, 2010, Maloney
and Volpe, 2005 and Stewart et al., 2010). Additionally, the model has been applied to characterize advanced nursing roles beyond the original American context, in places such as the United Kingdom and Australia, and in specialties other than acute care, such as psychiatry and endocrinology (Bahadori and Fitzpatrick, 2009, Harwood et al., 2004 and Ridley et al., 2000). Internationally, aspects of the Strong Model have PD0325901 been used by policy makers and health service planners in creating position descriptions for advanced nursing roles. For example, in both Wales and Scotland, advanced practice is conceptualized around four “pillars”, namely clinical, education, research, and management/leadership. With the exception of systems support, these reflect the pillars of the Strong Model (NLIAH, 2011 and NHS Scotland, 2008). The current NSW CNC position description also appears to have been based on the Strong Model and its pillars, although this is not explicitly acknowledged in the documentation (NSW Health, 2011a). In this position
description, the domains of clinical service and consultancy; leadership; research; education; and planning and management, are listed as being central to the CNC role, and bear clear similarities to the five pillars of the Strong Model (NSW Health, 2011a). However, at this stage, the question arises as to whether the Strong Model does in fact provide an accurate conceptualization of the CNC role and other Australian advanced nursing positions. As explained previously, the model was originally G protein-coupled receptor kinase developed as a means selleck screening library of conceptualizing the role of an acute care nurse practitioner in the United States, a role which differs from that of the NSW CNC in important ways. Second, the Strong Model was developed in the mid-1990s, almost 20 years previously, and as Lowe and colleagues correctly suggested, advanced practice nursing roles are not static (Lowe, Plummer, O’Brien, & Boyd, 2012). Rather, as the health care system changes, such roles tend to evolve, and consequently, a model of practice which was
appropriate years ago may not be appropriate now, and may require updating to better reflect contemporary practice. A number of Australian researchers have investigated CNC practice, however, there are several weaknesses associated with these studies. First, apart from one study by Chiarella and colleagues, which examined CNC roles across NSW (Chiarella et al., 2007), the research has tended to be small in scale, and concentrate on single sites or health services. For example, Dawson and Benson examined the CNC role in Wentworth Area Health Service, where a total of 13 CNCs were employed (Dawson & Benson, 1997), whilst McIntyre and colleagues’ more recent paper looked at ward nurses’ attitudes to intensive care unit CNCs at a single health service (McIntyre et al.