Growth of Physicians and Nurse Practitioners Practicing Full Time in Nursing Homes

2021 ◽  
Author(s):  
James S. Goodwin ◽  
Pooja Agrawal ◽  
Shuang Li ◽  
Mukaila Raji ◽  
Yong-Fang Kuo
Keyword(s):  
Nursing Homes ◽  
Nurse Practitioners ◽  
Full Time

scholarly journals A mixed methods study of the work patterns of full-time nurse practitioners in Canadian nursing homes

2021 ◽  
Author(s):  
R. Martin-Misener ◽  
F. Donald ◽  
Abigail Wickson-Griffiths ◽  
Noori Akhtar-Danesh ◽  
J. Ploeg ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Case Studies ◽  
Nurse Practitioners ◽  
National Survey ◽  
Nurse Practitioner ◽  
Family Care ◽  
Full Time ◽  
Work Patterns ◽  
Practitioner Role

The aim of this study was to explore the integration of the nurse practitioner role in Canadian nursing homes to enable its full potential to be realised for resident and family care. The objective was to determine nurse practitioners' patterns of work activities. Nurse practitioners were introduced in Canadian nursing homes a decade ago on a pilot basis. In recent years, government and nursing home sector interest in the role has grown along with the need for data to inform planning efforts. The study used a sequential mixed methods design using a national survey followed by case studies. A national survey of nurse practitioners included demographic items and the EverCare Nurse Practitioner Role and Activity Scale. Following the survey, case studies were conducted in four nursing homes. Data were collected using individual and focus group interviews, document reviews and field notes. Twenty-three of a target population of 26 nurse practitioners responded to the survey, two-thirds of whom provided services in nursing homes with one site and the remainder in nursing homes with as many as four sites. On average, nurse practitioners performed activities in communicator, clinician, care manager/coordinator and coach/educator subscales at least three to four times per week and activities in the collaborator subscale once a week. Of the 43 activities, nurse practitioners performed daily, most were in the clinician and communicator subscales. Case study interviews involved 150 participants. Findings complemented those of the survey and identified additional leadership activities. Nurse practitioners undertake a range of primary health care and advanced practice activities which they adapt to meet the unique needs of nursing homes. Knowledge of work patterns enables nursing homes to implement the full range of nurse practitioner roles and activities to enhance resident and family care.

scholarly journals FACILITY AND RESIDENT LEVEL DIFFERENCES: ANTIBIOTIC USE IN NURSING HOMES FOR RESIDENTS WITH ADVANCE DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S883-S883
Author(s):  
Meghan Hendricksen ◽  
Daniel Habtemariam ◽  
Susan Mitchell
Keyword(s):  
Infectious Disease ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nurse Practitioners ◽  
Nursing Home Residents ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Antimicrobial Use ◽  
Full Time ◽  
Advanced Dementia

Abstract Previous studies have shown that there is a high frequency of antibiotic use in NH for advance dementia patients. However, research has shown limited clinical benefit from antimicrobial use for this population, and antimicrobial exposure increases colonization with drug-resistant bacteria in nursing homes. The aim of this study was to identify NH and resident level characteristics associated with antibiotic use for patients with advance dementia. Using data from an ongoing cluster RCT in 28 Boston NHs; Trial to Reduce Antimicrobial use in Nursing home residents with Alzheimer’s disease and other Dementias (TRAIN-AD), testing a program intervention to improve management of infections in advanced dementia. These data are taken from baseline measurements 2 months prior to intervention, and individual nursing home residents with advance dementia are units of analysis (n = 425). We ran multivariable logistic regression model with antibiotic use as the outcome, adjusting for clustering at NH level, with NH (#beds, profit status, staffing, #cognitively impaired, etc.) and individual patient characteristics (age, gender, race, etc.) as independent variables. Analyses found residents were more likely to receive antibiotics if they resided in nursing homes that employed less intense infectious disease practices prior to baseline (AOR = 2.34; 95% CI 1.08, 5.05), and full-time nurse practitioners or physician assistants (AOR= 3.68; 95%CI 1.49, 9.04). Female patients also had higher odds of receiving antibiotics (AOR=2.16; 95%CI1.10, 4.67). These findings provide potential insight into the importance of education regarding stringent infectious disease practices for practitioners, particularly for patients with advanced dementia.

scholarly journals A mixed methods study of the work patterns of full-time nurse practitioners in nursing homes

