Investigation of nurse practitioner-patient interactions: using the Nurse Practitioner Rating Form

Primary care has become a major focus of health care reform. To create the most effective delivery of primary care services by nurse practitioners (NPs), researchers, clinicians, and administrators must continue to develop knowledge about the structure, process, and outcomes of NP primary care patient encounters. Few measures of NP-patient care encounters exist. This exploratory study examines a method of investigating NP practice and a description of the process of NP primary care. The Nurse Practitioner Rating Form (NPRF) was used to analyze 20 videotaped NP visits with Latino clients in a primary care setting. Major findings are that NPs spent visit time engaged in assessment (61%), management (29%), and charting, consultation, and other (10%). The content or focus of the majority of NP time during visits (90%) was directed to existing physical problems. NPs received high scores for communication style and degree of client participation. Problems with using the NPRF are noted and key recommendations are made to enhance NP care and improve investigation of primary care practice.