A unique set of interactions: the MSU sustained partnership model of nurse practitioner primary care

To present a unified conceptual model that identifies the integral processes of nurse practitioner (NP) care delivery and that integrates major structural influences and potential outcomes. The model is further characterized to delineate the unique and "value-added" nature of NP primary care and to describe how this nature may be correlated with specific clinical outcomes.

Extensive review of the literature, relevant conceptual models, clinical experiences of th authors, and two sets of qualitative dat exploring differences between NP practice an other practices.

The basis of NP primary care is the unique provider-client relationship that develops within the primary care setting. This relationship is oriented toward (a) helping client become empowered to more appropriately manage their own care in a way that will best meet their needs, (b) encouraging mutual deci sion making, (c) ensuring clients' continuity o care, and (d) providing a holistic approach to primary care. The major structural influences are NP role components, interdisciplinary practice relationships, budget resources and payer mix, and environmental characteristics. The potential outcomes are increased health promoting behaviors, improved utilization of care, higher client satisfaction levels, and improved health status.

NPs can use this model to articulate the unique contribution of NP practice and its interrelationships within the broader primary care setting. Practicing NPs can use this framework to better understand the complexities of their current and future primary care practices. Faculty can utilize the concepts to help guide students' understanding of their prospective roles as advanced practice nurses. Finally, this conceptual framework can inform research about specific NP processes and related outcomes. A clearly delineated model that accurately depicts structures, processes, and outcomes relevant to NP primary care can strengthen NP education, distinguish NP practice, and advance evidenced-based research linking NP practice and outcomes.