Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T03:45:42.296Z Has data issue: false hasContentIssue false
  • English
  • Français

Nurse Practitioner and Physician Collaboration in Long-Term Care Homes: Survey Results*

Published online by Cambridge University Press:  01 March 2009

Faith Donald ,
E. Ann Mohide ,
Alba DiCenso ,
Kevin Brazil ,
Michael Stephenson  and
Noori Akhtar-Danesh
Faith Donald*
Affiliation:
Daphne CockwellSchool of Nursing, Ryerson University, Toronto, ON
E. Ann Mohide
Affiliation:
School of Nursing, McMaster University, Hamilton, ON
Alba DiCenso
Affiliation:
School of Nursing, McMaster University, Hamilton, ON Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
Kevin Brazil
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
Michael Stephenson
Affiliation:
School of Nursing, McMaster University, Hamilton, ON Wellington Nursing Home, Hamilton, ON
Noori Akhtar-Danesh
Affiliation:
School of Nursing, McMaster University, Hamilton, ON
*
*Request for offprints should be sent to: Faith Donald Daphne Cockwell School of Nursing, Ryerson University 350 Victoria Street Toronto, ON M5B 2K3 Telephone: (416) 979-5000 ext. 6309 Fax: (416) 979-5332 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This survey assessed the extent of and satisfaction with collaboration between physicians and nurse practitioners (NPs) working in Ontario long-term care homes. Questionnaires, which included the Measure of Current Collaboration and Provider Satisfaction with Current Collaboration instruments, were mailed to NPs and physicians with whom the NP most frequently worked. The 14 matched-pairs of NPs and physicians reported similar levels of collaboration; however, physicians were significantly more satisfied with collaboration than were NPs (z = -2.67, p = 0.008). The majority of physicians (85%) and NPs (86%) indicated that collaboration was occurring, and 96 per cent of physicians and 79 per cent of NPs were satisfied with their collaboration. About one third of physicians reported that the NP had a negative effect on their income, but their satisfaction with collaboration did not differ from those who reported a positive effect. Overall, these physicians and NPs collaborate in delivering care and are satisfied with their collaboration.

Résumé

Dans cette étude transversale, on a mesuré l’étendue et la satisfaction de la collaboration entre les médecins et les infirmières praticiennes (IP) travaillant dans des maisons de soins de longue durée en Ontario. Des questionnaires, qui incluaient les instruments Mesure de Collaboration Courante et Satisfaction du Prestataire avec la Collaboration Courante, ont été envoyés par la poste aux IP et aux médecins avec qui les IP travaillent le plus fréquemment. La comparaison de 14 questionnaires appariés entre les IP et les médecins a démontré des niveaux de collaboration similaires. Cependant, les médecins étaient considérablement plus satisfaits avec la collaboration que les IP (z = -2.67, p = 0.008). La majorité des médecins (85%) et des IP (86%) ont indiqués que la collaboration se produisait et 96 pour cent des médecins et 79 pour cent des IP étaient satisfaits avec la collaboration. Environ un tiers des médecins ont indiqués que les IP ont eu un effet négatif sur leurs revenus mais leur satisfaction avec la collaboration n’a pas changée par rapport à ceux qui ont rapporté un effet positif. En général, ces médecins et ces IP collaborent dans la prestation des soins et sont satisfaits de leur collaboration.

Keywords

vieillissementcollaborationmaisons de soins infirmierséquipe soignante multidisciplinaireinfirmières praticiennesmédecinsagingcollaborationnursing homesmulti-disciplinary care teamnurse practitionersphysicians
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 28 , Issue 1 , March 2009 , pp. 77 - 87
Copyright
Copyright © Canadian Association on Gerontology 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors wish to thank Kwadwo Bosompra, Ph.D., for his assistance with the statistical components of this study and Célyne Laflamme for the French translation of the Abstract.

We gratefully acknowledge funding from the Ontario Ministry of Health and Long-Term Care, Nursing Secretariat.

