scholarly journals Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement

2018 ◽  
Vol 20 ◽  
Author(s):  
Julian Barratt ◽  
Nicola Thomas
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Convenience Sample ◽  
Primary Health ◽  
Communication Processes ◽  
Consultation Time

AbstractBackgroundResearch has not yet fully investigated links to consultation duration, patient expectations, satisfaction, and enablement in nurse practitioner consultations. This study was developed to address some of these research gaps in nurse practitioner consultations, particularly with a focus on expectations, satisfaction, and enablement.AimTo explore the influence of pre-consultation expectations, and consultation time length durations on patient satisfaction and enablement in nurse practitioner consultations in primary health care.DesignSurvey component of a larger convergent parallel mixed methods case study designed to conjointly investigate the communication processes, social interactions, and measured outcomes of nurse practitioner consultations. The survey element of the case study focusses on investigating patients’ pre-consultation expectations and post-consultation patient satisfaction and enablement.MethodsA questionnaire measuring pre-consultation expectations, and post-consultation satisfaction and enablement, completed by a convenience sample of 71 adults consulting with nurse practitioners at a general practice clinic. Initial fieldwork took place in September 2011 to November 2012, with subsequent follow-up fieldwork in October 2016.ResultsRespondents were highly satisfied with their consultations and expressed significantly higher levels of enablement than have been seen in previous studies of enablement with other types of clinicians (P=0.003). A significant, small to moderate, positive correlation of 0.427 (P=0.005) between general satisfaction and enablement was noted. No significant correlation was seen between consultation time lengths and satisfaction or enablement.ConclusionHigher levels of patient enablement and satisfaction are not necessarily determined by the time lengths of consultations, and how consultations are conducted may be more important than their time lengths for optimising patient satisfaction and enablement.

scholarly journals Patient satisfaction with nurse practitioner care in Newfoundland and Labrador

2018 ◽  
Vol 6 (4) ◽  
pp. 101 ◽  
Author(s):  
Wanda Emberley-Burke ◽  
Robert J. Meadus ◽  
June Creina Twomey ◽  
Kelly Power Kean
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Newfoundland And Labrador ◽  
Health Care Services ◽  
Health Care Settings ◽  
Primary Health ◽  
Primary Health Care Settings

Objective: The aim of the study was to determine the level of patient satisfaction with health care provided by Nurse Practitioners (NPs) in Newfoundland and Labrador (NL), in primary health care settings.Methods: This is a descriptive study. 155 adult patients (N = 155) were recruited from the four regional health authorities (RHAs) throughout NL who employed NPs in a primary health care setting. A 47-item questionnaire called the Nurse Practitioner Satisfaction Survey (NPSS) was given to patients after receiving care from a NP.Results: Over 93% of the participants agreed or strongly agreed with their degree of satisfaction of care provided by the NP. Patients who visited the NP one to five times in the past year reported higher levels of satisfaction. No significant differences based upon marital status, gender or ethnicity were found.Conclusions: Patient satisfaction was rated as high for care provided by NPs with over 98% of participants reporting they would seek the services of a NP in the future. The majority of the participants would recommend the NP to others seeking health care services. This study describes patient satisfaction with NP care and highlights NPs as valued providers of care in rural and urban primary health care settings. Identified narrative themes were timely access to care, NP knowledge, trust, and provider consistency. NPs should seek ways to ensure they work to their full scope of practice to meet the needs of the population and increase their presence in primary health care settings.

scholarly journals Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes

2018 ◽  
Vol 20 ◽  
Author(s):  
Julian Barratt ◽  
Nicola Thomas
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Social Interactions ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Interaction Analysis ◽  
Interaction Styles ◽  
Primary Health ◽  
Patient Enablement ◽  
Consultation Time

AbstractObjectiveTo determine the discrete nature of social interactions occurring in nurse practitioner consultations and investigate the relationship between consultation social interaction styles (biomedical and patient-centred) and the outcomes of patient satisfaction, patient enablement, and consultation time lengths.MethodsA case study-based observational interaction analysis of verbal social interactions, arising from 30 primary health care nurse practitioner consultations, linked with questionnaire measures of patient satisfaction and enablement.ResultsA significant majority of observed social interactions used patient-centred communication styles (P=0.005), with neither nurse practitioners nor patients or carers being significantly more verbally dominant. Nurse practitioners guided the sequence of consultation interaction sequences, but patients actively participated through interactions such as asking questions. Usage of either patient-centred or biomedical interaction styles were not significantly associated with increased levels of patient satisfaction or patient enablement. The median consultation time length of 10.1 min (quartiles 8.2, 13.7) was not significantly extended by high levels of patient-centred interactions being used in the observed consultations.ConclusionHigh usage levels of patient-centred interaction styles are not necessarily contingent upon having longer consultation times available, and clinicians can encourage patients to use participatory interactions, whilst still then retaining overall guidance of the phased sequences of consultations, and not concurrently extending consultation time lengths. This study adds to the body of nurse practitioner consultation communication research by providing a more detailed understanding of the nature of social interactions occurring in nurse practitioner consultations, linked to the outcomes of patient satisfaction and enablement.

