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Aims: To validate the 'safe and effective staffing tool' and explore the impact of COVID‐19 on the quality of Australian primary health care (PHC). Design: A national survey was conducted from October to December 2020. Methods: The online survey was distributed via social media and professional organisations to PHC nurses. Results: Three‐hundred fifty‐nine PHC nurses participated. A two‐factor solution was found with factors named; 'Perception of quality of care provided' and 'Personal satisfaction with care delivered'. Cronbach's alpha demonstrated good internal consistency for the total scale (α =.915) and each subscale (α =.879/α =.864). Nearly three‐quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor 'perceptions of quality of care provided' and the total 'quality and satisfaction with care'. A lack of time, inadequate supervision and support, and performing non‐nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID‐19 had impacted negatively on the detection and management of non‐COVID related health conditions. Conclusion: The 'safe and effective staffing tool' is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID‐19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID‐19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high‐quality care to optimise health outcomes and maintain nurse satisfaction. Impact: This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to explore the perceptions, attitudes and beliefs of middle‐aged Australians around their health, lifestyle risks and chronic disease. Background: Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. Design: A qualitative descriptive study using semi‐structured interviews. Reporting was guided by the COREQ checklist. Methods: Thirty‐four participants aged 40–65 years were recruited across South Eastern New South Wales, Australia, using convenience sampling. Semi‐structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. Results: Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles; denial; an impetus for change; and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. Conclusions: Understanding the perceptions of health of middle‐aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. Relevance to Clinical Practice: These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person‐centred health promotion and chronic disease prevention strategies in this age group. [ABSTRACT FROM AUTHOR]

Aim: To explore the job satisfaction and turnover intentions of general practice nurses and examine factors that influence job satisfaction and turnover intention. Background: Workforce issues such as satisfaction, retention and turnover intention have been explored in acute care. However, increasingly nurses are being employed outside hospitals. General practice is a significantly different work environment to acute care. Understanding workforce issues in community settings is important for employers, managers and policymakers to sustain and grow this workforce to meet consumer demands. Method: A descriptive survey was conducted within a single Primary Health Network in Australia. Results: Having an identified practice nurse leader/manager, feeling that their training and qualifications are used to the full and not feeling isolated, alone or lacking opportunities for mentoring were all significantly correlated with higher job satisfaction. The lowest average satisfaction scores related to pay. 44.9% of participants were unsure whether they would remain working in general practice. The relationship between total job satisfaction and intention to leave was significant. Conclusion: These findings guide managers in developing strategies to recruit and retain nurses in general practice employment. Implications for Nursing Management: Managers must consider factors influencing job satisfaction and turnover intention to maximize recruitment and retention of nurses. [ABSTRACT FROM AUTHOR]

Aim: To identify Australian primary health care nurses' immediate support needs during the COVID‐19 pandemic. Background: COVID‐19 has had widespread implications for primary health care nurses. Supporting these nurses' capacity to deliver quality care ensures that ongoing health needs can be met. Methods: Primary health care nurses were recruited to an online survey via social media and professional organisations in April 2020. Results: Six‐hundred and thirty‐seven responses were included in the analysis. Participants provided 1,213 statements about perceived supports required to provide quality clinical care. From these, seven key categories emerged, namely personal protective equipment, communication, funding, industrial issues, self‐care, workplace factors and valuing nurses. Conclusion: A number of key issues relating to personal health and safety, care quality and job security need to be addressed to support primary health care nurses during the COVID‐19 pandemic. Addressing these support issues can assist in retaining nurses and optimizing the role of primary health care nurses during a pandemic. Implications for Nursing Management: Responding to the needs of primary health care nurses has the potential to facilitate their role in providing community‐based health care. This knowledge can guide the provision of support for primary health care nurses during the current pandemic, as well as informing planning for future health crises across the health service. [ABSTRACT FROM AUTHOR]

Increasingly, middle-aged people are demonstrating lifestyle risk factors that increase their risk of developing chronic disease. Reducing lifestyle risk in middle age can significantly reduce future morbidity and mortality and improve quality of life. Understanding peoples' perceptions of health support is important to inform health professionals and policymakers regarding strategies to support lifestyle risk reduction. This paper seeks to explore middle-aged Australians' perceptions of support for lifestyle risk reduction. Thirty-four middle-aged Australians were interviewed using a semi-structured interview schedule. Interviews were audio-recorded, transcribed and analysed using thematic analysis. The overarching theme 'support for healthy lifestyles' comprised three subthemes. 'Engagement with general practice' highlighted gender differences in why people attend and what impacts their access to general practice. 'Providing information' emphasised participants' experiences of lifestyle risk communication in general practice. Finally, 'Sources of support' revealed participants' current health advice-seeking behaviours. Findings highlight a need for general practices to better engage middle-aged people in behaviour change and educate them about the role of general practice in prevention and health promotion. Consistent messaging across the community and strategies that focus on gender-specific concerns are likely to ensure that middle-aged people are able to make informed choices about seeking support for lifestyle risk reduction. Primary care practitioners play a pivotal role in identifying chronic conditions and health promotion, yet little is known about how consumers perceive their role in providing support to achieve healthy lifestyles. This study identified a lack of consumer knowledge about roles of health professionals; suggested gender differences in relation to seeking health advice; and indicated that lifestyle risk discussions were perceived as often being opportunistic rather than planned. Findings indicate that programs and information promoting healthy lifestyles need to be flexible and adaptable to maximise their effect. [ABSTRACT FROM AUTHOR]

