Characterizing nurse practitioner practice by sampling patient encounters: an APRNet study.
Characterizing nurse practitioner practice by sampling patient encounters: an APRNet study.
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通过对患者接触情况进行抽样来描述执业护士的实践：一项 APRNet 研究。
DOI：
10.1111/j.1745-7599.2008.00318.x
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发表时间：
2008
影响因子：
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通讯作者：
Grey,Margaret
中科院分区：
文献类型：
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作者：
Deshefy-Longhi,Terry;Swartz,MarthaK;Grey,Margaret
目的：本研究的目的是通过使用患者接触报告比以前更准确地反映执业模式来描述执业护士 (NP) 的实践特征。这项研究是由 20 个基于实践的研究网络 (PBRN) 组成的联盟进行的更大规模的初级保健实践调查的一部分。因此，在适当的情况下，我们还对该 NP 网络（高级执业注册护士网络，APRNet）与其他 19 个医生运营的研究网络进行了比较。 数据来源：由 20 个 PBRN 联盟在医疗保健研究和质量局的资助下开展了一项描述性调查。该联盟的目标是收集 6 个月内的初级保健数据，并记录和比较美国的初级保健实践。这些数据是在会员与患者接触后立即收集的，而不是从计费电子表格中收集的。 19 个 PBRN 可能在构成其网络的实践中拥有 NP。然而，这些 NP 的数据是根据每个诊所的医生所有者的研究 ID 号收集的。因此，APRNet 是唯一由 NP 组成的研究网络，他们根据自己的研究 ID 号收集和报告数据。结论：急性健康问题占 NP 治疗的所有发作的 45%，相比之下，慢性病恶化发作的比例为 30%，非疾病和健康促进就诊的发作比例为 24.5%。此外，我们的研究结果表明，无论就诊原因如何，NP 在 84% 的初级保健就诊中提供咨询（医生为 61%），而且咨询类型因 NP 类型而异。 对实践的启示：尽管有许多关于 NP 实践的可比性和结果的研究，但仍需要识别、澄清和记录初级保健机构中 NP 的实践。本调查迈出了重要且有用的第一步，通过在接触患者后立即对 APRN 进行调查，提供一种系统的方法来描述这些做法。
Purpose:The purpose of this study was to characterize nurse practitioners’ (NPs’) practice by using reports of patient encounters to more accurately reflect practice patterns than has been previously performed. This study was part of a larger primary care practice survey by a consortium of 20 practice‐based research networks (PBRNs). Therefore, comparisons, when appropriate, were also made between this network of NPs (Advanced Practice Registered Nurse Network, APRNet) and the other 19 physician‐run research networks.Data sources:A descriptive survey was developed by the 20 PBRN consortium under grants from the Agency for Healthcare Research and Quality. The consortium’s goal was to collect primary care data over a 6‐month period and to document and compare primary care practice in the United States. The data were collected immediately following members’ encounters with patients rather than from billing spreadsheets. Nineteen PBRNs may have had NPs in the practices that comprised their networks. However, the data from these NPs were collected under the study ID numbers of the physician owners of each practice. APRNet, therefore, was the sole research network comprised exclusively of NPs who collected and reported data under their own study ID numbers.Conclusions:Acute health problems comprised 45% of all episodes treated by NPs compared to 30% of episodes for exacerbations of chronic conditions and 24.5% for nonillness and health promotion visits. In addition, our findings suggest that NPs provide counseling in 84% (vs. 61% for physicians) of their primary care visits, regardless of the reason for visit, and the type of counseling varies by the type of NP.Implications for practice:Despite many studies on the comparability and outcomes of NP practice, the need to identify, clarify, and document the practices of NPs in primary care settings remains. The present survey provides an important and useful first step in providing a systematic way to characterize these practices through a survey of APRNs immediately following their patient encounters.