Jessica E. Moulton , Noushin Arefadib , Jessica R. Botfield , Karen Freilich , Danielle Mazza
{"title":"临床、组织和政策因素影响护士主导的长效可逆避孕和药物流产护理模式在澳大利亚全科实践中的实施：一项定性探索","authors":"Jessica E. Moulton , Noushin Arefadib , Jessica R. Botfield , Karen Freilich , Danielle Mazza","doi":"10.1016/j.ssmhs.2025.100095","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Access to sexual and reproductive healthcare in rural and regional areas is often limited, particularly for contraception and abortion care. Nurse-led models of care offer a promising solution, yet their implementation and evaluation in Australian primary care remain underexplored. We therefore examined stakeholders’ perceptions of clinical, organisational and policy factors influencing the adoption of nurse-led contraception and abortion care in rural and regional Australian general practice.</div></div><div><h3>Methods</h3><div>A secondary analysis of qualitative data from a co-design workshop, aimed at developing a nurse-led model of care, was conducted. Participants included consumers, nurses, physicians, practice managers, community and advocacy organisation representatives, academics, and policymakers. The secondary analysis focused solely on data related to clinical, organisational, and policy factors that may influence the implementation of nurse-led contraception (involving contraceptive implant insertion) and medication abortion in rural and regional general practice. The Consolidated Framework for Implementation Research guided data analysis to enrich our understanding of implementation factors.</div></div><div><h3>Results</h3><div>Fifty-two stakeholders participated in the workshop. Five themes were constructed: 1) the influences on nurses' capability to work to their full scope of practice<em>,</em> 2) formalising general practitioner-nurse partnerships for model sustainability, 3) integrating practice-based nurse training, 4) medico-legal implications for collaborative care and 5) leveraging funding models to support nurse-led care.</div></div><div><h3>Conclusion</h3><div>Successful implementation of nurse-led contraception and medication abortion care requires improved funding models to ensure adequate nurse and practice remuneration, strengthened nurse-general practitioner partnerships, and employer support for ongoing nurse education. Policies fostering collaborative, multidisciplinary care will enhance the sustainability and effectiveness of these models in general practice.</div></div><div><h3>Reporting method</h3><div>Reported in line with the Standards for Reporting Qualitative Research (SRQR) checklist.</div></div><div><h3>Patient or public contribution</h3><div>Two consumer representatives contributed to the development of the co-design methodology as members of the ORIENT Intervention Advisory Group Governance Committee.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100095"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical, organisational and policy factors influencing the implementation of nurse-led models of long-acting reversible contraception and medication abortion care in Australian general practice: A qualitative exploration\",\"authors\":\"Jessica E. Moulton , Noushin Arefadib , Jessica R. Botfield , Karen Freilich , Danielle Mazza\",\"doi\":\"10.1016/j.ssmhs.2025.100095\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Access to sexual and reproductive healthcare in rural and regional areas is often limited, particularly for contraception and abortion care. Nurse-led models of care offer a promising solution, yet their implementation and evaluation in Australian primary care remain underexplored. We therefore examined stakeholders’ perceptions of clinical, organisational and policy factors influencing the adoption of nurse-led contraception and abortion care in rural and regional Australian general practice.</div></div><div><h3>Methods</h3><div>A secondary analysis of qualitative data from a co-design workshop, aimed at developing a nurse-led model of care, was conducted. Participants included consumers, nurses, physicians, practice managers, community and advocacy organisation representatives, academics, and policymakers. The secondary analysis focused solely on data related to clinical, organisational, and policy factors that may influence the implementation of nurse-led contraception (involving contraceptive implant insertion) and medication abortion in rural and regional general practice. The Consolidated Framework for Implementation Research guided data analysis to enrich our understanding of implementation factors.</div></div><div><h3>Results</h3><div>Fifty-two stakeholders participated in the workshop. Five themes were constructed: 1) the influences on nurses' capability to work to their full scope of practice<em>,</em> 2) formalising general practitioner-nurse partnerships for model sustainability, 3) integrating practice-based nurse training, 4) medico-legal implications for collaborative care and 5) leveraging funding models to support nurse-led care.</div></div><div><h3>Conclusion</h3><div>Successful implementation of nurse-led contraception and medication abortion care requires improved funding models to ensure adequate nurse and practice remuneration, strengthened nurse-general practitioner partnerships, and employer support for ongoing nurse education. Policies fostering collaborative, multidisciplinary care will enhance the sustainability and effectiveness of these models in general practice.</div></div><div><h3>Reporting method</h3><div>Reported in line with the Standards for Reporting Qualitative Research (SRQR) checklist.</div></div><div><h3>Patient or public contribution</h3><div>Two consumer representatives contributed to the development of the co-design methodology as members of the ORIENT Intervention Advisory Group Governance Committee.</div></div>\",\"PeriodicalId\":101183,\"journal\":{\"name\":\"SSM - Health Systems\",\"volume\":\"5 \",\"pages\":\"Article 100095\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SSM - Health Systems\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949856225000479\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SSM - Health Systems","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949856225000479","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical, organisational and policy factors influencing the implementation of nurse-led models of long-acting reversible contraception and medication abortion care in Australian general practice: A qualitative exploration
Background
Access to sexual and reproductive healthcare in rural and regional areas is often limited, particularly for contraception and abortion care. Nurse-led models of care offer a promising solution, yet their implementation and evaluation in Australian primary care remain underexplored. We therefore examined stakeholders’ perceptions of clinical, organisational and policy factors influencing the adoption of nurse-led contraception and abortion care in rural and regional Australian general practice.
Methods
A secondary analysis of qualitative data from a co-design workshop, aimed at developing a nurse-led model of care, was conducted. Participants included consumers, nurses, physicians, practice managers, community and advocacy organisation representatives, academics, and policymakers. The secondary analysis focused solely on data related to clinical, organisational, and policy factors that may influence the implementation of nurse-led contraception (involving contraceptive implant insertion) and medication abortion in rural and regional general practice. The Consolidated Framework for Implementation Research guided data analysis to enrich our understanding of implementation factors.
Results
Fifty-two stakeholders participated in the workshop. Five themes were constructed: 1) the influences on nurses' capability to work to their full scope of practice, 2) formalising general practitioner-nurse partnerships for model sustainability, 3) integrating practice-based nurse training, 4) medico-legal implications for collaborative care and 5) leveraging funding models to support nurse-led care.
Conclusion
Successful implementation of nurse-led contraception and medication abortion care requires improved funding models to ensure adequate nurse and practice remuneration, strengthened nurse-general practitioner partnerships, and employer support for ongoing nurse education. Policies fostering collaborative, multidisciplinary care will enhance the sustainability and effectiveness of these models in general practice.
Reporting method
Reported in line with the Standards for Reporting Qualitative Research (SRQR) checklist.
Patient or public contribution
Two consumer representatives contributed to the development of the co-design methodology as members of the ORIENT Intervention Advisory Group Governance Committee.
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