Paper
Wednesday, July 11, 2007
This presentation is part of : Advanced Practice Nursing Strategies
The extent of and satisfaction with collaboration between nurse practitioners and physicians in long-term care homes: Survey results
Faith C. Donald, RN(EC), PhD, School of Nursing, Ryerson University, Toronto, ON, Canada, Alba DiCenso, RN, PhD, Nursing and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada, Michael Stephenson, MD, MHSc, Medicine, Wellington Nursing Home, Ancaster, ON, Canada, E. Ann Mohide, BScN, MHSc, MSc, School of Nursing, McMaster University, Hamilton, ON, Canada, and Kevin Brazil, PhD, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Learning Objective #1: compare and contrast the extent of and satisfaction with collaboration between nurse practitioners and physicians in long-term care homes.
Learning Objective #2: describe an effective strategy for matched-pair sampling using a mailed survey.

Purpose:  To assess the extent of and satisfaction with collaboration between physicians (MDs) and nurse practitioners (NPs) working in Ontario long-term care homes (LTCHs).

Methods:  A mailed survey was sent to all 15 NPs and the 33 MDs with whom they worked most frequently in LTCHs. Extent of and satisfaction with collaboration scales were included in the survey, measured on a Likert scale from 1 (strongly disagree or dissatisfied) to 6 (strongly agree or satisfied).

Results:  The response rate was 93.3% (14/15) for NPs and 90.9% (30/33) for MDs, including 3 incomplete MD surveys. Forty-one individual and 26 NP-MD matched-pair survey results were analyzed. MDs scored higher on the extent of collaboration with NPs scale than did NPs on the extent of collaboration with MDs scale (mean = 4.9 vs 4.5) (p < 0.01). MDs were more satisfied with collaboration with NPs than were NPs with collaboration with MDs (mean = 5.3 vs 4.4) (p < 0.001). Matched-pair differences in mean scores for the extent of collaboration scale (NP score - MD score) varied from -3.67 to 2.33; 19 pairs (73.1%) differed by 1.00 or less. The difference in mean scores for satisfaction with collaboration (NP score – MD score) ranged from -2.73 to 1.45, with 17 pairs (65.4%) differing by 1.00 or less.

Conclusions: The MDs reported a statistically significant higher level of and satisfaction with collaboration with NPs than did the NPs rating their level of and satisfaction with collaboration with the MDs. While statistically significant, the difference in matched-pair scores was typically one point or less. It is not known if this difference in scores is clinically important or how the difference may relate to process and outcome measures. Findings indicate that matched-pairs of NPs and MDs have similar perceptions and expectations of collaboration.