Qian Zhang , Shifan Han , Wenjing Dong , Gege Cao , Zhenyu Wang , Mingzi Li , Ruifang Zhu
{"title":"Barriers and facilitators to the application of nurse practitioners' training pilot programs in China: A CFIR-guided descriptive qualitative study","authors":"Qian Zhang , Shifan Han , Wenjing Dong , Gege Cao , Zhenyu Wang , Mingzi Li , Ruifang Zhu","doi":"10.1016/j.nedt.2024.106501","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The <em>Guidelines on Prescriptive Authority for Nurses</em> released by the International Council of Nurses indicate that 44 countries or territories worldwide have enacted legislation granting prescriptive authority to nurses. In the US, 27 states, two territories, and Washington, D.C. have authorized certified nurse practitioners full practice authority, including prescriptive authority, and momentum is building. Currently, in mainland China, there is no national legal mandate for nurse practitioners to prescribe, although a few institutions have initiated pilot training programs for nurse practitioners. However, little is known about the factors influencing their prescribing. Research on the value of such pilot programs from the perspectives of nurse practitioners and stakeholders is required.</div><div>Aim</div><div>The purpose of this study is to identify, assess and synthesize the perceptions of nurse practitioners and stakeholders in two pilot training programs on the barriers and facilitators to the potential development and implementation of nurse prescribing in mainland China.</div></div><div><h3>Design</h3><div>A descriptive qualitative research design.</div></div><div><h3>Settings</h3><div>The study was conducted at two nurse practitioner pilot institutions in mainland China.</div></div><div><h3>Participants</h3><div>Five nurse practitioners, three collaborators, three policymakers and three trainers of nurse practitioners from two pilot institutions.</div></div><div><h3>Methods</h3><div>Data were collected via semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) was used as a framework to orient the data analysis.</div></div><div><h3>Results</h3><div>Within the five Consolidated Framework for Implementation Research domains, we identified 31 barriers and 50 facilitators influencing the potential implementation of nurse practitioner prescribing. Barriers mainly included insufficient urgency for change, lack of policy and legal support, inadequate education and training on prescribing, and low public awareness. Facilitators encompassed nurses' practical prescribing experience, their competence and confidence in role expansion, effective teamwork, and a strong demand orientation within healthcare settings.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that China possesses significant potential to successfully carry out nurse practitioner prescribing initiatives. It is crucial to explore factors hindering or promoting the development of nurse practitioners to effectively support their implementation within healthcare systems while strategizing for future advancements in this area. In the case that the national policy has not yet been promulgated, the outcomes derived from our pilot work will carry substantial influence over national policies.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"145 ","pages":"Article 106501"},"PeriodicalIF":3.6000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nurse Education Today","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0260691724004118","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The Guidelines on Prescriptive Authority for Nurses released by the International Council of Nurses indicate that 44 countries or territories worldwide have enacted legislation granting prescriptive authority to nurses. In the US, 27 states, two territories, and Washington, D.C. have authorized certified nurse practitioners full practice authority, including prescriptive authority, and momentum is building. Currently, in mainland China, there is no national legal mandate for nurse practitioners to prescribe, although a few institutions have initiated pilot training programs for nurse practitioners. However, little is known about the factors influencing their prescribing. Research on the value of such pilot programs from the perspectives of nurse practitioners and stakeholders is required.
Aim
The purpose of this study is to identify, assess and synthesize the perceptions of nurse practitioners and stakeholders in two pilot training programs on the barriers and facilitators to the potential development and implementation of nurse prescribing in mainland China.
Design
A descriptive qualitative research design.
Settings
The study was conducted at two nurse practitioner pilot institutions in mainland China.
Participants
Five nurse practitioners, three collaborators, three policymakers and three trainers of nurse practitioners from two pilot institutions.
Methods
Data were collected via semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) was used as a framework to orient the data analysis.
Results
Within the five Consolidated Framework for Implementation Research domains, we identified 31 barriers and 50 facilitators influencing the potential implementation of nurse practitioner prescribing. Barriers mainly included insufficient urgency for change, lack of policy and legal support, inadequate education and training on prescribing, and low public awareness. Facilitators encompassed nurses' practical prescribing experience, their competence and confidence in role expansion, effective teamwork, and a strong demand orientation within healthcare settings.
Conclusion
Our findings suggest that China possesses significant potential to successfully carry out nurse practitioner prescribing initiatives. It is crucial to explore factors hindering or promoting the development of nurse practitioners to effectively support their implementation within healthcare systems while strategizing for future advancements in this area. In the case that the national policy has not yet been promulgated, the outcomes derived from our pilot work will carry substantial influence over national policies.
期刊介绍：
Nurse Education Today is the leading international journal providing a forum for the publication of high quality original research, review and debate in the discussion of nursing, midwifery and interprofessional health care education, publishing papers which contribute to the advancement of educational theory and pedagogy that support the evidence-based practice for educationalists worldwide. The journal stimulates and values critical scholarly debate on issues that have strategic relevance for leaders of health care education.
The journal publishes the highest quality scholarly contributions reflecting the diversity of people, health and education systems worldwide, by publishing research that employs rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of education and systems globally. The journal will publish papers that show depth, rigour, originality and high standards of presentation, in particular, work that is original, analytical and constructively critical of both previous work and current initiatives.
Authors are invited to submit original research, systematic and scholarly reviews, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing and related health care education, and which will meet and develop the journal''s high academic and ethical standards.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
