Evidence-based educational commissioning and policy making: a case for the prospective use of a psychometric approach in defining the role and preparation of the nurse practitioner in Australia.
The concept of evidence-based care and the profile of the nurse practitioner (NP) have together assumed mounting importance as possible solutions to the problem of meeting escalating demands for high quality health care with decreasing resources. With regard to the former, concerted efforts to ensure that clinical practice has its base in scientific evidence, have resulted in health care delivery that is increasingly informed by research rather than ritual and tradition. This success notwithstanding, health management and policy-making have remained grounded in assumption, principally because of the paucity of available research in these areas. With regard to the NP, there is little agreement regarding the boundaries of professional practice and preparatory education, both of which need to be defined to some degree at the local level, if the health needs of the indigenous population are to be met. If these two issues are integrated, the policies regarding the preparation and occupational scope of the NP could incorporate research-based decision-making, and thus could simultaneously develop the NP according to locally specified needs, as well as meeting the requirements of the evidence-based care culture. This paper discusses a psychometrically valid and reliable instrument that has the capacity to provide research data which can inform strategic thinking regarding the definition, education and operation of the NP at a variety of levels. The technique has been used extensively in the UK, repeatedly demonstrating its value in NP educational commissioning. While the instrument has not yet been used to inform NP education in Australia, it has been administered to a cohort of acute sector nurses in Victoria. It is argued that the relevance of the instrument to the Australian health system, coupled with its proven importance in the development of the NP in comparable health care cultures, makes this approach worthy of consideration for the preparation of the NP for a variety of Australian health contexts.
Hicks
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C
School of Continuing Studies, University of Birmingham, UK.
Hennessy
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D
D001315:Australia; D003625:Data Collection / Q000379:methods / Q000592:standards; D004511:Education, Nursing, Graduate; D019317:Evidence-Based Medicine; D006291:Health Policy; D006801:Humans; D007587:Job Description; D009722:Nurse Practitioners / Q000193:education* / Q000458:organization & administration*; D015403:Nursing Evaluation Research / Q000379:methods*; D017009:Professional Autonomy; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards