Nurse-led services in Queensland: A scoping study

Background: Nurse-led services are expanding in Australia, yet current information about the scope and nature of these services is lacking. The need for more coordinated service planning and systematic evaluation prompted a scoping study to inform future development. Aim: To provide a comprehensive profile of nurse-led services in the Queensland public health system. Methods: A scoping study of 257 nurse-led services was conducted using an online survey distributed through each Hospital and Health Service in Queensland. Service level data were collected on structure, process and outcome evaluation, as well as enablers and barriers to sustainability of care delivery models. Findings: There is a diverse and growing range of nurse-led services across the state that have evolved to meet the dynamic needs of their communities. Increasingly, registered nurses are rising to the challenge of providing equitable and accessible healthcare in ways that transcend traditional professional or care setting boundaries. The major challenges for sustainability were funding and resource limitations, particularly for developing service capacity to meet growing demands. There were also tensions around the need for ongoing negotiation and review of nurse-led services with medical and administrative stakeholders. Discussion: Findings underscore the need for a modernised regulatory and policy framework to support sustainable nurse-led services and allow nurses to work to their full potential to optimise outcomes for the community. Conclusion: Nurse-led services are the sleeping giant of healthcare reform in Australia. Now is the time for policy and practice changes that will realise the transformative potential of nurse-led care. (C) 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.