Kelley Kilpatrick1,2, Mira Jabbour2, Éric Tchouaket3, Michelle Acorn4, Faith Donald5, Sylvie Hains6. 1. Ingram School of Nursing, McGill University, Montreal, QC, Canada. 2. Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Ïle-de-Montréal, Maisonneuve-Rosemont Hospital Site, Montreal, QC, Canada. 3. Faculty of Nursing, Université du Québec en Outaouais (UQO), Saint-Jérôme, QC, Canada. 4. Faculty of Nursing, University of Toronto, Toronto, ON, Canada. 5. Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada. 6. Ministère de la Santé et des Services sociaux, Quebec, QC, Canada.
Abstract
AIM: To identify the conditions needed to implement nurse practitioners (NP) in long-term care (LTC) 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 NPs located near healthcare teams facilitated communication and improved implementation. Half-time NP 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 LTC and daily physician presence at some sites limited implementation. CONCLUSION: The project fostered an understanding of the conditions needed to successfully implement NPs in LTC. An examination of the perspective of residents and families is needed.
AIM: To identify the conditions needed to implement nurse practitioners (NP) in long-term care (LTC) 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 NPs located near healthcare teams facilitated communication and improved implementation. Half-time NP 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 LTC and daily physician presence at some sites limited implementation. CONCLUSION: The project fostered an understanding of the conditions needed to successfully implement NPs in LTC. An examination of the perspective of residents and families is needed.
Authors: Rae R A Petrucha; Elizabeth G Hansen; Lindsay D Ironside; Olivia J M Lafrance; Rhonda D T Bryce; Nicole A Jacobson; Vivian R Ramsden Journal: Can Geriatr J Date: 2022-03-02