Advertisement

Canadian Journal of Public Health

, Volume 101, Issue 4, pp 309–313 | Cite as

Nurse Practitioner Role Implementation in Ontario Public Health Units

  • Angela de GuzmanEmail author
  • Donna Ciliska
  • Alba DiCenso
Quantitative Research
  • 1 Downloads

Abstract

Objectives

To identify the barriers and facilitators associated with the implementation of the nurse practitioner (NP) role in Ontario’s public health units (PHUs), the NPs’ job satisfaction, and the relationship between NP job satisfaction and practice dimensions.

Methods

This descriptive study involved a postal survey of all NPs (N=29) working in Ontario PHUs.

Results

Twenty-eight (96.5%) NPs completed the survey. The facilitators to role implementation most often identified by the NPs were management support, the NPs’ knowledge of the PHU programs, and access to PHU programs for their clients. The barriers most often cited were being the only NP working in the PHU, inadequate salary, and lack of coverage when the NP was away. When working with community physicians, the most common facilitators were the trust shown by physicians when making shared decisions and physician respect for the NP. The most common barriers were the unwillingness of specialist physicians to accept referrals from the NP and physicians’ lack of understanding of the role. Overall, the NPs were satisfied with working in the PHU, satisfied with their collaborative relationship with physicians and minimally satisfied with their salaries.

Conclusion

NPs have recently been introduced in PHUs in Ontario. A number of factors have facilitated role integration. At the same time, a number of barriers to their role implementation have been identified and if addressed, can contribute to the optimal utilization of this role in PHUs.

Key words

Nurse practitioners public health primary health care role implementation job satisfaction 

Résumé

Objectifs

Définir les éléments qui entravent et ceux qui favorisent l’implantation du rôle des infirmières praticiennes (IP) dans les bureaux de santé publique de l’Ontario, la satisfaction professionnelle des IP et le lien entre la satisfaction professionnelle et divers aspects de l’exercice de la profession.

Méthode

Étude descriptive avec enquête postale auprès de toutes les IP (N=29) travaillant dans les bureaux de santé publique de l’Ontario.

Résultats

Vingt-huit IP (96,5 %) ont répondu au sondage. Les éléments le plus souvent cités comme favorisant l’implantation du rôle des IP étaient l’appui de la direction, la connaissance des programmes du bureau de santé publique par les IP et l’accès à ces programmes pour leurs clients. Les obstacles les plus souvent cités étaient le fait d’être la seule IP à travailler dans le bureau, le salaire insuffisant et l’absence de remplaçants pour les IP. Quand les IP travaillent avec des médecins communautaires, les éléments les plus souvent cités comme favorisant leur implantation étaient la confiance manifestée par le médecin dans la prise de décisions partagées et le respect du médecin envers l’IP. Les obstacles les plus courants étaient le refus des médecins spécialistes d’accepter les personnes dirigées par l’IP et le manque de compréhension du rôle des IP par les médecins. Globalement, les IP étaient satisfaites de leur travail dans les bureaux de santé publique, satisfaites de leur collaboration avec les médecins et marginalement satisfaites de leur salaire.

Conclusion

La présence des IP dans les bureaux de santé publique de l’Ontario est récente. Un certain nombre de facteurs ont facilité leur intégration. Simultanément, des obstacles à l’implantation de leur rôle ont été cernés; l’abolition de ces obstacles pourrait contribuer à optimiser l’utilisation des IP dans les bureaux de santé publique.

