Research Article

Australian Nurse Practitioner Practice: Value Adding through Clinical Reflexivity

Table 2

Summation of results: practice themes, NP interventions and innovations, and value to health care systems.

Practice themesNP interventions and innovationsValue to health care systems

Specialized care access(i) Development of clinics responsive to service gaps; for example, rapid response and consistent care/systematic clinics(i) Improved access to speciality care 
(ii) Aversion of emergency department and hospital admission 
(iii) Decreased waiting times for speciality care clinics 
(iv) Reduction on adverse health outcomes

Diagnostic and complications(i) Clinical expertise and clinical alignment in advance practice interventions in the review of people with complex healthcare issues and the interplay of complications and comorbidities(i) Concerted and patient specific care plans that address multifactorial factors that contribute to a patient poor health outcomes such as deteriorating glycaemic control, increased infections, and risk for mental health status 
(ii) Detection of other conditions impacting on health care not previously identified

Pharmaceutical treatment(i) Timely and functional review and prescribing, titration and monitoring of medication 
(ii) Advocacy and development of pharmaco-therapeutic options for poorly controlled patients living with multiple complications and comorbidities
(i) Improvement in patient knowledge and efficacy in medication management 
(ii) Responsive communication channels developed for patients to engage with NP to obtain individualized and achievable biomedical, metabolic, and glycaemic targets in effective time frame 
(iii) Advocacy and coordination of innovative treatment options for patients with demonstrable improvements compared to status quo treatment

Vulnerable populations(i) Targeted intervention for vulnerable populations, including delivery of multidisciplinary clinics and changes in models of care to address poor health outcomes(i) Significant reduction in congenital malformations pre and postdelivery of GDM care model of care 
(ii) Quantifiable improvement in screening and treatment of metabolic syndrome and diabetes for patients living with schizophrenia

Leadership(i) NP Participation, representation, and leadership roles in strategic initiatives in forming alliances between tiers of health care systems(i) Contribute to development of state-wide referral pathways for improving care for patients living with diabetes 
(ii) NP committee participation for health care reform has provided a voice for the role and demonstration of the clinical leadership