Nurse Practitioners' Role in the Emergency Department Facilitators and Barriers to Practice as Viewed by Nurse Practitioners


Recent studies support the increased utilization of nurse practitioners (NPs) in the emergency department (ED) for providing primary care for patients presenting with nonurgent needs (Buchanan & Powers, 1996, Dowling & Dudley, 1995, Hooker & McCaig). The purpose of this study was examine current facilitators and barriers to NP role implementation in the ED. The design of the research was an exploratory descriptive study. Letters of invitation were mailed to 1,649 NPs in the State of Florida. Response cards were returned by 569 (34.5%) NPs. Of the 569 responses, questionnaires were mailed to the 46 NPs who met the inclusion criteria and agreed to participate in the study. Sampling criteria was that participating NPs were currently employed in a hospital-based ED. The returned questionnaires resulted in a final sample of n=35. Results from the study were compared with original research (Hayden, Davies, & Clore, 1982, Widhalm & Anderson, 1982) which investigated the same factors perceived by emergency nurse practitioners (ENPs) employed in the ED. Current facilitators to accepting employment in the ED were good salary/benefits, ability to utilize NP skills, and location. These were similar to the findings in 1982, with the exception of good/salary/benefits. The majority of participants from the current and past studies reported that the listed tasks were appropriate to their role performance. Measurement of autonomy revealed an increase in today's NP perception of role autonomy and independence in the ED. The studies also examined perceptions of acceptance by other health care members, patients, and the community . The NPs in the current study viewed themselves as less well-accepted than the ENPs in 1982 by patients, the community, staff nurses, and physicians. The participants in the current study reported legal restraints, lack of MD support, and resistance from other health care workers as the leading barriers to practice. Current facilitators and barriers to NP practice in the ED have been identified and compared with prior studies. Further studies are needed with larger samples before generalizations can be established. In addition, the decreased perception of NP role acceptance in the ED needs to be examined.


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Graduation Date





Sole, Mary Lou


Master of Science (M.S.)


College of Health and Public Affairs






87 p.



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Masters Thesis (Open Access)




Dissertations, Academic -- Health and Public Affairs; Health and Public Affairs -- Dissertations, Academic

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