They lacked administrative support and research time. Budget cuts and a government-applied recruitment moratorium were said to hamper the development of specialist/advanced practice roles.
Healthcare policy-makers believe that specialists and advanced practitioners contribute to higher quality patient/client care, particularly at a strategic level.
These roles could make an important contribution to future health service developments, particularly in relation to chronic-disease management and community care, where more advanced practitioner posts are required.
确定并探究关键医疗保健政策制定者对临床专科护士及高级实践护士和助产士角色影响的看法。
专科及高级实践角色在全球普遍存在，并于2000年引入爱尔兰。在经历这些角色十年后，作为国家评估的一部分，征求了医疗保健政策制定者的意见。
采用定性描述性设计。在获得伦理批准后，2010年使用六部分访谈提纲对12名政策制定者进行了访谈。
政策制定者认为，专科及高级实践角色带来了更好的护理连续性、改善了患者/服务对象的结局，并采用了更全面的方法。这些临床医生还被认为在引领指南制定、护理新举措、员工教育、审计及政策制定。他们缺乏行政支持和研究时间。预算削减和政府实施的招聘暂停据说是阻碍专科/高级实践角色发展的因素。
医疗保健政策制定者认为，专科护士和高级实践护士对提高患者/服务对象护理质量有贡献，尤其是在战略层面。
这些角色可为未来卫生服务发展做出重要贡献，特别是在慢性病管理和社区护理方面，这需要更多高级实践岗位。
