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Nurse practitioner practice and deployment: electronic mail Delphi study


Janet Marsden, Department of Health Care Studies, Manchester Metropolitan University, Hathersage Road, Manchester M13 9WL, UK.


Background. The nature of modern government and needs of policy-makers demand accurate information that is delivered quickly. This study was part of a larger project for the Department of Health relating to nurse practitioner (NP) education and practice in UK.

Aims. The aim of the study was to identify the principal factors that help or hinder the development of NP roles in the National Health Service.

Methods. In order to facilitate a rapid response, a Delphi study was undertaken using electronic mail (e-mail) and was completed within 4 weeks. Key stakeholders in NP practice, education and research and (non-governmental) policy-making were invited to participate. Key themes relating to the deployment and practice of NPs were generated. These were refined and collated by the research team and then rated by the respondents.

Results. This approach generated valuable expert consensus data around NP deployment and practice. Nurse practitioners’ practice is recognized as an integral part of health care that needs to be recognized by regulatory bodies to promote understanding of their potential at local levels. Nurse practitioners need freedom to innovate, adequate support and appropriate education to allow true autonomy. Limited prescribing and local restrictions on requesting investigations hinder practice.

Limitations. Although this was a small-scale study, the expert panel was wide-ranging and achieved substantial consensus.

Conclusion. The organisational and cultural changes that are required to foster the development of practice and deployment of NPs have yet to be instigated, according to the comments of the key stakeholders in this study. There appears to be a clear message that the government needs to take a more interventionist role in supporting nursing developments, rather than leaving this to local arrangements.