References

Abdallah, L., Fawcett, J., Kane, R.L., Dick, K., & Chen, J. (2005). Development and psychometric testing of the EverCare Nurse Practitioner Role and Activity Scale (ENPRAS). Journal of the American Academy of Nurse Practitioners, 17(1), 21–26.CrossRefGoogle ScholarPubMed
Baggs, J.G., Schmitt, M.H., Mushlin, A.I., Eldredge, D.H.Oakes, D., & Hutson, A.D. (1997). Nurse-physician collaboration and satisfaction with the decision-making process in three critical care units. American Journal of Critical Care, 6(5), 393–399.CrossRefGoogle ScholarPubMed
Bouchard, M., Holdway, K., Corbeil, S., Tasse, H., & Joanisee, J. (2004). Evaluating the nurse practitioner role in LTC: Staff perceptions of the nurse practitioner’s role in a long-term care setting. Canadian Nursing Home, 15(2), 7–12.Google Scholar
Caprio, T.V. (2006). Physician practice in the nursing home: Collaboration with nurse practitioners and physician assistants. Annals of Long-Term Care, 14(3), 17–24.Google Scholar
College of Family Physicians of Canada (2007). National physician surveys, Retrieved August 13, 2008, from College of Family Physicians of Canada. http://www.nationalphysiciansurvey.ca/nps/2007_Survey/2007results-e.aspGoogle Scholar
College of Nurses of Ontario (2006). Extended class: Present and future. Retrieved March 9, 2008, from College of Nurses of Ontario. http://www.cno.org/for/rnec/index.htm#ovGoogle Scholar
Converse, J.M., & Presser, S. (1986). Survey questions: Handcrafting the standardized questionnaire. Beverly Hills, CA: Sage.CrossRefGoogle Scholar
DiCenso, A., Paech, G., & IBM Corporation (2003). Report on the integration of primary health care nurse practitioners into the province of Ontario: Final report June 30, 2003. Retrieved March 9, 2008, from Ministry of Health and Long-Term Carehttp://www.health.gov.on.ca/english/public/pub/ministry_reports/nurseprac03/np_report.pdfGoogle Scholar
Edwards, P., Roberts, I., Clarke, M., DiGuiseppi, C., Pratap, S., Wentz, R., et al. . (2002). Increasing response rates to postal questionnaires: Systematic review. British Medical Journal, 324, 1183–1191.CrossRefGoogle ScholarPubMed
Fagin, C.M. (1992). Collaboration between nurses and physicians: No longer a choice. Academic Medicine, 67(5), 295–303.CrossRefGoogle ScholarPubMed
Flaherty, E. (2000). The nurse practitioner: Emerging issues and considerations. Annals of Long-Term Care, 8(7), 48–50.Google Scholar
Henneman, E.A., Lee, J.L., & Cohen, J.I. (1995). Collaboration: A concept analysis. Journal of Advanced Nursing, 21(1), 103–109.CrossRefGoogle Scholar
Hojat, M., Nasca, T.J., Cohen, M.J.M., Fields, S.K., Rattner, S.L., Griffiths, M., et al. . (2001). Attitudes toward physician-nurse collaboration: A cross-cultural study of male and female physicians and nurses in the United States and Mexico. Nursing Research, 50, 123–128.CrossRefGoogle Scholar
Howell, D.C. (2002). Statistical methods for psychology (5th ed.). Pacific Grove, CA: Duxbury.Google Scholar
Kaasalainen, S., Di Censo, A., Donald, F.C., & Staples, E. (2007). Optimizing the role of the nurse practitioner around pain management in long-term care. Canadian Journal of Nursing Research, 39(2), 14–31.Google Scholar
Kane, R.L., Keckhafer, G., Flood, S., Bershadsky, B., & Siadaty, S. (2003). The effect of Evercare on hospital use. Journal of the American Geriatrics Society, 51(10), 1427–1434.CrossRefGoogle ScholarPubMed
Keith, K.M., & Askin, D.F. (2008). Effective collaboration: The key to better healthcare. Nursing Leadership, 21(2), 51–61.CrossRefGoogle Scholar
Knaus, W.A., Draper, E.A., Wagner, D.P., & Zimmerman, J.E. (1986). An evaluation of outcomes from intensive care in major medical centers. Annals of Internal Medicine, 104, 410–418.CrossRefGoogle ScholarPubMed
Larson, E. (1999). The impact of physician-nurse interaction on patient care. Holistic Nursing Practice, 13(2), 38–46.CrossRefGoogle ScholarPubMed
