Practice nursing in Australia: A review of education and career pathways

<p>Abstract</p> <p>Background</p> <p>Nurses in Australia are often not educated in their pre registration years to meet the needs of primary care. Careers in primary care may not be as attractive to nursing graduates as high-tech settings such as intensive or acute care. Yet, it is in primary care that increasingly complex health problems are managed. The Australian government has invested in incentives for general practices to employ practice nurses. However, no policy framework has been developed for practice nursing to support career development and post-registration education and training programs are developed in an ad hoc manner and are not underpinned by core professional competencies. This paper reports on a systematic review undertaken to establish the available evidence on education models and career pathways with a view to enhancing recruitment and retention of practice nurses in primary care in Australia.</p> <p>Methods</p> <p>Search terms describing education models, career pathways and policy associated with primary care (practice) nursing were established. These search terms were used to search electronic databases. The search strategy identified 1394 citations of which 408 addressed one or more of the key search terms on policy, education and career pathways. Grey literature from the UK and New Zealand internet sites were sourced and examined. The UK and New Zealand Internet sites were selected because they have well established and advanced developments in education and career pathways for practice nurses.</p> <p>Two reviewers examined titles, abstracts and studies, based on inclusion and exclusion criteria. Disagreement between the reviewers was resolved by consensus or by a third reviewer.</p> <p>Results</p> <p>Significant advances have been made in New Zealand and the UK towards strengthening frameworks for primary care nursing education and career pathways. However, in Australia there is no policy at national level prepare nurses to work in primary care sector and no framework for education or career pathways for nurses working in that sector.</p> <p>Conclusion</p> <p>There is a need for national training standards and a process of accreditation for practice nursing in Australia to support the development of a responsive and sustainable nursing workforce in primary care and to provide quality education and career pathways.</p

Nurses in Australian general practice: implications for chronic disease management

Aims. The purpose of this study was to describe the demographic and employmentcharacteristics of Australian practice nurses and explore the relationship betweenthese characteristics and the nurses? role.Background. Nursing in general practice is an integral component of primary care andchronic disease management in the United Kingdom and New Zealand, but inAustralia it is an emerging specialty and there is limited data on the workforce and role.Design. National postal survey embedded in a sequential mixed method design.Methods. 284 practice nurses completed a postal survey during 2003?2004.Descriptive statistics and factor analysis were utilized to analyse the data.Results. Most participants were female (99%), Registered Nurses (86%), employedpart-time in a group practice, with a mean age of 458 years, and had a hospital nursingcertificate as their highest qualification (63%). The tasks currently undertaken byparticipants and those requiring further education were inversely related(R2 0779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 08996).There was a mismatch between the number of participants who perceived that aparticular task was appropriate and those who undertook the task. This disparity wasnot completely explained by demographic or employment characteristics. Extrinsicfactors such as legal and funding issues, lack of space and general practitioner attitudeswere identified as barriers to role expansion.Conclusion. Practice nurses are a clinically experienced workforce whose skills are notoptimally harnessed to improve the care of the growing number of people with chronicand complex conditions.Relevance to clinical practice. Study data reveal a need to overcome the funding,regulatory and interprofessional barriers that currently constrain the practice nurserole. Expansion of the practice nurse role is clearly a useful adjunct to specialistmanagement of chronic and complex disease, particularly within the context ofcontemporary policy initiatives

Evolution of practice nursing in Australia

This paper describes the evolution of Australian practice nursing and documents seminal events in crystallizing the importance of the nursing role in general practice