Introduction
Health services are under pressure as the burden of disease
and changing demographics of the healthcare consumer are
stretching the capacity of systems to meet demand. A prominent
response to these current pressures is development
and adoption of innovative health service delivery models.
The nurse practitioner service is one of these reform models
that has been adopted globally to improve timely access to
clinical care for specific populations.
The International Council of Nurses states that the
characteristics of nurse practitioner practice is ‘shaped by
the context and/or country in which s/he is credentialed to
practice’(International Council of Nurses Nurse Practitioner/Advanced Practice Nursing Network 2005). Common elements
across all definitions of the role are that the nurse
practitioner is educated at masters level, works from a nursing
model of care and, in many countries, has legislative
support to prescribe, refer and diagnose. These practice
enhancements enable the nurse to complete an episode of
care without the need to ‘hand over’ the patient at critical
points in the care trajectory (Gardner et al. 2006, Carryer
et al. 2007). This expansion of nursing practice is a timely
and logical response to increasing demands on health
services