Module 07 – Researching for Evidence

Module 07 Written Assignment – Researching for Evidence

Nurse practitioners (NPs) are autonomous professionals who work in tandem with other healthcare workers to coordinate patient care. NPs are registered nurses with advanced, specialized education, and clinical competency to care for diverse populations in various acute, ambulatory, and long-term healthcare settings. The scope of practice for nurse practitioners aligns with the Advanced Practice Registered Nurse (APRN) consensus model. As these nurses practice in diverse settings, their roles are not setting-specific. Instead, their scope of practice is dependent on patient needs. Module 07 – Researching for Evidence

A best practice in the role of nurse practitioners is developing and implementing comprehensive plans of care to decrease hospitalizations, coordinate discharges, and improve quality outcomes among residents in nursing facilities. Together with the patient and their family, the nurse practitioner formulates an evidence-based mutually acceptable plan of care that is affordable, effective, and maximizes the health potential of the patient. Plan of care implementation is dependent on established priorities and is consistent with the clinical practice and specialized education for nurse practitioners.

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Mileski et al. (2020) discuss the role of nurse practitioners in minimizing hospitalizations in long-term nursing facilities. Their discussion underscores the identified best practice for NPs that centres on developing and executing comprehensive plans of care to streamline the discharge process, improve the quality of care, and minimize hospitalization rates. Nursing homes are crucial elements in the healthcare system as they provide efficient care to old, frail, and vulnerable adults. Nursing home residents are at increased risk of hospitalizations. The above authors suggest that approximately one-fifth Medicare beneficiaries are readmitted 30 days after discharge. Majority of these hospitalizations are unplanned, costly, and preventable. Primary causes of these readmissions are insufficient care coordination and lack of well-developed plans of care. Module 07 – Researching for Evidence

In their study, Mileski et al. (2020) obtained their findings by systematically reviewing peer-reviewed articles in Academic Search Ultimate (ASU), CINAHL Complete, and PubMed databases. The initial search centred on articles describing the role of nurse practitioners in decreasing hospital readmissions and enhancing the quality of care for patients in long-term nursing facilities. Articles were only included if academic journals between 2004 and 2019 published them, were in English publications, and explored the influence of nurse practitioners on hospital readmissions on patients in long-term care. Articles focusing on nurse practitioners in acute care were excluded. The authors selected thirty articles for further review.

Herein, the authors highlight that nurse practitioners serve a vital role in enhancing the quality of care, decreasing re-admissions, and improving health outcomes in long-term healthcare facilities. Utilizing full-time advanced practice nurses has numerous benefits, among them improved decision making and increased health technology use. Mileski et al. (2020) noted that avoidable hospitalizations reduced by 17 percent under the use of nurse practitioners. Using NPs to evaluate medications and merge them reduces unnecessary hospitalizations by approximately 5.7 percent. Overall, the use of nurse practitioners in long-term care facilities improves care transitions, ultimately reducing the rates of unnecessary hospitalizations.

When developing plans of care, nurse practitioners bring a heightened capability to establish relationships with patients and their families as well as residents. In turn, NPs improve the understanding of these populations on care and allow them to make decisions on an informed choice. All these are significant aspects that improve health outcomes and quality of care when nurse practitioners are involved. Among the improved health outcomes are improve disease management, development of comprehensive care plans, and streamlined patient transitions. During decision making, nurse practitioners provide multidisciplinary education to patients and their families, serve as patient advocates, and establish a safe environment to enhance the quality of care for patients in long-term care facilities. In long-term care, NPs serve as lead primary healthcare providers. Their capability to effectively communicate with patients, collaborate with other staff, engage patients and their families in informed decision making, and execute plans of care is vital in preventing hospitalizations and improve health outcomes. Module 07 – Researching for Evidence

The study by Mileski et al. (2020) concludes that a notable difference in health outcomes and rates of readmissions occur in states with increased levels of nurse practitioners participation contrary to states with low engagement.  Therefore, using nurse practitioners in long-term care settings should be encouraged to improve the quality of care and reduce hospital readmissions. I believe that the research findings support the conclusion and best practice for nurse practitioners. Despite the limitations of this research, it provides valuable findings that underscore the crucial role of nurse practitioners in improving health outcomes and minimizing readmissions in long-term healthcare facilities. Formulating plans of care requires nurse practitioners to formulate priorities to meet the health needs of patients, formulate necessary interventions, and develop plans of patient education, taking into consideration the literacy levels of the patient. Collaborating with other healthcare professionals and using effective communication to engage patients in their plans of care are vital steps during care planning. Implementation of the plan of care should also be dependent on patient preferences. Overall, this article supports the crucial role of nurse practitioners in developing and implementing comprehensive care plans to reduce hospitalizations and improve care outcomes in long-term care.

Reference

Mileski, M., Pannu, U., Payne, B., Sterling, E., & McClay, R. (2020). The Impact of Nurse Practitioners on Hospitalizations and Discharges from Long-term Nursing Facilities: A Systematic Review. Healthcare, 8(2), 114. https://doi.org/10.3390/healthcare8020114

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Module 07 – Researching for Evidence