A unique practice model for Nurse Practitioners in long-term care homes
Article first published online: 15 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 62, Issue 5, pages 562–571, June 2008
How to Cite
McAiney, C. A., Haughton, D., Jennings, J., Farr, D., Hillier, L. and Morden, P. (2008), A unique practice model for Nurse Practitioners in long-term care homes. Journal of Advanced Nursing, 62: 562–571. doi: 10.1111/j.1365-2648.2008.04628.x
- Issue published online: 15 MAY 2008
- Article first published online: 15 MAY 2008
- Accepted for publication 22 January 2008
- long-term care;
- Nurse Practitioners;
- nursing home;
- participatory evidence-based patient-focused process;
- role evaluation;
- role implementation
Title. A unique practice model for Nurse Practitioners in long-term care homes
Aim. This paper is a report of a study examining a practice model for Nurse Practitioners (NPs) working in long-term care (LTC) homes and its impact on staff confidence, preventing hospital admission, and promoting early hospital discharge.
Background. The recent introduction of NPs in LTC homes in Ontario, Canada, provided an opportunity to explore unique practice models. In a pilot project, two full-time equivalent NPs provided primary care to a consortium of 22 homes serving approximately 2900 residents. The practice model was based on the specific needs of the homes and residents.
Methods. The NPs working in this project prospectively collected data (from July 2003 until June 2004) on their clinical activities and resident outcomes. Directors of Care (n = 18) of the participating homes completed a questionnaire (March 2004) assessing the impact on prevention of hospitalization and staff confidence.
Findings. The NPs had 2315 clinical contacts in the 1-year period; the majority (64%) were follow-up contacts. Many contacts were for uncomplicated medical problems or more complex but straightforward medical issues, and had positive outcomes. Hospital admission was prevented in 39–43% of cases. NPs had a positive impact on improving staff confidence, but no impact on facilitating early discharge from hospital.
Conclusion. Practice models designed to meet the distinctive needs of LTC homes and residents can enhance quality of care, even with low NP:resident ratios. Participation of key stakeholders in the identification of care priorities and planning contributed to the success of this model.