| The organizational and performance effects of nurse practitioner roles. | |
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MedLine Citation:
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PMID: 15324437 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Most studies evaluating the roles of Nurse Practitioners have compared the care delivered by individual Nurse Practitioners with that provided by other professionals. These studies should be complemented by research focusing on a higher unit of analysis, namely the organization of the care process for a specific patient group. The most important reason is that Nurse Practitioners are increasingly involved in direct, multiprofessional care in complex health care organizations and networks. In these work settings, their roles may, in both positive and negative ways, lead to changes in the organization of the entire care delivery system. AIM: The aim of this paper is to stimulate awareness and evaluation of these organizational changes and their potential impact on the effectiveness of the care process. APPROACH: A conceptual model based on patterned systems contingency theory is proposed. With the help of this model, attention is drawn to issues at the level of the organization and the effectiveness of the care processes that merit attention when Nurse Practitioner positions are being introduced. These issues are derived from case studies in Dutch hospitals. RESULTS: According to the model, a Nurse Practitioner position will change the work structure of the care process involved. Therefore, the effectiveness of a Nurse Practitioner position will be dependent on the changes realized in the work structure. The resulting structure should fit the task characteristics of the care services demanded by the specific patient group. On the basis of this model and the examples presented, questions for further study are formulated. CONCLUSIONS: Nurse Practitioner roles can only enhance the effectiveness of care processes when embedded in a work structure that is internally consistent and adjusted to the task environment and available skill-mix. A structural contingency framework may be helpful in identifying relevant organizational issues. To determine the effects of Nurse Practitioner roles, cross-sectional as well as longitudinal studies are needed. |
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Authors:
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Marjolein A G van Offenbeek; Marrig Knip |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of advanced nursing Volume: 47 ISSN: 0309-2402 ISO Abbreviation: J Adv Nurs Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-24 Completed Date: 2004-12-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609811 Medline TA: J Adv Nurs Country: England |
Other Details:
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Languages: eng Pagination: 672-81 Citation Subset: IM; N |
Affiliation:
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Faculty of Management and Organisation, University of Groningen, Groningen, The Netherlands. m.a.g.van.offenbeek@bdk.rug.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Clinical Competence
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standards* Humans Nurse Practitioners / organization & administration*, standards Nurse's Role Quality of Health Care / standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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