Evaluation of Nurse Practitioners in Cardiac Sciences Christoff, L., MSN, NP(F), Furlan, Belinda-Ann, MSN, NP(F), & Choy, Patricia, MN, NP(A) Vancouver Coastal Health, Vancouver, B.C.
BACKGROUND The first Nurse Practitioners (NPs) were hired by the health authorities in 2005. At Vancouver Coastal Health, there are currently nine NPs in the Cardiac Sciences program between Vancouver General Hospital (VGH) and St. Paul’s Hospital (SPH). Since the first hiring of NPs, there has been no formal evaluation of the NP role. This is an evaluation of the patient’s and healthcare team’s satisfaction with the NP role at Vancouver Coastal Health.
RESULTS
102 patient surveys collected 44 healthcare team surveys collected (mostly nurses)
PATIENTS
HEALTHCARE TEAM In an evaluation of the NPs’ knowledge, their ability to collaborate, communicate, & implement the plan of care, over 90% of respondents rated the NPs’ ability as very good or excellent How would you rate how well the NP coordinates patient's care?
The survey resulted in a high level of patient satisfaction with >80% of patients having positive interactions and outcomes with NP care.
How would you rate how well the NP implements the plan of care for patients?
Neutral, 3%
Patient and healthcare team satisfaction surveys 1 based on the Patient Satisfaction Questionnaire and St. Paul’s Hospital Patient Satisfaction Survey were created. Survey questionnaires were given to patients and staff in the following areas: Heart Function Clinics, Atrial Fibrillation clinics and acute cardiology unit. The surveys evaluated patients’ satisfaction with NPs’ knowledge, accessibility, and continuity of care, the NPs’ communication skills, and patients’ trust/confidence in the NP. Surveys utilized a five point Likert scale and opened ended questions that asked patients how NPs differed from other healthcare providers. The healthcare team was asked to comment on the value of the NP & the role’s influence on their practice.
RECRUITMENT
Strongly Agree, 63%
How well would you rate the NP collaborates with the healthcare team? Excellent
I was satisfied with the care I received from the NP Good, 10%
Very Good, 23%
Excellent, 67%
Patients were recruited from the outpatient heart function and atrial fibrillation clinics at VGH & SPH. The inpatient acute cardiology unit at VGH & cardiac surgery unit at SPH were also included. Patients seen by the NP on ≥1 visit over a one month collection period from February to March 2011 were asked to participate. Staff (physicians, nurses, allied health) in these areas were also asked to participate.
33%
73%
23%
64%
Very Good
30%
Good
9%
7% 2%
5%
5% 2%
Fair
Team Feedback Themes Accessible Timely/Efficient Holistic Approach Consistent Collaborative Problem solving Knowledgeable resource Effective communication
CONCLUSION/RECOMMENDATIONS Overall, how would you rate the care you received from the NP?
28%
58%
How would you rate how well the NP addresses the needs of patients?
METHODS Agree, 34%
63%
Patient Feedback Themes –narrative response Adequate Time Attentive Informative Relationship building; interpersonal skills Patience/Compassion Expertise Communication Care comparable to physician
Overall, patients and healthcare team members were satisfied with the care provided by NPs in the cardiac sciences program at Vancouver Coastal Health. 2, 3 These findings are consistent with literature evaluating patient satisfaction with the NP role. Knowledge translation: conferences, SET, regional teams and staff meetings. Future potential applications of survey: -NP performance appraisal -Expand survey to measure other outcomes of NP practice (i.e. ED visits, hospital readmissions, satisfaction with leadership & education) -Extend to other areas of the organization
1. Zandbelt, L.C., Smets, E.M.A., Oort, F.J., Godfried, M.H., & de Haes, H.C.J.M (2004). Satisfaction with the outpatient encounter: A comparison of patients’ and physicians’ views. Journal of General Internal Medicine, 19, 1088. 2. Agosta, L.J. (2009). Patient satisfaction with nurse practitioner-delivered primary healthcare services. Journal of the American Academy of Nurse Practitioners, 21, 610. 3. Jarvis, M. (2007). Satisfaction guaranteed? Emergency Nurse, 14(9), 34.