McAtee and Silver Reply

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 620-621
Author(s):  
Patricia A. McAtee ◽  
Henry K. Silver
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Personalized Care ◽  
Primary Health ◽  
Primary Health Services ◽  
Better Than

We appreciate the commentary of Dr. Austin regarding our article. The nurse practitioner role was created because the needs of children for primary health care were not being adequately met through the existing health care delivery system. Pediatricians who practice with nurse practitioners have found that the pediatrician and the nurse can provide more primary health services to children and can give more personalized care than they previously were able to do. Acceptance by patients and their parents has been excellent; more than one half of the parents indicated that joint care was better than that received from the same pediatrician alone.

scholarly journals Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience

2021 ◽  
Author(s):  
◽  
Tara Officer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Services ◽  
Health System ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Workforce ◽  
Primary Health ◽  
Advanced Practitioner

<p>Internationally, health workforce redesign provides a means to cope with an increasing demand for health services. The development of advanced practitioner professions provides a major change in health service delivery that challenges traditional practice boundaries. Yet, we know very little about how to introduce such roles into existing health systems successfully. This research investigates how nurse practitioner and pharmacist prescriber roles are developing in New Zealand primary health care, and what is needed to better support the future development of these roles.  A realist methodology guided this research. The study used a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services. Documents provided by interviewees relating to practice-specific roles supplemented these interviews. Data analysis facilitated the generation, testing, and refinement of theories on nurse practitioner and pharmacist prescriber role development.  This research provided an account of the complexities of developing new health professional roles in an already established health system. Theories formed in this research considered advanced practitioner role creation, realisation, and subsequent delivery of health services. Mechanisms for their development included: (1) engagement in planning and integrating roles; (2) establishing opportunities as part of a well-defined career pathway; and (3) championing role uptake and work to full scopes of practice. Various health system and workplace contexts, practitioner goals, and patient needs influenced the ability for these mechanisms to trigger and thus have an effect on role development.  Theories arising from this research emphasise the complexity inherent in the development of advanced practitioner roles. In addition, the findings demonstrate that a structured and informed health workforce redesign could improve use of roles, such as those of the nurse practitioner and pharmacist prescriber. In light of these results, this study recommends, implementing a national strategy that aligns policy and practice decisions if we are to succeed in making better use of such practitioner skills and expertise.</p>

Psychometric Evaluation of the Nurse Practitioner Satisfaction Survey (NPSS)

2009 ◽  
Vol 17 (2) ◽  
pp. 114-133 ◽  
Author(s):  
Lucie J. Agosta
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Primary Health Care ◽  
Nurse Practitioner ◽  
Health Care Services ◽  
Factor Model ◽  
Psychometric Evaluation ◽  
Internal Consistency Reliability ◽  
Satisfaction Survey ◽  
Primary Health

The purpose of this study was to identify and define underlying latent constructs within the concept of patient satisfaction with nurse practitioner delivered primary health care. The Nurse Practitioner Satisfaction Survey (NPSS), a 28-item, Likert-type, researcher developed instrument was completed by 300 clients presenting for primary health care visits in a hospital outpatient clinic. Factor analysis with promax rotation resulted in a three factor model explaining 70.77% of the variance. Eighteen items loaded on general satisfaction. Six items loaded on communication, and four items loaded on accessibility and convenience. Cronbach’s alpha internal consistency reliability coefficients were .98, .83, and .76 for the three factors, respectively. The NPSS was found to be reliable and valid for measuring patient satisfaction with nurse practitioner delivered primary health care services.

The School Nurse Practitioner: Providing Improved Health Care to Children

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 580-584
Author(s):  
Henry K. Silver ◽  
Judith Bellaire Igoe ◽  
Patricia Rooney Mcatee
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
School Nurse ◽  
School Age ◽  
Highly Qualified ◽  
Primary Health ◽  
Direct Primary

School nurse practitioners have the competence to participate in providing a broad range of direct primary health care and services to the school-age child. Greater utilization of these specially prepared and highly qualified nurse practitioners as providers of health care in the school is a practical and effective method of adding to the quality, availability, and continuity of health care for the school-age child.

scholarly journals ‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tara N. Officer ◽  
Jackie Cumming ◽  
Karen McBride-Henry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Consumer Satisfaction ◽  
Care Delivery ◽  
Realist Evaluation ◽  
Structured Interviews ◽  
Primary Health ◽  
Advanced Practitioner

Abstract Background Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services. Methods As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research. Results Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion. Conclusions This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.

scholarly journals Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience

2021 ◽  
Author(s):  
◽  
Tara Officer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Services ◽  
Health System ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Workforce ◽  
Primary Health ◽  
Advanced Practitioner

<p>Internationally, health workforce redesign provides a means to cope with an increasing demand for health services. The development of advanced practitioner professions provides a major change in health service delivery that challenges traditional practice boundaries. Yet, we know very little about how to introduce such roles into existing health systems successfully. This research investigates how nurse practitioner and pharmacist prescriber roles are developing in New Zealand primary health care, and what is needed to better support the future development of these roles.  A realist methodology guided this research. The study used a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services. Documents provided by interviewees relating to practice-specific roles supplemented these interviews. Data analysis facilitated the generation, testing, and refinement of theories on nurse practitioner and pharmacist prescriber role development.  This research provided an account of the complexities of developing new health professional roles in an already established health system. Theories formed in this research considered advanced practitioner role creation, realisation, and subsequent delivery of health services. Mechanisms for their development included: (1) engagement in planning and integrating roles; (2) establishing opportunities as part of a well-defined career pathway; and (3) championing role uptake and work to full scopes of practice. Various health system and workplace contexts, practitioner goals, and patient needs influenced the ability for these mechanisms to trigger and thus have an effect on role development.  Theories arising from this research emphasise the complexity inherent in the development of advanced practitioner roles. In addition, the findings demonstrate that a structured and informed health workforce redesign could improve use of roles, such as those of the nurse practitioner and pharmacist prescriber. In light of these results, this study recommends, implementing a national strategy that aligns policy and practice decisions if we are to succeed in making better use of such practitioner skills and expertise.</p>

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