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Table 2 Definition of the macro-, meso- and micro-components and list of barriers and enablers evident in the model shown in Fig. 1

From: A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia

Barriers Enablers
Macro - Perceived structural, legal, regulatory and economic external conditions that are beyond the influence of individual organisations or practitioners.
• National policy and regulatory systems (MBS & PBS)
• Lack of jobs
• Inadequate funding of roles
• Scope of role
• Support for education and endorsement
• State health service policy and practice
Meso - Local institutional factors and influences, as well as community issues that often characterise or define the parameters of service delivery.
• Local health service policy and budget constraints
• Workload
• Lack of community understanding
• Community support
• Networks
• Local Health Service Manager support
Micro - Day-to-day practice and attributes or characteristics of individual practitioners and their practice environments that affect how services are delivered.
• Lack of role clarity and understanding
• Health professional status, hierarch & identity
• Working in isolation
• Support from colleagues
• Interprofessional teamwork
• Capabilities of Nurse Practitioner
• Negotiation, advocacy, diplomacy & promotion of role