Cardiovascular disease management: time to advance the practice nurse role?
OBJECTIVE
More than two-thirds of health expenditure is attributable to chronic conditions, of which a significant proportion are related to cardiovascular disease. This paper identifies and explores the factors cited by practice nurses as impacting on the development of their role in cardiovascular disease management.


METHODS
Sequential mixed methods design combining postal survey (n = 284) and telephone interviews (n = 10) with general practice nurses.


RESULTS
The most commonly cited barriers to role extension were legal implications (51.6%), lack of space (30.8%), a belief that the current role is appropriate (29.7%), and general practitioner attitudes (28.7%). The most commonly cited facilitators of role extension were collaboration with the general practitioner (87.6%), access to education and training (65.6%), the opportunity to deliver primary health care (61.0%), a high level of job satisfaction (56.0%) and positive consumer feedback (54.6%).


CONCLUSIONS
Australian government policy demonstrates a growing commitment to an extended role for general practice in primary health care and cardiovascular disease management. In spite of these promising initiatives, practice nurses face a range of professional and system barriers to extending their role. By addressing the barriers and enabling features identified in this investigation, there is potential to further develop the Australian practice nurse role in cardiovascular disease management.
Halcomb
Elizabeth J
EJ
School of Nursing, University of Western Sydney, Locked Bag 1797, Penrith South DC, Sydney, NSW 1797, Australia. e.halcomb@uws.edu.au
Davidson
Patricia M
PM
Griffiths
Rhonda
R
Daly
John
J
D000328:Adult; D001315:Australia; D002318:Cardiovascular Diseases / Q000451:nursing*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role