Combination model of care for community nurse practitioners

Twenty-two community nurse practitioners were researched, primarily to establish whether or not they were able to achieve a 'higher level of practice'. Grounded theory, the qualitative research methodology developed by Glaser and Strauss, was used as a framework for the research. Data was gathered using primary observation with some participation (581 consultations being observed in the process), and by interviewing the community nurse practitioners and their clinical managers. From the overall theoretical framework that emerged from the research, a category, the 'combination model of care', was developed as a theoretical model, together with a conceptual framework for the process of nursing, 'HADPIPE'. This model of care/nursing and the HADPIPE framework provide a basis from which nurse practitioners can practice with a holistic nursing focus. The article analyses and discusses the combination model, and provides a detailed example of it in action.