The work of nurse practitioners.
OBJECTIVE
This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities.


BACKGROUND
The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models.


METHODS
We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks.


RESULTS
A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.0% and service-related activities made up 31.9%.


CONCLUSIONS
These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.
Gardner
Glenn
G
Centre for Clinical Nursing, Queensland University of Technology and Royal Brisbane & Women's Hospital, Brisbane, Australia. ge.gardner@qut.edu.au
Gardner
Anne
A
Middleton
Sandy
S
Della
Phillip
P
Kain
Victoria
V
Doubrovsky
Anna
A
D000293:Adolescent; D001315:Australia; D005260:Female; D018166:Health Care Reform; D006801:Humans; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009739:Nursing Services / Q000458:organization & administration; D057184:Practice Patterns, Nurses'; D013647:Task Performance and Analysis; D013997:Time Factors