Nursing within primary care settings in Atlantic Canada: a research practicum

Curnew, Deanne R. (2017) Nursing within primary care settings in Atlantic Canada: a research practicum. Practicum Report. Memorial University of Newfoundland. (Unpublished)

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Abstract

Background: Newfoundland and Labrador (NL) ranks the highest in Canada for prevalence of chronic diseases and risk factors for chronic disease. To address this health system issue, the Government of NL has committed to primary healthcare reform, which includes implementing interdisciplinary team-based models of primary care. Successful integration of Nurse Practitioners (NP), Registered Nurses (RN), and Licensed Practical Nurses (LPN) into primary care teams requires better understanding of their current roles in primary care, barriers and facilitators of role optimization, and nursing contributions to patient and system-level outcomes. Purpose: The goal of this Master of Nursing (MN) research practicum project was to develop quantitative research skills by engaging in a variety of nursing research activities, which included examining and synthesizing the current state of knowledge related to nursing within primary care settings in Atlantic Canada, and engaging in knowledge translation activities. Methods: A scoping review of literature related to nursing in primary care settings in Atlantic Canada was conducted using Joanna Briggs Institute (JBI) methodology. The review was guided by the Nursing Role Effectiveness Model. A scoping review manuscript was prepared and submitted to the Canadian Journal of Nursing Research. Abstracts were submitted for oral presentations to three conferences taking place during Spring and Summer 2017, including the Community Health Nurses of Canada Conference, Primary Healthcare Partnership Forum, and Eastern Health Nursing Education and Research Council Nursing Research Symposium. In addition, a reflection article of research experiences was submitted to the Canadian Nurse. Results: A total of 20 articles met inclusion criteria and were reviewed. Approximately half of these articles discussed RNs and half discussed NPs in primary care settings. No literature focused on LPNs. Four studies were conducted in NL. Emphasis on interdisciplinary collaboration was evident across studies. The function of nurses within teams was found to be limited by institutional constraints and influence of other providers. Roles of RNs and NPs in primary care settings consisted primarily of chronic disease management, education, and health promotion. Primary care settings that incorporate nurses were associated with positive patient health outcomes, improved access to services, and high patient satisfaction. Conclusions: Emerging literature demonstrates the effectiveness of NPs and RNs in primary care settings across Atlantic Canada. However, there is a need to clarify the roles of NPs, RNs, and LPNs with respect to chronic disease management, health promotion, and preventive care within these settings. There is considerable opportunity for future research to investigate specific attributes of nursing within primary care teams that result in high-quality patient and system-level outcomes.

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