Nurse practitioner led model of after-hours emergency care in an Australian rural urgent care Centre: health service stakeholder perceptions.
2021
Background: The challenges of providing and accessing quality health care in rural regions have long been
identified. Innovative solutions are not only required but are also vital if effective, timely and equitable access
to sustainable health care in rural communities is to be realised. Despite trial implementation of some
alternative models of health care delivery, not all have been evaluated and their impacts are not well
understood. The aim of this study was to explore the views of staff and stakeholders of a rural health service
in relation to the implementation of an after-hours nurse practitioner model of health care delivery in its
Urgent Care Centre. Methods: This qualitative study included semi-structured individual and group interviews with professional
stakeholders of a rural health service in Victoria, Australia and included hospital managers and hospital staff
who worked directly or indirectly with the after-hours NPs in addition to local GPs, GP practice nurses, and
paramedics. Thematic analysis was used to generate key themes from the data. Results: Four themes emerged from the data analysis: transition to change; acceptance of the after-hours
nurse practitioner role; workforce sustainability; and rural context. Conclusions: This study suggests that the nurse practitioner-led model is valued by rural health practitioners
and could reduce the burden of excessive after-hour on-call duties for rural GPs while improving access to
quality health care for community members. As pressure on rural urgent care centres further intensifies with
the presence of the COVID-19 pandemic, serious consideration of the nurse practitioner-led model is
recommended as a desirable and effective alternative.
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