Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

Ploeg, Jenny; Kaasalainen, Sharon; McAiney, Carrie; Martin-Misener, Ruth; Donald, Faith; Wickson-Griffiths, Abigail; Carter, Nancy; Sangster-Gormley, Esther; Martin, Lori Schindel; Brazil, Kevin; Taniguchi, Alan

doi:10.1186/1472-6955-12-24

Cited by 29 publications

(59 citation statements)

References 33 publications

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“…Key strategies included part‐time positions for NPs in LTC, weekly meetings with physicians and nurse managers and an office for the NP near the healthcare team to facilitate communication with team members and improve NP integration. Consistent with a previous study (Ploeg et al., ), NPs facilitated family involvement and resident care was timelier. Healthcare teams noted improvements in the quality of nursing documentation as a result of close monitoring of residents by the NPs.…”

Section: Discussionsupporting

confidence: 87%

Implementing primary healthcare nurse practitioners in long‐term care teams: A qualitative descriptive study

Kilpatrick

Jabbour

Tchouaket

et al. 2019

Journal of Advanced Nursing

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Aim To identify the conditions needed to implement nurse practitioners (NP) in long‐term care (LTC) in Québec, Canada. Design A qualitative descriptive study was undertaken. Methods Semi‐structured interviews (N = 91) and socio‐demographic questionnaires were completed with providers and managers from May 2016–March 2017. Nurse practitioner activity logs were compiled at three sites. Content analysis was used. Results All sites initially implemented a shared care model but not all sites successfully implemented a consultative model. The progression was influenced by physicians’ level of comfort in moving towards a consultative model. Weekly meetings with physicians and nurse managers and an office for NPs located near healthcare teams facilitated communication and improved implementation. Half‐time NP positions facilitated recruitment. Improvements were noted in timely care for residents, family involvement and quality of documentation of the healthcare team. Regulatory restrictions on prescribing medications used frequently in LTC and daily physician presence at some sites limited implementation. Conclusion The project fostered an understanding of the conditions needed to successfully implement NPs in LTC. An examination of the perspective of residents and families is needed.

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Section: Discussionsupporting

confidence: 87%

Implementing primary healthcare nurse practitioners in long‐term care teams: A qualitative descriptive study

Kilpatrick

Jabbour

Tchouaket

et al. 2019

Journal of Advanced Nursing

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“…The relationship with the primary health provider was reported as having the greatest significance to patient satisfaction with respect and trust reported as significant factors. [10][11][12] Several studies in Australia, United Kingdom, United States and Canada [13][14][15][16][17][18][19] reported that patients are satisfied with the care received from NPs. The authors cite satisfaction related to NP communication increased especially when education was provided on disease prevention, health promotion and chronic disease management.…”

Section: Literature Reviewsmentioning

confidence: 99%

Patient satisfaction with nurse practitioner care in Newfoundland and Labrador

Emberley-Burke

Meadus

Twomey

2018

CNS

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Objective: The aim of the study was to determine the level of patient satisfaction with health care provided by Nurse Practitioners (NPs) in Newfoundland and Labrador (NL), in primary health care settings. Methods: This is a descriptive study. 155 adult patients (N = 155) were recruited from the four regional health authorities (RHAs) throughout NL who employed NPs in a primary health care setting. A 47-item questionnaire called the Nurse Practitioner Satisfaction Survey (NPSS) was given to patients after receiving care from a NP. Results: Over 93% of the participants agreed or strongly agreed with their degree of satisfaction of care provided by the NP. Patients who visited the NP one to five times in the past year reported higher levels of satisfaction. No significant differences based upon marital status, gender or ethnicity were found. Conclusions: Patient satisfaction was rated as high for care provided by NPs with over 98% of participants reporting they would seek the services of a NP in the future. The majority of the participants would recommend the NP to others seeking health care services. This study describes patient satisfaction with NP care and highlights NPs as valued providers of care in rural and urban primary health care settings. Identified narrative themes were timely access to care, NP knowledge, trust, and provider consistency. NPs should seek ways to ensure they work to their full scope of practice to meet the needs of the population and increase their presence in primary health care settings.

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“…Nor was the point of view of residents and their families assessed in this project. A more in-depth examination of their views is needed to guide the implementation of NPs in LTC in Québec, as researchers in other jurisdictions have found that residents and families appreciated the addition of NPs to LTC teams [85].…”

Section: Discussionmentioning

confidence: 99%

A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities

et al. 2020

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Background: To better meet long-term care (LTC) residents' (patients in LTC) needs, nurse practitioners (NPs) were proposed as part of a quality improvement initiative. No research has been conducted in LTC in Québec Canada, where NP roles are new. We collected provider interviews, field notes and resident outcomes to identify how NPs in LTC influence care quality and inform the wider implementation of these roles in Québec. This paper reports on resident outcomes and field notes. Methods: Research Design: This mixed methods quality improvement study included a prospective cohort study in six LTC facilities in Québec. Participants: Data were collected from September 2015-August 2016. The cohort consisted of all residents (n = 538) followed by the nurse practitioners. Nurse practitioner interventions (n = 3798) related to medications, polypharmacy, falls, restraint use, transfers to acute care and pressure ulcers were monitored. Analysis: Bivariate analyses and survival analysis of occurrence of events over time were conducted. Content analysis was used for the qualitative data. Results: Nurse practitioners (n = 6) worked half-time in LTC with an average caseload ranging from 42 to 80 residents. Sites developed either a shared care or a consultative model. The average age of residents was 82, and two thirds were women. The most common diagnosis on admission was dementia (62%, n = 331). The number of interventions/resident (range: 2.2-16.3) depended on the care model. The average number of medications/resident decreased by 12% overall or 10% for each 30-day period over 12 months. The incidence of polypharmacy, falls, restraint use, and transfers to acute care decreased, and very few pressure ulcers were identified. Conclusions: The implementation of NPs in LTC in Québec can improve care quality for residents. Results show that the average number of medications per day per resident, the incidence of polypharmacy, falls, restraint use, and transfers to acute care all decreased during the study, suggesting that a wider implementation of NP roles in LTC is a useful strategy to improve resident care. Although additional studies are needed, the implementation of a consultative model should be favoured as our project provides preliminary evidence of the contributions of these new roles in LTC in Québec.

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Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

Cited by 29 publications

References 33 publications

Implementing primary healthcare nurse practitioners in long‐term care teams: A qualitative descriptive study

Implementing primary healthcare nurse practitioners in long‐term care teams: A qualitative descriptive study

Patient satisfaction with nurse practitioner care in Newfoundland and Labrador

A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities

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