Strengthening Team-Based Care: Optimizing the Scope of Practice of Primary Care Nurses-Protocol
Notice bibliographique
Résumé
Goal: To strengthen team-based primary care and primary care nurses' (PC-Ns: Nurse Practitioners [NPs], Registered Nurses [RNs], Licensed/Registered Practical Nurses [LPN/RPNs]) intra-professional collaboration by delineating professional scopes of practice of each PC-N provider. Background and Rationale: In Canada, three regulated nursing designations work in primary care (NPs,RNs, LPNs/RPNs). PC-Ns are the second largest workforce in primary care and play critical roles in optimizing outcomes, while reducing health disparities. There is renewed interest in team-based primary care that includes nurses as a solution for health workforce challenges. Some team models enable PC-Ns to leverage one another’s expertise to work to optimal scope, while other models do not. A recent Canadian Institute for Health Information report compared PC-Ns’ legislated scopes of practice but did not offer insights into PC-Ns’ professional scopes to meet patient and population health needs. We will examine PCNs’ professional scopes of practice and how the presence of other PC-Ns and providers impacts scope enactment. Research Questions and Objectives: How do PC-N professional scopes of practice overlap/differ? How does the presence/absence of other PC-Ns impact (narrow, expand, and/or shift) activities of each PC-N provider? How does the presence/absence of other non-PC-N providers impact activities of each PC-N provider? How do characteristics of the clinical setting influence PC-Ns’ professional scope of practice enactment? This project consists of two linked studies: 1) umbrella review and 2) multiple case study. The objectives are: 1. To synthesize and compare international knowledge syntheses focused on scope of practice enactment (i.e., roles/activities) of PC-Ns in primary care. 2. To examine how nursing care organization (i.e., staffing, practice attributes) impacts professional scope of practice enactment of PC-N providers in a primary care team. Methods: The Umbrella Review will consolidate international scoping and systematic review evidence on PC-N roles into a single report. The Multiple Case Study consists of two compoenents: (1) qualitative interviews and (2) a measure of PC-N scope enactment (Actual Scope of Practice-Primary Care tool) in four provinces (Alberta, Ontario, Quebec, Newfoundland & Labrador). PC-Ns will describe their scope of practice, challenges/facilitators, and opportunities for role optimization. Overlap in care will be examined by presenting PC-Ns with clinical scenarios and prompting discussion about care activities. Thematic analysis will be used. Data will be compared across cases. Expertise: We are an interdisciplinary team comprising established and early-career researchers, persons with lived experience, and decision-makers. Our expertise spans PC-N, health workforce, practice regulation, and knowledge translation. Strong collaborations with knowledge users and primary care researchers enhance the project's robustness and allow for broad perspectives. Outcomes and Significance: This project will generate evidence about the extent to which PC-N scopes are optimized/enacted in teams and guide funding and staffing policies to ensure that the best qualified nurse, or team of nurses, is in place to realize the benefits of team-based care. Findings will enhance understanding of PC-Ns’ shared/unique contributions to patient care, strengthen collaboration, and enhance the capacity of primary care to optimize team configurations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,005 |
| Études des sciences et des technologies | 0,001 | 0,003 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,011 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».