Nursing service innovation: a case study examining emergency nurse practitioner service sustainability

Article

Fox, Amanda, Gardner, Glenn and Osborne, Sonya. 2018. "Nursing service innovation: a case study examining emergency nurse practitioner service sustainability." Journal of Advanced Nursing. 74 (2), pp. 454-464. https://doi.org/10.1111/jan.13454
Article Title

Nursing service innovation: a case study examining
emergency nurse practitioner service sustainability

ERA Journal ID14101
Article CategoryArticle
AuthorsFox, Amanda (Author), Gardner, Glenn (Author) and Osborne, Sonya (Author)
Journal TitleJournal of Advanced Nursing
Journal Citation74 (2), pp. 454-464
Number of Pages11
Year2018
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0309-2402
1365-2648
Digital Object Identifier (DOI)https://doi.org/10.1111/jan.13454
Web Address (URL)https://onlinelibrary.wiley.com/doi/full/10.1111/jan.13454
Abstract

Aim: This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service.
Background: Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision.

Design: This research used case study methodology (Yin, 2014).

Methods: Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions.

Findings: In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse.

Conclusion: This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability.

Keywordsadvanced practice nursing; emergency nursing; health services research; innovation; models of care; organizational management; sustainability
ANZSRC Field of Research 2020420599. Nursing not elsewhere classified
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Byline AffiliationsQueensland University of Technology
Institution of OriginUniversity of Southern Queensland
Funding source
Grant ID
Queensland University of Technology, “Women in Leadership, Research Grant”
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Osborne, Sonya Ranee, Jones, Lee and Webster, Joan. 2014. "Author response: missed opportunity related to statistical methods." AORN Journal. 99 (6), pp. 675-677. https://doi.org/10.1016/j.aorn.2014.04.002
Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients
Stankiewicz, Monica, Coyer, Fiona, Webster, Joan and Osborne, Sonya. 2015. "Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients." Dermatologic Surgery. 41 (7), pp. 775-783. https://doi.org/10.1097/DSS.0000000000000391
The skin safety model: reconceptualizing skin vulnerability in older patients
Campbell, Jill L, Coyer, Fiona M. and Osborne, Sonya R.. 2016. "The skin safety model: reconceptualizing skin vulnerability in older patients." Journal of Nursing Scholarship. 48 (1), pp. 14-22. https://doi.org/10.1111/jnu.12176
Skin preparation of the patient – more than skin deep
Levada, Lilliana and Osborne, Sonya. 2017. "Skin preparation of the patient – more than skin deep." Journal of Perioperative Nursing. 30 (2), pp. 57-59.
Making evidence-based perioperative practices stick: an introduction to an implementation science approach
Osborne, Sonya. 2017. "Making evidence-based perioperative practices stick: an introduction to an implementation science approach." Journal of Perioperative Nursing. 30 (4), pp. 53-55.
New ACORN guideline: perioperative nursing management of posthumous organ procurement
Gore, Amanda and Osborne, Sonya. 2017. "New ACORN guideline: perioperative nursing management of posthumous organ procurement." Journal of Perioperative Nursing. 30 (1 - Autumn), pp. 56-59.
Nursing physical assessment for patient safety in general wards: reaching consensus on core skills
Douglas, Clint, Booker, Catriona, Fox, Robyn, Windsor, Carol, Osborne, Sonya and Gardner, Glenn. 2016. "Nursing physical assessment for patient safety in general wards: reaching consensus on core skills." Journal of Clinical Nursing. 25 (13-14), pp. 1890-1900. https://doi.org/10.1111/jocn.13201
Intrathecal morphine–related perioperative hypothermia in women undergoing cesarean delivery: a retrospective case-control study
Munday, Judy, Osborne, Sonya and Yates, Patsy. 2018. "Intrathecal morphine–related perioperative hypothermia in women undergoing cesarean delivery: a retrospective case-control study." Journal of PeriAnesthesia Nursing. 33 (1), pp. 3-12. https://doi.org/10.1016/j.jopan.2016.04.142
