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