Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
This presentation is part of : Posters II
Home-Based Primary Care: Advanced Practice Nursing Interventions
Katherine Bent, RN, PhD, CNS, VA Eastern Colorado Health Care System, Denver, CO, USA
Learning Objective #1: n/a
Learning Objective #2: n/a
Background: Nurse Practitioners (NP) in the VA Eastern Colorado Health Care System have established a program of Home Based Primary Care (HBPC) that has a significant impact on the health care experience for home bound veterans. Important improvements have been shown in hospital readmission rates, patient satisfaction with care, and quality of life for patients and families. These outcomes are important for communicating the value of NPs in the home care setting, however, the nature of the care that is provided by the NP and the ways in which it is similar to or differs from primary care in the clinic or skilled nursing care in the home is less obvious.

Purpose: The purpose of this narrative inquiry is to describe the care provided by NPs to home-based primary care patients in VAECHCS.

Methods: This study uses descriptive qualitative design informed by narrative inquiry and the theory of human caring. Data were generated through open-ended analysis of narrative notes written in the medical record by NPs. Narrative data are supplemented by observational data and open-ended interviews with NPs. Using comparison analysis, categories and themes that describe the pnenomena of nursing therapeutics, patient care needs, and the experience of providing care were identified.

Results: The data illuminate the emphasis nurse practitioners in HBPC place on family-centered care.

Implications for Practice: Home-based care is one important and viable option for addressing the health needs of aging Americans. Results from this study may guide clinicians who serve home bound clients and clarify the NP role, contributions, and outcomes in caring for this population. The HBPC program has promise for expansion and generalization to other health care systems when the components and benefits of the program can be clearly defined.

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Sigma Theta Tau International
July 22-24, 2004