Preoperative warming versus no preoperative warming for maintenance of normothermia in women receiving intrathecal morphine for cesarean delivery: a single-blinded, randomized controlled trial
Munday, Judy, Osborne, Sonya, Yates, Patsy, Jones, Lee and Gosden, Edward. 2018. "Preoperative warming versus no preoperative warming for maintenance of normothermia in women receiving intrathecal morphine for cesarean delivery: a single-blinded, randomized controlled trial." Anesthesia and Analgesia. 126 (1), pp. 183-189. https://doi.org/10.1213/ANE.0000000000002026
Cohort study of a specialist social worker intervention on hospital use for patients at risk of long stay
Osborne, Sonya, Harrison, Gai, O'Malia, Angela, Barnett, Adrian Gerard, Carter, Hannah E. and Graves, Nicholas. 2018. "Cohort study of a specialist social worker intervention on hospital use for patients at risk of long stay." BMJ Open. 8 (12), pp. 1-6. https://doi.org/10.1136/bmjopen-2018-023127
Does preoperative oral carbohydrate reduce hospital stay? A randomized trial
Webster, Joan, Osborne, Sonya Ranee, Gill, Richard, Chow, Carina Faran Kalan, Wallin, Siobhan, Jones, Lee and Tang, Annie. 2014. "Does preoperative oral carbohydrate reduce hospital stay? A randomized trial." AORN Journal. 99 (2), pp. 233-242. https://doi.org/10.1016/j.aorn.2013.12.003
Quantitative data collection and study validity
Osborne, Sonya and Schneider, Zevia. 2013. "Quantitative data collection and study validity." Schneider, Zevia, Whitehead, Dean, LoBiondo-Wood, Geri and Haber, Judith (ed.) Nursing and midwifery research: methods and appraisal for evidence-based practice. Australia. Elsevier - Mosby. pp. 200-217
Infection control
Osborne, Sonya. 2013. "Infection control." Crisp, Jackie, Potter, Patricia Ann, Taylor, Catherine, Rebeiro, Geraldine and Douglas, Clint (ed.) Potter and Perry's fundamentals of nursing. Chatswood, NSW, Australia. Elsevier - Mosby. pp. 703-752
The ACORN standards - our aide-memoire to professional practice
Osborne, Sonya. 2013. "The ACORN standards - our aide-memoire to professional practice." ACORN: the journal of perioperative nursing in Australia. 26 (4), pp. 14-15.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, Joan, Osborne, Sonya, Rickard, Clare M. and New, Karen. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007798.pub3
Nursing management: intraoperative care
Shoup, Anita, Reilly, Maureen, Kless, Jack and Osborne, Sonya. 2012. "Nursing management: intraoperative care." Brown, Diane and Edwards, Helen (ed.) Lewis's medical surgical nursing: assessment and management of clinical problems. Australia. Elsevier. pp. 402-420
Exploring the culture of non-reporting in the perioperative environment
Marshall, J. and Osborne, Sonya. 2007. "Exploring the culture of non-reporting in the perioperative environment." ACORN: the journal of perioperative nursing in Australia. 20 (2), pp. 10-21.
Imperatives and strategies for developing an evidence-based practice in perioperative nursing
Osborne, Sonya and Gardner, Glenn. 2004. "Imperatives and strategies for developing an evidence-based practice in perioperative nursing." ACORN: the journal of perioperative nursing in Australia. 17 (1), pp. 18-24.
Occupational exposures: balancing the costs of prevention vs treatment in operating theatres, with particular focus on double gloving practices
Osborne, Sonya. 2001. "Occupational exposures: balancing the costs of prevention vs treatment in operating theatres, with particular focus on double gloving practices." ACORN: the journal of perioperative nursing in Australia. 14 (2), pp. 16-21.
Care and preventative maintenance of surgical instrumentation: the scrub nurse's responsibility
Osborne, Sonya R.. 1999. "Care and preventative maintenance of surgical instrumentation: the scrub nurse's responsibility." ACORN: the journal of perioperative nursing in Australia. 12 (4), pp. 10-13.
Latex allergy: a perioperative environmental hazard
Osborne, Sonya R.. 1998. "Latex allergy: a perioperative environmental hazard." ACORN: the journal of perioperative nursing in Australia. 11 (4), pp. 26-28.