Acute Events in Primary Health Care Settings: An Analysis of Advanced Practice Competencies in Nursing Consultations in Brazil

TL;DR

This study examines how nurses in Brazil handle acute events in primary care and whether they meet advanced practice standards.

Contribution

It provides empirical evidence on the application of Advanced Practice Nurse competencies in Brazilian primary care settings.

Findings

Nurses partially applied Advanced Practice Nurse competencies during acute event consultations.

Key competency areas included care focus, care provision, and assessment, with an average identification rate of 47.60%.

Gaps were noted in cultural diversity and advanced assessment skills.

Abstract

To describe nurse practices during acute event nursing consultations in Primary Health Care settings and analyse whether these professionals demonstrate the competencies proposed for Advanced Practice Nurses within a care management scope.

A multicenter, exploratory, cross‐sectional study employing both quantitative and qualitative analysis.

Data were collected through direct non‐participatory observations (film footage of nursing consultations) and medical record analysis. The study included 28 nurses and 203 patients from 17 primary care units across four municipalities in Brazil. Descriptive statistical analysis was applied to quantitative data, while qualitative data underwent content analysis.

Challenges were observed in performing the nursing process and clinical communication during nursing consultations. Some of the proposed competencies for Advanced Practice Nurses were partially applied within a care management framework in Primary Health Care settings. The competencies related to the focus on care (61.11%), care provision (41.20%) and assessment and diagnosis (40.50%) were notable, with an overall average of 47.60% competency identification across all three dimensions. Although some general advanced practice nurse competencies were observed, their application was often limited or inconsistent.

This study identified limitations in nursing consultations for acute events in Primary Health Care, particularly regarding the nursing process and the application of Advanced Practice Nurse competencies. Notable gaps were observed in areas such as cultural diversity and advanced assessment skills. Future efforts should focus on developing educational programmes, providing resources and creating clinical guidelines to enhance current nursing practices and facilitate the implementation of Advanced Practice Nursing in Brazil.

The results provide empirical evidence to inform policy decisions, educational programmes, nursing practices and planning for advanced practice nursing implementation in Brazil. These findings are particularly relevant for healthcare educators, researchers, regulatory institutions and managers aiming to enhance the effectiveness of nursing consultations for acute events.

This paper adheres to the COREQ and STROBE checklist.

No patient or public contributions.

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