Situational Analysis of Practices Among Nurse Practitioners Transferring to Local Administrative Organizations in Chiang Mai Province

Abstract

The transfer of sub-district health promoting hospitals to local administrative organizations may have an impact on the professional practice of nurse practitioners. This descriptive research study aimed to analyze the practices of nurse practitioners transferred to local administrative organizations. The analysis was performed using Donabedian's systems theory framework which consists of three domains: structure, process, and outcome. The participants consisted of 6 public health administrators for analyzing the structural domain, 10 practicing nurses for analyzing the process domain, and 73 nurse practitioners for analyzing the outcome domain. The research instruments included a semi-structured interview used for the structural and process domains, and a questionnaire used for the outcome domain. Data were analyzed using descriptive statistics, content analysis, and group classification.

The results found that, regarding the structural domain: 1) characteristics of the organization's public health development policy/plan operated according to the policy of the local administrative organization; 2) resources and tools, including the manual of standards and guidelines for public health work, were developed from multidisciplinary work, and the operations of practical nurses were directly dependent on the Public Health and Environment Division; and 3) in terms of human resources, there has been an increase in the number of professional nursing workforce frameworks being opened. Regarding the process domain, nurse practitioners performed their duties according to their main roles and professional competencies, adjusting the service model to the CUP Split format. The outcome domain also revealed that nurse practitioners who transferred their role reported satisfaction at a high level (M = 3.90, SD = 0.95).

These results can be used by the executive committee of the PAO as fundamental information for determining public health policies and for developing service models for health promotion, prevention, treatment, and rehabilitation to better align with operators and service recipients.