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UBC Theses and Dissertations

The role of registered nurses in primary care and public health collaboration : a scoping review Swanson, Monica Eleana


PURPOSE: As the British Columbia (BC) government works to improve primary care (PC) performance, attention to collaboration between PC and Public Health (PH) has been studied, especially improving health promotion in PC. Human resources and role optimization considerations are needed to operationalize this strategy. Nurses are the largest health care provider in BC, and yet nurses are an underutilized resource in the PC system in BC. This research aims to identify the roles of registered nurses (RN) in PC and PH collaboration and confirm if the BC RN scope of practice sufficiently covers the identified roles. METHODS: A scoping review of the current literature from North America, Western Europe and Australia/New Zealand from Jan. 2009 to Jan. 2016 was conducted. RESULTS: Twenty-three articles were obtained. Various nursing roles were identified that benefit PC/PH collaboration including: relationship builder, outreach professional, program facilitator and care coordinator. Through these roles, nurses supported vertical and horizontal transitions in chronic disease, communicable disease care and maternity care. Nurse’s roles were enacted at various levels from intrapersonal to organizational and systemic levels. The BC RN scope of practice supports the roles identified in this review, reaffirming that nurses are qualified to enact the roles. CONCLUSIONS: Based on their ability to work in a variety of roles and settings to promote collaboration between PC and PH, nurses could be more optimally utilized to support health care system change. Recommendations include political directives that support using nurses in system change. Health authorities could operationalize this by supporting more team-based nurses with an outreach role, especially for vulnerable populations, and utilizing nurses in inter-organization (such as PH to PC) program facilitation in chronic disease management. Education institutions need to ensure RN students are exposed to outreach experiences, and have practice working in the PC system, as well inter-organizational collaborative skills.

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