Collaborative practice by nurse practitioners and physicians in long-term care homes: A mixed methods study
Faith C. Donald, MS, PhD, NP-PHC
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Purpose. To understand how nurse practitioners (NPs) and physicians (MDs) collaborate with one another to provide resident care in Ontario long-term care homes (LTCHs).
Methods. A sequential two-phase, mixed methods design was used. During Phase One, a mailed survey was sent to all 15 NPs working in LTCHs and the 33 MDs with whom they most frequently worked. Based on Phase One survey results, using maximal variation in the extent of and satisfaction with collaboration scale scores, one NP-MD pair and one charge nurse in each of three LTCHs were selected for Phase Two data collection. At the three LTCHs, Phase Two qualitative data collection included document analysis, interview questionnaires, and individual semi-structured interviews. Phase Two data were analyzed using Miller and Crabtree's template approach.
Results. The Phase One quantitative survey data offered a broad understanding of the extent of and satisfaction with NP-MD collaborative practice in LTCHs. MDs reported higher scores for the extent of and satisfaction with NP-MD collaboration than did NPs. The majority of NPs and MDs agreed that collaboration was occurring and they were satisfied with it. Phase Two qualitative data provided an in-depth understanding of facilitators and barriers to collaboration, as well as recommendations to strengthen it. Collaborative practice processes, essential elements, and perceived outcomes were identified.
Conclusions. Ultimately collaboration is a choice of the individuals involved. However, there is a need for NP role clarity and integration to facilitate MD-NP collaboration. At sites where participants described clearly identified and well integrated NP roles, the extent of and satisfaction with collaboration was higher for the MDs and NPs. A Long-Term Care NP-MD Collaborative Practice Model informed this study and was revised based on study findings.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: NR28177; ProQuest document ID: 304806345. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Mixed/Multi Method Research|
Care Team Dynamics;
Long-term Care Residents
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