Lane Riki, Halcomb Elizabeth, McKenna Lisa, Zwar Nicholas, Naccarella Lucio, Davies Gawaine Powell, Russell Grant
Southern Academic Primary Care Research Unit and School of Primary Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia. Email.
School of Nursing, University of Wollongong, Building 41, Northfields Avenue, Wollongong, NSW 2522, Australia. Email.
Aust Health Rev. 2017 May;41(2):127-132. doi: 10.1071/AH15239.
Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally. What does this paper add? This study delineates organisational support roles for PHCOs in strengthening nurses' roles and career development in Australian general practice. What are the implications for practitioners? Effective implementation of appropriate responsibilities by PHCOs can assist development of the primary care nursing workforce.
目标 鉴于澳大利亚全科护士数量增加且职责加重，我们旨在明确初级卫生保健组织（PHCOs）支持这一劳动力群体的适当角色。方法 2012年1月至6月期间开展了两轮在线德尔菲共识达成过程，以文献综述和关键信息人访谈为依据。参与者经过有目的的挑选，包括来自澳大利亚五个州和领地的政府和专业组织的决策者、教育工作者、研究人员及临床医生。结果 在56名受邀受访者中，分别有35名（62%）和31名（55%）回复了第一轮和第二轮邀请。参与者就PHCOs在优化全科护理方面的五个关键角色达成了共识：（1）使劳动力规模和技能与人群需求相匹配；（2）促进领导机会；（3）提供教育及教育途径；（4）促进全科医疗与其他初级保健服务的整合以支持跨学科护理；（5）推动高级护理角色。诸如研究生教育和职业发展机会有限等全国性问题，被认为最好由全国护理组织、大学和行业顶尖机构来解决。结论 全科护理的发展需要一系列组织提供系统层面的支持。PHCOs在护士的教育和领导力发展以及将全国护理组织与全科医疗相联系方面发挥着重要作用。关于该主题已知的情况是什么？在过去十年中，澳大利亚全科护士的角色有所扩展，但他们面临有限的职业发展路径和晋升机会。一些国家组建了跨专业初级保健团队，充分利用护士的技能范围。PHCOs在澳大利亚及国际全科护理发展中发挥了重要作用。本文补充了什么内容？本研究明确了PHCOs在加强澳大利亚全科护士角色和职业发展方面的组织支持角色。对从业者有何启示？PHCOs有效履行适当职责有助于初级保健护理劳动力的发展。
