Grant: Project Grant

In Canada, three regulated nursing designations work in primary care (Nurse Practitioners, Registered Nurses, Licensed Practical Nurses/Registered Practical Nurses; hereafter referred to as primary care nurses [PC-Ns]). PC-Ns are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PC-Ns to leverage one another's expertise to work to optimal scope, while other models do not. Our project aims to strengthen team-based primary care and PC-Ns' intra-professional collaboration by delineating professional scopes of practice of each PC-N provider. The project consists of two linked studies: 1) umbrella review and 2) multiple case study. The Umbrella Review will consolidate international scoping and systematic review evidence on PC-N roles into a single comprehensive report. The Multiple Case Study consists of two components: (1) qualitative interviews and (2) a measure of PC-N scope enactment (i.e., Actual Scope of Practice-Primary Care tool) across four provinces (Alberta, Ontario, Quebec, Newfoundland and Labrador). PC-Ns will describe their scope of practice and opportunities for role optimization. Overlap in care delivery will be examined by presenting PC-Ns with patient scenarios based on typical patient visits and prompting discussion about care activities. This project will generate evidence about the extent to which PC-N scopes of practice are optimized (enacted) within teams. We will bring together knowledge users and findings to codevelop resources/aids to support decision-makers and health administrators in hiring the appropriate PC-N(s) to meet patient needs. Findings will enhance understanding of PC-Ns' unique contributions to patient care, strengthen collaboration, and enhance the capacity of primary care to optimize team configurations.