title: Consensus on an Australian Nurse practitioner specialty framework using Delphi methodology: results from the CLLEVER 2 study.
abstract: OBJECTIVE
  The aim of this study was to achieve profession-wide consensus on an Australian nurse practitioner specialty framework.
  
  
  BACKGROUND
  Since its introduction in 1998, the Australian nurse practitioner profession has grown to over 1300 endorsed practitioners, representing over 50 different specialties. To complement better a generalist learning and teaching framework with specialist clinical education, prior research proposed a broad framework of Australian nurse practitioner specialty areas termed metaspecialties.
  
  
  METHODS
  This study employed an online three-round modified Delphi method.
  
  
  METHODS
  Recruitment using purposive sampling and snowballing techniques identified an eligible sample from a population of nurse practitioners with at least 12 months' postendorsement experience (n = 966). Data were collected using online survey software from September 2014-January 2015 and analysed using descriptive statistics and content analysis. The Content Validity Index and McNemar's Test for Change were used to determine consensus on the nurse practitioner metaspecialties.
  
  
  RESULTS
  One-fifth of the total eligible population completed the study. Participants achieved high consensus on four metaspecialties, including: Emergency and acute care, primary health care, child and family health care and mental health care. Two metaspecialties did not achieve consensus and require further investigation.
  
  
  CONCLUSIONS
  A large sample of nurse practitioners achieved consensus on an Australian metaspecialty framework, increasing the likelihood of widespread acceptance across the profession. This technique may be appropriate for use in jurisdictions with smaller populations of nurse practitioners. Ongoing research is needed to re-evaluate the metaspecialties as the profession grows.
authors.affiliation: Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Watson, Australian Capital Territory, Australia.
authors.forename: Christopher
authors.identifier: http://orcid.org/0000-0003-1195-8153
authors.initials: C
authors.lastname: Helms
authors.affiliation: Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, James Cook University, Townsville, Queensland, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Gardner
authors.affiliation: Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, North Sydney, New South Wales, Australia.|Nursing Research Institute SVHA (Syd) & ACU, St Vincents Hospital, Darlinghurst, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McInnes
mesh_terms: D001315:Australia; D003697:Delphi Technique; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data*; D009722:Nurse Practitioners / Q000706:statistics & numerical data*; D000072184:Nurse Specialists / Q000706:statistics & numerical data*
keywords: Australia; Delphi; consensus; framework; metaspecialty; nurse practitioner; nursing; specialty