Thesis (Ph. D.)--State University of New York at Binghamton, Decker School of Nursing, 2008. / Includes bibliographical references.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing, Dept. of Graduate Studies. Title and description from dissertation home page (viewed Sept. 29, 2004). Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 53-56).

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.Ed.)--Memorial University of Newfoundland, 2003. / Bibliography: leaves 90-96. Also available online.

Background: Since 2012, nurse practitioners (NPs) in Ontario have the professional capacity to assume the role of the most responsible provider (MRP) in hospitals; however, few have implemented this model. Aim: To explore the barriers and facilitators to the integration of the NP as MRP model of care in a hospital setting. Methods: A qualitative descriptive design with secondary data collected from a larger study, was used with principles from integrated knowledge translation. Findings: Thirteen barriers and eleven facilitators were found, such as: (i) challenges with off hour coverage; (ii) funding and remuneration; (iii) discrepancies in the employment standards regulations; and (iv) lack of a critical mass. Facilitators included the plan for role implementation, establishment of trust and leadership from the team. Conclusion: Many barriers, predominantly at the healthcare system-level, make it difficult to integrate the NP as MRP model of care in hospitals.

Purpose: To describe the process of designing a new progressive nurse practitioner student clinical evaluation tool based on competencies. Data sources: Selected research articles and professional organization published guidelines. Conclusions: Evaluation of nurse practitioner students' clinical performance is an important and often complex responsibility of faculty. The clinical evaluation tool should reflect the changing expectations associated with particular courses across the curriculum and be based on the competencies identified by the National Organization of Nurse Practitioner Faculties. Collaboration by faculty is the key to development of an accurate and useful clinical evaluation tool. Implications for practice: The progressive nurse practitioner clinical evaluation tool presented here is the result of integrating specific clinical course outcomes and competencies recognized by key nurse practitioner associations.

Purpose. This study was designed to determine the perceptions of the Oregon-certified nurse practitioners (NPs) with respect to their usage, competency, and preparation for selected functions. Clarification of what NP's perceive themselves doing and with what degree of competence could give structure and direction to their preparation. In Oregon, NPs provide specialized primary care in collaboration with physicians and other health care professions and agencies. The performance of an NP may vary according to the specialty, setting, and needs of the consumer. If some functions of the NP could be brought into clearer focus, then not only could benefits come to the health care consumer, but also health care professionals could work together more efficiently and productively. Furthermore, educators could build programs with a clearer sense of purpose and structure. Procedure. The data were obtained through a survey of 574 NPs certified in Oregon. A four-part questionnaire was adapted from instruments developed by researchers of NPs in North Carolina, Arkansas, and Colorado. The analysis of service diaries provided by Oregon nurse practitioners, additions by the Oregon State Board of Nursing, and pretesting in the field resulted in statements about selected characteristics and attitudes, practice settings, and clinical and community functions of Oregon nurse practitioners. Questionnaires were mailed, and 386 were analyzed. Summary of Findings and Conclusions. Three research hypotheses were formed and tested by chi-square. The following findings and conclusions were identified: (a) Some relationships did exist between NP functions and specialty groups with respect to competency, frequency of performance, and preferred preparation. (b) Most nurse practitioners serve a large number of consumers in low or very low economic circumstances through community or home health agencies. (c) Some functions of high competency and usage are needed in the preparation of all nurse practitioners at the baccalaureate and master's level. (d) Higher education is preferred for preparation of nurse practitioners in a sequence of baccalaureate in nursing followed by a master's degree which qualifies for certification in a nursing specialty. (e) For the functions of lower competency and usage, reduced emphasis or deletion from nurse practitioner preparation is desirable. (f) Some functions are suitable for major emphasis in continuing education programs with the standards of higher education.

This study's purpose was to describe the practice patterns of nurse practitioners (NPs) in Tennessee--specifically, the demographic characteristics and health problems of their clients and the therapeutic services they provide. A random sample of NPs practicing 20 or more hours per week in primary care in Tennessee provided data on a total of 680 clients seen during one selected day of care. An instrument adapted from the National Ambulatory Medical Care Survey (NAMCS) allowed comparison of the NP findings with a national survey of office-based physicians in five areas: client demographics, client health status, diagnostic tests ordered, therapeutic interventions provided, and client disposition. Although many similarities were seen, differences included the tendency of NPs to care for more younger and female clients, to perform fewer office surgical procedures, and to provide more health teaching/counseling interventions.

Acute care nurse practitioners (ACNPs) are a new addition to the Canadian health care system, having been introduced in the Canadian health care system in the late 1980s. While some authors have suggested that nurse practitioners offer “something special” to patient care, no evidence to date has substantiated this claim. The findings of this grounded theory study offer a theory (Acute Care Health Professional-Patient Relationship (ACHPPR) Theory) to describe how three types of health care professionals establish relationships with patients in acute care settings (Figure 7). This qualitative study explored relationships that ACNPs, physicians and staff nurses establish with patients in a large urban multi-site university-affiliated hospital. Six quartets (patient, ACNP, physician, staff nurse) were recruited and interviews, using a semi-structured guide were audio-taped and subsequently transcribed verbatim. Each type of relationship was found to have a unique focus; ACNPs focus on making connections with patients, physicians focus on managing patients’ diseases and staff nurses focus on meeting patients’ needs. In order to establish relationships with patients, readiness conditions must be met. Health professionals use strategies to influence the achievement of readiness conditions as well as to move forward with relationship development. Each type of relationship varies in the range of potential intensity that can be achieved, which is influenced by various dimensions. Relational intensity ranges from the uncommon clinical relationship, which focuses on the patient’s disease, through the more typical professional relationship characterized by a comfortable rapport and then finally to the most relationally intense, but rare, personal relationship. If a relationship reaches professional or personal levels of relational intensity, relational products become evident. When comparing these three health professional-patient relationships, similarities and differences have been identified. Analysis of patient interviews yielded themes that substantiate the ACHPPR theory. The ACHPPR theory offers a beginning understanding of the complementary nature of three types of health professional-patient relationships in the acute care setting and has the potential to influence practice, education, theory development and future research related to ACNP-patient relationships.