Hunter New England Local Health District, James Fletcher Campus, 72 Watt Street Newcastle, Newcastle, NSW 2300, Australia.
School of Health, University of New England, Armidale, NSW, Australia.
BMC Nurs. 2014 Oct 13;13:30. doi: 10.1186/1472-6955-13-30. eCollection 2014.
The advanced practice role of the Nurse Consultant is unique in its capacity to provide clinical leadership across a range of contexts. However, the Nurse Consultant role has been plagued with confusion due to lack of clarity over function and appropriateness for purpose within health organisations across contexts. Changing health service delivery models are driving the emergence of new nursing roles, further clouding the waters related to role positioning and purpose. There is an urgent need for evidence of impact and demonstration of how Nurse Consultants contribute to health care outcomes. This study aims to gain a clearer understanding of the Nurse Consultant role and its impact in metropolitan and rural New South Wales (NSW) Australia.
The proposed study employs a sequential mixed method design, underpinned by Realistic Evaluation, to explore how Nurse Consultants contribute to organisational outcomes. The 'context - mechanism - outcome' approach of realistic evaluation provides a sound framework to examine the complex, diverse and multifaceted nature of the Nurse Consultant's role.
Participants will be stakeholders, recruited across a large Local Health District in NSW, comprising rural and metropolitan services. A modified and previously validated survey will be used providing information related to role characteristics, patterns and differences across health context. Focus groups with Nurse Consultant's explore issues highlighted in the survey data. Focus groups with other clinicians, policy makers and managers will help to achieve understanding of how the role is viewed and enacted across a range of groups and contexts.
Lack of role clarity is highlighted extensively in international and Australian studies examining the role of the Nurse Consultant. Previous studies failed to adequately examine the role in the context of integrated and complex health services or to examine the role in detail. Such examination is critical in order to understand the significance of the role and to ascertain how Nurse Consultants can be most effective as members of the health care team. This is the first Australian study to include extensive stakeholder perspectives in order to understand the relational and integrated nature and impact of the role across metropolitan and rural context.
护士顾问的高级实践角色因其能够在多种情况下提供临床领导力而独具特色。然而，由于在不同背景的卫生组织中对职能和适用性缺乏明确性，护士顾问的角色一直存在混淆。不断变化的医疗服务提供模式正在推动新护理角色的出现，这进一步使角色定位和目的变得更加复杂。迫切需要证明护士顾问对医疗保健结果的影响，并展示他们如何为此做出贡献。本研究旨在更清楚地了解护士顾问在澳大利亚新南威尔士州（NSW）的大都市和农村地区的角色及其影响。
拟议的研究采用基于现实评估的顺序混合方法设计，以探讨护士顾问如何为组织成果做出贡献。现实评估的“背景-机制-结果”方法为研究护士顾问角色的复杂性、多样性和多面性提供了一个健全的框架。
研究对象将是利益相关者，在新南威尔士州一个大型地方卫生区招募，包括农村和城市服务。将使用经过修改和先前验证的调查来提供与角色特征、模式和健康背景差异相关的信息。与护士顾问进行焦点小组讨论，探讨调查数据中突出的问题。与其他临床医生、政策制定者和管理人员进行焦点小组讨论，有助于了解该角色在不同群体和背景下的看法和实施情况。
国际和澳大利亚研究广泛强调了护士顾问角色缺乏明确性。以前的研究未能充分研究在综合和复杂的卫生服务中的角色，也未能详细研究该角色。为了了解该角色的重要性并确定护士顾问如何作为医疗保健团队的成员最有效，进行这样的研究至关重要。这是澳大利亚第一项包括广泛利益相关者观点的研究，以了解角色在大都市和农村背景下的关系和综合性质及其影响。
