Office Nursing

Abstract: This is a report of a mail survey undertaken on behalf of the Subcommittee on Pediatric Manpower of the Council on Pediatric Practice of the American Academy of Pediatrics. Its purposes were: (1) to collect information about how practitioners of pediatrics utilize their own time and that of other health workers for the performance of specific tasks carried out in the course of ambulatory pediatric care; (2) to ascertain the degree to which practice characteristics, including task delegation, were related to characteristics of the physician, his practice arrangement and his practice load; and, (3) to sound out general pediatric opinion concerning task delegation in ambulatory pediatric care. The genesis of this survey and its relationship to current health manpower shortages have been discussed elsewhere.1 Prior to this survey no information on a national basis had been available concerning the extent and nature of task delegation in pediatric office practice or the opinions of pediatricians about this subject. Although most American children receive preventive and therapeutic health care from physicians in private office practice, extraordinarily little information about the characteristics of this system of care is available. A structured, precoded questionnaire was designed to collect the desired information. In the summer of 1967, the first version was pretested on 273 Regular Fellows of the Academy of Pediatrics residing in Massachusetts and a 2% random sample of Fellows residing in the other 49 states and the District of Columbia. The results of this major pretest have been described elsewhere. Slight modifications were made in the original version of the questionnaire and the revised version was mailed in the late fall of 1967 to 6,820 Regular Fellows of tile American Academy of Pediatrics residing in the United States.

Abstract: This study focused on the introduction of mentors in the Common Foundation Programme of Project 2000 schemes of preregistration nurse education. The research, which was commissioned by the Department of Health Research and Development Division on behalf of the Welsh Office Nursing Division, began in February 1992 and was undertaken on an all-Wales basis. The completed report aims to provide policy makers with information relating to important issues which are central to the teaching and learning of nursing in clinical locations. This first paper discusses some background issues and gives a brief conceptual framework for considering policy reform, summarizes the research questions which emerged and describes the methods used to address them. The second paper (to appear in the next issue of the journal) will describe the key findings from the study and discuss some ensuing potential implications and considerations for all those involved in the preparation of future practitioners of nursing.

Abstract: Aim This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Background Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. Conclusions The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. Implications for nursing management There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

Abstract: Purpose: To develop an instrument to assess consumer satisfaction with nursing in general practice to provide feedback to nurses about consumers’ perceptions of their performance. Design: Prospective psychometric instrument validation study. Methods: A literature review was conducted to generate items for an instrument to measure consumer satisfaction with nursing in general practice. Face and content validity were evaluated by an expert panel, which had extensive experience in general practice nursing and research. Included in the questionnaire battery was the 27-item General Practice Nurse Satisfaction (GPNS) scale, as well as demographic and health status items. This survey was distributed to 739 consumers following intervention administered by a practice nurse in 16 general practices across metropolitan, rural, and regional Australia. Participants had the option of completing the survey online or receiving a hard copy of the survey form at the time of their visit. These data were collected between June and August 2009. Findings: Satisfaction data from 739 consumers were collected following their consultation with a general practice nurse. From the initial 27-item GPNS scale, a 21-item instrument was developed. Two factors, “confidence and credibility” and “interpersonal and communication” were extracted using principal axis factoring and varimax rotation. These two factors explained 71.9% of the variance. Cronbach's α was 0.97. Conclusions: The GPNS scale has demonstrated acceptable psychometric properties and can be used both in research and clinical practice for evaluating consumer satisfaction with general practice nurses. Relevance to Clinical Practice: Assessing consumer satisfaction is important for developing and evaluating nursing roles. The GPNS scale is a valid and reliable tool that can be utilized to assess consumer satisfaction with general practice nurses and can assist in performance management and improving the quality of nursing services.