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Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice

Authors

  • Glenn Gardner PhD RN FRCNA,

    Professor of Clinical Nursing, Director, Corresponding author
    1. Centre for Clinical Nursing, Royal Brisbane and Women's Hospital, Queensland, Australia
    • Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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  • Anne M. Chang PhD RN FRCNA,

    Professor of Clinical Nursing
    1. Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
    2. Mater Health Services, Brisbane, Queensland, Australia
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  • Christine Duffield PhD RN FRCNA,

    Professor of Nursing and Health Services Management
    1. Centre for Health Services Management, University of Technology Sydney, New South Wales, Australia
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  • Anna Doubrovsky BSc MPH

    Research Coordinator
    1. Queensland University of Technology, Brisbane, Queensland, Australia
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Correspondence to G. Gardner: e-mail: ge.gardner@qut.edu.au

Abstract

Aims

To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles.

Background

There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles.

Design

A statewide survey.

Methods

Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains.

Results

There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall.

Conclusion

Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service.

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