2014 ◽  
Vol 24 (9-10) ◽  
pp. 1327-1337 ◽  
Author(s):  
Ruth Martin-Misener ◽  
Faith Donald ◽  
Abigail Wickson-Griffiths ◽  
Noori Akhtar-Danesh ◽  
Jenny Ploeg ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Nurse Practitioners ◽  
Mixed Methods Study ◽  
Full Time ◽  
Work Patterns

scholarly journals A mixed methods study of the work patterns of full-time nurse practitioners in Canadian nursing homes

2021 ◽  
Author(s):  
R. Martin-Misener ◽  
F. Donald ◽  
Abigail Wickson-Griffiths ◽  
Noori Akhtar-Danesh ◽  
J. Ploeg ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Case Studies ◽  
Nurse Practitioners ◽  
National Survey ◽  
Nurse Practitioner ◽  
Family Care ◽  
Full Time ◽  
Work Patterns ◽  
Practitioner Role

The aim of this study was to explore the integration of the nurse practitioner role in Canadian nursing homes to enable its full potential to be realised for resident and family care. The objective was to determine nurse practitioners' patterns of work activities. Nurse practitioners were introduced in Canadian nursing homes a decade ago on a pilot basis. In recent years, government and nursing home sector interest in the role has grown along with the need for data to inform planning efforts. The study used a sequential mixed methods design using a national survey followed by case studies. A national survey of nurse practitioners included demographic items and the EverCare Nurse Practitioner Role and Activity Scale. Following the survey, case studies were conducted in four nursing homes. Data were collected using individual and focus group interviews, document reviews and field notes. Twenty-three of a target population of 26 nurse practitioners responded to the survey, two-thirds of whom provided services in nursing homes with one site and the remainder in nursing homes with as many as four sites. On average, nurse practitioners performed activities in communicator, clinician, care manager/coordinator and coach/educator subscales at least three to four times per week and activities in the collaborator subscale once a week. Of the 43 activities, nurse practitioners performed daily, most were in the clinician and communicator subscales. Case study interviews involved 150 participants. Findings complemented those of the survey and identified additional leadership activities. Nurse practitioners undertake a range of primary health care and advanced practice activities which they adapt to meet the unique needs of nursing homes. Knowledge of work patterns enables nursing homes to implement the full range of nurse practitioner roles and activities to enhance resident and family care.

Response to Drs Pappelbaum and Nazarian

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 824-825
Author(s):  
John L. Green
Keyword(s):  
Managed Care ◽  
Nurse Practitioners ◽  
Health Care Team ◽  
Academic Community ◽  
Full Time ◽  
Good View ◽  
Program Plan ◽  
Peer Help ◽  
Physician Extenders ◽  
Pediatric Nurse Practitioners

I liked Dr Pappelbaum's presentation a lot. My response? Read it; reread it; understand it; adjust to its doctrines; follow its prescriptions and program plan and be flexible and resilient. I totally concur with Dr Pappelbaum's belief that managed care need not be an end to one's pediatric career, but a program that can and must continue to work for our patients. Managed care will not go away; it is chronic, and we must adapt to it. The theme of both Dr Pappelbaums's article and of this meeting—as a whole and for every part of it—is that change is the "here and now," and that we must adapt to it. The constant message is that pediatricians must go forward in their communities with all the peer help and all the consultative help that each can muster. They must work within the structure and boundaries of change, striving for the most benefit for the patients they care for and for themselves. Dr Nazarian, whose presentation was equally excellent, has a good view of medicine now and medicine in the future. I have no challenge to his views or conclusions. Like Dr Nazarian and like Dr Elsa Stone, who spoke yesterday, I employ pediatric nurse practitioners (PNPs) in my clinical practice. I am the senior partner of an eight-physician (four male and four female) practice in an academic community. We have two full-time PNPs and one physician assistant associated in our practice. As valued and contributing members of our health care team, they are true physician extenders.

