Understanding the practice patterns of nephrology nurse practitioners.

Background: Nurse practitioners are advanced practice nurses with an expanded scope of practice beyond that of a registered nurse. Nurse practitioners in Australia manage patients at various points along the chronic kidney disease (CKD) trajectory although there has been limited investigation into their current practice patterns. Objectives: To describe the extent and nature of nephrology nurse practitioners (NNP) practice. Methods: Cross-sectional online survey was distributed to 73 NNP who were members of the Renal Society of Australasia. Data collected were demographic characteristics, practice setting features, clinical service patterns and activities. Descriptive statistics were used to analyse data. Results: Forty-five NNP completed the survey (response rate 61.6%). The majority were aged > 50 years (71.1%), female (88%) with a Masters level qualification (71.1%) and >20 years' experience in nephrology nursing (73.3%). NNP primarily worked in adult services (93.3%), managing those receiving haemodialysis or peritoneal dialysis (37.8%) or for those with CKD grades 1 - 4 (33.3%). Mean length of NNP service was 10.33 ± 3.1 years and they managed a median of 20 patients per week. Activities involved prescribing medications (86%), requesting diagnostic investigations (79.1%), and referring to other clinicians (83.7%). Conclusion/Implications for Practice: NNP are providing care across the continuum of CKD. They are highly qualified and experienced, although older which raises concern for sustainability and succession planning. Advanced practice positions such as the NNP are an opportunity to offer a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce. [ABSTRACT FROM AUTHOR]