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Perceptions of Emergency Department Physicians Toward Collaborative Practice With Nurse Practitioners in an Emergency Department Setting

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Technical Report

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Uniformed Services University Of The Health Sciences Bethesda United States

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As the role of the family nurse practitioner within the United States Air Force continues to be defined, one setting where a need for additional primary care providers exists is the Emergency Department. Nurse practitioners utilized in this setting could augment physician staffing, or could be utilized in non-urgent, Fast-Track areas within Air Force emergency departments. One essential element for role development in this area is approval and appreciation of the role of the nurse practitioner by Air Force Emergency Department physicians. This study explored Emergency Department physicians attitudes toward collaborative health care with nurse practitioners using exploratory, descriptive, qualitative methodology. Utilizing a semi-structured guide adapted from a similar 1996 study, five board-certified emergency department physicians assigned to a Level II emergency department, were interviewed. The physicians were encouraged to elaborate on their definition of nurse practitioners, to discuss their knowledge of the educational requirements, and to describe their view of the scope of practice and limitations of these advanced practice nurses. Munhall and Boyds methods of data analysis which included theme categorization were utilized in this study. Four major themes categories emerged. The theme categories were separated into those which described a Role Performance Issues, b Educational BackgroundsKnowledge Base c Trust Issues d Role Receptivity. Air Force physicians, though supportive of the role of the family nurse practitioner in the Emergency Department, felt physicians should have an oversight role of all care provided in the Emergency Department. Physicians views regarding the interchangeability of nurse practitioners and physicians assistants, trust issues, concerns about legal liability and educational requirements are also described.

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