McColl, E., Jacoby, A., Thomas, I., Soutter, J., Bamford, C., Steen, N., et al. . (2001). Design and use of questionnaires: A review of best practice applicable to surveys of health service staff and patients. Executive summary. Health Technology Assessment, 5(31), iii–v.CrossRefGoogle Scholar
Mezey, M., Burger, S.G., Bloom, H.G., Bonner, A., Bourbonniere, M., Bowers, B., et al. . (2005). Experts recommend strategies for strengthening the use of advanced practice nurses in nursing homes. Journal of the American Geriatrics Society, 53(10), 1790–1797.CrossRefGoogle ScholarPubMed
Mezey, M.D., Mitty, E.L., & Burger, S.G. (2008). Rethinking teaching nursing homes: Potential for improving long-term care. Gerontologist, 48(1), 8–15.CrossRefGoogle ScholarPubMed
Neale, J. (1999). Nurse practitioners and physicians: A collaborative practice. Clinical Nurse Specialist, 13(5), 252–258.CrossRefGoogle ScholarPubMed
Rosenfeld, P., Kobayashi, M., Barber, P., & Mezey, M. (2004). Utilization of nurse practitioners in long-term care: Findings and implications of a national survey. Journal of the American Medical Directors Association, 5(1), 9–15.CrossRefGoogle ScholarPubMed
Ryan, J.W. (1999). Collaboration of the nurse practitioner and physician in long-term care. Lippincott’s Primary Care Practice, 3(2), 127–134.Google ScholarPubMed
Scott, C.M., & Thurston, W.E. (2004). The influence of social contest on partnerships in Canadian health systems. Gender, Work, and Organization, 11(5), 481–505.CrossRefGoogle Scholar
Siegler, E.L., & Whitney, F.W. (1994). Social and economic barriers to collaborative practice. In Siegler, E.L. & Whitney, F.W. (Eds.), Nurse-physician collaboration: Care of adults and the elderly (pp. 21–31). New York: Springer.Google Scholar
Stevenson, C., Kamholz, B., & Siegler, E.L. (1994). The nursing home. In Siegler, E.L. & Whitney, F.W. (Eds.), Nurse-physician collaboration: Care of adults and the elderly (pp. 59–67). New York: Springer.Google Scholar
Stolee, P., Hillier, L.M., & æstima research (2002). The Ontario nurse practitioner in long-term care facilities pilot project: Interim evaluation final report. Retrieved March 9, 2008, from Ministry of Health and Long-Term Carehttp://www.health.gov.on.ca/english/public/pub/ministry_reports/nurseprac02/np_report_022302.pdfGoogle Scholar
Stolee, P., Hillier, L.M., Esbaugh, J., Griffths, N., & Borrie, M.J. (2006). Examining the nurse practitioner role in long-term care: Evaluation of a pilot project in Canada. Journal of Gerontological Nursing, 32(10), 28–36.Google ScholarPubMed
Truscott, J.E. (2007). Nurse practitioners and GPs–addressing the needs of older persons living in residential aged care. Australian Family Physician, 36(9), 765–767.Google ScholarPubMed
Way, D., Jones, L., & Baskerville, N.B. (2001). Improving the effectiveness of primary health care delivery through nurse practitioner/family physician structured collaborative practice: Final report to the Health Transitions Fund. Joint University of Ottawa Department of Family Medicine and School of Nursing project funded by Health Canada’s Health Transition Fund. Retrieved March 9, 2008, from University of Ottawahttp://www.familymedicine.uottawa.ca/eng/final_report.aspxGoogle Scholar
Way, D.O., Jones, I., & Busing, N. (2000). Implementation strategies: “Collaboration in primary care – family doctors & nurse practitioners delivering shared care”. Retrieved March 9, 2008, from Ontario College of Family Physicianshttp://www.ocfp.on.ca/include/asp/FileDownload.asp?getFile=%7B63FE6AB0-EEB3-4EA7-A67D-2DE92814AAE8%7DGoogle Scholar
Yurkow, J. (1999). Integration and collaboration. The advanced practice nursing role in gerontologic rehabilitation. Nurse Practitioner Forum, 10(1), 20–26.Google Scholar
Zwarenstein, M., & Reeves, S. (2000). What’s so great about collaboration? British Medical Journal, 320(7241), 1022–1023.CrossRefGoogle ScholarPubMed