title: The role of nurse practitioners in health sector reform in Iran (2011).
abstract: BACKGROUND
  Most countries use educated nurses called "nurse practitioners" (NPs) besides the family physicians for diagnosis, treatment, and specifically health education of the family. The main goal of this study was to redefine the role of NPs for better use of their capabilities in the so-called "family physician reform" in Iran.
  
  
  METHODS
  This is a qualitative and comparative study carried out in three stages (triangulation method) in 2011. In the first stage, we conducted a literature review to design a conceptual framework. The second stage was a comparative study on four countries. In this study, we focused on the role of NPs, which in turn helped to redefine this role in the health sector reform of Iran. In the third stage, two expert panels were involved and the suggested roles were confirmed.
  
  
  RESULTS
  In the United States, NPs are licensed by the state in which they practice and have a national board certification. In Canada, nurses involved in clinics should participate in specific training course of diagnosis and management of health care after registration. In Austria, nurses in Nursing homes and maternity do some of the medical procedures under the supervision of the physicians. In the United Kingdom, NPs increasingly substitute for GPs in the care of minor illness and routine management of chronic diseases.
  
  
  CONCLUSIONS
  There is still debate in nursing and medical circles about what the focus of the NP roles should be. In Iran, whereas a noticeable reform toward "family physician" is ongoing, redefining the nurses' role is essential. They can perform more active roles in associating with GPs in the clinics of family physicians, both in urban and rural areas, even with higher degrees of autonomy.
authors.affiliation: Associate Professor of Health Services Management, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Soudabe
authors.initials: S
authors.lastname: Vatankhah
authors.affiliation: Associate Professor of Health Services Management, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Khalesi
authors.affiliation: Professor of Health Services Management, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farbod
authors.initials: F
authors.lastname: Ebadifardazar
authors.affiliation: Assistant Professor of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Ferdousi
authors.affiliation: MSc, Facualty Member of Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Homayon
authors.initials: H
authors.lastname: Naji
authors.affiliation: Bachelor of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seyed Mohammad Ehsaan
authors.initials: SM
authors.lastname: Farahabadi
keywords: General practitioner; Iran; health care sector; nurse practitioner; reform