The role of nurse practitioners in outreach services and facilitating access for marginalized adult women in British Columbia

Studies show that marginalized adult women experience significant barriers in the process of gaining access to health care in British Columbia. Their needs and risk factors have been studied extensively and much attention has been given to the ways in which the significant inequalities experienced by these women can be addressed. The purpose of this integrative literature review is to understand the role of Nurse Practitioners (NPs) working in outreach services in British Columbia, and to examine ways in which NPs can better facilitate access to health care for marginalized adult women with high-risk lifestyles. Due to the dearth of research on NPs in these practice settings, a review of the health literature was undertaken to identify research that examines the current barriers encountered by marginalized adult women, and the way in which outreach centers might serve as an entry point for access to health care. A rigorous literature search method revealed 18 articles, which were considered appropriate for analysis. The key findings identified the individual and structural barriers to health care access for marginalized women, and emphasized the significant role of outreach centers in facilitating access to health services. The role of NPs in outreach centers is examined by way of a feminist lens, one that is informed by the life experiences of these marginalized women in order to formulate an appropriate, person-centered treatment plan. Nurse Practitioners can facilitate access to health care for marginalized women by fostering a harm reduction philosophy in their practice, by establishing therapeutic relationships with women to overcome the fear and mistrust they have around the health care system and its providers, and by incorporating a person-centered approach to caring for women. Implications for research and education are discussed. --Leaf ii.