Experiences Of Nurse Practitioners Research Articles

Factors influencing nurse practitioner panel size in team-based primary care: a qualitative case study

BackgroundLack of access to health care is a worldwide public health crisis. In primary care it has led to increases in the implementation of nurse practitioners and heightened interest in their patient panel capacity. The aim of this study was to examine factors influencing nurse practitioner patient panel size in team-based primary care in Ontario, Canada.MethodsWe used a multiple case study design. Eight team-based primary care practices including rural and urban settings were purposively selected as cases. Each case had two or more nurse practitioners with a minimum of two years experience in the primary care setting. Interviews were conducted in-person, audio recorded, transcribed and analysed using content analysis.ResultsForty participants, including 19 nurse practitioners, 16 administrators (inclusive of executives, managers, and receptionists), and 5 physicians were interviewed. Patient, provider, organizational, and system factors influenced nurse practitioner patient panel size. There were eight sub-factors: complexity of patients’ health and social needs; holistic nursing model of care; nurse practitioner experience and confidence; composition and functioning of the multidisciplinary team; clerical and administrative supports, and nurse practitioner activities and expectations. All participants found it difficult to identify the panel size of nurse practitioners, calling it— “a grey area.” Establishing and maintaining a longitudinal relationship that responded holistically to patients’ needs was fundamental to how nurse practitioners provided care. Social factors such as gender, poverty, mental health concerns, historical trauma, marginalisation and literacy contributed to the complexity of patients’ needs. Participants indicated NPs tried to address all of a patient’s concerns at each visit.ConclusionsNurse practitioners have a holistic approach that incorporates attention to the social determinants of health as well as acute and chronic comorbidities. This approach compels them to try to address all of the needs a patient is experiencing at each visit and reduces their panel size. Multidisciplinary teams have an opportunity to be deliberate when structuring their services across providers to meet more of the health and social needs of empanelled patients. This could enable increases in nurse practitioner panel size.

Nurse Practitioner COVID-19 Experience in Skilled Nursing Facilities

Health care providers have faced unprecedented changes in practice since the COVID-19 pandemic began in early 2020. Advanced practice nurses in skilled nursing are no exception. This article reflects on the experience of Nurse Practitioners (NP) caring for older adults with COVID-19 in skilled nursing facilities in Northern California. The personal impact of COVID on NPs is as varied as the symptoms of the patients.

The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

Review question/objective This review asks “What is the experience and effectiveness of nurse practitioners in orthopaedic settings”? The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators. The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation. The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Types of participants Nurse practitioner is an expanded form of advanced practice.11 For the purpose of this systematic review the International Council of Nurses (ICN) definition20 of nurse practitioner will apply whereby a Nurse Practitioner/Advanced Practice Nurse is defined as a Registered Nurse with expert knowledge, complex decision making skills and possessing competency for expanded practice. Importantly the practice of nurse practitioner/advanced practice nurse is characterised further by the “context and/or country” that they practice within.20 Therefore an ‘orthopaedic’ nurse practitioner is defined in accordance with the above definition and with a specific scope of practice (as authorised) within a relevant and specific ‘orthopaedic’ setting. The quantitative and qualitative components of this review will consider studies that include orthopaedic nurse practitioners in acute care or sub-acute orthopaedic settings. The textual component of this review will consider publications that pertain to orthopaedic nurse practitioners in acute care or sub-acute orthopaedic settings, where there exists a particular focus on the ‘orthopaedic’ aspect of nurse practitioner practice. Types of intervention(s)/phenomena of interest The quantitative component of this review will examine interventions of orthopaedic nurse practitioner specific care. For this systematic review, orthopaedic nurse practitioner specific care refers to those aspects of care the orthopaedic nurse practitioner is responsible for and/or records as performance outcomes such as: occasions of service/numbers seen; time to and length of nurse practitioner consultation; time to nurse practitioner intervention; referral patterns and other measures of intervention effectiveness. The qualitative component of the review will examine as phenomena of interest the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation. The text and opinion component of the review will examine opinions on the effectiveness and experience of nurse practitioners in orthopaedic settings including role development, implementation and evaluation of nurse practitioners in orthopaedic settings. Types of outcomes The quantitative component of this review will consider as primary outcomes the following patient outcomes: • patients’ level of pain • pressure injury • urinary tract infection • patient satisfaction • in-hospital patient mortality • hospital readmission • patients’ health-related quality of life • functional status • malnutrition score • constipation • wound care/complications • other clinical complications • morbidity • other patient encounter data that characterise orthopaedic nurse practitioner practice • other relevant nurse-sensitive outcome data The quantitative component of this review will consider as secondary outcomes the following nurse related outcomes or process indicators/outcomes: • orthopaedic nurse practitioner satisfaction • key stakeholder (health professional) satisfaction • specialised knowledge/skill translation • hospital length of stay • cost benefit

Working With Older Adults: A Nurse Practitioner's Experience From a Humanbecoming Perspective

Although nurse practitioners use medical knowledge and skills for diagnosing and treating various diseases, the approach to care for their patients should be firmly grounded in nursing science from a nursing theoretical perspective. This column explicates a nurse practitioner's experiences working with community-dwelling older persons in a house-call program and using the theory of humanbecoming as a guide for practice. Three practice situations are described to illustrate the humanbecoming approach to nurse practitioner practice.

A Nurse Practitioner's Experience With Older Adults and Humanbecoming in Practice

A Nurse Practitioner's Experience With Older Adults and Humanbecoming in Practice

Student nurse practitioners – A rite of passage? The universality of Van Gennep’s model of social transition

Whilst much has been written on the competence and clinical effectiveness of qualified nurse practitioners, the literature reveals little on the educational experience of student nurse practitioners. This paper reviews an ethnography that examined, over a two-year period, the experiences of student nurse practitioners undertaking a clinical degree programme (B.Sc. (Hons) Nurse Practitioner). The findings revealed the student nurse practitioner experience as a composite of social and cultural transitions, and subsequently Van Gennep's (Van Gennep, A., 1960. The Rites of Passage (Trans). Routledge & Kegan Paul, London) rite of passage model was found to have similarity with this emergent model. Finally, it was noted that, whilst social transition is modelled in the literature in many ways, the stages of a rite of passage had universal application.

Type Of Nursing Education And The Nurse Practitioner Experience

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