PEPPA Framework and NP Role Implementation

Comprehensive vocabulary flashcards covering the PEPPA framework steps, NP provider models (MRP, Consultative, Shared), and Rogers' Theory of Diffusion of Innovation as presented in the lecture notes.

PEPPA Framework

Participatory, Evidence-based, Patient-focused Process for Advanced practice nursing role development, implementation and evaluation; developed by Bryant-Lukosius and DiCenso in Canada.

PEPPA Step 1

Define patient population and describe current model of care; includes mapping how care is delivered and identifying patient flow.

PEPPA Step 2

Identify stakeholders and recruit participants, including patients, families, clinicians, administrators, and policy groups.

PEPPA Step 3

Determine need for a new model of care by assessing gaps such as unmet needs, inefficiencies, and access issues.

PEPPA Step 4

Identify priority problems and goals, such as wait times, continuity, and patient satisfaction, before defining the specific APN role.

PEPPA Step 5

Define new model of care and APN role, including scope (clinical care, education, leadership, research) and accountability structures.

PEPPA Step 6

Plan implementation strategies, identifying facilitators/barriers and developing an evaluation plan with baseline data.

PEPPA Step 7

Initiate APN role implementation plan, including developing policies, protocols, and providing education and support.

PEPPA Step 8

Evaluate APN role and new model of care using a structure–process–outcome framework focused on safety, quality, and cost-effectiveness.

PEPPA Step 9

Long-term monitoring of the APN role and model of care to adjust the role as healthcare system needs change.

Most Responsible Provider (MRP)

A role where the NP assumes primary accountability and consistent care for a patient across admission, treatment, diagnostics, prescribing, and discharge.

Consultative NP

An NP role providing episodic input through consultations, rapid response, or specialty clinics without primary accountability.

Shared Care NP

A model where the NP and MD collaboratively manage patient care with overlapping responsibilities and ongoing communication.

Rogers' Theory of Diffusion of Innovation

A communication process that forms attitudes toward an innovation, aims to reduce uncertainty, and facilitates adoption through four key areas.

Adopter Categories (Rogers' Theory)

The five groups into which individuals are classified based on innovation adoption: Innovators, Early adopters, Early majority, Late majority, and Laggards.

Decision-making steps (Rogers' Theory)

The sequence of exposure and action: Knowledge, Persuasion, Decision, and Implementation.

Pro-innovation Bias

The implication that using a theory of diffusion ensures an innovation will be adopted by all, despite barriers like regulatory delays or lack of funding.

Most Responsible Physician (MRPh)

A role established in the Ontario Shores study to provide final physician oversight in a model where NPs functioned as MRPs.

PEPPA Plus

An in-depth approach to evaluating APN roles at the introduction, implementation, and long-term sustainability stages of role development.

NP Approachability

A relational dimension highlighted in the Acorn article that influences communication, team functioning, and patient trust.

Role Ambiguity

A common implementation barrier characterized by a lack of understanding of the NP scope of practice among MDs, RNs, and other stakeholders.

Relational Continuity

A benefit offered by APNs that involves a stabilizing, coordinating presence and holistic assessment, especially for older adults with fragmented care.