Exploring the Nurse Practitioner Role in Managing Fractures in Long-Term Care

Abstract

The purpose of this study was to assess the current level of involvement of nurse practitioners (NPs) in activities related to preventing and managing fractures in long-term care (LTC). This study used a sequential explanatory mixed methods design that included two phases-a crosssectional survey followed by qualitative interviews. A final sample of 12 NPs completed the online survey for a response rate of 67%. Eleven of the 12 NPs who completed the survey agreed to participate in a follow-up interview. NPs reported that they were quite engaged in managing fractures in LTC; specifically, they were most active in caring for residents post-fracture. NPs described their role as being holistic in nature in their assessment and treatments related to managing fractures. The findings from this mixed method study add to the growing body of knowledge related to how NPs manage fractures in LTC.

The Impact of Nurse Practitioners on Hospitalizations and Discharges from Long-term Nursing Facilities: A Systematic Review

“…Improved patient and family satisfaction were mentioned in 2 of 136 occurrences of facilitator themes, or 1.47% [ 19 , 32 ]. Improved quality of care was mentioned in 26 of 136 occurrences of facilitator themes, or 19.12% [ 8 , 13 , 14 , 18 , 19 , 20 , 23 , 24 , 26 , 27 , 28 , 31 , 33 ]. Improved end-of-life care was mentioned in 3 of 136 occurrences of facilitator themes, or 2.21% [ 16 ].…”

“…Additional facilitator themes identified during the review of the articles were as follows. Increased access to healthcare was mentioned in 14 of 136 occurrences of facilitator themes, or 10.29% [ 18 , 20 , 23 , 24 , 25 , 30 , 32 , 33 , 34 ]. Patient and family education were mentioned in 3 of 136 occurrences of facilitator themes, 2.21% [ 13 , 20 ].…”

“…Reduced healthcare costs were mentioned in 9 of 136 occurrences of facilitator themes, or 6.62% [ 7 , 8 , 9 , 12 , 14 , 23 , 30 ]. Unrestrictive or least restrictive scope of practice for NPs was mentioned in 10 of 136 occurrences of facilitator themes, 7.35% [ 10 , 14 , 16 , 17 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

“…Improved quality of care was mentioned in 23 of 132 occurrences (19.21%) of facilitator themes encompassing the improvement of quality measures, providing education to staff and assisting with clinical care, and involvement with quality improvement initiatives, e.g., the Intervention to Reduce Acute Care Transfers (INTERACT) [ 7 , 8 , 9 , 12 , 13 , 14 , 16 , 17 , 18 , 19 , 20 , 21 , 23 , 24 , 27 , 28 , 29 , 30 , 32 , 33 ]. One qualitative study reviewed provided insights to person-centered care from the residents’ and family perspectives [ 23 ].…”

“…Inadequate staffing was also identified as a concern surrounding the use of NPs in 6 of 45 occurrences (13.33%) [8,10,17,23,28,33]. Many long-term care facilities operated with limited resources and inadequate staffing further increasing the barriers NPs faced [8,10,17,23,28,33]. Many long-term care facilities do not have the capacity or resources to have an available NP to perform a stabilization and medication reconciliation visit upon each admission, for example [8].…”