Staff Experiences with the Implementation of Nurse Practitioner (NP)-led Clinics in New Brunswick, Canada.

Abstract

BackgroundAccess to primary care is a challenge across Canada. In the province of New Brunswick (NB), approximately 15% of citizens do not have a primary care provider (PCP). The Government of NB recently implemented clinics staffed by nurse practitioners (NPs) in various regions in the province to reduce the provincial waitlist for a PCP.PurposeThis study aimed to identify facilitators and barriers to NP-led clinic implementation, as perceived by clinic staff.MethodsUsing a cross-sectional qualitative descriptive design, data was collected using semi-structured interviews and analysed using qualitative content analysis.ResultsStudy participants included 16 employes of two NP-led clinics in NB (NPs, registered nurses (RN), licensed practical nurses (LPN), administrative staff, and managerial staff). Facilitators include having experienced mentors, collaborative practices, and well-equipped clinics. Barriers include rushed timelines, complex decision-making processes, large and complex caseloads, inadequate clinic space, and difficulty in staff recruitment and retention. Participants discussed the positive impact of NP-led clinics through improved access to primary care, resulting in reduced burdens on emergency departments and walk-in clinics. Participants recommend adding additional NP-led clinics and integrating multidisciplinary allied health professional teams to enhance care integration.ConclusionNP-led clinics are increasingly being implemented across Canada to improve primary care access, particularly in areas where there are shortages of PCPs. Findings from this study will help inform the development and implementation of other NP-led clinics across NB and Canada.