Get access

An investigation of the international literature on nurse practitioner private practice models

Authors

  • J. Currie NP, BSc, MSc, PhD Candidate,

    Coordinator pre-registration Masters of Nursing, Lecturer, Nurse Practitioner, Corresponding author
    1. Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
    2. Campbelltown Hospital, Sydney, NSW, Australia
    • Correspondence address: Ms Jane Currie, Faculty of Nursing, University of Sydney, 88 Mallett Street, Camperdown, Sydney, NSW 2050, Australia; Tel: +61-416647340; Fax: +61 2 9036 0000; E-mail: jane.currie@sydney.edu.au.

    Search for more papers by this author
  • M. Chiarella RN, RM, LLB (Hons), PhD (UNSW),

    Professor of Nursing
    1. Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
    Search for more papers by this author
  • T. Buckley RN, BSc, MN, PhD

    Coordinator for Masters of Nursing (Nurse Practitioner), Senior Lecturer
    1. Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
    Search for more papers by this author

  • There are no conflicts of interest.

Abstract

Aim

To investigate and synthesize the international literature surrounding nurse practitioner (NP) private practice models in order to provide an exposition of commonalities and differences.

Background

NP models of service delivery have been established internationally and most are based in the public healthcare system. In recent years, opportunities for the establishment of NP private practice models have evolved, facilitated by changes in legislation and driven by identification of potential patient need. To date, NP private practice models have received less attention in the literature and, to the authors' knowledge, this is the first international investigation of NP private practice models.

Design

Integrative literature review.

Method

A literature search was undertaken in October 2012. Database sources utilized included Medical Literature Analyses and Retrieval (MEDLINE), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Scopus and the Cochrane Database of Systematic Reviews (CDSR). The grey literature was also searched. The following Medical Subject Headings (MeSH) and search terms used both individually and in combination included nurse practitioners; private practice; joint practice; collaboration; and insurance, health and reimbursement. Once literature had been identified, a thematic analysis was undertaken to extract themes.

Results

Thirty manuscripts and five publications from the grey literature were included in the final review. Private practice NP roles were identified in five countries, with the majority of the literature emanating from the USA. The thematic analysis resulted in the identification of five themes: reimbursement, collaborative arrangements, legislation, models of care and acceptability.

Conclusion

Proportionally, there are very few NPs engaged in private practice internationally. The most common NP private practice models were community based, with NPs working in clinic settings, either alone or with other health professionals. Challenges in the context of legislation and financial reimbursement were identified in each country where private practice is being undertaken.

Ancillary