Nurse practitioner’s perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients

Heale, Roberta; James, Susan; Wenghofer, Elizabeth; Garceau, Marie-Luce

doi:10.1017/s1463423617000913

Cited by 24 publications

(54 citation statements)

References 15 publications

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“…Data from the interviews were analysed using the processes related to an integrative description design 10. The draft themes arising from the analysis were forwarded to the participants for their feedback and were confirmed through a review of literature.…”

Section: Examples Of Studies Using Triangulationmentioning

confidence: 99%

Triangulation in research, with examples

2019

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Section: Examples Of Studies Using Triangulationmentioning

confidence: 99%

Triangulation in research, with examples

2019

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“…The search retrieved 435 documents after removal of duplicates (Fig. ), and after eligibility screening, a total of 87 documents were finally included (Appendix ).…”

Section: Resultsmentioning

confidence: 99%

Quality of care assessment for people with multimorbidity

et al. 2019

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Multimorbidity, the simultaneous presence of multiple health conditions in an individual, is an increasingly common phenomenon globally. The systematic assessment of the quality of care delivered to people with multimorbidity will be key to informing the organization of services for meeting their complex needs. Yet, current assessments tend to focus on single conditions and do not capture the complex processes that are required for providing care for people with multimorbidity. We conducted a scoping review on quality of care and multimorbidity in selected databases in June 2018 and identified 87 documents as eligible for review, predominantly original research and reviews from North America, Europe and Australasia and mostly frequently related to primary care settings. We synthesized data qualitatively in terms of perceived challenges, evidence and proposed metrics. Findings reveal that the association between quality of care and multimorbidity is complex and depends on the conditions involved (quality appears to be higher for those with concordant conditions, and lower in the presence of discordant conditions) and the approach used for measuring quality (quality appears to be higher in people with multimorbidity when measured using condition/drug‐specific process or intermediate outcome indicators, and worse when using patient‐centred reports of experiences of care). People with discordant multimorbidity may be disadvantaged by current approaches to quality assessment, particularly when they are linked to financial incentives. A better understanding of models of care that best meet the needs of this group is needed for developing appropriate quality assessment frameworks. Capturing patient preferences and values and incorporate patients’ voices in the form of patient‐reported experiences and outcomes of care will be critical towards the achievement of high‐performing health systems that are responsive to the needs of people with multimorbidity.

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“…Despite these perceived constraints, NPs describe their autonomous practice in ways that attend to these primary health care attributes by drawing on their knowledge of patients, team composition and community context to shape their own role using approaches that could redress inequities for patients and promote primary health care. Previous research has highlighted that NPs are committed to attending to the social determinants of health, 14 and that NPs may prioritize social or economic issues 25 over a biomedical focus. Although research has clearly shown the benefits of the NP role, for example, that NPs improve clinical outcomes and deliver quality care accompanied by high levels of patient satisfaction, [26][27][28][29] and that NPs help reduce use of emergency departments 30 and hospitals, 31 it is necessary to describe the actual practices that contribute to these outcomes so that they can be understood and formally supported.…”

Section: Discussionmentioning

confidence: 99%

Engagement of nurse practitioners in primary health care in northern British Columbia: a mixed-methods study

Wilson

Pammett

McKenzie

et al. 2021

cmajo

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rimary health care reforms in many countries include paying attention to increasing access to health care. One approach to improving access in Canada is integration of nurse practitioners (NPs) into primary care, particularly in rural settings, where NPs are more likely to work in the community rather than in a hospital. 1 This study focuses on the practices of NPs working in northern British Columbia, where factors influencing integration of NP roles can include the combination of changing patterns in the family physician workforce, 2 increasing patient medical and social complexity 3,4 and uptake of the message by decisionmakers that "NPs increase access to care." 5 Nurse practitioners have been regulated primary care providers in British Columbia since 2005.Access to health care is dependent on interrelated dimensions of the health system and abilities of patients, 6 and although evidence supports that NPs do increase access to care, 7,8 few studies have evaluated how this is accomplished. [6][7][8][9][10] As advanced practice nurses, NPs have competencies that extend beyond direct patient care to encompass proficiencies related to research, education and leadership. 11 Therefore, NPs are poised to contribute to a shift toward delivery of comprehensive, interprofessional, community-based primary health care, 12,13 and away from selective or niche models of primary care that may not address patient or community needs in a thorough manner. 7,14 The message that NPs increase access is consistently offered as a rationale for NP role creation, [15][16][17] but there may be more nuanced aspects of NP practice that can be explicated to support further successful integration of NP roles and strengthen the primary health care system.The aim of this study was to evaluate how NPs are engaged in primary health care practices in the context of their work settings as salaried health authority employees who are part of interprofessional primary care teams in northern BC primary care clinics. Methods DesignThe study was a qualitative-dominant mixed-methods study, 18 using a survey and interviews. The study team included 3 members whose roles encompass research and clinical work

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Nurse practitioner’s perceptions of the impact of the nurse practitioner-led clinic model on the quality of care of complex patients

Cited by 24 publications

References 15 publications

Triangulation in research, with examples

Triangulation in research, with examples

Quality of care assessment for people with multimorbidity

Engagement of nurse practitioners in primary health care in northern British Columbia: a mixed-methods study

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