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Learning Objective 1: The learner will be able to outline the utility of evaluation methodology as an approach to evaluate nursing policy.
Learning Objective 2: The learner will be able to compare the challenges faced by international nurse leaders with their own when regulatory nursing policies are introduced.
Methods: Evaluation methodology was used because of the ascending approach to evaluating policy rather than the ‘top-down’ approach. As such, nurses (N = 88) and midwives (N = 10) were recruited from metropolitan, regional and rural facilities working in government and privately owned hospitals, community and aged care centres. Using focus groups, participants’ views on the utility of the Framework were explored. Triangulation was achieved through observation studies of nurses and midwives (N = 6) across contexts and document analysis from participant organisations.
Transcripts of focus group data were analysed using HyperRESEARCH 2.8 to identify data-rich themes. Observation data was subjected to theoretical analysis and documents were coded and analysed using content analysis and quasi-statistical methods to identify trends.
Results: The data produced 12 significant outcomes including the overt and covert pressure on nurses to work outside of their scope of practice, usually from upper to middle management in most environments. At some sites, institutional policies limited the scope of practice of the registered nurse while expanding the scope of the enrolled (licensed practical) nurse and unlicensed carer resulting in worker and workplace tension.
Conclusion: The findings suggest that the evaluation method was appropriate for this study and the recommendations highlight the need for further education at all levels of nursing to strengthen the overall understanding of the principles of the Framework.