Authors: Michael L. Boninger, MD, Jennifer Davison, DNP, CRNP, AGNP‐C, Susan Saxon, MSN, CRNP, FNP‐BC
Summary: Nurse practitioners (NPs) have become critical members of the interdisciplinary team at nursing facilities since introduced to this setting more than 35 years ago.1-3 One national survey found that physicians with patients in this setting spend only approximately 2 hours per week with these patients.4 A physician‐centered approach may have worked in the past in nursing facilities when the patients were primarily of a supportive care focus, but as times have changed these patients have become more acute with increasing medical and technological needs.4 One solution to this change has been the use of NPs and other advanced practice providers (APPs) in nursing facilities.4 Kane et al published a study in 2001 that evaluated the daily work activities of NPs within specific Medicare HMO nursing facilities.1 This study found that NPs spent approximately 35% of their working day on direct patient care, 26% of time on indirect care activities, and the remainder of time on various administrative and other nonwork activities.1 As healthcare demands increase, insurance coverage changes, and reimbursement transforms with more emphasis than ever on productivity, it is essential to know how NPs spend their time within the nursing facility environment and how this role may have evolved. Since the original descriptive study conducted in 2000,1 no one has revisited the daily work activities of NPs or other APPs in nursing facilities despite growing pressures regarding productivity and increasing healthcare costs.
Source: Journal of the American Geriatrics Society, 10 February 2020