Nurse Practitioners Navigating the Consequences of Directives, Policies, and Recommendations Related to the COVID-19 Pandemic in Long-Term Care Homes.
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ABSTRACT: Objectives
New models for the workforce are required in long-term care (LTC) homes, as was made evident during the Coronavirus Disease 2019 (COVID-19) pandemic. Nurse Practitioner (NP)-led models of care represent an effective solution. This study explored NPs' roles in supporting LTC homes as changes in directives, policies, and recommendations related to COVID-19 were introduced.Design
Qualitative exploratory study.Context
Thirteen NPs working in LTC homes in Ontario, Canada.Methods
Semi-structured interviews were conducted in March/April 2021. A five-step inductive thematic analysis was applied.Findings
Analysis generated four themes: leading the COVID-19 vaccine rollout; promoting staff wellbeing related to COVID-19 fatigue; addressing complexities of new admissions; and negotiating evolving collaborative relationships.Conclusions
Nurse practitioners were instrumental in supporting LTC homes through COVID-19 regulatory changes producing unintended consequences. The NPs' leadership in transforming care is equally essential in LTC homes as in other established healthcare settings, such as primary and acute care.
SUBMITTER: McGilton KS
PROVIDER: S-EPMC9234378 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundWhile optimal utilization of the nurse practitioner (NP) workforce is an increasingly popular proposal to alleviate the growing primary care shortage, federal, state, and organizational scope of practice policies inhibit NPs from practicing to the full extent of their license and training. In March of 2020, NP state-specific supervisory requirements were temporarily waived to meet the demands of the coronavirus disease 2019 (COVID-19) pandemic in Massachusetts.ObjectiveThe objective of this study was to examine the impact of temporarily waived state practice restrictions on NP perception of care delivery during the initial surge of the COVID-19 pandemic in Massachusetts.Research designMixed methods descriptive analysis of a web-based survey of Massachusetts NPs (N=391), conducted in May and June 2020.ResultsThe vast majority (75%) of NPs believed the temporary removal of practice restriction did not perceptibly improve clinical work. Psychiatric mental health NPs were significantly more likely than other NP specialties to believe the waiver improved clinical work (odds ratio=6.68, P=0.001). NPs that experienced an increase in working hours during the pandemic surge were also more likely to report a positive effect of the waiver (odds ratio=2.56, P=0.000).ConclusionsTemporary removal of state-level practice barriers alone is not sufficient to achieve immediate full scope of practice for NPs. The successful implementation of modernized scope of practice laws may require a collective effort to revise organizational and payer policies accordingly.
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