Nurse Practitioner Practice Environments in Primary Care and Quality of Care for Chronic Diseases

Medical Care
Lusine PoghosyanMark W Friedberg

Abstract

The chronic disease burden in the United States represents a significant challenge for the primary care system. The nurse practitioner (NP) workforce can help meet the demand for care; however, organizational barriers such as poor practice environments prevent NPs from delivering high quality care. We investigated the relationship between NP practice environments and quality of care for chronic diseases. We fit regression models to assess cross-sectional associations between claims-based quality measure performance and survey data on NP practice environments in Massachusetts. We used survey data from 221 primary care NPs from 118 practices. We obtained quality of care data for patients with asthma, diabetes, and cardiovascular disease. The Nurse Practitioner Primary Care Organizational Climate Questionnaire was used to measure practice environments with its following 4 subscales: NP-Physician Relations, Independent Practice and Support, Professional Visibility, and NP-Administration Relations. Three Healthcare Effectiveness Data and Information Set measures were used to evaluate the quality of care. A 1-SD increase in the organizational-level NP-Administration Relations subscale score was associated with a near doubling of the ...Continue Reading

References

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Citations

Mar 11, 2020·Journal of Nursing Management·Amy-Louise ByrneBridget Ferguson
Jul 23, 2020·Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc·Kathleen R Delaney, Diana McIntosh
Aug 31, 2020·The Journal for Nurse Practitioners : JNP·J Margo Brooks CarthonLinda Aiken
Nov 4, 2020·Journal of General Internal Medicine·Kimberly S HsiungDavid J Kolko
Feb 18, 2021·Nursing Outlook·Jordan M HarrisonGrant R Martsolf
Jul 9, 2021·Journal of Advanced Nursing·Nerea Elizondo RodriguezCristina Garcia-Vivar
Jul 11, 2020·Journal of the American Association of Nurse Practitioners·Daniel E Geller, Beth Ann Swan
Jan 5, 2022·Journal of the American Psychiatric Nurses Association·Antonio R Moreno-PoyatoJuan F Roldán-Merino
Nov 21, 2020·Medical Care Research and Review : MCRR·Hayley D GermackGrant R Martsolf

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

MHQP
AR
SAS

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