title: Australian nurses in general practice, enabling the provision of cervical screening and well women's health care services: a qualitative study.
abstract: BACKGROUND
  The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women's health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area.
  
  
  METHODS
  A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women's health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints.
  
  
  RESULTS
  Four enablers for the implementation of a change in the PN role to include cervical screening and well women's health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women's health service provider; PNs being willing to expand their role to include cervical screening and well women's health services; clients preferring a female practice nurse to meet their cervical screening and well women's health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women's health service providers.
  
  
  CONCLUSIONS
  The influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider's role will be fundamental to comprehensive service delivery in the future.
authors.affiliation: School of Nursing, Midwifery & Nutrition, James Cook University, Cairns Campus, Cairns, QLD, 4878, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Mills
authors.affiliation: School of Nursing, Midwifery & Nutrition, James Cook University, Cairns Campus, Cairns, QLD, 4878, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chamberlain-Salaun
authors.affiliation: Queensland Cervical Screening Program, Queensland Health, Herston, QLD, 4029, Australia.
authors.forename: Leane
authors.initials: L
authors.lastname: Christie
authors.affiliation: Sexual Health & HIV Service, Queensland Health, Brisbane, QLD, 4000, Australia.
authors.forename: Margot
authors.initials: M
authors.lastname: Kingston
authors.affiliation: General Practice Queensland, Brisbane, QLD, 4001, Australia.
authors.forename: Elise
authors.initials: E
authors.lastname: Gorman
authors.affiliation: Family Planning Queensland, 100 Alfred Street, Fortitude Valley, QLD, 4006, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Harvey