Advanced Practice Nurses and Attending Physicians: A Collaboration to Improve Quality of Care in the Nursing Home

Philpot, Carolyn D.; Tolson, Debbie; Morley, John E.

doi:10.1016/j.jamda.2010.12.012

Cited by 41 publications

(13 citation statements)

References 103 publications

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“…This is particularly important for countries that are just beginning the process, so that they can identify early on any implementation issues. In geriatric care, APNs are showing particular expertise in providing care in nursing homes 69 and also in early recognition and management of frailty and other geriatric syndromes. 70,71 In the United States, NPs play a major role in the annual wellness visit.…”

Section: Resultsmentioning

confidence: 99%

RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care

Fougère

Morley

Decavel

et al. 2016

Journal of the American Medical Directors Association

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Section: Resultsmentioning

confidence: 99%

RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care

Fougère

Morley

Decavel

et al. 2016

Journal of the American Medical Directors Association

Self Cite

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“…DONs reported about modes of employment of NP/PAs: 14.5% of NHs with NHCOPR under 1 had NP/PAs who were employed by the NH, 19% with NHCOPR 1–2, and 22% with NHCOPR 2–3. This finding serves as additional validation to the NHCOPR measure and is in line with the literature that reports that NP/PAs provide complementary and not exchangeable care to that provided by physicians 20,21 . How NHCOPR varies among NHs with NP/PAs and whether the concept of control of physician resources can be extended to NP/PAs are topics for future study.…”

Section: Discussionsupporting

confidence: 85%

Nursing Home Control of Physician Resources

Intrator

Lima

Wetle

2014

Journal of the American Medical Directors Association

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Objective Physician services are increasingly recognized as important contributors to quality care provision in nursing homes (NHs), but knowledge of ways in which NHs manage/ control physician resources is lacking. Data Primary data from surveys of NH Administrators and Directors of Nursing from a nationally representative sample of 1,938 freestanding U.S. NHs in 2009–2010 matched to Online Survey Certification and Reporting (OSCAR), aggregated NH Minimum Data Set (MDS) assessments and Medicare claims, and data from the Area Resource File (ARF). Methods The concept of NH Control of Physician Resources (NHCOPR) was measured using NH Administrators’ reports of management implementation of rules, policies, and procedures aimed at coordinating work activities. The NHCOPR scale was based on measures of formal relationships, physician oversight and credentialing. Scale values ranged from weakest (0) to tightest (3) control. Several hypotheses of expected associations between NHCOPR and other measures of NH and market characteristics were tested. Principal Findings The full NHCOPR score averaged 1.58 (SD=0.77) on the 0–3 scale. Nearly 30% of NHs had weak control (NHCOPR <= 1), 47.5% had average control (NHCOPR between 1 and 2), and the remaining 24.8% had tight control (NHCOPR > 2). NHCOPR exhibited good face- and predictive-validity as exhibited by positive associations with more beds, more Medicare services, cross coverage and number of physicians in the market. Conclusions The NHCOPR scale capturing NH’s formal structure of control of physician resources can be useful in studying the impact of NH’s physician resources on residents’ outcomes with potential for targeted interventions by education and promotion of NH administration of physician staff.

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“…A study evaluating collaboration between advanced practice nurses (APNs) and physicians in nursing homes showed that collaboration enhanced the quality of care, including decreasing transfers to hospitals (Philpot, Tolson, & Morley, 2011). Likewise in the tertiary hospital setting, collaboration between APNs and physicians has been associated with reduced length of stay and lower healthcare cost without altering readmissions or mortality (Cowan et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Attitudes towards interprofessional collaboration among primary care physicians and nurses in Singapore

Zheng

Sim

Koh

2016

Journal of Interprofessional Care

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Interprofessional collaboration (IPC) has been shown to improve patient outcomes, cost efficiency, and health professional satisfaction, and enhance healthy workplaces. We determined the attitudes of primary care physicians and nurses towards IPC and factors facilitating IPC using a cross-sectional study design in Singapore. A self-administered anonymous questionnaire, based on the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), was distributed to primary healthcare physicians and nurses working in National Healthcare Group Polyclinics (N = 455). We found that the mean JSAPNC score for physicians was poorer than that for nurses (50.39 [SD = 4.67] vs. 51.61 [SD = 4.19], respectively, mean difference, MD = 1.22, CI = 0.35-2.09, p = .006). Nurses with advanced education had better mean JSAPNC score than nurses with basic education (52.28 [SD = 4.22] vs. 51.12 [SD = 4.11], respectively, MD = 1.16, CI = 0.12-2.20, p = .029). Male participants had poorer mean JSAPNC score compared to females (50.27 [SD = 5.02] vs. 51.38 [SD = 4.22], respectively MD = 1.11, CI = 0.07-2.14, p = .036). With regression analysis, only educational qualification among nurses was independently and positively associated with JSAPNC scores (p = .018). In conclusion, primary care nurses in Singapore had more positive attitudes towards IPC than physicians. Among nurses, those with advanced education had more positive attitudes than those with basic education. Greater emphasis on IPC education in training of physicians and nurses could help improve attitudes further.

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Advanced Practice Nurses and Attending Physicians: A Collaboration to Improve Quality of Care in the Nursing Home

Cited by 41 publications

References 103 publications

RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care

RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care

Nursing Home Control of Physician Resources

Attitudes towards interprofessional collaboration among primary care physicians and nurses in Singapore

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