| December
2020
- Volume 14, Issue 3
Barriers
to the Implementation of the Advanced Practice Nursing Role
in Primary Health Care Settings: An Integrative Review
Maryam
Fatemi (1)
Kathleen Benjamin (2)
Jessie Johnson (3)
Robin O’Dwyer (1)
(1) Primary Healthcare
Corporation, Qatar
(2) Adjunct, Faculty of Nursing, University of Calgary, Canada
(3) Faculty of Nursing University of Calgary Qatar
Corresponding author:
Maryam FATEMI, BScN, MN, Primary Healthcare Corporation, Qatar
Email: mgfatemi@ucalgary.ca
Received: September 2020; Accepted: October 2020; Published:
November 1, 2020
Citation: Maryam Fatemi et al. Barriers to the Implementation
of the Advanced Practice Nursing Role in Primary Health Care
Settings: An Integrative Review. Middle East Journal of Nursing
2020; 14(2): 16-37. DOI: 10.5742/MEJN2020.93794
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ABSTRACT
Background: Advanced practice nurses are nurses prepared
with advanced clinical education, skills, and competencies
required to assess, diagnose, treat and deliver continuous
care for acute or chronic conditions. The move toward using
advanced practice nurses in
primary healthcare settings in Qatar is inevitable to advance
the nurse’s role, improve the level of services provided,
raise patient satisfaction, and improve the organizational
outcomes.
Aim: The aim of this review
was to explore the barriers in implementing advanced practice
nursing in primary health care settings in order to facilitate
its implementation in Qatar.
Method: Whittemore and Knalf’s
framework guided this integrative review. Fourteen studies
published between 2009 and 2019 were included in the review.
The mixed-methods appraisal tool was used to assess the quality
of the studies. The socio-ecological model was used to categorize
and present barriers at the individual; organizational, social,
cultural, policies, and environmental level.
Result: Three main barriers
noted were a lack of clarity and support of the role, lack
of organizational and policy support for the role, and a lack
of designated space for APN practice.
Conclusion: Identifying and
addressing barriers is necessary to achieve successful implementation
of the APN role within primary healthcare in Qatar. Key recommendations
for Qatar include integrating key stakeholders in the implementation
process, use of a clear job description and policies, and
providing designated workspaces for APN practice.
Key words: advanced practice
nursing, clinical nurse specialist, nursing practitioners,
primary health care, barriers
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