Scoping study into wound management nurse practitioner models of practice

Abstract

Objectives The primary objective of this research was to investigate wound management nurse practitioner (WMNP) models of service for the purposes of identifying parameters of practice and how patient outcomes are measured. Methods A scoping study was conducted with all authorised WMNPs in Australia from October to December 2012 using survey methodology. A questionnaire was developed to obtain data on the role and practice parameters of authorised WMNPs in Australia. The tool comprised seven sections and included a total of 59 questions. The questionnaire was distributed to all members of the WMNP Online Peer Review Group, to which it was anticipated the majority of WMNPs belonged. Results Twenty-one WMNPs responded (response rate 87%), with the results based on a subset of respondents who stated that, at the time of the questionnaire, they were employed as a WMNP, therefore yielding a response rate of 71% (n = 15). Most respondents (93%; n = 14) were employed in the public sector, with an average of 64 occasions of service per month. The typical length of a new case consultation was 60 min, with 32 min for follow ups. The most frequently performed activity was wound photography (83%; n = 12), patient, family or carer education (75%; n = 12), Doppler ankle–brachial pressure index assessment (58%; n = 12), conservative sharp wound debridement (58%; n = 12) and counselling (50%; n = 12). The most routinely prescribed medications were local anaesthetics (25%; n = 12) and oral antibiotics (25%; n = 12). Data were routinely collected by 91% of respondents on service-related and wound-related parameters to monitor patient outcomes, to justify and improve health services provided. Conclusion This study yielded important baseline information on this professional group, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are measured. What is known about the topic? The nurse practitioner (NP) is an established and legitimised entity of health service in Australia, with NPs in a range of specialities. To date, there is a paucity of research on the role and practice parameters of WMNP in the Australian context. What does this paper add? This paper provides important baseline information on WMNP models of practice in the Australian context, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are currently measured. This information will help inform the development of WMNP roles and highlights potential areas of evaluation for WMNP models of care. What are the implications for practitioners? Measurement of outcomes is essential to demonstrate efficacy of NP service. Yet, there is no way currently to measure these outcomes for WMNP service. Nationally consistent data collection on processes of care and patient outcomes supports ongoing development of the WMNP role.