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The implementation of the nurse practitioner (NP) role in Victoria and other States and Territories in Australia stemmed from the recognition of the need to improve health service access; offer greater diversity in services; increase flexibility in modes of health care delivery; better manage and coordinate health care provision; and, improve the career structure for advanced clinical nurses.!
The Victorian Nurse Practitioner Project began in July 1998 when the Victorian Minister for Health appointed a taskforce to develop a framework and process for the implementation of the NP role in the State. The process of developing the implementation framework was eclectic and included the development of policy, community and practitioner consultation, along with the development and evaluation of a number of Victorian NP models of practice (demonstration projects) occurring concurrently and interactively.
This article briefly explores the work of six Victorian NP models of practice currently under development to increase the understanding of the NP concept and provide useful insights into the benefits of the role in specific local clinical settings.
The nurse practitioner role
In Victoria, the NP role has been set at the apex of clinical nursing practice. The role involves advanced assessment and care management approaches; and, incorporates a strong foundation in knowledge, skills and competencies for both population and individual health. The role can also include the extended practices of limited medication prescribing, initiating diagnostic imaging and laboratory testing, referring directly to medical specialists, admitting patients to hospital, and, approving absence from work certificates, depending on the context of practice. The extended practices of the role, while only constituting a small part of the overall function, differentiate NPs from other advanced clinical nurses.
The NP role involves collaborative relationships with other disciplines, in partnership with patients and communities while retaining a nursing perspective. The role also integrates advanced clinical practice, based on evidence and international best practice, with education, research, management, leadership and consultation. It requires nurses to utilise their considerable experience, knowledge and clinical judgment in enhancing health care delivery.2
The Victorian models of practice
A variety of NP models of practice have been funded by the Victorian Department of Human Services to examine the role in terms of: feasibility, safety, effectiveness, and, quality and cost, consistent with the...