Experts Recommend Strategies for Strengthening the Use of Advanced Practice Nurses in Nursing Homes

Mezey, Mathy; Burger, Sarah Greene; Bloom, Harrison G.; Bonner, Alice; Bourbonniere, Mary; Bowers, Barbara J.; Burl, Jeffrey B.; Capezuti, Elizabeth; Carter, Diane; Dimant, Jacob; Jerro, Sarah A.; Reinhard, Susan C.; Maat, Marilyn Ter

doi:10.1111/j.1532-5415.2005.53556.x

Cited by 37 publications

(30 citation statements)

References 17 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A prior study recommended changes in Medicare physician and APN reimbursement to reflect the value of currently nonbillable practitioner time (Mezey et al, 2005). Building on those previous recommendations, the expert panel recommended adjusting RVUs to reflect the increasingly complex needs of short-and long-term care nursing home residents.…”

Section: Rvu Codingmentioning

confidence: 96%

“…Drawing on empiric evidence and clinical expertise, the panel developed six recommendations related to APN use: (a) increase the presence of APNs in nursing homes; (b) add geriatric content to APN educational preparation; (c) delineate resident, facility, and practitioner factors that influence the number and type of APN visits per day; (d) restructure APN reimbursement to account for nonbillable activities related to resident care; and (e) describe the technical assistance necessary to facilitate APN practice in nursing homes. Details of these six panel recommendations have been published elsewhere (Mezey et al, 2005).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Expanding the Knowledge Base of Resident and Facility Outcomes of Care Delivered by Advanced Practice Nurses in Long-Term Care

Bourbonniere

Mezey

Mitty

et al. 2009

Policy, Politics, & Nursing Practice

Self Cite

View full text Add to dashboard Cite

In 2003, a panel of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care convened to examine and make recommendations about care quality and safety issues related to advanced practice nurses (APNs) in nursing home practice. This article reports on the panel recommendation that addressed expanding the evidence base of resident and facility outcomes of APN nursing home practice. A review of the small but important body of research related to nursing home APN practice suggests a positive impact on resident care and facility outcomes. Recommendations are made for critically needed research in four key areas: (a) APN nursing home practice, (b) relative value unit coding, (c) outcomes related to geropsychiatric and mental health nursing services, and (d) outcomes related to geriatric specialization. The APN role could be significantly enhanced and executed if its specific contribution to resident and facility outcomes was more clearly delineated through the recommended rigorous research.

show abstract

Section: Rvu Codingmentioning

confidence: 96%

mentioning

confidence: 99%

Expanding the Knowledge Base of Resident and Facility Outcomes of Care Delivered by Advanced Practice Nurses in Long-Term Care

Bourbonniere

Mezey

Mitty

et al. 2009

Policy, Politics, & Nursing Practice

Self Cite

View full text Add to dashboard Cite

show abstract

“…7,8,14,24,25 The need for further education and better preparation of healthcare providers to manage these symptoms is quite clear. 19 There can be little doubt that without standardized, formal education, NPs are unlikely to have the necessary knowledge base upon which to properly manage symptoms at and near the end of life. Indeed, a gap very likely exists between the best palliative care practices and the usual practices as provided by NPs in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

“…18,19 Studies have demonstrated the effectiveness of NPs in providing cost-effective, quality care in nursing homes. 16 Given their education and training in patient assessment, coordination of care, and communication skills, NPs are well suited to direct and deliver care to patients who are living with, and dying of, progressive disease.…”

Section: Introductionmentioning

confidence: 99%

An Educational Intervention for Nurse Practitioners Providing Palliative Care in Nursing Homes

