What can nurse do to solve the primary care woes of Canadian healthcare systems?
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1 What can nurse do to solve the primary care woes of Canadian healthcare systems? A case for integrating nurse practitioners into healthcare systems CAHSPR/ACRSPS May 26, 2015 Dr. Esther Sangster Gormley, PhD, RN Associate Professor University of Victoria 1
2 Integrating NPs into BC healthcare system 3 year mixed methods study Funded by Michael Smith Foundation Interprofessional research team: researcher, physician, health authorities, policy makers 2
3 Data Sources and Participants Phase (Year) Data Collection Method Type of Participant (number) 1 PP Survey NPs (31) Focus Groups (Encounter Codes) NPs (9) Chief Nursing Officers (7) NP leads (4) 2 Patient Survey Patients of NPs (148) Focus Group NPs 13 (Time and Access) 2 Co worker Survey Coworkers of NPs: Non health care professionals (8) (e.g. social worker, director of care, research colleague) Pharmacist (2) Physician (9) NP (1) RN (7) LPN and Care Worker (2) MOA (9) 38 2 Interviews (EMR) NPs (15) 15 3 Interviews (Patients) Patients of NPs (20) 20 3 PP Survey NPs (96) Case Studies (one rural and two urban settings) NPs (3) Patients (4) Coworkers of NPs (30): Non health care professionals (7) Physician (4) NP (4) RN (4) MOA and admin (5) 3 Allied health care professionals (6) Total participants for project (includes known and potential duplicates) 418 Total Participants 20 37
4 Patients Perceptions Satisfied Care was: Comprehensive Continuity of care Convenient Behavioral changes: Dietary changes Self care management Physical activity 4
5 Co workers Perceptions (nurses, physicians, other professionals) Satisfied working with NP Increased access to care Spent time with patients Supported other nurses/staff Referred to other health professionals Met expectations 5
6 Value added to Healthcare System Access to care that is comprehensive, continuous & convenient Patients are satisfied with care & take more responsibility Co workers are satisfied collaborating with NPs NPs are caring for people/populations: Homeless, mental health issues, frail seniors, First Nations people in rural/remote communities 6
7 Challenges to NP Integration Structures that facilitate collaborative team work Adequate space for NPs to practice On going funding for NP positions Funding models that facilitate team based care Remove legislative barriers to NP practice Value nursing knowledge, ability and voice Create space in the healthcare system for all nurses to use their knowledge and abilities to provide a different dimension to primary care 7
8 Thank you 8
9 References Browne, G., Birch, S., Thabane, L. (2012). Better care: An analysis of nursing and healthcare systems outcomes. Canadian Health Services Research Foundation. Retrieved from /dced281f d36 8b0f a797aa7eec41.aspx Charlton, C., Dearing, K., Berry, J. & Johnson, M. (2008). Nurse practitioners communication styles and their impact on patient outcomes: An integrative literature review. Journal of the American Academy of Nurse Practitioners, 20, Jacobson, P.M. & HDR Inc. (2012). Evidence synthesis for the effectiveness of interprofessional teams in primary care. Canadian Health Research Foundation. Retrieved from fcass.ca/publicationsandresources/researchreports/articleview/ /0f b8e 4f67 b2c0 65f6e95b2bdf.aspx Kleinpell, R., Ely, E., & Grabenkort, R. (2008). Nurse practitioner and physician assistants in the intensive care unit: An evidencebased review. Critical Care Medicine, 36(10), National Governors Association. (2012). The role of nurse practitioners in meeting increasing demand for primary care. Retrieved from center for best practices/center publications/page healthpublications/col2 content/main content list/the role of nurse practitioners.html Newhouse et al. (2011). Advanced practice nurse outcomes : A systematic review. Nursing Economic$, 29(5),
Stakeholder Engagement and Insight for Education, Employment and Practice. CASN Nursing Research Conference 2012
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