Results of an Immunization Audit

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 547-547
Author(s):  
JOHN E. BLOOM
Keyword(s):  
Nurse Practitioners ◽  
Private Practice ◽  
Full Time ◽  
Pediatric Nurse ◽  
Urban Group ◽  
The Past ◽  
Pediatric Nurse Practitioners

To the Editor: The provocative article by McDaniel et al. (Pediatrics 56:504, October 1975) regarding private practice immunization stimulated me to carry out our own audit, following the authors' criteria as closely as possible. Ours is a three-pediatrician, urban group which utilizes three full-time pediatric nurse practitioners. We reviewed 400 “active” cases (at least one office contact in the past year). Forty-seven patients had incomplete immunizations,giving us an 87.3% completeness record according to the

Physical therapy in the emergency department: surveying primary care practitioners' perceptions and recommendations

2020 ◽  
Vol 26 (8) ◽  
pp. 1-12
Author(s):  
Stacy J Fisher
Keyword(s):  
Emergency Department ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Physician Assistants ◽  
Geographic Region ◽  
Full Time ◽  
Chi Square ◽  
The Usa ◽  
Primary Care Practitioners ◽  
The Impact

Background/aims Little is known regarding the impact that physiotherapists can have on patients in the emergency department. A study was carried out to explore attitudes of physicians, physician assistants and nurse practitioners in emergency departments about physiotherapists being staffed full-time to assist with patient care. It also aimed to investigate whether physiotherapists should be staffed in emergency departments, what they are capable of doing in an emergency department and identify areas where physiotherapists are most useful in emergency departments in the USA. Methods This sequential mixed method study examined the perceptions and recommendations of emergency medicine practitioners regarding physiotherapists' services in the emergency department. Phase one analysed geographical data. Phase two analysed qualitative components of the survey. Frequencies were analysed and either Fisher's exact or Chi-square tests used to analyse the findings. Participants included physician assistants, nurse practitioners and physicians in emergency departments in the USA. Results A statistically significant association was shown between the geographic region and whether or not physiotherapists were staffed within the emergency departments in states outside the western region. Additionally, 97% of qualified participants reported positive experiences working with physiotherapists regularly. Conclusions Physiotherapists should be used for the specialisation and knowledge they have. More education is needed in emergency departments around the USA to understand what a physiotherapist can offer and how this reduces unnecessary hospital admission. Physiotherapists working in the emergency department can ultimately reduce costs for hospitals.

scholarly journals Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study

BMJ Open ◽  
2017 ◽  
Vol 7 (6) ◽  
pp. e015134 ◽  
Author(s):  
Marleen Hermien Lovink ◽  
Anke Persoon ◽  
Anneke JAH van Vught ◽  
Lisette Schoonhoven ◽  
Raymond TCM Koopmans ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Realist Evaluation

scholarly journals Western Cape Primary Care Assessment Tool (PCAT) study: Measuring primary care organisation and performance in the Western Cape Province, South Africa (2013)

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Graham F. Bresick ◽  
Abdul-Rauf Sayed ◽  
Cynthia Le Grange ◽  
Susheela Bhagwan ◽  
Nayna Manga ◽  
...  
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Assessment Tool ◽  
Health Sector ◽  
Full Time ◽  
Western Cape ◽  
Western Cape Province ◽  
Community Orientation ◽  
Care Assessment ◽  
Comprehensive Services

Background: Major health sector reform and the need for baseline measures of performance to determine impact.Aim: Baseline audit of primary healthcare (PHC) performance.Setting: Cape Town and Cape Winelands (rural) PHC facilities (PCFs) in Western Cape Province, South Africa.Method: The South African cross-culturally validated ZA PCAT to audit PHC performance on 11 subdomains associated with improved health and reduced costs. Adult PCF users systematically sampled. All full-time doctors and nurse practitioners in PCFs sampled and all PCF managers in sub-districts sampled invited into the study.Results: Data from 1432 users, 100 clinicians and 64 managers from 13 PCFs in 10 sub-districts analysed (figures show stakeholder percentages scoring subdomain performance ‘acceptable to good’). 11.5% users scored access ‘acceptable to good’; community orientation and comprehensive services provided 20.8% and 39.9%, respectively. Total PHC score for users 50.2%; for managers and practitioners 82.8% and 88.0%, respectively. Among practitioners access was lowest (33.3%); PHC team (98.0%) and comprehensive services available (100.0%) highest. Among managers, access (13.5%) and family centredness (45.6%) are lowest; PHC team (85.9%) and comprehensive services available (90.6%) highest. Managers scored access, family centredness and cultural competence significantly lower than practitioners. Users scored comprehensive services available, comprehensive services provided and community orientation significantly lower than practitioners and managers.Conclusion: Gaps between users’ experience and providers’ assessments of PHC performance are identified. Features that need strengthening and alignment with best practice, provincial and national, and health policies are highlighted with implications for practitioner and manager training, health policy, and research.

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