A unique practice model for Nurse Practitioners in long-term care homes

Area of Science:

• Gerontology
• Healthcare Management
• Nursing Practice

Background:

• Introduction of Nurse Practitioners (NPs) in Ontario, Canada's long-term care (LTC) homes.
• Pilot project involving 2 full-time equivalent NPs serving approximately 2900 residents across 22 LTC homes.
• Practice model developed based on specific needs of LTC homes and residents.

Purpose of the Study:

• Examine a Nurse Practitioner (NP) practice model in long-term care (LTC).
• Assess the model's impact on staff confidence.
• Evaluate the model's effectiveness in preventing hospital admissions and promoting early hospital discharge.

Main Methods:

• Prospective data collection by NPs on clinical activities and resident outcomes from July 2003 to June 2004.
• Survey of 18 Directors of Care to assess impact on hospitalization prevention and staff confidence in March 2004.
• Analysis of 2315 clinical contacts, with 64% being follow-up contacts.

Main Results:

• Nurse Practitioners (NPs) managed a high volume of clinical contacts, addressing various medical issues with positive outcomes.
• Hospital admissions were prevented in 39-43% of cases.
• NPs positively impacted staff confidence but did not significantly facilitate early hospital discharge.

Conclusions:

• Practice models tailored to the unique needs of long-term care (LTC) homes and residents can improve care quality, even with limited Nurse Practitioner (NP) resources.
• Stakeholder involvement in identifying care priorities and planning was crucial for the model's success.
• The study highlights the potential of specialized NP roles in enhancing geriatric care within LTC settings.