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Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care. / Lynne Grundy

Swansea University Author: Lynne Grundy

Abstract

Background and Aims Nurses' roles, responsibilities and practice have changed and the boundaries between nursing and medicine have blurred. Few studies compare clinical outcomes of patients managed by Advanced Nurse Practitioners (ANPs) and junior doctors in acute secondary care. Aims of the st...

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Published: 2014
Institution: Swansea University
Degree level: Doctoral
Degree name: D.N.Sc
URI: https://cronfa.swan.ac.uk/Record/cronfa42750
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first_indexed 2018-08-02T18:55:27Z
last_indexed 2019-10-21T16:48:23Z
id cronfa42750
recordtype RisThesis
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spelling 2018-08-31T15:32:30.7932581 v2 42750 2018-08-02 Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care. d5d9a4f39a2f0a65072bffd19e0647ae NULL Lynne Grundy Lynne Grundy true true 2018-08-02 Background and Aims Nurses' roles, responsibilities and practice have changed and the boundaries between nursing and medicine have blurred. Few studies compare clinical outcomes of patients managed by Advanced Nurse Practitioners (ANPs) and junior doctors in acute secondary care. Aims of the study were to identify any observable differences between ANPs undertaking traditional junior doctor roles and junior doctors in relation to senior doctor congruence with diagnosis and clinical management planning, and clinical assessment practices. Setting The study took place in an acute hospital in the UK from April 2009 to August 2010. Design and methods This was a retrospective review of clinical records of patients presenting to the emergency medicine division. Data were collected from 311 randomly selected case notes of patients presenting to 10 ANPs and 10 junior doctors. Data were analysed using bivariate and multivariate techniques in SPSS version 19. Analyses were repeated including only patients presenting to Acute Medical Assessment Unit (AMA). Findings Statistically significant findings included: patients presenting to junior doctors were older, had more co-existing problems and were prescribed more medicines before presentation. Patients presenting to ANPs were more likely to have chest pain. ANPs were less likely to prescribe medicines. Clinical management plans were less likely to be agreed for patients with more coexisting problems. There were few inter-professional differences in senior congruence with clinical management planning and diagnosis and clinical assessment practices. These findings are reassuring as nurses' work moves into what was formerly the medical domain. E-Thesis Nursing.;Medical personnel.;Health care management. 31 12 2014 2014-12-31 COLLEGE NANME Nursing COLLEGE CODE Swansea University Doctoral D.N.Sc 2018-08-31T15:32:30.7932581 2018-08-02T16:24:30.3361968 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Lynne Grundy NULL 1 0042750-02082018162519.pdf 10807519.pdf 2018-08-02T16:25:19.0230000 Output 11788084 application/pdf E-Thesis true 2018-08-02T16:25:19.0230000 false
title Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
spellingShingle Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
Lynne Grundy
title_short Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
title_full Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
title_fullStr Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
title_full_unstemmed Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
title_sort Crossing the boundaries: Nurses in the medical domain ; An examination of safety and outcomes in secondary care.
author_id_str_mv d5d9a4f39a2f0a65072bffd19e0647ae
author_id_fullname_str_mv d5d9a4f39a2f0a65072bffd19e0647ae_***_Lynne Grundy
author Lynne Grundy
author2 Lynne Grundy
format E-Thesis
publishDate 2014
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
active_str 0
description Background and Aims Nurses' roles, responsibilities and practice have changed and the boundaries between nursing and medicine have blurred. Few studies compare clinical outcomes of patients managed by Advanced Nurse Practitioners (ANPs) and junior doctors in acute secondary care. Aims of the study were to identify any observable differences between ANPs undertaking traditional junior doctor roles and junior doctors in relation to senior doctor congruence with diagnosis and clinical management planning, and clinical assessment practices. Setting The study took place in an acute hospital in the UK from April 2009 to August 2010. Design and methods This was a retrospective review of clinical records of patients presenting to the emergency medicine division. Data were collected from 311 randomly selected case notes of patients presenting to 10 ANPs and 10 junior doctors. Data were analysed using bivariate and multivariate techniques in SPSS version 19. Analyses were repeated including only patients presenting to Acute Medical Assessment Unit (AMA). Findings Statistically significant findings included: patients presenting to junior doctors were older, had more co-existing problems and were prescribed more medicines before presentation. Patients presenting to ANPs were more likely to have chest pain. ANPs were less likely to prescribe medicines. Clinical management plans were less likely to be agreed for patients with more coexisting problems. There were few inter-professional differences in senior congruence with clinical management planning and diagnosis and clinical assessment practices. These findings are reassuring as nurses' work moves into what was formerly the medical domain.
published_date 2014-12-31T03:53:34Z
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score 11.01628

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