Provision of Resident-Centered Care by Nurse Practitioners in Saskatchewan Long-Term Care Facilities: Qualitative Findings From a Mixed Methods Study

Abstract

With their education and skill set, nurse practitioners (NPs) are ideally situated to provide primary care to long-term care (LTC) residents, and this is a timely development as physician presence in LTC has been decreasing. A sequential follow-up explanatory mixed methods design was used for the current study, which focused on the interviews that followed the initial survey. The sample included seven NPs who work with LTC residents in urban and rural settings in a western Canadian province. The interviews provided an opportunity for in-depth discussion regarding survey results. Interpretive description guided the data analysis. NPs provide timely access to primary care, address medication reconciliation, decrease transfers to hospitals, and take part in collaborative practice. NPs promote the health care goals of LTC residents. Departments of health would benefit from the inclusion of a wider range of health providers, including NPs, to provide timely access to quality care in LTC facilities. [ Research in Gerontological Nursing, 13 (2), 73–81.]

Complexity of Nurse Practitioners’ Role in Facilitating a Dignified Death for Long-Term Care Home Residents during the COVID-19 Pandemic

“…Findings from our study correlate with other studies that demonstrated an increase in ACP discussion where NPs were involved in the residents' care team [20][21][22], with one study showing a 300% increase in the number of residents with ACP discussions [20]. Similar to the findings in our study, Campbell and colleagues also found that NPs were part of the collective approach in ensuring residents were frequently assessed, especially those in the last stage of their life [43]. NPs worked hard so that residents' distressing symptoms were addressed, that they were comfortable, and died in their familiar surroundings rather than a hospital, when appropriate.…”

“…In addition, they are able to collaborate with other healthcare practitioners including primary care physicians and palliative care specialists and seek further advice when required. Furthermore, they embrace shared decision-making and serve as a link bringing the healthcare team, residents and their care partners together for coordinated care planning [43,54]. As a result, NPs globally can be in a better position to deliver timely and person-centered care to LTC home residents, which includes the provision of a dignified death.…”

Professional development and career planning for nurses working in care homes for older people: A scoping review

“…Three reviews of the literature addressed deterrents to participation in clinical education for care home RNs (Schweitzer & Krassa, 2010 ), experiences of care home RNs as clinical leaders and managers (Dwyer, 2011 ), and leadership and RNs working after‐hours in residential aged care facilities (Nhongo et al, 2018 ). Sixteen empirical studies investigated competencies (Stanyon et al, 2017 ) and roles of care home RNs (Campbell et al, 2020 ; Huizenga et al, 2016 ; Thompson et al, 2015 , 2016 , 2018 ); intention to stay (McGilton et al, 2014 ); turnover (Hodgin et al, 2010 ; Kash et al, 2010 ); professional development (Cooper et al, 2017 ; Corbett et al, 2015 ; Dyck & Kim, 2018 ; Spilsbury et al, 2015 ); and three studies focused on care home RN leadership (Fiset et al, 2017 ; Venturato & Drew, 2010 ; Vogelsmeier et al, 2010 ). The over‐arching themes identified were as follows: factors affecting nurses' career choices in the care home sector; promoting a career as a care home RN; professional development—content and methodologies; and barriers and facilitators for care home RNs' professional development and career planning (Figure 2 ).…”

“…Specialist roles such as nurse practitioner (NP) and other specialist pathways were advocated (Dwyer, 2011 ; Spilsbury et al, 2015 ). For instance, NPs in a care home setting were reported as providing resident‐centred care through timely access to primary care, medication review, decreased transfers to hospital and more collaborative interprofessional practice (Campbell et al, 2020 ). Initiatives such as a specialist gerontological qualification helped validate nurses' expertise and were positive for recruitment and retention (Aaron, 2011 ; Cooper et al, 2017 ; Dwyer, 2011 ; Spilsbury et al, 2015 ; Thompson et al, 2015 ), as did new roles (Venturato & Drew, 2010 ).…”

“…Specialist roles such as nurse practitioner (NP) and other specialist pathways were advocated (Dwyer, 2011;Spilsbury et al, 2015). For instance, NPs in a care home setting were reported as providing resident-centred care through timely access to primary care, medication review, decreased transfers to hospital and more collaborative interprofessional practice (Campbell et al, 2020).…”