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Background: Patient harm from unsafe care is an increasingly global phenomenon leading to death or disability. Drawing on their expertise, Advanced Practice Nurses provide the opportunity to improve care quality and safety., Aim: To explore Nurse Practitioners and Clinical Nurse Consultants' experiences in patient safety., Design: A qualitative design was used involving six audio-visually recorded focus group interviews. Participants working in an acute or community adult nursing speciality were involved., Methods: Twenty-eight Advanced Practice Nurses (female 82.1%, mean age 47.5 ± 10 years) were recruited by convenience and snowball sampling. After transcription of interview data, qualitative content analysis was conducted., Results: Six categories were identified: patient safety as the highest priority (1), special contribution to patient safety (2), patients/relatives role in safety (3), multidisciplinary team approach (4), government regulation in safety (5), and further needs to improve safety (6). Advanced Practice Nurses saw themselves as role models and leaders for other healthcare staff through their expertise and professional experience and thus able to see the bigger picture in health. They identified as change agents at the system-level due to their decision-making ability and multi-professional team connectivity., Conclusions: This study emphasises the key position of extended nursing roles and the need for future development of patient safety strategies in hospitals and community care. As influential leaders, Advanced Practice Nurses are best placed to identify improvements. They play a central role in guiding the multi-professional team, the patient and their family, educating nursing staff, and identifying and addressing system-wide safety gaps to improve patient safety.

Like other countries, Australia is looking to reforms in the primary health care sector to meet the growing demand for care. Expansion of the role of practice nurses (PNs) is one way in which this demand may be met. To date the Federal Australian government has played a significant role in encouraging growth in the PN workforce. If PNs tend to be GP directed, with little autonomy, care must be taken to consider whether to expand existing scopes of practice. In contrast, if PNs rely on their own independent clinical judgment and skill, this would support potential expansions to the scope of the PN role. Understanding these issues is important to inform the development of future workforce policy. This paper examines the structural policy dimensions within which these changes are occurring, and makes recommendations for future research on PNs.

As in many other developed countries, the proportion of the population in Australia that will experience a mental health disorder is increasing. To respond adequately and appropriately to what some might say is an epidemic will require not only an available workforce but also one which is highly skilled. Unfortunately the current protracted shortage of nurses generally, and which is projected to worsen over the next few years, will also have a significant impact on the provision of care for a large and vulnerable portion of the population, those who experience mental illness. This article will provide an overview of the issues and challenges confronting the development of a sustainable mental health nursing workforce.

This paper presents the findings of a work sampling study undertaken in New South Wales (Australia) to ascertain the amount of time spent by nursing unit managers directly educating nurses. The results indicate that they spend very little time in teaching, traditionally one of their role tasks. It is argued that their teaching at unit level should focus on their role as leader, mentor, preceptor and coach. This role shift needs to be articulated to managers and nurses to minimise confusion over the role and to ensure that direct teaching is placed into the hands of expert clinicians.

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both significant functions of the role as well as areas of role conflict and confusion. 13 factors were identified from 4 major scales indicating that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficient (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded. The findings in this study have been presented in two parts: Part 1 discussed the factors identified in two scales, Functional Management and Patient Care Management; Part II discusses the factors identified in the remaining two scales, Staff Management and Leadership (subdivided into two subscales for analysis).