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Nurs Outlook. 2015 Mar-Apr;63(2):130-6. doi: 10.1016/j.outlook.2014.08.004. Epub 2014 Aug 15.

Role of the registered nurse in primary health care: meeting health care needs in the 21st century.

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Columbia University School of Nursing, New York, NY. Electronic address:
Jefferson Interprofessional Education Center, Thomas Jefferson University, Philadelphia, PA.
Department of Maternal Child and Family Nursing, Seattle University, Seattle, WA.
Centers for Medicare and Medicaid Services, Baltimore, MD.
Saint Catherine University, Saint Paul, MN.
Adult Inpatient and Integrative Oncology, Dana Faber Cancer Institute and Brigham and Women's Hospital, Boston, MA.
Boston Children's Hospital, Boston MA.


There is widespread interest in the redesign of primary health care practice models to increase access to quality health care. Registered nurses (RNs) are well positioned to assume direct care and leadership roles based on their understanding of patient, family, and system priorities. This project identified 16 exemplar primary health care practices that used RNs to the full extent of their scope of practice in team-based care. Interviews were conducted with practice representatives. RN activities were performed within three general contexts: episodic and preventive care, chronic disease management, and practice operations. RNs performed nine general functions in these contexts including telephone triage, assessment and documentation of health status, chronic illness case management, hospital transition management, delegated care for episodic illness, health coaching, medication reconciliation, staff supervision, and quality improvement leadership. These functions improved quality and efficiency and decreased cost. Implications for policy, practice, and RN education are considered.


Primary care; Primary health care; Registered nurse

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