Letizia¹,

Jones²

2012

Journal of Hospice & Palliative Nursing

View full text Add to dashboard Cite

The nursing home is a major setting for death and dying in the United States, yet palliative care approaches are underused in these facilities. Nurse practitioners are increasingly responsible for the management of these patients and their families. Although they are well suited to provide palliative care, most nurse practitioners have not received formal education about this specialty practice.The purpose of this project was to develop, implement, and evaluate an online educational program designed to improve the knowledge of nurse practitioners who are directing and delivering care in nursing home facilities across the United States. Aims included (1) develop and deliver three learning modules; (2) measure improvement in knowledge by comparing pretest and posttest examination scores; and (3) describe relationships between nurse practitioner characteristics and examination scores. This educational project was based on the well-established End-of-Life Nursing Education Consortium curriculum.One hundred seven nurse practitioners registered for the program; 99 completed the program. Program evaluations were extraordinarily positive. Strong reliability of the test was demonstrated. A statistically significant difference in the mean pretest and posttest scores indicated significant learning gains among the participants. Reported level of confidence in providing palliative care increased from the beginning to the end of the program. Nearly 93% of participants reported changing their practice as a result of this program. These findings support both the need and the strength of the program.

show abstract

“…For example, higher levels of educational preparation and specialty knowledge in nursing homes have been related to more effective RN leadership and supervisory skills (Fleming & Kayser-Jones, 2008; Siegel, Young, Mitchell, & Shannon, 2008). Nursing home use of advanced practice nurses (APNs) has been related to better resident quality of care outcomes (Kane, Keckhafer, Flood, Bershadsky, & Siadaty, 2003; Lekan, Hendrix, McConnell, & White, 2010; Mezey et al, 2005). A higher proportion of RNs among nursing home staff, as well as having overall higher RN staffing levels, have been linked to better quality of care (Akinci & Krolikowski, 2005; Anderson, Hsieh, & Su, 1998; Bostick, 2004; Castle, 2002; Horn et al, 2005; Weech-Maldonado, Meret-Hanke, Neff, & Mor, 2004).…”

mentioning

confidence: 99%

Jurisdiction Over Nursing Care Systems in Nursing Homes

et al. 2012

View full text Add to dashboard Cite

Background In the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode. Objectives The purpose of this study is to develop a typology of professional nursing jurisdiction in nursing homes in relation to characteristics of RN staffing, drawing upon Abbott's (1988) tasks and jurisdictions framework. Method The study was a cross-sectional, observational study using the 2004 National Nursing Home Survey (N=1,120 nursing homes). Latent class analysis tested whether RN staffing indicators differentiated facilities in a typology of RN jurisdiction, and compared classes on key organizational environment characteristics. Multiple logistic regression analysis related the emergent classes to presence or absence of specialty care programs in 8 clinical areas. Results Three classes of capacity for jurisdiction were identified, including ‘low capacity’ (41% of homes) with low probabilities of having any indicators of RN jurisdiction, ‘mixed capacity’ (26% of homes) with moderate to high probabilities of having higher RN education and staffing levels, and ‘high capacity’ (32% of homes) with moderate to high probabilities of having almost all indicators of RN jurisdiction. ‘High capacity’ homes were more likely to have specialty care programs relative to ‘low capacity’ homes; such homes were less likely to be chain-owned, and more likely to be larger, provide higher technical levels of patient care, have unionized nursing assistants, have a lower ratio of LPNs to RNs, and a higher education level of the administrator. Discussion Findings provide preliminary support for the theoretical framework as a starting point to move beyond extensive reliance on staffing levels and mix as indicators of quality. Further, findings indicate the importance of RN specialty certification.

show abstract

Experts Recommend Strategies for Strengthening the Use of Advanced Practice Nurses in Nursing Homes

Cited by 37 publications

References 17 publications

Expanding the Knowledge Base of Resident and Facility Outcomes of Care Delivered by Advanced Practice Nurses in Long-Term Care

Expanding the Knowledge Base of Resident and Facility Outcomes of Care Delivered by Advanced Practice Nurses in Long-Term Care

An Educational Intervention for Nurse Practitioners Providing Palliative Care in Nursing Homes

Jurisdiction Over Nursing Care Systems in Nursing Homes

Contact Info

Product

Resources

About