Nurse Practitioners and Treatment

¶ … Quality of Care Provided by Nurse Practitioners

The use of nurse practitioners in providing primary care services has increased in the recent past as the number of trained NPs also increases. This study focuses on examining the cost-effectiveness and quality of care provided by nurse practitioners given their increased used in the primary care setting. The research was carried out on a group of ten female participants with a background in the healthcare profession. This paper provides an analysis and discussion of the data collected from interviews of these participants. The study shows why nurse practitioners provide high quality primary care services that are characterized by high levels of patient outcomes and satisfaction.

Cost Effectiveness and Quality of Care Provided by Nurse Practitioners

Nurse practitioners (NP) are being utilized as a point of contact in delivery of primary care for patients throughout the United States and the United Kingdom. Trained nursing practitioners who can deliver in-person primary healthcare services for patients are gradually increasing. While patients provide positive feedback about the nursing roles, there is still a debate whether nursing practitioners can deliver cost-effective patients' treatment compared with other healthcare professionals. Additionally, concerns on the effectiveness of nurse practitioners in delivering patient care are also centered on their capabilities to deliver quality healthcare that meet patients' needs (Venning et al., 2000).

Purpose of Study

This study focused on examining the cost effectiveness and quality of care provided by nurse practitioners. The research was carried out on the premise that the number of trained nurse practitioners is gradually increasing at a time when these professionals are increased used in delivering primary care to patients.

Research Questions and Answers

To achieve the goals of this ethnographic study, the researcher developed some research questions that were filled out by research participants. The research questions were given to a group of ten participants who helped in determining the quality of care provided by nurse practitioners. The research questions and their answers were as follows:

Research Questions:

1. When you go to your regular primary care office, who do you regularly see MD or NP?

Respondent 1. I see a nurse practitioner.

Respondent 2. I usually see an NP

Respondent 3. I always see my MD when I go to my primary care office.

Respondent 4. I regularly see an MD.

Respondent 5. I see my MD.

Respondent 6. I see my MD.

Respondent 7. I see my MD.

Respondent 8. I see either MD or NP, whoever is available.

Respondent 9. I see my MD most of the time.

Respondent 10. I see my NP.

2. What are your feelings seeing a Nurse Practitioner as your PCP?

Respondent 1. The NP has more available appointments and I see her for minor illness like sore throat, cold symptoms, rash, allergy, etc. I would see my PCP for my annual physical exam.

Respondent 2.I have no problem seeing a nurse practitioner as my PCP.

Respondent 3. At first, I was not comfortable seeing an NP, but through the visit, I felt that she was qualified to see me.

Respondent 4. I had an overwhelming feeling of apprehension.

Respondent 5. I felt that I was not going to get the same care as my PCP, but it turned out that I got a better care.

Respondent 6. I was a little hesitant to see the NP, but since I need to be seen, I went and was satisfied with the care I received.

Respondent 7. I was feeling anxious to see an NP.

Respondent 8. It didn't bother me.

Respondent 9. I was prejudiced because I will be seeing a provider who is not a physician.

Respondent 10. I prefer to see an NP as my PCP.

3. What is your perception of receiving care from a Nurse Practitioner?

Respondent 1. My NP is excellent and very thorough.

Respondent 2. NP listened to suggestion how to control my BP better.

Respondent 3. NP has more time to answer questions and explain everything.

Respondent 4. Care received from NP was fine.

Respondent 5. I like the care received from the NP because of her experience.

Respondent 6. NP is great, helped me more than PCP. NP is never in a rush.

Respondent 7. It doesn't bother me at all.

Respondent 8. Being an NP student, my perception is slightly bias.

Respondent 9. NP spend more time, obtained detailed medical history.

Respondent 10. I felt that NP is more helpful, not in a hurry to get out of the room.

4. Have you ever received treatment from the NP?

Respondent 1. Yes. Recently I had sinusitis (and she was very good) and gave me the medicine I needed.

Respondent 2. Yes, I have received many treatments from my NP.

Respondent 3. Yes, I have received treatment

Respondent 4. No, I never received a treatment from an NP.

Respondent 5. Yes, I have received treatment from the NP.

Respondent 6. Yes, I have received treatment from my NP.

Respondent 7. Yes, I have received treatment from the NP.

Respondent 8. Yes, I have received a treatment from the NP.

Respondent 9. Yes, I have received treatment from the NP.

Respondent 10. Yes, I have received treatment from the NP.

5. What did you think after receiving care from the nurse practitioner?

Respondent 1. I appreciate my NP, she talks to me in detail and seems to have more time to answer my questions.

Respondent 2. I personally prefer to see an NP.

Respondent 3. I enjoyed seeing an NP. She was thorough and effective.

Respondent 4. Care was fine.

Respondent 5. I feel like the NP have more time to discuss the issues with me than the MD. I feel the care received from NP is more personal.

Respondent 6. She knows her stuff; she was very helpful.

Respondent 7. I appreciate my NP, she talks to me in detail, and seems to have more time to answer questions.

