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Supporting nurse practitioners’ practice in primary healthcare settings: a three-level qualitative model

Overview of attention for article published in BMC Health Services Research, June 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)

Mentioned by

24 tweeters
1 Facebook page


14 Dimensions

Readers on

89 Mendeley
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Supporting nurse practitioners’ practice in primary healthcare settings: a three-level qualitative model
Published in
BMC Health Services Research, June 2017
DOI 10.1186/s12913-017-2363-4
Pubmed ID

Véronique Chouinard, Damien Contandriopoulos, Mélanie Perroux, Catherine Larouche


While greater reliance on nurse practitioners in primary healthcare settings can improve service efficiency and accessibility, their integration is not straightforward, challenging existing role definitions of both registered nurses and physicians. Developing adequate support practices is therefore essential in primary healthcare nurse practitioners' integration. This study's main objective is to examine different structures and mechanisms put in place to support the development of primary healthcare nurse practitioner's practice in different healthcare settings, and develop a practical model for identifying and planning adequate support practices. This study is part of a larger multicentre study on primary healthcare nurse practitioners in the province of Quebec, Canada. It focuses on three healthcare settings into which one or more primary healthcare nurse practitioners have been integrated. Case studies have been selected to cover a maximum of variations in terms of location, organizational setting, and stages of primary healthcare nurse practitioner integration. Findings are based on the analysis of available documentation in each primary healthcare setting and on semi-structured interviews with key actors in each clinical team. Data were analyzed following thematic and cross-sectional analysis approaches. This article identifies three types of support practices: clinical, team, and systemic. This three-level analysis demonstrates that, on the ground, primary healthcare nurse practitioner integration is essentially a team-based, multilevel endeavour. Despite the existence of a provincial implementation plan, the three settings adopted very different implementation structures and practices, and different actors were involved at each of the three levels. The results also indicated that nursing departments played a decisive role at all three levels. Based on these findings, we suggest that support practices should be adapted to each organization's environment and experience and be modified as needed throughout the integration process. We also stress the importance of combining this approach with a strong coordination mechanism involving managers who have in-depth understanding of nursing professional roles and scopes of practice. Making primary healthcare nurse practitioner integration frameworks more flexible and clarifying and strengthening the role of senior nursing managers could be the key to successful integration.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 89 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 89 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 19%
Student > Bachelor 9 10%
Student > Doctoral Student 7 8%
Researcher 6 7%
Student > Ph. D. Student 6 7%
Other 9 10%
Unknown 35 39%
Readers by discipline Count As %
Nursing and Health Professions 32 36%
Social Sciences 6 7%
Medicine and Dentistry 5 6%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Economics, Econometrics and Finance 1 1%
Other 3 3%
Unknown 40 45%

Attention Score in Context

This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 November 2017.
All research outputs
of 22,605,515 outputs
Outputs from BMC Health Services Research
of 7,547 outputs
Outputs of similar age
of 288,209 outputs
Outputs of similar age from BMC Health Services Research
of 4 outputs
Altmetric has tracked 22,605,515 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,547 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.6. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 288,209 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.