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J Adv Nurs. 2019 Jan 29. doi: 10.1111/jan.13962. [Epub ahead of print]

Implementing primary healthcare nurse practitioners in long term care teams: A qualitative descriptive study.

Author information

1
Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University.
2
Centre intégré universitaire de santé et de services sociaux de l, 'Est-de-l'Ïle-de-Montréal, Maisonneuve-Rosemont Hospital Site.
3
Faculty of Nursing, Université du Québec en Outaouais (UQO).
4
Primary Health Care - Global Health NP Co-ordinator/Lecturer:, University of Toronto, Ontario, Canada.
5
Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3.
6
Ministère de la Santé et des Services sociaux, 1075, chemin Sainte-Foy, Quebec, Quebec, G1S 2M1.

Abstract

AIM:

To identify the conditions needed to implement nurse practitioners in long-term care in Québec, Canada.

DESIGN:

A qualitative descriptive study was undertaken.

METHODS:

Semi-structured interviews (N=91) and socio-demographic questionnaires were completed with providers and managers from May 2016 - March 2017. Nurse practitioner activity logs were compiled at three sites. Content analysis was used.

RESULTS:

All sites initially implemented a shared care model but not all sites successfully implemented a consultative model. The progression was influenced by physicians' level of comfort in moving towards a consultative model. Weekly meetings with physicians and nurse managers and an office for nurse practitioners located near healthcare teams facilitated communication and improved implementation. Half-time nurse practitioner positions facilitated recruitment. Improvements were noted in timely care for residents, family involvement and quality of documentation of the healthcare team. Regulatory restrictions on prescribing medications used frequently in long-term care and daily physician presence at some sites limited implementation.

CONCLUSION:

The project fostered an understanding of the conditions needed to successfully implement nurse practitioners in long-term care. An examination of the perspective of residents and families is needed. This article is protected by copyright. All rights reserved.

KEYWORDS:

advanced practice nurse; implementation; inter-professional; interviews; long-term care; nurse practitioner; qualitative descriptive study; team

PMID:
30697772
DOI:
10.1111/jan.13962

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