title: A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis.
abstract: BACKGROUND
  Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration. However, this literature is much less prolific in discussing the operational level implications of those barriers and facilitators and in offering practical recommendations.
  
  
  METHODS
  In the context of a large-scale research project on the introduction of nurse practitioners in Quebec (Canada) we relied on a logic-analysis approach based, on the one hand on a realist review of the literature and, on the other hand, on qualitative case-studies in 6 primary healthcare teams in rural and urban area of Quebec.
  
  
  RESULTS
  Five core themes that need to be taken into account when integrating nurse practitioners into primary care teams were identified. Those themes are: planning, role definition, practice model, collaboration, and team support. The present paper has two objectives: to present the methods used to develop the themes, and to discuss an integrative model of nurse practitioner integration support centered around these themes.
  
  
  CONCLUSIONS
  It concludes with a discussion of how this framework contributes to existing knowledge and some ideas for future avenues of study.
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. damien.contandriopoulos@umontreal.ca.
authors.forename: Damien
authors.initials: D
authors.lastname: Contandriopoulos
authors.affiliation: Department of Community Health Sciences, University of Sherbrooke, 150, place Charles-Le Moyne, Bureau 200, Longueuil, Québec, J4K 0A8, Canada. astrid.Brousselle@usherbrooke.ca.
authors.forename: Astrid
authors.initials: A
authors.lastname: Brousselle
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. carl.ardy.dubois@umontreal.ca.
authors.forename: Carl-Ardy
authors.initials: CA
authors.lastname: Dubois
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. melanie.perroux@umontreal.ca.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Perroux
authors.affiliation: Department of Family Medicine and Emergency Medicine, University of Montreal, Pavillon Roger-Gaudry, 2900, boul Édouard Montpetit, Montréal, Québec, H3T 1J4, Canada. marie-dominique.beaulieu@umontreal.ca.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Beaulieu
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. isabelle.brault@umontreal.ca.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brault
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. kelley.kilpatrick@umontreal.ca.
authors.forename: Kelley
authors.initials: K
authors.lastname: Kilpatrick
authors.affiliation: Faculty of Nursing, University of Montreal, C.P. 6128 succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada. danielle.damour@umontreal.ca.
authors.forename: Danielle
authors.initials: D
authors.lastname: D'Amour
authors.affiliation: School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada. egorm@uvic.ca.
authors.forename: Esther
authors.initials: E
authors.lastname: Sansgter-Gormley
mesh_terms: D002170:Canada; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D006801:Humans; D009722:Nurse Practitioners; D010348:Patient Care Team; D011320:Primary Health Care; D036301:Qualitative Research; D011792:Quebec