Evaluation of Veterans Affairs primary care nurse practitioner residency: Achievement of competencies
Evaluation of Veterans Affairs primary care nurse practitioner residency: Achievement of competencies
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DOI：
10.1016/j.outlook.2017.06.004
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发表时间：
2018-01-01
期刊：
影响因子：
4.3
通讯作者：
Harada, Nancy
中科院分区：
文献类型：
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作者：
Rugen, Kathryn Wirtz;Dolansky, Mary A.;Harada, Nancy
背景：医学研究所建议为高级实践护理毕业生建立住院医师计划。目前，有关项目有效性的证据有限。目的：描述由弗吉尼亚州初级保健教育卓越中心（VA CoEPCE）建立的七个能力领域的护士执业（NP）住院结果。方法：我们在五个地点的NP住院医师项目中评估了为期12个月的NP住院医师能力自我评定和导师评定的平均值。分析了最高、最低评价项目及NP居民自评与导师评价的差异。结果：平均NP居民自我评分和平均导师评分在所有领域都有统计学上显著的改善（p < 0.0001）。在12个月时，NP住院医师被他们的导师评为能够在没有监督的情况下在所有能力领域进行实践。在1个月和12个月时，临床、领导和质量改进/人口管理能力是得分最低的领域，而以患者为中心的护理、跨专业团队协作、共同决策和持续关系能力是得分最高的领域。结论：这些结果为VA CoEPCE NP住院医师项目的有效性提供了初步证据，也突出了需要改进的领域。
Background: The Institute of Medicine has recommended the establishment of residency programs for advanced practice nursing graduates. Currently, the evidence about program effectiveness is limited.Purpose: To describe the nurse practitioner (NP) resident outcomes on seven competency domains established by the VA Centers of Excellence in Primary Care Education (VA CoEPCE).Methods: We evaluated mean NP resident competency self-ratings and mean mentor ratings over the 12-month program across NP residency programs at five sites. Highest and lowest rated items and differences between NP resident self ratings and mentor ratings were analyzed.Results: Mean NP resident self-ratings and mean mentor ratings demonstrated statistically significant improvement in all domains (p < .0001). At 12 months, NP residents were rated by their mentors as able to practice without supervision in all competency domains. At 1 and 12 months, clinical, leadership and quality improvement/population management competencies were the lowest scored domains while patient-centered care, interprofessional team collaboration, shared decision-making and sustained relationships competencies were highest.Conclusions: These results provide initial evidence for the effectiveness of VA CoEPCE NP residency programs and also highlight areas of needed improvement.