Nurse Practitioners as Primary Care Providers Within the VA

Fletcher, Carol E.; Copeland, Laurel A.; Lowery, Julie C.; Reeves, Pamela

doi:10.7205/milmed-d-10-00329

Cited by 26 publications

(45 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NPs perceived, more than MPs, that they could perform tasks autonomously [62,75]. Some MPs stated that NPs require regular MP supervision [62] and that NPs care for patients who are too complex for the NPs’ skills and knowledge [68].…”

Section: Resultsmentioning

confidence: 99%

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

View full text Add to dashboard Cite

BackgroundThis integrative review synthesises research studies that have investigated the perceptions of nurse practitioners and medical practitioners working in primary health care. The aggregation of evidence on barriers and facilitators to working collaboratively and experiences about the processes of collaboration is of value to understand success factors and factors that impede collaborative working relationships.MethodsAn integrative review, which used systematic review processes, was undertaken to summarise qualitative and quantitative studies published between 1990 and 2012. Databases searched were the Cochrane Library, the Joanna Briggs Institute Library, PubMed, Medline, CINAHL, Informit and ProQuest. Studies that met the inclusion criteria were assessed for quality. Study findings were extracted relating to a) barriers and facilitators to collaborative working and b) views and experiences about the process of collaboration. The findings were narratively synthesised, supported by tabulation.Results27 studies conducted in seven different countries met the inclusion criteria. Content analysis identified a number of barriers and facilitators of collaboration between nurse practitioners and medical practitioners. By means of data comparison five themes were developed in relation to perceptions and understanding of collaboration. Nurse practitioners and medical practitioners have differing views on the essentials of collaboration and on supervision and autonomous nurse practitioner practice. Medical practitioners who have a working experience with NPs express more positive attitudes towards collaboration. Both professional groups report concerns and negative experiences with collaborative practice but also value certain advantages of collaboration.ConclusionsThe review shows that working in collaboration is a slow progression. Exposure to working together helps to overcome professional hurdles, dispel concerns and provide clarity around roles and the meaning of collaboration of NPs and MPs. Guidelines on liability and better funding strategies are necessary to facilitate collaborative practice whether barriers lie in individual behaviours or in broader policies.

show abstract

Section: Resultsmentioning

confidence: 99%

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

View full text Add to dashboard Cite

show abstract

“…As the largest fully integrated healthcare system in the US, the VHA had 8.8 million veterans enrolled and 703,500 inpatient admissions in 2012 . Although this makes the VHA an ideal environment to study the role of APPs, few studies have done so . Although studies have compared NPs and PAs to physicians, very little is known about how NPs differ from PAs when practicing in the same environment.…”

mentioning

confidence: 99%

“…14 Although this makes the VHA an ideal environment to study the role of APPs, few studies have done so. 13,[15][16][17][18][19] Although studies have compared NPs and PAs to physicians, very little is known about how NPs differ from PAs when practicing in the same environment.…”

mentioning

confidence: 99%

Nurse practitioner and physician assistant scope of practice in 118 acute care hospitals

Kartha

Restuccia

Burgess

et al. 2014

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…An analysis of administrative primary care data between the years of 2005 and 2010 identified that 19.2% of primary care visits in the VHA were conducted by NPs (Morgan et al., ). Evidence suggests that consistent with non‐VHA studies, chronic care outcomes among veterans with NP‐provided care are similar to those of physician colleagues (Fletcher, Copeland, Lowery, & Reeves, ; Liu, Finkelstein, & Poghosyan, ; McCleery, Christensen, Peterson, Humphrey, & Helfand, ; Mundinger et al., ; Poghosyan, Boyd, & Knutson, ). A secondary data analysis of the Survey of Healthcare Experiences of Patients (SHEP) among veterans between the years 2002 and 2006 suggests that an increase in the number of NPs in a Veteran Integrated Service Network (VISN) can contribute to a statistically significant increase in veteran patient satisfaction with healthcare services.…”

Section: The Np Role In Primary Care At the Vhamentioning

confidence: 57%

Improving the care of veterans

Hobson¹,

Curtis²

2017

Journal of the American Association of Nurse Practitioners

View full text Add to dashboard Cite

Background and purpose Improving healthcare delivery for U.S. veterans is a national priority. The Veterans Health Administration (VHA) employs a variety of team‐based, population health strategies to address critical issues in veterans’ health including the effective management of chronic disease. Nurse practitioners (NPs) are integral members of the VHA patient care team with a substantial role to play in the organization and delivery of healthcare services for veterans. This report explores the contributions of NPs in team‐based, population health strategies within the VHA. Methods This review of the literature examines peer‐reviewed articles published between 2006 and 2017 to explore the contributions of NPs in team‐based, population health strategies within the VHA. Search words include veterans, VHA, NPs, population health, panel management, and chronic disease. Conclusions NPs are vital members of the VHA primary care team; however, there is a dearth of available evidence reflecting the unique contribution of NPs within VHA team‐based, population health management strategies. Implications for practice The VHA adoption of full practice authority for NP practice provides NPs with an expanded capacity to lead improvements in veterans’ health. Future research is needed to fully understand the unique role of the NP in the delivery of population health management strategies for veterans.

show abstract

Nurse Practitioners as Primary Care Providers Within the VA

Cited by 26 publications

References 23 publications

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Nurse practitioner and physician assistant scope of practice in 118 acute care hospitals

Improving the care of veterans

Contact Info

Product

Resources

About