MODELS OF NURSE AUTONOMY IN HEALTHCARE SYSTEMS OF DIFFERENT COUNTRIES

Abstract

Introduction. Health care reform, the need for rapid response, and staff shortages have increased the responsibility of nurses for decisions and responsibilities. In many countries, the autonomous practice of nurses is growing, and its level depends on the legislation and health care system. In Ukraine, this concept requires in-depth analysis, and studying global models will help improve practice and implement effective approaches.

The aim of the study – to analyze the existing models of nursing autonomy in medical institutions around the world, identify features and study potential in order to determine the need to implement this practice in Ukraine to improve the quality of the health care system.

The main part. The study used a comparative analysis of nursing autonomy models in the USA, Canada, Great Britain, Germany and Sweden, taking into account the limits of autonomy, level of education and their role in the provision of primary and emergency medical care. A content analysis of scientific publications, legislative documents and international reports was conducted; examples of autonomy in practice in different countries, statistics on the impact of nurse autonomy on mortality, response time to emergencies and overall patient satisfaction were considered. Nurse practitioners have long been an independent entity in healthcare in the world, as “Advanced Practice Nurses (APNs)” or “Nurse Practitioners”. They can provide primary care, diagnose illnesses, order and interpret diagnostic tests, assess vital signs, prescribe treatments, and perform medical interventions without the constant supervision of a physician. As a result, in countries with higher autonomy, patients receive emergency care faster and spend less time in the hospital, while lower autonomy of nurses in hospitals puts patients at increased risk. Also, the capabilities of nurses depend on the level of education, which gives them more legally defined rights. In some countries, the healthcare culture has historically been physician-centered, which limits the autonomy of nurses.

Conclusions. Legislative changes, improved working conditions, and support for nurses’ autonomy will have a positive impact on the quality of care, professional development, and job satisfaction.