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An advanced nurse practitioner‐led service – consequences of service redesign for managers and organizational infrastructure

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barton d. & mashlan w. (2011) Journal of Nursing Management 19, 943–949

An advanced nurse practitioner‐led service – consequences of service redesign for managers and organizational infrastructure

Aim  A service review of a secondary care advanced nurse practitioner‐led service.

Background  An acute hospital‐based elderly care rehabilitation service evolved over a 9‐year period from a traditional consultant/junior doctor configuration to a consultant/advanced nurse practitioner configuration. The review evaluated the advanced nurse practitioner team’s role in the clinical setting, and the constraints experienced as a result of the traditions of the hospital organization.

Evaluation  The review drew its conclusions from opinion data collected from 38 professionals and non‐professionals within the rehabilitation service.

Key issues  The organizational infrastructure and traditions that had an impact on service delivery by the advanced nurse practitioner team. There is a demand for senior management to act on developmental constraints.

Conclusions  The advanced nurse practitioner‐led rehabilitation service was fit for purpose and an emerging model of a non‐medical led care. However, important organizational constraints were identified.

Implications for nursing management  An advanced nurse practitioner team, working in collaboration with medical consultants, was a model for future service redesign in the acute hospital setting. Nevertheless, it presented challenges to senior health‐care managers on current organizational infrastructures.
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Document Type: Research Article

Affiliations: 1: Head of the Department of Nursing, College of Human and Health Science, Swansea University 2: Lead Advanced Nurse Practitioner– Rehabilitation, Abertawe Bro Morgannwg University Health Board (ABMU), UK

Publication date: October 1, 2011

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