Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy

Introduction: Eswatini, a small, largely rural country in Southern Africa, has a high burden of morbidity/mortality in the setting of a critical shortage of human resources for health. To help achieve universal access to healthcare across the lifespan, the advanced practice family nurse practitioner...

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Autores principales:	Colile P. Dlamini, Thembisile Khumalo, Nkosinathi Nkwanyana, Tengetile R. Mathunjwa-Dlamini, Liz Macera, Bonisile S. Nsibandze, Louise Kaplan, Eileen M. Stuart-Shor
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/5c1971137b99465e934ecc83acab8595
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spelling	oai:doaj.org-article:5c1971137b99465e934ecc83acab85952021-12-02T10:20:20ZDeveloping and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy2214-999610.5334/aogh.2813https://doaj.org/article/5c1971137b99465e934ecc83acab85952020-05-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2813https://doaj.org/toc/2214-9996Introduction: Eswatini, a small, largely rural country in Southern Africa, has a high burden of morbidity/mortality in the setting of a critical shortage of human resources for health. To help achieve universal access to healthcare across the lifespan, the advanced practice family nurse practitioner (FNP) role was proposed and is in the process of being implemented. Methods/Approach: The PEPPA framework (Participatory, Evidence-based, Patient focused Process for Advanced practice nursing) illustrates the steps in the process of developing and implementing the FNP role in a country. These steps include: determining the need for the role, deciding on a model of care, developing/implementing the curriculum, relevant policies, and scope of practice (SOP), and integrating the role into relevant nursing regulations and Ministry of Health (MOH) guidelines and documents. Outcomes: The assessment has been completed, a locally tailored competency-based FNP curriculum has been developed, revised, and implemented, the FNP SOP has been approved and MOH guidelines are being updated to reflect current evidence-based practice and to integrate the FNP role. Continuous cycles of improvement/revision were needed to adapt the curriculum and SOP to meet local needs. Clinical placements were challenging since this is a new health cadre, but most challenges were overcome and many resulted in important opportunities for interdisciplinary collaboration. Summary: Outcomes from this quality improvement initiative demonstrate that it is feasible to develop and implement a locally responsive, competency-based FNP program in a low resource setting and enroll students, despite time and financial constraints. Adapting the curriculum and SOP from western countries can provide a foundation for program development but revision to assure that the program is responsive to local context is then needed. There is general acceptance of the role among Eswatini communities and professional stakeholders with emphasis on the need for FNP graduates to be clinically competent and able to function independently. Policy work related to deploying new graduates is ongoing.Colile P. DlaminiThembisile KhumaloNkosinathi NkwanyanaTengetile R. Mathunjwa-DlaminiLiz MaceraBonisile S. NsibandzeLouise KaplanEileen M. Stuart-ShorUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Colile P. Dlamini Thembisile Khumalo Nkosinathi Nkwanyana Tengetile R. Mathunjwa-Dlamini Liz Macera Bonisile S. Nsibandze Louise Kaplan Eileen M. Stuart-Shor Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
description	Introduction: Eswatini, a small, largely rural country in Southern Africa, has a high burden of morbidity/mortality in the setting of a critical shortage of human resources for health. To help achieve universal access to healthcare across the lifespan, the advanced practice family nurse practitioner (FNP) role was proposed and is in the process of being implemented. Methods/Approach: The PEPPA framework (Participatory, Evidence-based, Patient focused Process for Advanced practice nursing) illustrates the steps in the process of developing and implementing the FNP role in a country. These steps include: determining the need for the role, deciding on a model of care, developing/implementing the curriculum, relevant policies, and scope of practice (SOP), and integrating the role into relevant nursing regulations and Ministry of Health (MOH) guidelines and documents. Outcomes: The assessment has been completed, a locally tailored competency-based FNP curriculum has been developed, revised, and implemented, the FNP SOP has been approved and MOH guidelines are being updated to reflect current evidence-based practice and to integrate the FNP role. Continuous cycles of improvement/revision were needed to adapt the curriculum and SOP to meet local needs. Clinical placements were challenging since this is a new health cadre, but most challenges were overcome and many resulted in important opportunities for interdisciplinary collaboration. Summary: Outcomes from this quality improvement initiative demonstrate that it is feasible to develop and implement a locally responsive, competency-based FNP program in a low resource setting and enroll students, despite time and financial constraints. Adapting the curriculum and SOP from western countries can provide a foundation for program development but revision to assure that the program is responsive to local context is then needed. There is general acceptance of the role among Eswatini communities and professional stakeholders with emphasis on the need for FNP graduates to be clinically competent and able to function independently. Policy work related to deploying new graduates is ongoing.
format	article
author	Colile P. Dlamini Thembisile Khumalo Nkosinathi Nkwanyana Tengetile R. Mathunjwa-Dlamini Liz Macera Bonisile S. Nsibandze Louise Kaplan Eileen M. Stuart-Shor
author_facet	Colile P. Dlamini Thembisile Khumalo Nkosinathi Nkwanyana Tengetile R. Mathunjwa-Dlamini Liz Macera Bonisile S. Nsibandze Louise Kaplan Eileen M. Stuart-Shor
author_sort	Colile P. Dlamini
title	Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
title_short	Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
title_full	Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
title_fullStr	Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
title_full_unstemmed	Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy
title_sort	developing and implementing the family nurse practitioner role in eswatini: implications for education, practice, and policy
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/5c1971137b99465e934ecc83acab8595
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Developing and Implementing the Family Nurse Practitioner Role in Eswatini: Implications for Education, Practice, and Policy

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