Monday, November 5, 2007

This presentation is part of : Strategies for the Advanced Practice Nurse
Primary Care NP Survey: Defining NP Encounters
Mary Jo Goolsby, EdD, MSN, APRN-C, FAANP, American Academy of Nurse Practitioners, Austin, TX, USA
Learning Objective #1: describe characteristics of NP-patient encounters, based on the PCNPS.
Learning Objective #2: discuss implications for further research on NP practice patterns

Background: Most of the literature describing specifics about NP-patient encounters details prescribing patterns. Few reports describe comprehensive variables such as complaints, components of physical assessment and diagnostic studies included, diagnoses, preventive counseling, collaboration, and disposition. The Primary Care NP Survey (PCNPS) was adapted from the PRINS2 and NAMCS surveys, designed to collect data primarily on physician-patient encounters. Purpose: The purpose of this presentation is to describe characteristics of NP-patient encounters and to describe how PCNPS findings relate to prior research and identification of recommendations for future research. Methodology: In the first PCNPS iteration conducted Fall 2006 (second wave anticipated 2007), over 30 NP members of the AANPNR, a practice-based research network, participated in the practice-defining descriptive project. Each completed the survey on 25 patient encounters,randomized over a 1-week period, documenting a range of variables, including: patient demographics, payor sources, whether NP was patient's regular provider and the patient new or established in the practice, as well as patients' complaints/diagnoses and the NP's assessments, diagnostic studies, preventive counseling, procedures, and dispositions, including referrals and/or consultations. At this time, 800 patient encounters have been analyzed and will be described i presentation. Findings: The PCNPS data support previously reported descriptions of prescribing patterns and numbers of patients seen, and provide a rich description of the diversity of problems addressed by NPs on a routine basis. Data yield detailed description of the diagnoses and procedures involved in typical NP encounters, including a range of acute/episodic (45%), exacerbations (13%), stable chronic (25%) and wellness or procedural follow-ups (17%). Problems were identified in all body systems. Implications for NP Faculty: The PCNPS provides a comprehensive description of the diversity and similarities of NP practice in 2006, providing vital evidence to inform NP faculty charged with developing and updating curricular plans.