Nurses are increasingly needed in primary healthcare settings to support community-based healthcare delivery. Programs to facilitate transition of new graduate nurses are well established in acute care; however, there are few similar programs reported in settings like general practice. This paper sought to explore the experiences of new graduate registered nurses and their registered nurse mentors in a new graduate program within Australian general practice. New graduates (n = 9) and their mentors participated in interviews before, during and at the conclusion of a 12-month new graduate program. Interviews were digitally audio-recorded and professionally transcribed verbatim before being analysed using thematic analysis. Eighteen new graduate and 10 mentor interviews were conducted, revealing four themes. Preparation and Opportunities describes the influence that pre-registration education had on preparing nurses for general practice employment. Exceeding Expectations highlights the positive experiences within the program. Program Challenges draws attention to the difficulties experienced by participants, and Future Career Intentions explores future career plans. This study highlights that a general practice new graduate nurse program has the potential to build the workforce. However, strengthening undergraduate preparation of nurses around primary health care and addressing funding issues in general practice, are important to promote the success of such programs. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the experiences of acute care registered nurses transitioning to primary healthcare settings. Background: The worldwide increasing demand for primary healthcare services has resulted in skilled acute care nurses transitioning to primary healthcare settings to meet workforce requirements. Little is known about the experiences and challenges associated with the transition. Knowledge of this will enable employers to design appropriate support processes and transitioning nurses can make informed choices. Methods: Semistructured interviews were conducted with nurses who had transitioned into primary healthcare employment in the last 5 years. Data analysis was undertaken using Braun and Clarke’s (2006) thematic analysis approach. Results: Thirteen nurses were interviewed, and two themes identified—role learning: the new environment, and role socialisation: transition validation. Role learning was influenced according to the quality of orientation programmes, previous experience, clinical knowledge and professional support. Support and professional respect from mentors and/or employers greatly assisted with role socialisation and the transition experience. Conclusions: Transitioning to primary healthcare employment provides unique challenges which must be considered by employers if they are to attract and retain experienced acute care registered nurses. Relevance to Clinical Practice: Understanding the experiences of nurses who transition from acute to primary healthcare employment can inform the design of orientation programmes and ongoing professional supports to address barriers and challenges. Targeted orientation and support has the potential to enhance recruitment and retention of experienced nurses in primary health care. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the experiences of registered nurses who transition from acute to primary health care ( PHC) employment. Background Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses. Design A sequential mixed-methods study comprising a survey, and semi-structured interviews. This study reports on survey findings relating to the transition experience. Methods Convenience and snowballing techniques were used to recruit 111 registered nurses who had transitioned from Australian acute settings to PHC employment within the last 5 years. An online survey gathered data relating to personal and professional demographics, type of PHC setting and transition experiences. Results Most respondents ( n = 90, 81.1%) reported receiving some orientation, although the length and content varied considerably. Those working in metropolitan locations were more likely to report concerns associated with their orientation, with respondents from rural or remote locations more likely to have access to a preceptor than city/metropolitan respondents. Just under half of respondents found prioritising workload ( n = 47; 42.7%) or organisational knowledge ( n = 45; 40.9%) difficult or very difficult, and 47.7% ( n = 53) felt isolated or unsupported. 49.5% ( n = 55) reported being overwhelmed with the new role either sometimes or regularly. Barriers to transitioning successfully included limited employer support to attend professional development activities. Conclusions Availability of specific support measures may assist in the transition process. Findings from our study should be considered by employers when recruiting nurses new to PHC, and when designing orientation and ongoing education programmes. Relevance to clinical practice This study highlights the challenges faced by nurses who transition from acute care into PHC employment. Understanding the barriers and facilitators to successful transitions enhances the process for future recruitment and retention of PHC nurses. This evidence can inform managers, educators and policymakers in developing support programmes for nurses moving into PHC. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Background Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Design Concurrent mixed methods design. Methods Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Findings Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. Conclusion The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Background Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Design Integrative review. Methods A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Results Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Conclusion Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Relevance to clinical practice Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce. [ABSTRACT FROM AUTHOR]

Aims and objectives. Lessons for cross-border standard development learned in the consultation to create the Australian National Framework for the Development of Decision-Making Tools for Nursing and Midwifery ( National DMF). Background. Although existing tools are broadly consistent, no cross-border or internationally accepted version exists of scope of practice decision-making guides. Development of a national framework in Australia’s federated political system required commitment to wide consultation and consensus. Concurrent moves towards national registration stimulated timely completion of the work. Contextual factors such as differentiation of the profession of midwifery from nursing and varying understanding of scope of practice concepts in eight Australian jurisdictions were challenges. Design. A consultative policy development framework was used. Methods. Thematic analysis of written responses to a draft document and of focus group feedback informed the production of the National DMF. Results. A widely accepted National DMF allowing nurses and midwives in Australia to engage in planned changes to professional practice, grounded in the professional judgement of the individual nurse or midwife, and collaboration with the consumer. Conclusions. The project’s grounding in consensus influenced the process and outcomes of consultation. A nationally consistent framework, incorporating useful decision-making tools for two professions and principles to guide implementation and evaluation, was a distinct achievement. The article adds to accumulated knowledge by: • identifying the professional and political factors influencing consultation and outcomes in cross-border standard development and • exploring key considerations for future projects to produce national or international professional standards that are relevant across borders and across professions. Relevance to clinical practice. Decision-making tools that assist nurses and midwives in determining their scopes of practice and guide them in delegating aspects of consumer care to other health care workers are an essential component of any suite of professional practice standards. [ABSTRACT FROM AUTHOR]