Mots clés

infirmiers praticiens santé publique soins de santé primaires implantation du rôle satisfaction professionnelle 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sloan C, Pong R, Rukholm E, Caty S. Nurse Practitioner Workforce Survey and NPAO Electronic Registry Project Report. 2006.Google Scholar
  2. 2.
    Canadian Nurse Practitioner Initiative. Nurse practitioners: The time is now. A solution to improving access and reducing wait times in Canada, 2006. Available at: www.206.191.29.104/documents/pdf/tech-report/section1/01_Integrated_Report.pdf (Accessed July 8, 2009).Google Scholar
  3. 3.
    van Soeren M, Hurlock-Chorostecki C, Goodwin S, Baker E. The primary health care nurse practitioner in Ontario: A workforce study. Can J Nurs Lead-ersh 2009;22(2):58–72.CrossRefGoogle Scholar
  4. 4.
    Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. Br Med J 2002;324:819–23.CrossRefGoogle Scholar
  5. 5.
    Michel I, Ehrlich A, Lynn-Wright B, Szadkowski M, McFarland V. Nurse Practitioner Cervical Screening Pilot Project Evaluation Report. Toronto, ON: Public Health Research Education and Development Program, 2003.Google Scholar
  6. 6.
    Snelling S, Ehrlich A, Grafton D, Michel I, MacLean L, McFarland V. Evaluation of the prenatal and postnatal nurse practitioner services initiative: Interim report. Toronto: PHRED, 2005.Google Scholar
  7. 7.
    Public Health Research Education and Development Program. Evaluation of the Prenatal and Postnatal Nurse Practitioner Services Initiative: Final Report. Sudbury, ON: PHRED, 2006.Google Scholar
  8. 8.
    Middlesex-London Health Unit. An Overview of the Characteristics of Nurse Practitioners in Public Health Units across Ontario. London, ON: Middlesex-London Health Unit, 2005.Google Scholar
  9. 9.
    Capacity Review Committee. Revitalizing Ontario’s Public Health Capacity: The Final Report of the Capacity Review Committee, 2006. Available at: https://doi.org/www.health.gov.on.ca/english/public/pub/ministry_reports/capacity_review06/capacity_review06.pdf (Accessed January 12, 2007).Google Scholar
  10. 10.
    IBM Business Consulting Services, McMaster University. Report on the Integration of Primary Health Care Nurse Practitioners into the Province of Ontario: Final Report, 2005. Available at: https://doi.org/www.health.gov.on.ca/english/public/pub/ministry_reports/nurseprac03/nurseprac03_mn.html (Accessed October 10, 2005).
  11. 11.
    Green SB, Salkind NJ. Using SPSS for Windows and Macintosh: Analyzing and understanding data. Upper Saddle River, New Jersey: Pearson Prentice Hall, 2005.Google Scholar
  12. 12.
    Pallant J. SPSS Survival Manual. Buckingham: Open University Press, 2003.Google Scholar
  13. 13.
    Ontario Ministry of Health. Mandatory Health Programs and Service Guidelines. Toronto: Queen’s Printer for Ontario, 1997.Google Scholar
  14. 14.
    Ontario Ministry of Health and Long-Term Care. Ontario Public Health Standards, 2008. Available at: https://doi.org/www.health.gov.on.ca/english/providers/program/pubhealth/oph_standards/ophs/progstds/pdfs/ophs_2008.pdf (Accessed July 26, 2009).Google Scholar
  15. 15.
    Martin-Misener R, Valaitis R. A scoping literature review of collaboration between primary care and public health: A report to the Canadian Health Services Research Foundation, September 30, 2008. Available at: https://doi.org/www.fhs.mcmaster.ca/nursing/docs/MartinMisener-Valaitis-Review.pdf (Accessed July 16, 2009).Google Scholar
  16. 16.
    Bryant-Lukosius D, DiCenso A, Browne G, Pinelli J. Advanced practice nursing roles: Development, implementation and evaluation. J Adv Nurs 2004;48(5):519–29.CrossRefGoogle Scholar
  17. 17.
    Mick DJ, Ackerman MH. Advanced practice nursing role delineation in oncology nursing: A role delineation study in acute and critical care: Application of the Strong Model of advanced practice. Heart Lung 2000;29:210–21.CrossRefGoogle Scholar
  18. 18.
    Sidani S, Irvine D, DiCenso A. Implementation of the primary care nurse practitioner role in Ontario. Can J Nurs Leadersh 2000;13(3):13–19.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Angela de Guzman
    • 1
    Email author
  • Donna Ciliska
    • 2
  • Alba DiCenso
    • 2
    • 3
  1. 1.Toronto Public HealthTorontoCanada
  2. 2.School of NursingMcMaster UniversityHamiltonCanada
  3. 3.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada

Personalised recommendations