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 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 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

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

Implementation of the Acute Care Nurse Practitioner Role

1994 ◽  
Vol 5 (3) ◽  
pp. 404-407
Author(s):  
Lynn A. Kelso ◽  
Lori M. Massaro
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Center ◽  
Care Nurse ◽  
University Of Pittsburgh ◽  
Acute Care Nurse Practitioner ◽  
The University ◽  
Pittsburgh Medical ◽  
Practitioner Role

In this article, the experiences of two new acute care nurse practitioners working at the University of Pittsburgh Medical Center arc described. Included are the experiences they encountered in initiating the role and some of the responsibilities they assumed.

scholarly journals Using the PEPPA Framework to Develop and Implement a Nurse Practitioner Role Within Canada’s National Ballet School

2021 ◽  
Vol 1 (1) ◽  
pp. 10-22
Author(s):  
Erin Ziegler ◽  
Sophia Kim ◽  
Rachel J. Bar
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Advanced Practice Nursing ◽  
Health And Wellness ◽  
Physical And Mental Health ◽  
Wellness Program ◽  
Nursing Role ◽  
Dance Training ◽  
Timely Access ◽  
Practitioner Role

Aim: To outline the successful development and implementation of a nurse practitioner role within a professional ballet school. Background: Nurse practitioners are well integrated into primary and acute care in Ontario, yet the role within schools and private athletic institutions is not well documented. Canada’s National Ballet School is a professional ballet school with a combination of day students and those living in residences. Students complete both dance training and academics at the School. The physical and mental health of students was identified as a key priority by the school, leading to the development of an integrated health and wellness program. To facilitate more timely access to healthcare and provide an opportunity for collaboration and consultation within the school, a plan to implement a nurse practitioner role into the school was developed. Methods: In order to develop and implement the role of the nurse practitioner within the institution, the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (PEPPA) framework was used. The first seven steps of the PEPPA framework were applied in this project. Findings: The PEPPA framework allowed for us to identify key barriers and facilitators for the role implementation and successfully implement the nurse practitioner role. While the initial plan was for a slower implementation, the COVID-19 pandemic highlighted the need for a nurse practitioner in the institution more urgently. Conclusion: The PEPPA framework provided us with an organized process for developing and implementing the nurse practitioner role at Canada’s National Ballet School.

scholarly journals The Process of Oncology Nurse Practitioner Patient Navigation: Triage an Essential Process

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Grounded Theory ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Cancer Care ◽  
Patient Navigation ◽  
Care Delivery ◽  
Theory Approach ◽  
Full Time ◽  
Oncology Nurse ◽  
Grounded Theory Approach

One of the most daunting challenges faced in the health care delivery system is the complexity of cancer care, and the process of care coordination, a subcomponent of patient navigation. A study was undertaken to identify a central navigation process utilized by nurse practitioners practicing oncology. The data in this article is a component of a larger study entitled: The Process of Oncology Nurse Practitioner Patient Navigation: A Grounded Theory Approach. Utilizing a grounded theory approach N = 20 oncology nurse practitioners (ONP) were recruited. To be eligible for the study the ONP had to have a: 1) license to practice in their respective state; 2) certification to practice as an oncology nurse; 3) minimum of 5 years full time experience in oncology nursing; and 4) English speaking. The participants were recruited by: 1) word of mouth networking with peers: 2) Soliciting volunteers through public announcements at professional nursing conferences; 3) Contacting authors of oncology NP navigation articles or convention pamphlets via telephone or e-mail; 4) Posting information soliciting oncology NP volunteers on blogs or websites of professional organizations with organizational director approval; and, 5) Recruiting by snowball sampling. Telephone interviews were conducted utilizing an open-ended questionnaire. Data analysis and coding revealed the central navigation processes. The triage process was carried out in a variety of unique settings, and utilized in some instances within navigation subsystems. Key triage paths were identified along the cancer continuum; documenting the need for ONP navigators to strategically place these systems in areas along the cancer continuum, to expedite timely delivery of patient care. Literature search revealed that cancer specific triage tools are lacking. Implications for research and practice include the development of these tools for cancer care. Of critical importance is the need to identify service gaps in cancer care, and strategically place triage systems, to offset these service gaps. Practical application of the research findings in relationship to current literature is integrated for discussion.

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 COVID-19 in French Nursing Homes during the Second Pandemic Wave: A Mixed-Methods Cross-Sectional Study

2021 ◽  
Author(s):  
Morgane Dujmovic ◽  
Thomas Roederer ◽  
Severine Frison ◽  
Carla Melki ◽  
Thomas Lauvin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Care Home ◽  
Case Fatality ◽  
Well Being ◽  
Crisis Response ◽  
Full Time ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Pandemic Wave

Introduction French nursing homes were deeply affected by the first wave of the COVID-19 pandemic, with 38% of all residents infected and 5% dying. Yet, little was done to prepare these facilities for the second pandemic wave, and subsequent outbreak response strategies largely duplicated what had been done in the spring of 2020, regardless of the unique needs of the care home environment. Methods A cross-sectional, mixed-methods study using retrospective, quantitative data from residents of 14 nursing homes between November 2020 and mid-January 2021. Four facilities were purposively selected as qualitative study sites for additional in-person, in-depth interviews in January and February 2021. Results The average attack rate in the 14 participating nursing facilities was 39% among staff and 61% among residents. One-fifth (20) of infected residents ultimately died from COVID-19 and its complications. Failure-to-Thrive-Syndrome (FTTS) was diagnosed in 23% of COVID-positive residents. Those at highest risk of death were men (HR=1.78; IC95: 1.18 - 2.70; p=0.006) with FTTS (HR=4.04; IC95: 1.93 - 8.48; p<0.001) in facilities with delayed implementation of universal FFP2 masking policies (HR=1.05; IC95: 1.02 - 1.07; p<0.001). The lowest mortality was found in residents of facilities with a partial (HR=0.30; IC95: 0.18 - 0.51; p<0.001) or full-time physician on staff (HR=0.20; IC95: 0.08 - 0.53; p=0.001). Significant themes emerging from qualitative analysis centered on (i) the structural, chronic neglect of nursing homes, (ii) the negative effects of the top-down, bureaucratic nature of COVID-19 crisis response, and (iii) the counterproductive effects of lockdowns on both residents and staff. Conclusion Despite high resident mortality during the first pandemic wave, French nursing homes were ill-prepared for the second, with risk factors (especially staffing, lack of medical support, isolation/quarantine policy etc) that affected case fatality and residents' and caregivers' overall well-being and mental health.

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