Nurse Practitioner Led Services in Primary Health Care in Rural NSW– Two Case Studies

Abstract

Background Nurse Practitioners (NPs) are a relatively new advanced nursing role. It was hoped that NPs would reduce some of the challenges facing health care, address workforce shortages and improve access to services for rural populations. The most recent census of Australian NPs showed that just twelve of 208 working NPs were located in primary health care settings. It also showed the majority of NPs were employed in metropolitan areas. Few previous studies describe NP roles in detail, or in rural primary health care settings. Aims This study aims to describe, in detail, the roles of two NPs in rural New South Wales in primary health care settings. One case study focuses on the delivery of an integrated mental health service and the other on leadership in aged care. Methods A case study methodology was employed, using multiple data sources. Data were gathered using semi-structured interviews with 31 key stakeholders, the examination of key documentation, and observation of the NPs within these settings. In the first case study, quantitative data were also analysed. Interview data were analysed thematically. Results The case studies offer an in-depth description of why and how these roles were established, what the NPs do and their impact within the context of small rural towns. They illustrate how NPs established intersectoral partnerships, new service delivery models and advocacy regarding the way health care was provided. The case studies also provide valuable information on how to best incorporate NPs into rural primary health care. Conclusion This study details the complexity of two NP roles within rural primary health care settings. The two case studies show that in these settings, NPs are providing leadership, supporting other services, helping to address workforce shortages, improving access to services for rural populations, and therefore demonstrating the positive impact of NPs working in these settings.