Understanding the practice patterns of nephrology nurse practitioners in Australia

Abstract

Background: Nurse practitioners (NP) have an expanded scope of practice beyond that of a registered nurse. In kidney care, nephrology NP can manage patients at various points along the chronic kidney disease (CKD) trajectory. Objectives: To profile the characteristics, service patterns, and domains of practice of nephrology NP in Australia. Design: A cross-sectional online secure survey. Participants: Nephrology NP (NP students) who were members of the Renal Society of Australasia and working in Australia (n = 73). Measurements: Data collected were demographic and practice characteristics, and domains of practice (using the modified Strong Model of Advanced Practice). The survey also sought qualitative perspectives of the enablers and barriers to sustainability nurse practitioner healthcare delivery services. Results: Nephrology NP (n = 45) primarily worked in adult services, managing those receiving haemodialysis, peritoneal dialysis, or patients with earlier grades of CKD. Providing direct comprehensive care was the dominant domain of advanced practice although administrative activities took up considerable time each week. Support from nurse leaders and medical colleagues was identified as key enablers for sustainability of these services whereas succession planning, and workload were the main barriers. Conclusions: This study found a highly qualified, experienced but older nephrology nurse practitioner workforce who provide an additional model of health service delivery which can meet the growing CKD burden. Internationally, this level of nurse provides an opportunity for a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce.