Background: At the time of this study (2009) the role of the nurse practitioner was new to the province of British\r\nColumbia. The provincial government gave the responsibility for implementing the role to health authorities.\r\nManagers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the\r\nneed for the NP role, determining how the NP would function, and gaining team members� acceptance for the\r\nnew role.\r\nMethod: The purpose of the study was to explain the process of nurse practitioner role implementation as it was\r\noccurring and to identify factors that could enhance the implementation process. An explanatory, single case study\r\nwith embedded units of analysis was used. The technique of explanation building was used in data analysis. Three\r\nprimary health care settings in one health authority in British Columbia were purposively selected. Data sources\r\nincluded semi-structured interviews with participants (n=16) and key documents.\r\nResults: The results demonstrate the complexity of implementing a new role in settings unfamiliar with it. The\r\nfindings suggest that early in the implementation process and after the nurse practitioner was hired, team\r\nmembers needed to clarify intentions for the role and they looked to senior health authority managers for\r\nassistance. Acceptance of the nurse practitioner was facilitated by team members� prior knowledge of either the\r\nrole or the individual nurse practitioner. Community health care providers needed to be involved in the\r\nimplementation process and their acceptance developed as they gained knowledge and understanding of the role.\r\nConclusion: The findings suggest that the interconnectedness of the concepts of intention, involvement and\r\nacceptance influences the implementation process and how the nurse practitioner is able to function in the setting.\r\nWithout any one of the three concepts not only is implementation difficult, but it is also challenging for the nurse\r\npractitioner to fulfill role expectations. Implications for research, policy, practice and education are discussed.
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