Barriers and facilitators of nurse practitioners in the outpatient clinic

Abstract

Background: Nurse practitioners (NPs) are being trained to reallocate tasks from physicians. NPs can, among other things, perform medical procedures and prescribe medication. The role of the NP is still evolving. The experienced barriers/facilitators are important factors to be studied in this process to optimize the implementation and their position. These barriers/facilitators are often dependent on the context and could be related to primary motives of the employment of NPs. Aim: Identifying experienced barriers/facilitators of NPs working in the outpatient clinic of hospitals. Primary motives for the employment of NPs were the secondary objective. Method: An explanatory mixed methods design study was conducted from January to June 2017. Quantitative data were collected through a questionnaire. Subsequently, qualitative data was collected through interviews. The primary outcome were experienced barriers and facilitators. Background data was collected regarding age, gender, hospital type and years of experience. Results: A total of 179 NPs completed the questionnaire. NPs experience more facilitators than barriers. ‘A good collaboration with physicians’ was considered the most important facilitator. The most important barrier was ‘obscure boundaries between professions’. Improving the care process was considered the most important motive for the employment of NPs. No relation between primary motives and barriers/facilitators was found. Six interviews were conducted. The participants agreed with the results of the questionnaire about experiencing more facilitators. Making clear working agreements was stated important in experiencing barriers or facilitators. Conclusion: NPs are satisfied with their jobs. The identified experienced barriers and facilitators in the task reallocation can potentially contribute to the implementation of NPs in outpatient clinics. Recommendation: Clear agreements about collaboration and tasks in the outpatient clinic is key to reducing barriers and lead to experiencing facilitating factors.