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一项质性研究,探讨诊所资金对纽芬兰和拉布拉多地区家庭执业护士整合的影响。

A qualitative study exploring the influence of clinic funding on the integration of family practice nurses in Newfoundland and Labrador.

作者信息

Mathews Maria, Ryan Dana, Buote Richard, Parsons Sandra, Lukewich Julia

机构信息

Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.

Faculty of Nursing, Memorial University, St. John's, NL, Canada.

出版信息

Nurs Open. 2020 Jul;7(4):1067-1073. doi: 10.1002/nop2.477. Epub 2020 Apr 14.

Abstract

AIM

This study explores the contributions of family practice nurses in primary care across Newfoundland and Labrador funded by fee-for-service and alternate payment plans to examine the influence of funding arrangements on nursing roles/activities.

DESIGN

A qualitative descriptive design was employed.

METHODS

Semi-structured telephone interviews were conducted between March-July 2018 with physicians and Registered Nurses working in primary care settings in Newfoundland and Labrador. Interviews were transcribed verbatim, and a content analysis approach was used to identify recurring themes.

RESULTS

Clinic funding was instrumental in the integration of family practice nurses into primary care settings and influenced roles/activities. In fee-for-service practices, nurses work with physicians and focus on one-on-one patient care in office-based settings, whereas nurses in alternate payment plans practices work more independently, in a wider range of settings and with emphasis on both individual and group-based encounters. Compared with alternate payment plans practices, fee-for-service practices tend to be more restrictive due to physician billing requirements.

摘要

目的

本研究探讨由按服务收费和替代支付计划资助的纽芬兰和拉布拉多省初级保健中家庭执业护士的贡献,以检验资金安排对护理角色/活动的影响。

设计

采用定性描述性设计。

方法

2018年3月至7月间,对在纽芬兰和拉布拉多省初级保健机构工作的医生和注册护士进行了半结构化电话访谈。访谈内容逐字记录,并采用内容分析法确定反复出现的主题。

结果

诊所资金有助于将家庭执业护士融入初级保健机构,并影响其角色/活动。在按服务收费的诊所中,护士与医生合作,在门诊环境中专注于一对一的患者护理,而在替代支付计划诊所工作的护士则更加独立,工作环境更广泛,并且注重个体和群体接触。与替代支付计划诊所相比,由于医生计费要求,按服务收费的诊所往往限制更多。

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