A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis




Contandriopoulos, Damien
Brousselle, Astrid
Dubois, Carl-Ardy
Perroux, Mélanie
Beaulieu, Marie-Dominique
Brault, Isabelle
Kilpatrick, Kelley
D’Amour, Danielle
Sansgter-Gormley, Esther

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BMC Health Services Research


Background: Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration. However, this literature is much less prolific in discussing the operational level implications of those barriers and facilitators and in offering practical recommendations. Methods: In the context of a large-scale research project on the introduction of nurse practitioners in Quebec (Canada) we relied on a logic-analysis approach based, on the one hand on a realist review of the literature and, on the other hand, on qualitative case-studies in 6 primary healthcare teams in rural and urban area of Quebec. Results: Five core themes that need to be taken into account when integrating nurse practitioners into primary care teams were identified. Those themes are: planning, role definition, practice model, collaboration, and team support. The present paper has two objectives: to present the methods used to develop the themes, and to discuss an integrative model of nurse practitioner integration support centered around these themes. Conclusion: It concludes with a discussion of how this framework contributes to existing knowledge and some ideas for future avenues of study.


BioMed Central


Collaboration, Delivery of health care, Integrating process, Logic evaluation, Nurse practitioners, Practice model, Primary health care, Role definition, Team support


Contandriopoulos et al.: A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis. BMC Health Services Research (2015) 15:78