NPs as Primary Care Providers: Support for Independent Practice Improves Patient Care

Jennifer Barrett, Assistant Editor
Published Online: Wednesday, October 11th, 2017
Nurse practitioners (NPs) who work in supportive environments are more likely to have their own patient panels than those who work in less supportive environments, according to a survey conducted by the Columbia University School of Nursing.1
According to the results, NPs who had access to organizational resources and supports for them to practice independently were able to deliver ongoing continuous care for their patients and serve as primary care providers.
The researchers investigated the role of NPs in health care delivery and how work environments affected this role through a survey of 807 NPs who were listed in the Massachusetts Provider Database as delivering primary care. The survey measured the NPs’ role in delivery of care, their work environment, and demographics.
NPs were asked to rate certain characteristics of their organizations, including their relationships with physicians and administrators, the support they received to practice independently, and their visibility within health care organizations. The survey also collected information including age, sex, education, years of work experience, and the location, type, and size of their practice.
Overall, 314 of NPs from 163 primary care organizations participated in the survey. About 45% of respondents reported having their own panel of patients to whom they provided ongoing primary care. The results indicated that NPs who worked in practices where they received physicians’ support of their patient care decisions, staff help in preparing patients for visits, and the freedom to apply their knowledge and skills to patient care were more likely to fill primary care provider roles for their patients.
“The findings suggest that work environments that support NPs’ independent practice may be important factors in meeting the nation’s growing need for primary care,” Lusine Poghosyan, PhD, lead author, and assistant professor of nursing at Columbia University School of Nursing, said in a press release about the findings.2
1.     Poghosyan L, Liu J, Norful A. Nurse practitioners as primary care providers with their own patient panels and organizational structures: a cross-sectional study. Int J Nurs Stud. September 2017. Accessed October 4, 2017.
2.     Support to Practice Independently Helps Nurse Practitioners Deliver Ongoing Primary Care to Patients [news release]. New York. Columbia School of Nursing website. Accessed October 4, 2017. 

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