Contributory Elements in the Introduction of New Health Care Delivery Models to Health Care Systems Globally
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Purpose: The purpose of this study was to describe influential factors in the introduction of expanded nursing roles to existing health-care systems for improving access to care in health workforce shortage areas globally. Methods: Comparative analysis of several studies and commentaries was made to summarize critical factors impacting the introduction of nurse practitioners, or nurses with expanded roles, into existing health-care systems globally. Results: Key contributory elements for consideration in the introduction of new health-care models to existing health-care systems include: 1) population health needs; 2) readiness of the profession; 3) innovation; 4) roles; 5) education/expertise; 6) environment 7) policies related to practice; 8)workforce; 9) collaboration; and 10) discovery of evidence and its dissemination. Conclusion: Disparities in health persist worldwide. One contributing factor to these inequities is insufficient access to care. The literature supports that advanced practice nurses (APNs) make a vital contribution to expanding access to care for vulnerable populations. In an attempt to improve access to care and health outcomes globally, a sensitive and systematic process for introduction of an expanded nursing role into existing health-care systems must be established. Development of a theoretical framework to guide the process of introducing new sustainable health-care services reform must begin with further investigation of the influential factors in the process, such as those identified in this study.