Publication Name

Journal of Advanced Nursing


Aims: To validate the ‘safe and effective staffing tool’ and explore the impact of COVID-19 on the quality of Australian primary health care (PHC). Design: A national survey was conducted from October to December 2020. Methods: The online survey was distributed via social media and professional organisations to PHC nurses. Results: Three-hundred fifty-nine PHC nurses participated. A two-factor solution was found with factors named; ‘Perception of quality of care provided’ and ‘Personal satisfaction with care delivered’. Cronbach's alpha demonstrated good internal consistency for the total scale (α =.915) and each subscale (α =.879/α =.864). Nearly three-quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor ‘perceptions of quality of care provided’ and the total ‘quality and satisfaction with care’. A lack of time, inadequate supervision and support, and performing non-nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID-19 had impacted negatively on the detection and management of non-COVID related health conditions. Conclusion: The ‘safe and effective staffing tool’ is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID-19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID-19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high-quality care to optimise health outcomes and maintain nurse satisfaction. Impact: This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.

Open Access Status

This publication may be available as open access

Funding Sponsor

University of Wollongong



Link to publisher version (DOI)