Experts Recommend Strategies for Strengthening the Use of Advanced Practice Nurses in Nursing Homes

  1. Mathy Mezey EdD, RN,
  2. Sarah Greene Burger MPH, RN,
  3. Harrison G. Bloom MD,
  4. Alice Bonner APRN-BC, GNP,
  5. Mary Bourbonniere PhD, RN,
  6. Barbara Bowers PhD, RN,
  7. Jeffrey B. Burl MD,
  8. Elizabeth Capezuti PhD, RN,
  9. Diane Carter MSN, RN,
  10. Jacob Dimant MD,
  11. Sarah A. Jerro MA, RN,
  12. Susan C. Reinhard PhD, RN,
  13. Marilyn Ter Maat MSN, RNC

Article first published online: 30 AUG 2005

DOI: 10.1111/j.1532-5415.2005.53556.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 53, Issue 10, pages 1790–1797, October 2005

Additional Information

How to Cite

Mezey, M., Greene Burger, S., Bloom, H. G., Bonner, A., Bourbonniere, M., Bowers, B., Burl, J. B., Capezuti, E., Carter, D., Dimant, J., Jerro, S. A., Reinhard, S. C. and Ter Maat, M. (2005), Experts Recommend Strategies for Strengthening the Use of Advanced Practice Nurses in Nursing Homes. Journal of the American Geriatrics Society, 53: 1790–1797. doi: 10.1111/j.1532-5415.2005.53556.x

Author Information

  1. From the *Director, John A. Hartford Foundation Institute for Geriatric Nursing, New York University, Steinhardt School of Education, Division of Nursing†Senior Advisor on Special Projects, John A. Hartford Foundation Institute for Geriatric Nursing, New York University, Steinhardt School of Education, Division of Nursing‡Associate Clinical Professor, Department of Geriatrics, Mt. Sinai School of Medicine, NY, NY§Gerontological Nurse Practitioner, Fallon Clinic & Graduate School of Nursing, University of Massachusetts, Worcester, MA; Representing the National Conference of Gerontological Nurse Practitioners∥Assistant Professor, Yale University School of Nursing, New Haven, CTProfessor, University of Wisconsin-Madison; Representing the Expert Panel on Aging, American Academy of Nursing#Director of Geriatrics, The Fallon Clinic, Worcester, MA**Associate Professor, Co-Director, John A. Hartford Foundation Institute for Geriatric Nursing, New York University, Steinhardt School of Education, Division of Nursing††President, CEO and representing American Association of Nurse Assessment Coordinators‡‡Chief of Geriatric Medicine, Lutheran Medical Center, and Medical Director, Lutheran Augustana Center for Extended Care and Rehabilitation, Brooklyn, New York, NY§§Director of Nursing, Eden Park Health Care Center, Poughkeepsie, N.Y, National Board Trustee, Representing National Association of Directors of Nursing Administration in Long Term Care∥∥Professor and Co-Director, Rutgers University, New Brunswick, NJ: Representing the Expert Panel on Aging, American Academy of Nursing¶¶Director Resident Services, Good Samaritan Society, Sioux Falls, SD; Representing The National Gerontological Nursing Association

*Address correspondence to Mathy Mezey, EdD, RN, Independence Foundation Professor of Nursing Education, Director, Hartford Institute for Geriatric Nursing, New York University, College of Education, Division of Nursing, 246 Greene Street, New York, NY 10003. E-mail: mathy.mezey@nyu.edu

  1. Preliminary conceptual ideas surrounding this paper were presented at the Gerontological Society of America Annual Meeting, November 2004. Data were never presented or published.

Publication History

  1. Issue published online: 21 SEP 2005
  2. Article first published online: 30 AUG 2005

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Keywords:

  • advanced practice nursing;
  • nursing homes;
  • advanced practice nursing caseloads;
  • advanced practice nursing models

In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload parameters, including provider characteristics, practice models, resident acuity, and facility factors; changes in Medicare reimbursement to acknowledge nonbillable time spent in resident care; and technical assistance to promote a climate conducive to APN practice in nursing homes. Detailed research findings and clinical expertise underpin each recommendation. These recommendations provide practitioners, payers, regulators, and consumers with a rationale and details of current advanced practice nursing models and caseload parameters, preferred geriatric education, reimbursement strategies, and a range of technical assistance necessary to strengthen, enhance, and increase APNs' participation in the care of nursing home residents.

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