Respondent 8. The NP knows what she is doing.

Respondent 9. I think the NP is excellent, she has explained the problem very well.

Respondent 10. Care was excellent.

6. What was your reason for seeking care when you saw an NP? (primary, stat health, specialist)

Respondent 1. I was not feeling well. I had a cough and cold.

Respondent 2. I saw NP for general physical and follow up of blood pressure which is not controlled.

Respondent 3. I saw NP for checkup, for primary care.

Respondent 4. I saw the NP for primary care as my doctor is not available.

Respondent 5. I saw the NP for OBGYN concern.

Respondent 6. I saw an NP for headache and cold.

Respondent 7. I saw NP for primary care.

Respondent 8. I see an NP for common cold, headaches, URI and back pain.

Respondent 9. I saw NP for primary care.

Respondent 10. I saw NP for UTI, primary care.

7. How was the result of the treatment you received from the NP?

Respondent 1. The medications the NP prescribed were effective.

Respondent 2. NP provided excellent treatment, great routine exam completed and prescription renewal was obtained. Blood pressure was well controlled.

Respondent 3. Satisfactory, the wait to see an NP is not as long as an MD appointment.

Respondent 4. I didn't get a treatment when I saw the NP.

Respondent 5. The medication the NP prescribed was effective.

Respondent 6. Everything was good.

Respondent 7. The treatment was great. I got relief of my sinus pressure.

Respondent 8. I always get good results with the care that my NP provide.

Respondent 9. The NP gave me the me

Respondent 10. NP calls to follow up, takes her time with the visit.

8. How do you compare this experience with your prior experience with your MD?

Respondent 1. The NP gave me more insight about my illness, she told me what meds would do and she actually offered Diflucan, and she prescribed antibiotic. I'm glad she did because I did need it. My NP takes time to explain things to me and I appreciate that. The MD (PCP) seems to spend less time explaining things to me.

Respondent 2. NP took her time not like the MD who is in a rush to get out of the room. MD kept adding meds while NP increased dosage, but decreased number of meds. BP is better controlled with NP than MD.

Respondent 3. NP visit was better. NP was friendly. I didn't feel rushed and NP gave me her undivided attention.

Respondent 4. The wait time to see an NP is not long vs. MD. NP takes her time, calls to follow-up.

Respondent 5. Experience was positive. Received excellent care. NP was compassionate and respectful. I appreciate her bedside manner and clinical expertise.

Respondent 6. Experience is the same.

Respondent 7.Overall, MD is good, but personal care is better with NP.

Respondent 8. I prefer NP rather than MD having seeing both many times.

Respondent 9. NP has more available appointment while MD is booked most of the time, spend less time and barely explain what is wrong.

Respondent 10. I think the NP is more sensitive to the complaint that I had.

Research Methodology

The researchers developed a list of eight open-ended questions that were utilized to interview ten study participants. The research methodology utilized for this study was a survey of ten patients who had received treatment from nurse practitioners for their respective conditions. The ten participants were interviewed face-to-face for at least 30 minutes based on their view of the quality of care they received from these practitioners. The interviews did not include questions regarding the cost-effectiveness of care provided by nurse practitioners since the interviewees were colleagues in the job. Additionally, the participants or respondents pay the same co-pay to see a nurse practitioner or MD, which implies that the focus of the interview was more on the quality of care provided by nurse practitioners. The interviews were conducted on 6 registered nurses, 2 medical assistants, a practice nurse, and a nursing student.

All the respondents were females aged between 31-40 and 41-50 years (70% of the respondents) and between 20-30 and 51-60 years (30% of the respondents). 60% of these respondents had a bachelor's degree while the rest has some form of college education, which implies that they all had a background as healthcare professionals. 50% of the participants were single while 40% were married and 10% divorced. In addition, 50% of these respondents were African/Americans or Blacks whereas 30% were whites and the rest were Hispanic and Asian.

Analysis

Most of the participants stated that they see an MD when they visit a primary care office with a few of them seeing a nurse practitioner. However, they had no problem seeing a nurse practitioner as their primary care provider. For those who were skeptical or anxious about seeing a nurse practitioner as their primary care provider, they ended up receiving better care than they had initially anticipated or feared. Following their experiences with nurse practitioners in the primary care office, approximately 90% reported that they were satisfied with the kind of care they received while the remaining 10% were not concerned or had biased perceptions regarding the quality of care. Additionally, 90% reported that they had received at least one treatment from nurse care practitioners.

All the participants reported being satisfied with the care they received because nurse practitioners had more time to attend to them, were detailed in their work, were more personal, were competent in providing care, and did an overall excellent job in providing treatment. They reported satisfaction with the quality of care across different conditions because they visited the primary care office with different health conditions. However, one of the participants did not receive the necessary treatment for their condition because she saw the nurse practitioner because her physician was unavailable. Finally, all the respondents stated that the experience with the nurse practitioner was better than their experiences with MD. These positive experiences were brought by the fact that the NPs took more time in attending to the patient, were detailed in their practice, and were more sensitive and compassionate.