The Nature of the Extended/Expanded Nursing Role in Canada

A Project of the Advisory Committee on Health Human Resources

Funded by the Health Transition Fund Secretariat
Project Identifier - NA 321

Project Consultants:

The Centre for Nursing Studies in collaboration with
The Institute for the Advancement of Public Policy, Inc.

March 30, 2001

This project was supported by a financial contribution from the Health Transition Fund, Health Canada. The views expressed herein do not necessarily represent the official policy of the federal, provincial or territorial governments.

Table of Contents

Executive Summary Project Team and Acknowledgements Acronyms Glossary of Terms 1.0 Introduction 1.1_ Overview and Purpose 1.2_ Rationale 1.3_ Background 1.4_ The Public Policy Context - Policy Objectives and Extended/Expanded Nursing Roles 1.5 Health Care Reform and the Extended/Expanded Role of the Registered Nurse 1.6 Overview 2.0 Methodology 2.1 Method 2.2 Determination of Terms and Definitions 2.3 Population and Sample 2.4 Procedure 2.5 Instruments 2.6 Data Analysis 2.7 Overview of Restrictions and Limitations 2.7.1 Restrictions 2.7.2 Limitations 3.0 Results 3.1 Policy and Legislative Frameworks for Extended/Expanded Nursing Roles 3.1.1 Title - Policy Framework 3.1.2 Scope of Practice - Policy Framework 3.1.3 Educational Preparation - Policy Framework 3.1.4 Summary 3.2 Organizational Structure: Administrative Personnel Perceptions 3.2.1 Models of Practice 3.2.1.1 Location and Setting 3.2.1.2 Job Requirements and Core Competencies 3.2.2 Lines of Authority 3.2.3 Quality Measures and Evaluation of Outcomes 3.2.4 Summary 3.3 On-site Data Collection 3.3.1 Practical Knowing 3.3.2 Collaborative versus Independent Practice Models 3.3.3 Role Confusion: Patient Understanding, Acceptance and Satisfaction 3.3.4 Barriers to and Facilitators of Collaborative Practice Models 3.4 Patient Perceptions 3.5 Observation of Nurses Practice 4.0 Conclusions and Recommendations 4.1 Policy and Legislative Frameworks 4.2 Regulatory Framework 4.3 Terminology and Definition Problems 4.4 Availability of Quality Services to the Public 5.0 Dissemination Plan Appendix A - Sources SD1 Profile of Extended/Expanded Nursing Practice in Primary Health Care Settings SD2 Research Protocol for on-site data collection SD3 Results of on-site data collection SD4 Dissemination Plan