Nurses’ perceptions of the skills, knowledge and attributes required to optimise scope of practice and improve access to care for people experiencing homelessness in Australia: A cross-sectional study

Abstract

Background: People experiencing homelessness are less likely to access healthcare, particularly primary and preventive care. Nurses are well placed to improve access to healthcare for this vulnerable population. Aim: To explore nurses’ perceptions of the skills, knowledge and attributes required to optimise scope of practice and improve access to healthcare for people experiencing homelessness, to underpin an education framework. Design: A cross-sectional national survey of nurses in Australia. Methods: Part of a larger study, a 222-item electronic survey was disseminated via social media and nursing colleges and associations. Participants rated the level of priority of specific skills knowledge and attributes to optimise nurses’ scope of practice and improve access to care for people experiencing homelessness. Quantitative data were analysed descriptively and qualitative data thematically. Findings: The final analysis comprised n = 67 surveys. Participants were registered nurses (n = 54), nurse practitioners (n = 12) and one enrolled nurse. Items rated as highest priority and used in practice to optimise access to care were interpersonal attributes (n = 66.5, 99%), diagnosing presenting complaints (n = 64, 95%) and interpreting diagnostic test results (n = 63, 93%). Organisationally, support from colleagues (n = 58, 87%), managers (n = 57, 85%) and clear clinical guidelines (n = 46, 69%) are reportedly important. Most participants stated willingness to undertake further education in the care of people experiencing homelessness (93%, n = 62). Conclusion: In developing a nursing education framework to optimise nurses’ scope of practice and improve access to care for people experiencing homelessness, the findings suggest that interpersonal skills, diagnosis and treatment are priority topics.