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Nurse Practitioner Clinical Settings Key to Delivery of Patient-Centered Care

It’s long been understood that care that respects and integrates the wants, needs, and preferences of patients results in higher ratings of satisfaction and improved health outcomes. Yet, several barriers still often impede the delivery of patient-centered care. A new study from the University of Pennsylvania School of Nursing (Penn Nursing) shows that organizational supports for nurse practitioners (NPs) can enhance their ability to deliver patient-centered care.

March 19, 2020
Penn Nursing's J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor and lead investigator of the study. Penn Nursing's J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor and lead investigator of the study.
Penn Nursing’s J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor and lead investigator of the study.

By surveying more than 1,700 NPs in four states, the investigators learned that NPs who work in good practice environments were significantly more likely to integrate patient preferences into care compared to those working in a mixed or poor environment. Good practice environments included adequate resources and better relationships with healthcare team members and administration. In these environments, NPs worked more autonomously and were enabled to guide care that was tailored and relevant to the individual, family, or community, the research shows.

“The delivery of patient-centered care is dependent on each healthcare team member practicing to the top of their license,” says Penn Nursing’s J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor and lead investigator of the study. “Organizations that constrain NP practice fall counter to the innovative models of care delivery that emphasize maximizing the value of team members across all levels of the delivery system.”

Addressing organizational culture represents an actionable strategy that can help facilitate NP delivery of patient-centered care. “We emphasize the organizational supports offered in NP clinical settings because, unlike the size or location of practices, clinical environments represent modifiable aspects of healthcare organizations,” says Brooks Carthon.

The study’s findings have been published in the Journal for Nurse Practitioners in an article titled “Supportive Clinical Practice Environments Associated with Patient-Centered Care.” Co-investigators of the study include Linda Aiken, PhD, FAAN, FRCN; Heather Brom, PhD, APRN; Marguerite Daus, BSN, RN, all of Penn Nursing; Lusine Poghosyan, PhD, MPH, RN, FAAN, of Columbia University; and Barbara Todd, DNP, ACNP-BC, FAANP, FAAN, of Penn Nursing and the Hospital of the University of Pennsylvania.

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